• The Korean Journal of Pain
• /
• 제29권2호
• /
• pp.123-128
• /
• 2016

Phantom limb pain is a phenomenon in which patients experience pain in a part of the body that no longer exists. In several treatment modalities, spinal cord stimulation (SCS) has been introduced for the management of intractable post-amputation pain. A 46-year-old male patient complained of severe ankle and foot pain, following above-the-knee amputation surgery on the right side amputation surgery three years earlier. Despite undergoing treatment with multiple modalities for pain management involving numerous oral and intravenous medications, nerve blocks, and pulsed radiofrequency (RF) treatment, the effect duration was temporary and the decreases in the patient's pain score were not acceptable. Even the use of SCS did not provide completely satisfactory pain management. However, the trial lead positioning in the cauda equina was able to stimulate the site of the severe pain, and the patient's pain score was dramatically decreased. We report a case of successful pain management with spinal cauda equina stimulation following the failure of SCS in the treatment of intractable phantom limb pain.

• Archives of Plastic Surgery
• /
• 제48권3호
• /
• pp.310-322
• /
• 2021

The incidence of extremity amputation is estimated at about 200,000 cases annually. Over 25% of patients suffer from terminal neuroma or phantom limb pain (TNPLP), resulting in pain, inability to wear a prosthetic device, and lost work. Once TNPLP develops, there is no definitive cure. Therefore, there has been an emerging focus on TNPLP prevention. We examined the current literature on TNPLP prevention in patients undergoing extremity amputation. A literature review was performed using Ovid Medline, Cochrane Collaboration Library, and Google Scholar to identify all original studies that addressed surgical prophylaxis against TNPLP. The search was conducted using both Medical Subject Headings and free-text using the terms "phantom limb pain," "amputation neuroma," and "surgical prevention of amputation neuroma." Fifteen studies met the inclusion criteria, including six prospective trials, two comprehensive literature reviews, four retrospective chart reviews, and three case series/technique reviews. Five techniques were identified, and each was incorporated into a targetbased classification system. A small but growing body of literature exists regarding the surgical prevention of TNPLP. Targeted muscle reinnervation (TMR), a form of physiologic target reassignment, has the greatest momentum in the academic surgical community, with multiple recent prospective studies demonstrating superior prevention of TNPLP. Neurorrhaphy and transposition with implantation are supported by less robust evidence, but merit future study as alternatives to TMR.

• 한국의학물리학회:학술대회논문집
• /
• 한국의학물리학회 2006년도 제33회 추계학술대회 발표논문집
• /
• pp.127-127
• /
• 2006

• 한국전기전자재료학회:학술대회논문집
• /
• 한국전기전자재료학회 2007년도 하계학술대회 논문집 Vol.8
• /
• pp.369-369
• /
• 2007

본 연구에서는 CD-RAD Phantom을 이용하여 의료영상의 명세성 (image clarity)분석을 위하여 동일한 X선 영상을 대상으로 물리적 평가와 시각적 평가를 비교분석 하였다. 측정방법은 CD-RAD Phantom을 X선 조사하여 CR 영상처리장치를 통해 영상을 획득하였으며, 영상분석은 CD-RAD analyser program을 통한 통계학적 방법으로 물리적 평가를 시행하고, 동일한 영상의 시각적 평가는 관찰자 20명을 대상으로 blind test를 시행하였다. 분석결과는 Contrast-detail curve의 물리적 평가 IQF값은 25, 시각적 평가 IQF값은 30으로 분석되어 물리적 평가가 시각적 평가에 비해 우수하게 나타났다. 의료영상의 특성은 영상 판독자에게 영상의 정보 전달능력이 매우 중요하므로 객관적인 물리적 분석법과 시각적 분석법이 병행되어야 한다고 판단된다.

• 대한방사선기술학회지:방사선기술과학
• /
• 제42권3호
• /
• pp.223-229
• /
• 2019

In order to reduce the radiation exposure dose of the patient and to obtain accurate diagnosis results, the quality control of the diagnostic radiation generator must be conducted periodically In particular, bone density test equipment could be influenced by many factors, and it is far more important because inaccurate measurement would eventually affect the result value. However, the cross-correction phantom of DXA equipment is poorly penetrated due to lack of awareness of the industry and the high cost. Therefore, this study developed a BMD phantom using a 3D printer and Korean BMD phantom with low cost by cross analyzing Korean BMD value from The Korean National Health and Nutrition Examination Survey and evaluated it. The L1, L2, and L3 BMD values of phantoms produced with the 3D printer were measured to be $0.887{\pm}0.006g/cm^2$, $0.927{\pm}0.006g/cm^2$, and $0.960{\pm}0.005g/cm^2$, at 215 mm height and $0.882{\pm}0.011g/cm^2$, $0.914{\pm}0.005g/cm^2$, $0.933{\pm}0.008g/cm^2$ at 155 mm height displaying statistically significant relevance. The result suggests that a proper quality control and cross calibration of DXA device be possible and expected to be an essential data for various medical phantom manufacture development using 3D printer.

• 대한방사선기술학회지:방사선기술과학
• /
• 제46권1호
• /
• pp.15-21
• /
• 2023

This study was purpose to assessment of the resolution characteristics by using ATS 535H Basic quality assurance (QA) phantom for ultrasound. The ultrasound equipment was used Logiq P6 (Ultrasound, GE Healthcare System, Chicago, IL, USA). And the ultrasound transducer were used Convex 4C (4~5.5 MHz), Linear 11L (10~13 MHz), Sector 3SP (3~5.5 MHz) probe. As for the noise power spectrum (NPS) comparison results by using ATS 535H Basic QA ultrasound phantom and Convex 4C, Linear 11L, Sector 3SP probe. The NPS value of the Convex 4C probe image was 0.0049, Linear 11L probe image was 0.0049, Sector 3SP probe image was 0.1422 when the frequency is 1.0 mm^-1. The modulation transfer function (MTF) comparison results by using ATS 535H Basic QA ultrasound phantom and Linear 11L probe the MTF value of the 3 cm focus image was 0.7511 and 4 cm focus image was 0.9001 when the frequency is 1.0 mm^-1. This study was presented characteristics of spatial resolution a quantitative evaluation methods by using ultrasound medical images for QA of ultrasound medical QA phantom. The quality control (QC) for equipment maintenance can be efficiently used in the clinic due to the quantitative evaluation of the NPS and MTF as the standard methods. It is meaningful in that it is applied mutatis mutandis and presented the results of physical resolution characteristics of the ultrasound medical image.

• Journal of Korean Neurosurgical Society
• /
• 제62권4호
• /
• pp.476-486
• /
• 2019

Objective : The functional information of $^{11}C$-methionine positron emission tomography (MET-PET) images can be applied for Gamma knife radiosurgery (GKR) and its image quality may affect defining the tumor. This study conducted the phantom-based evaluation for geometric accuracy and functional characteristic of diagnostic MET-PET image co-registered with stereotactic image in Leksell $GammaPlan^{(R)}$ (LGP) and also investigated clinical application of these images in metastatic brain tumors. Methods : Two types of cylindrical acrylic phantoms fabricated in-house were used for this study : the phantom with an array-shaped axial rod insert and the phantom with different sized tube indicators. The phantoms were mounted on the stereotactic frame and scanned using computed tomography (CT), magnetic resonance imaging (MRI), and PET system. Three-dimensional coordinate values on co-registered MET-PET images were compared with those on stereotactic CT image in LGP. MET uptake values of different sized indicators inside phantom were evaluated. We also evaluated the CT and MRI co-registered stereotactic MET-PET images with MR-enhancing volume and PET-metabolic tumor volume (MTV) in 14 metastatic brain tumors. Results : Imaging distortion of MET-PET was maintained stable at less than approximately 3% on mean value. There was no statistical difference in the geometric accuracy according to co-registered reference stereotactic images. In functional characteristic study for MET-PET image, the indicator on the lateral side of the phantom exhibited higher uptake than that on the medial side. This effect decreased as the size of the object increased. In 14 metastatic tumors, the median matching percentage between MR-enhancing volume and PET-MTV was 36.8% on PET/MR fusion images and 39.9% on PET/CT fusion images. Conclusion : The geometric accuracy of the diagnostic MET-PET co-registered with stereotactic MR in LGP is acceptable on phantom-based study. However, the MET-PET images could the limitations in providing exact stereotactic information in clinical study.

• Journal of Acupuncture Research
• /
• 제34권3호
• /
• pp.101-107
• /
• 2017

Objectives : We report a case of Phantom Limb Pain (PLP) and propose the possibility of integrative Korean and Western medicine in PLP treatment. Methods : For 42 days, a patient who complained of pain and insomnia with PLP (December 20, 2016 to January 20, 2017) received Korean and Western medical treatment. The patient was treated with analgesic injection, a neuropathic pain inhibitor, the combined herbal formula powders Bojungikgitang, and acupuncture. Symptom improvement was assessed using the numerical rating scale (NRS) and continuous sleep time. Results : The patient's NRS scores decreased, and continuous sleep time increased after treatment. The NRS scores decreased from 10 to 0, and the continuous sleep time increased from 2 hours to 7 to 8 hours. Conclusion : According to the results, this report suggests that integrative Korean and Western medicine could be effective in the treatment of PLP patients.

• 대한의용생체공학회:의공학회지
• /
• 제36권1호
• /
• pp.7-15
• /
• 2015

The egg white phantom is a thermal lesion visualization phantom able to illustrate a thermal lesion. It is often used to evaluate the performance of HIFU and is less expensive than the BSA phantom. This study determined the optimal phantom composition for evaluated therapeutic ultrasound machines by varying the egg white concentration in the egg white phantom and demonstrated its utility as a therapeutic ultrasound phantom. The egg white phantom at varying egg white concentrations (10-40% in 10% intervals) was fabricated, and its thermal properties and acoustic properties were assessed. In addition, the size and shape of the formed lesion were compared between the egg white phantom and bovine liver tissue according to the electrical power. The results showed that 30% egg white phantom was optimal for the performance evaluation due to its thermal and acoustic properties. The generated thermal lesions formed sequentially as a cigar, ellipse, tadpole, and cone shapes according to the electrical power; a similar tendency was observed in the liver tissue. Hence, we conclude that the egg white phantom will prove useful in quantitatively evaluating the thermal effects of therapeutic ultrasound.

• 한국의학물리학회지:의학물리
• /
• 제25권2호
• /
• pp.100-109
• /
• 2014

정위신체방사선치료(SBRT)에서 환자의 호흡에 대한 정확한 치료위치의 확보는 필수적으로 고려되어야 하며 그 정확성에 관련하여 많은 연구들이 진행되어왔다. 본 연구에서는 실제 호흡에 의한 움직임과 실제 환자 폐의 형태를 고려한 팬텀실험으로 실제 치료에서 일어나는 임상적 상황을 모사함으로 호흡 동조 부피적조절회전 방사선치료(Volumeric Modulated Arc Therapy, VMAT) 기법을 이용한 폐부 SBRT의 정확성을 분석하는 방법을 제시하고자 하였다. SBRT을 받은 폐암 환자의 CT 영상을 기반으로 3D 프린터를 이용하여 치료부위와 유사하게 폐 팬텀을 제작하였고 환자 호흡과 동일하게 움직임을 재현할 수 있도록 $QUASAR^{TM}$ 호흡 동조 구동 팬텀(Modus Medical Devices, London, Canada)에 장착하여 호흡동조 VMAT에서의 2차원 선량 분포를 평가할 수 있는 시스템을 구축하였다. 폐 팬텀은 종양부위를 중심으로 2등분하여 EBT3 필름을 삽입하고 선량분포를 측정할 수 있도록 제작되었다. 비균질 조건에서의 선량계산의 정확성을 확인하기 위하여 균질한 플라스틱 팬텀과 제작된 비균질 폐 팬텀에서 Analytical Anisotropic Algorithm (AAA)와 AcurosXB (AXB) 두가지 알고리즘으로 선량계산을 하여 비교, 분석하였다. 움직임에 대한 치료의 정확성을 평가하기 위하여 호흡동조와 비 호흡동조의 경우, 그리고 움직임이 없는 조건에서 선량분포를 취득하여 치료계획 선량에 대한 감마지표를 분석하였다. 치료부위 GTV에서의 CT number는 실제 환자의 경우 78 HU를 나타내었고 모사된 폐 팬텀의 경우 92 HU를 나타내었다. 팬텀 내 폐 조직부분은 3D프린터로 적층하는 과정에서 격자구조의 형태를 이용하여 구현하였다. 측정된 필름선량은 AAA 알고리즘을 이용한 치료계획 선량에 대하여 움직이는 팬텀에서 호흡동조의 유무에 따라 3%/3 mm 감마지표 조건하에서 각각 88%와 78%의 감마합격률을 나타내었으며, 움직임이 없는 경우 95% 이상의 감마합격률을 보였다. AXB 알고리즘을 적용하였을 경우에는 모든 경우에서 98% 이상의 합격률을 나타내었다. 균질한 플라스틱 팬텀에 대하여 측정하였을 때 두가지 선량계산 알고리즘을 포함한 모든 조건에서 99% 이상의 감마합격률을 나타내었다. 선택된 환자의 호흡 진폭이 비교적 작고 inhale보다는 exhale에 더 오래 머무르는 호흡패턴 때문에 3%/3 mm 감마 기준에서는 호흡에 따른 차이가 거의 나타나지 않은 것으로 이해되었다. 선량계산의 정확성에서는 AAA 알고리즘을 적용하였을 때보다 AXB 알고리즘을 적용하였을 때가 균질과 비균질 환경에서의 선량 분포에 따른 감마 합격률의 차이가 적게 나타남을 확인 할 수 있었다. 본 논문에서는 환자와 유사하게 제작된 폐 팬텀에 실제 환자 호흡 패턴을 연동함으로 새로운 4D 치료선량 분포 검증 방법을 제시하였고 보다 사실적인 선량분포를 반영한 개별 환자 치료의 정확성 검증이 가능할 것으로 평가되었다.