• Radiation Oncology Journal
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• v.11 no.2
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• pp.321-330
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• 1993

Purpose: A retrospective analysis was performed to evaluate the incidence of radiation induced lung damage after the radiation therapy for the patients with carcinoma of the lung. Method and Materials: Sixty-six patients with lung cancer (squamous cell carcinoma 27, adenocarcinoma 14, large cell carcinoma 2, small cell carcinoma 13, unknown 10) were treated with definitive, postoperative or palliative radiation therapy with or without chemotherapy between July 1987 and December 1991. There were 50 males and 16 females with median age of 63 years (range: 33~80 years). Total lung doses ranged from 500 to 6,660 cGy (median 3960 cGy) given in 2 to 38 fractions (median 20) over a range or 2 to 150 days (median in days) using 6 MV or 15 MV linear accelerator. To represent different fractionation schedules of equivalent biological effect, the estimated single dose (ED) model, $ED=D{\dot}N^{-0.377}{\dot}T^{-0.058}$ was used in which D was the lung dose in cGy, N was the number of fractions, and T was the overall treatment time in days. The range of ED was 370 to 1357. The endpoint was a visible increase in lung density within the irradiated volume on chest X-ray as observed independently by three diagnostic radiologists. Patients were grouped according to ED, treatment duration, treatment modality and age, and the percent incidence of pulmonary damage for each group was determined. Result: In 40 of 66 patients, radiation induced change was seen on chest radiographs between 11 days and 314 days after initiation of radiation therapy. The incidence of radiation pneumonitis was increased according to increased ED, which was statistically significant (p=0.001). Roentgenographic changes consistent with radiation pneumonitis were seen in $100\%$ of patients receiving radiotherapy after lobectomy or pneumonectomy, which was not statistically significant. In 32 patients who also received chemotherapy, there was no difference in the incidence of radiation induced change between the group with radiation alone and the group with radiation and chemotherapy, among the sequence of chemotherapy No correlation was seen between incidence of radiation pneumonitis and age or sex. Conclusions: The occurrence of radiation pneumonitis varies. The incidence of radiation pneumonitis depends on radiation total dose, nature of fractionation, duration of therapy, and modifying factors such as lobectomy or pneumonectomy.

• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.212-218
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• 2018

Objective : Surgical clipping of the cerebral aenurysm is considered as a standard therapy with endovascular coil embolization. The surgical clipping is known to be superior to the endovascular coil embolization in terms of recurrent rate. However, a recurrent aneurysm which is initially treated by surgical clipping is difficult to handle. The purpose of this study was to research the management of the recurrent cerebral aneurysm after a surgical clipping and how to overcome them. Methods : From January 1996 to December 2015, medical records and radiologic findings of 14 patients with recurrent aneurysm after surgical clipping were reviewed retrospectively. Detailed case-by-case analysis was performed based on preoperative, postoperative and follow-up radiologic examinations and operative findings. All clinical variables including age, sex, aneurysm size and location, type and number of applied clips, prognosis, and time to recurrence are evaluated. All patients are classified by causes of the recurrence. Possible risk factors that could contribute to those causes and overcoming ways are comprehensively discussed. Results : All recurrent aneurysms after surgical clipping were 14 of 2364 (0.5%). Three cases were males and 11 cases were females. Mean age was 52.3. At first treatment, nine cases were ruptured aneurysms, four cases were unruptured aneurysms, and one case was unknown. Locations of recurrent aneurysm were determined; anterior communicating artery (A-com) (n=7), posterior communicating artery (P-com) (n=3), middle cerebral artery (n=2), anterior cerebral artery (n=1) and basilar artery (n=1). As treatment of the recurrence, 11 cases were treated by surgical clipping and three cases were treated by endovascular coil embolization. Three cases of all 14 cases occurred in a month after the initial treatment. Eleven cases occurred after a longer interval, and three of them occurred after 15 years. By analyzing radiographs and operative findings, several main causes of the recurrent cerebral aneurysm were found. One case was incomplete clipping, five cases were clip slippage, and eight cases were fragility of vessel wall near the clip edge. Conclusion : This study revealed main causes of the recurrent aneurysm and contributing risk factors to be controlled. To manage those risk factors and ultimately prevent the recurrent aneurysm, neurosurgeons have to be careful in the technical aspect during surgery for a complete clipping without a slippage. Even in a perfect surgery, an aneurysm may recur at the clip site due to a hemodynamic change over years. Therefore, all patients must be followed up by imaging for a long period of time.

• Hip & pelvis
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• v.35 no.3
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• pp.183-192
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• 2023

Purpose: This study aims to determine which intertrochanteric (IT) hip fracture and patient characteristics predict the necessity for adjunct reduction aides prior to prep and drape aiming for a more efficient surgery. Materials and Methods: Institutional fracture registries from two academic medical centers from 2017-2022 were analyzed. Data on patient demographics, comorbidities, fracture patterns identified on radiographs including displacement of the lesser trochanter (LT), thin lateral wall (LW), reverse obliquity (RO), subtrochanteric extension (STE), and number of fracture parts were collected, and the need for additional aides following traction on fracture table were collected. Fractures were classified using the AO/OTA classification. Regression analyses identified significant risk factors for needing extra reduction aides. Results: Of the 166 patients included, the average age was 80.84±12.7 years and BMI was 24.37±5.3 kg/m². Univariate regression revealed increased irreducibility risk associated with RO (odds ratio [OR] 27.917, P≤0.001), LW (OR 24.882, P<0.001), and STE (OR 5.255, P=0.005). Multivariate analysis significantly correlated RO (OR 120.74, P<0.001) and thin LW (OR 131.14, P<0.001) with increased risk. However, STE (P=0.36) and LT displacement (P=0.77) weren't significant. Fracture types 2.2, 3.2, and 3.3 displayed elevated risk (P<0.001), while no other factors increased risk. Conclusion: Elderly patients with IT fractures with RO and/or thin LW are at higher risk of irreducibility, necessitating adjunct reduction aides. Other parameters showed no significant association, suggesting most fracture patterns can be achieved with traction manipulation alone.

• The korean journal of orthodontics
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• v.35 no.6 s.113
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• pp.420-432
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• 2005

Bolton analysis is widely used to predict tooth size discrepancy. but its accuracy has been challenged. The purpose of this study was to describe true anterior tooth size discrepancies among orthodontic patients and to evaluate the factors that affect true anterior tooth size discrepancies. The subjects consisted of 80 patients with varying malocclusions (Class I. Class II. Class III. and Class III surgery) who were treated orthodontically. Pre-treatment models. set-up models from post-treatment models. and lateral cephalometric radiographs were analyzed The results were as follows. The means. the standard deviations. and ranges of anterior Bolton ratio in the present study were somewhat higher than those of Bolton's samples and Korean normal samples. The number of patients showing maxillary deficiency was larger than that of patients showing maxillary excess in view of true anterior discrepancies. There was a significant difference between anterior Bolton discrepancy from pre-treatment models and true anterior discrepancy from set-up models (p < 0.05) There was no significant difference in true anterior discrepancies among malocclusion groups (p > 0.05). And there was also no significant difference between the male and female groups (p> 0.05). Overbite and the incisal edge thickness of maxillary anterior teeth have little relationship with true anterior discrepancies. Multiple regression analysis showed that true anterior discrepancy was mainly determined by anterior Bolton ratio, upper incisor to occlusal plane angle after treatment. interincisal angle after treatment. and upper right lateral incisor width.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.2
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• pp.114-119
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• 2018

Purpose: Patients who treated implant immediate loading within a week after implant placement at Wonkwang University Dental Hospital Implant Center were evaluated marginal bone resorption. These retrospective analyses are intended to reinforce the clinical evidence for the implant immediate loading. Materials and methods: Medical history and radiographic data were investigated, which were the patients' who treated implant immediate loading and restoration with provisional prostheses between January 2005 and June 2016, at Wonkwang University Dental Hospital Implant Center. Total number of implants was 70, marginal bone resorption was measured according to implant length, diameter and connection type. To measure marginal bone resorption, periapical radiographs were taken when the implants were placed and after 6 month. Statistical analysis was done in Mann-whitney U test and Kruskal-wallis test with SPSS 22.0 software (P<.05). Results: Mean marginal bone resorption around immediately loaded implants according to implant connection type was shown $1.24{\pm}0.72mm$ in internal hexagon connection type and $1.73{\pm}1.27mm$ in external hexagon connection type. There was no statically significant difference in marginal bone resorption with implant length and diameter. Conclusion: Implants with immediated loading in internal hexagon connection type showed less marginal bone resorption significantly than in external hexagon connection type.

• Journal of radiological science and technology
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• v.33 no.2
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• pp.109-120
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• 2010

The purpose of this study was first to analyze the utilization of dental examination through questionnaire to develop a diagnostic reference level of patient doses for dental radiography in korea. 77 dental institutions were classified into three groups: A group for the dental hospitals of the college of dentistry (11 institutions), B group for dental hospitals (30 institutions) and C group for dental clinics (36 institutions). The results were as follows : The mean numbers of unit chairs and medical staffs were 140.2, 15.3 and 5.8 sets, 112.6, 7.3 and 1.7 dentists, 3.1, 0.5 and no one radiologic technologists, and 19.7, 12.5 and 3.3 dental hygienists in A, B and C groups, respectively. The mean numbers of dental X-ray equipments were 14.64, 3.21 and 2.19 in A, B and C groups, respectively. Intraoral dental X-ray unit was used the most, the following equipments were panoramic, cephalometric, and cone-beam CT units. The most used X-ray imaging system was also digital system (above 50%) in all three groups. Insight dental film (Kodak, USA) having high sensitivity was routinely used for periapical radiography. The automatic processor was not used in many dental institutions, but the film-holding device was used in many dental institutions. The utilization rates of PACS in A, B and C groups were 90.9%, 83.3% and 16.7% respectively, and the PACS software program was used the most PiView STAR (Infinitt, Korea). The annual mean number of radiographic cases in one dental institution in 2008 for A group was 6.8 times and 21.2 times more than those for B and C groups, and periapical and panoramic radiographs were taken mostly. Tube voltage (kVp) and tube current (mA) for periapical radiography were similar in all three groups, but exposure time in C group was 12.0 times and 3.5 times longer than those in B and C groups. The amount of radiation exposure in C group, in which dental hygienists take dental radiographs, was more than those in other groups. The exposure parameters for panoramic radiography were similar in all three groups. In conclusion, the exposure parameters in dental radiography should be determined with reference level, not past experiences. Use of automatic processor and film-holding devices reduces the radiation exposure in film system. The quality assurance of dental equipments are necessary for the reduction of the patient dose and the improvement of X-ray image quality.

• Journal of radiological science and technology
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• v.8 no.2
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• pp.21-28
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• 1985

We serveyed the actual condition of business of the departments of radiology of 45 health conters (except 3) in the area of Seoul, Kyungki and Inchon from March, 1984 to November, 1984. The results are summarized as follows : 1. T.O. of the radiologic technologist is three persons in each health center of Seoul area, and one person in each one of Kyungki and Inchon area. P.O. is 2-5 persons in Seoul area, 1-2 persons in Kyungki or Inchon area. 2. The number of all the radiologic technologists employed now is 75 persons, and among all of them, when analized by position class 7th is 54.7%, class 8th 28.0%, class 9th is 13.3%, and class 6th is 2.7%, and by sex, female is 68.0%, male is 32.0%, by educational background, for the most part, junior college graduates come to 73.3%, by age group 60% of them is in their twenties, 16.0% is in their thirties and forties, 8.0% is in their fifties, and by career after certificate 60% have the career of 1-5 years, 13.3% have the one of 6-7 years or mor than 21 years, and 6.7% have the one of 11-15 years of 16-20 years. 3. All the diagnostic x-ray equipment being kept is 62, and among them flxing equipment is 71.0%, portable equipment is 29.0% and by rating of X-ray equipment, maximum tube current 100 mA is 46.8%, maximum KV 100KVP is 72.6%, the most part. 4. Photofluorographic camera and hood are equipped in every health center. While, as to the radiographic cassettes, $14{\times}14"$ cassetts are equipped in every health center, but cassettes of other sizes are in half of them. 5. Bucky's table is equipped in 11.9% health centers, the automatic processor is in 21.4%, the photofluorographic film changer is 9.5%, the grid is 73.8%, the protective apron is in 88.1%, and the protective glove is in 57.1% health centers. 6. The number of the people who got the x-ray examination for one year (by the year 1989) is the most, 1,000-6,000 in direct radiography of the chest, or 15,0001-45,000 in the health centers of Seoul area, 5,000-20,000 in Kyungki and Inchon area in photofluorography of the chest. Moreover, other radiographies are being taken extremely limitedly in all health centers. 7. In processing types of x-ray film, automatic processing is used in 9 health centers (21.4%), manual tank processing is in 30 (71.4%), and manual tray processing in 3 (7.2%). 8. As for collimation of x-ray exposure field, "continual using restricted by a subject size" has the most part, 78.6% "restricted using at every radiography" has 19%, and the case of "never considered" has 2.4% response. 9. As for the dosimeter used for radiation control, film badge (35.7%) and pocket dosimeter (26.2%) are used, and in 38.1% health centers the dosimeter is not equipped at all. Consideration of the previous radiation exposure is being done in only one health center. 10. Reading of radiographs is mainly depended on the radiologists electively (45.2%) or on the genral practitioners(45.2%).

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.4
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• pp.587-597
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• 2004

Over the past 20 years, great strides have been made in research regarding the mechanisms involved in the progression of carious lesions, but new equipment and research tools need to be developed to continue these advancements in caries research. Various methods have been applied to reduce the incidence of carious lesions, which have led to a significant decrease in the number of occlusal caries, but a concurrent increase in the proportion of proximal carious lesions. New diagnostic equipment has been developed to detect early stage carious lesions, and these have demonstrated excellent laboratory results and show promise in clinical applications. The research presented here examines the efficacy of the newly developed $DIFOTI^{TM}$ system in detecting proximal carious lesions compared to traditional intraoral exam and bitewing radiography, possible problems or deficiencies of using the system in clinic, possible improvements that can be made to the system, and the efficacy of detecting early, reversible carious lesions that can be remineralized by preventative fluoride applications. The subject pool consisted of 23 grammer school age patients just prior to entering the mixed dentition phase. Each patient was given a thorough oral examination, radiographic examination consisting of bitewing radiographs of the posterior teeth, and $DIFOTI^{TM}$ examination of the anterior and posterior teeth. Each examination was carried out two times by two examiners, and the data were statistically analyzed. The results are as follows: 1. The mean alpha value of reliability test of the visual oral examination was as follows; occlusal surface was 0.8470. mesial surface was 0.6430, distal surface was 0.5727. lingual surface was 0.2807 and distal surface was 0.2339. When the examination was limited to posterior teeth, the mean alpha value was as follows; occlusal surface was 0.8577, distal surface was 0.8211, lingual surface was 0.7728, buccal surface was 0.7152 and mesial surface was 0.6782. 2. The alpha value of reliability test of the radiographic analysis of carious lesions of the occlusal, mesial, and distal surfaces was 0.8500. 3. The alpha value of reliability test of the $DIFOTI^{TM}$ diagnostic analysis of carious lesions of the occlusal, buccal, lingual, mesial, and distal surfaces was determined to be 0.7917. 4. The $DIFOTI^{TM}$ diagnostic system was found to be the most accurate means of detecting occlusal, buccal, and lingual surface carious lesions (p<0.05), while mesial and distal proximal carious lesions were most accurately assessed using bitewing radiography (p<0.05).

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.28 no.2
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• pp.435-459
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• 1998

In order to achieve a successful endodontic treatment, root canals must be obturated three-dimensionally without causing any damage to apical tissues. Accurate length determination of the root canal is critical in this case. For this reason, I've used the conventional periapical radiography, Digora/sup (R)/(digital imaging system) and Root ZX/sup (R)/(the frequency dependent type apex locator) to measure the length of the canal and compare it with the true length obtained by cutting the tooth in half and measuring the length between the occlusal surface and the apical foramen. From the information obtained by these measurements, I was able to evaluate the accuracy and clinical usefulness of each systems. whether the thickness of files used in endodontic therapy has any effect on the measuring systems was also evaluated in an effort to simplify the treatment planning phase of endodontic treatment. 29 canals of 29 sound premolars were measured with #15, #20, #25 files by 3 different dentists each using the periapical radiography. Digora/sup (R)/ and Root ZX/sup (R)/. The measurements were then compared with the true length. The results were as follows: 1. In comparing mean discrepancies between measurements obtained by using periapical radiography(mean error: -0.449±0.444 mm), Digora/sup (R)/(mean error: -0.417±0.415 mm) and Root ZX/sup (R)/(mean error: 0.123±0.458 mm) with true length. periapical radiography and Digora/sup (R)/ system had statistically significant differences(p<0.05) in most cases while Root ZX/sup (R)/ showed none(p>0.05). 2. By subtracting values obtained by using periapical radiography, Digora/sup (R)/ and Root ZX/sup (R)/ from the true length and making a distribution table of their absolute values. the following analysis was possible. In the case of periapical film. 140 out of 261<53.6％) were clinically acceptable satisfying the margin of error of less than 0.5 mm. 151 out of 261 (53,6％) were acceptable in the Digora/sup (R)/ system while Root ZX/sup (R)/ had 197 out of 261(75.5％) within the limits of 0.5mm margin of error. 3. In determining whether the thickness of files has any effect on measuring methoths, no statistically significant differences were found(p>0.05). 4. In comparing data obtained from these methods in order to evaluate the difference among measuring methods, there was no statistically significant difference between periapical radiography and Digora/sup (R)/ system(p>0.05), but there was statistically significant difference between Root ZX/sup (R)/ and periapical radiography(p<0.05). Also there was statistically significant difference between Root ZX/sup (R)/ and Digora/sup (R)/ system(p<0.05). In conclusion, Root ZX/sup (R)/ was more accurate when compared with the Digora/sup (R)/ system and periapical radiography and seems to be more effective clinically in determining root canal length. But Root ZX/sup (R)/ has its limits in determining root morphology and number of roots and its accuracy becomes questionable when apical foramen is open due to unknown reasons. Therefore the combined use of Root ZX/sup (R)/ and the periapical radiography are mandatory. Digora/sup (R)/ system seems to be more effective when periapical radiographs are needed in a short period of time because of its short processing time and less exposure.

• Journal of the Korean Society of Radiology
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• v.17 no.4
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• pp.607-614
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• 2023

Clear overlapping of the bilateral epicondyle and proper separation of the elbow joint are crucial for obtaining accurate lateral general radiographs of the elbow. However, due to the complex anatomical structure of the elbow, achieving optimal positioning is challenging, leading to the need for repeated x-ray examinations. Therefore, the purpose of this study was to investigate the angle of the forearm in patients where accurate lateral images of the elbow joint can't be obtained after vertical incidence using a styrofoam device during elbow joint lateral x-ray imaging. Twenty patients were enrolled in our study following the established protocol. First, a vertical x-ray at an angle of 0° between the forearm and the table was taken (control group). Here, if the lateral image of the elbow joint was deemed inadequate, the forearm angle was adjusted using custom-made styrofoam supports with 5° and 10° inclinations (experimental groups). For the evaluation method, two assessors utilized a 5-point Likert scale to assess the images. The reliability of the assessments was analyzed using Cronbach's alpha coefficient. As a result, patients with inadequate overlap of the bilateral epicondyle and separation of the elbow joint in the initial examination (control group) were able to obtain the best images when setting a 10° angle between the forearm and the table. The subjective evaluation was 1.6 ± 0.8 points at 0°, 2.7 ± 0.8 points at 5°, and 4.4 ± 1.3 points at 10°, respectively. The reliability analysis for the angles of 0°, 5°, and 10° yielded Cronbach's alpha values of 0.867, 0.697, and 0.922, respectively. In conclusion, when it is not possible to obtain accurate images using the conventional position and X-ray beam direction, it is considered that by initially acquiring images with an angle of 10° between the forearm and the table, and gradually decreasing the angle while obtaining images, it would be possible to achieve the optimal image while reducing the number of repeat examinations.