• Title/Summary/Keyword: Patient table

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Reduction of Radiation Dose to Eye Lens in Cerebral 3D Rotational Angiography Using Head Off-Centering by Table Height Adjustment: A Prospective Study

  • Jae-Chan Ryu;Jong-Tae Yoon;Byung Jun Kim;Mi Hyeon Kim;Eun Ji Moon;Pae Sun Suh;Yun Hwa Roh;Hye Hyeon Moon;Boseong Kwon;Deok Hee Lee;Yunsun Song
    • Korean Journal of Radiology
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    • v.24 no.7
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    • pp.681-689
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    • 2023
  • Objective: Three-dimensional rotational angiography (3D-RA) is increasingly used for the evaluation of intracranial aneurysms (IAs); however, radiation exposure to the lens is a concern. We investigated the effect of head off-centering by adjusting table height on the lens dose during 3D-RA and its feasibility in patient examination. Materials and Methods: The effect of head off-centering during 3D-RA on the lens radiation dose at various table heights was investigated using a RANDO head phantom (Alderson Research Labs). We prospectively enrolled 20 patients (58.0 ± 9.4 years) with IAs who were scheduled to undergo bilateral 3D-RA. In all patients' 3D-RA, the lens dose-reduction protocol involving elevation of the examination table was applied to one internal carotid artery, and the conventional protocol was applied to the other. The lens dose was measured using photoluminescent glass dosimeters (GD-352M, AGC Techno Glass Co., LTD), and radiation dose metrics were compared between the two protocols. Image quality was quantitatively analyzed using source images for image noise, signal-to-noise ratio, and contrast-to-noise ratio. Additionally, three reviewers qualitatively assessed the image quality using a five-point Likert scale. Results: The phantom study showed that the lens dose was reduced by an average of 38% per 1 cm increase in table height. In the patient study, the dose-reduction protocol (elevating the table height by an average of 2.3 cm) led to an 83% reduction in the median dose from 4.65 mGy to 0.79 mGy (P < 0.001). There were no significant differences between dose-reduction and conventional protocols in the kerma area product (7.34 vs. 7.40 Gy·cm2, P = 0.892), air kerma (75.7 vs. 75.1 mGy, P = 0.872), and image quality. Conclusion: The lens radiation dose was significantly affected by table height adjustment during 3D-RA. Intentional head off-centering by elevation of the table is a simple and effective way to reduce the lens dose in clinical practice.

Evaluation of Radiation Dose and Image Quality according to CT Table Height (CT 테이블 높이에 따른 방사선 선량 및 화질 평가)

  • Lee, Jongwoong;Jung, Hongmoon
    • Journal of the Korean Society of Radiology
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    • v.11 no.6
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    • pp.453-458
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    • 2017
  • Computed Tomography (CT) provides information on the Diagnostic Reference Level Computed Tomography Dose Index (CTDI) and Dose Length Product (DLP) for accurate diagnosis of patients. However, it does not provide a dose change according to the table height for the diagnostic reference level provided by the CT equipment. The purpose of this study was to evaluate the image and dose according to the table height change using phantom (PMMA: Polymethyl Methacrylate) in order to find the optimal image and the minimum dose during computed tomography examination. When examining using a 32 cm PMMA phantom with the same thickness as the abdomen of an adult, there was little change in dose with table height. However, the noise evaluation of the image caused a high fluctuation of noise depending on the table height. and in the case of the 16 cm PMMA phantom, the change of the noise was small, but the dose change was about 30%. In conclusion, the location of the patient and the center of the detector are important during computed tomography (CT) examinations. In addition, table height setting is considered to be important for examinations with optimized image and minimum dose.

Patient Compliance and Associated Factors in the Community-based Hypertension Control Program (지역단위 고혈압사업에 있어서 환자의 치료순응도와 결정요인)

  • Kim, Jee;Min, Kyung-Bok;Kwon, Soon-Ho;Han, Dal-Sun;Bae, Sang-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.2
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    • pp.215-227
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    • 1999
  • Objectives: To investigate compliance of hypertension patients using modified Theory of Reasoned Action(TRA). Methods: The data were collected for 7-12 April 1997, by interviewing 190 Hypertension patients in Hwachon, Kangwon-do. The analytical techniques employed include contingency table analysis and logit analysis. Results: 15.1% of patients were unaware of the fact that he/she has hypertension and 11.2% did not know that he/she should take drug. 20.8% of patients took drug continuously, 20.1% had drug intermittently, and 53.1% had never have treatment. In the contingency table analysis, several variables were found to be significantly related to patient compliance. They included variables for attitude towards the consequences of taking drugs, normative beliefs, systolic BP at the enrollment, knowledge of how to take hypertensive drugs, variables for general health behavior and experience with having health worker's home visit. The logit analysis was performed by two steps. first step uses experience with drug treatment of hypertension as the dependent variable, and second step uses continuity of treatment. Included in the predictors that are significantly related to the former analysis are subjected norms produced by combining normative beliefs and motivation to comply, knowledge of how to take hypertensive drugs, and opinion about natural recovery of diseases. The only significant determinant of continuous treatment was knowledge of how to take hypertensive drugs. Conclusions: The results of analysis suggest the usefulness of TRA as a framework for the study of compliance of hypertensive patients. The findings have some practical implication as well. One is that efforts for enhancing compliance should be directed not only patients but also to other persons influencing patient's attitude and behavior. It also suggest that correct understanding of hypertension treatment is essential to perform the appropriate patient role.

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Medical costs for patients with Facial paralysis : Based on Health Big Data (보건의료 빅데이터를 이용한 얼굴마비환자의 의료비용에 관한 연구)

  • Hong, Min-Jung;Umh, Tae-Woong;Kim, Sina;Kim, Nam-Kwen
    • The Journal of Korean Medicine
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    • v.36 no.3
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    • pp.98-110
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    • 2015
  • Objectives: The purpose of this study was to analyze the medical cost of facial paralysis in payer perspective and to estimate the practice pattern of patient using 2011 Health Insurance Review & Assessment Service-National Patients Sample(HIRA-NPS). Methods: Basic statistical system was used for descriptive analysis of NPS dataset. A table for general information (table20) was extracted by disease code, and social demographic characteristics, distribution of the use among inpatients and outpatients, utilization of each kind of medical care institutions, medical cost were analyzed. Subgroup analysis was conducted for assuming the practice pattern of korean medicine and western medicine. Results: A total of 8,219 people and 64,345 claims data were identified as having facial paralysis. Proportion of outpatient was 95.23%, inpatient 0.84% and patient using both services 3.93%. Mean patient charges was 44,229 won per outpatient, 178,886 won per inpatient and 523,542 won per patient using both services. Utilization of korean medical care institutions was 68.81%(claims), 40.46%(patients), utilization of western medical care institutions was 31.19%(claims), 59.54%(patients). The amount charged by korean medical care institutions was 52.61% and western medical care institutions was 47.39%. Cost per claim was higher than those of the korean treatment and cost per patient of western treatment was lower than those of the korean treatment. Conclusions: The research assessed the medical cost and practice pattern associated with facial paralysis. These findings could be used in health care policy and subsequent studies.

A Review of Subbrow Approach in the Management of Non-Complicated Anterior Table Frontal Sinus Fracture

  • Kim, Jeenam;Choi, Hyungon
    • Archives of Craniofacial Surgery
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    • v.17 no.4
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    • pp.186-189
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    • 2016
  • Frontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are controversial. The subbrow approach enables accurate reduction and internal fixation of the fractures in the anterior table of the frontal sinus by allowing direct visualization of the fracture. Given the surgical success in reduction and rigid fixation, patient satisfaction, and aesthetic benefits, the transcutaneous approach through a subbrow incision is superior to other reduction techniques used in the management of an anterior table frontal sinus fracture.

Evaluation of Image Quality according to the Use of Attachable X-ray Table Equipped with Heating Device (가열장치를 구비한 부착형 X선 촬영대의 사용에 따른 화질 평가)

  • Song, Jongnam;Kim, Eungkon
    • Journal of the Korean Society of Radiology
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    • v.9 no.4
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    • pp.219-225
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    • 2015
  • This study aims to evaluates the image quality of CR and DR that are scanned with the use of the attachable carbon heater X-ray scanner table equipped with heating device by measuring SNR and CNR before and after the attachment of the said table. In the aluminum staircase testing, CR increased SNR and CNR when attached with the table, while DR decreased SNR and CNR. In the human-body model phantom testing, CR increased SNR and CNR only in the low-energy low-dose radiation and the high-energy high-dose radiation, but decreased SNR and CNR under all other conditions. In conclusion, the use of such table can make the patient feel comfortable by removing his or her anxiety, thus helping the testing, but in the actual clinical application thereof, if the thickness and material of the bottom film and the protective film, including the carbon heater, are not considered, it affects the picture quality, thereby requiring continuous research on the use of such table.

Analysis of the Bacteria in Nuclear Medicine (핵의학 검사실내 세균 분석)

  • Shin, Seong-Gyu;Lee, Hyo-Yeong
    • Journal of the Korea Safety Management & Science
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    • v.19 no.2
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    • pp.95-100
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    • 2017
  • In this study, the bacterial contamination level of equipments and devices in the nuclear medicine department of a university hospital was investigated. CNS was detected from the sample collected from the door opening button of the nuclear medicine department. Bacillus sp. was detected from the table and CNS with Bacillus sp. were detected from the control button at the PET-CT room no.1. Also, CNS was detected from the table and the control button at the PET-CT room no.2. In the distribution room no.1, CNS and Bacillus sp. were detected while CNS being detected from the distribution room no.2 and CNS with Bacillus sp. being detected from the distribution room no.3. In the injection room, Enterrococcus faecium and Pontoea sp. were detected. On the table of the ecsomatics room, Pontoea sp. was detected. Bacillus sp. was detected from the inside of the syringe Pb shield and CNS was detected from the outside. Enterrococcus faecium was detected from the Gamma camera table and Bacillus sp. was detected from the door grip. On the chair at the patient waiting room, Pseudomonas aeruginosa abd Bacillus sp. were detected. Therefore, it was understood that infection should be prevented by securely sterilizing examination devices after each examination, maintaining cleanliness by regular sterilization of waiting chairs and such objects with a number of direct contacts with patients, and infection education for the features of nuclear department.

A Case Report of Seborrheic Dermatitis With a Gastrointestinal Symptom Treated by Jeokseokji-uyeoryang-tang Based on Shanghanlun (상한론에 근거하여 소화기 이상을 동반한 지루성 피부염 환자에 대한 적석지우여량탕 치험 1례)

  • Lee, Sung-Jun;Yoon, Hye-ji;Lee, Soong-In
    • Herbal Formula Science
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    • v.24 no.1
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    • pp.45-52
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    • 2016
  • objective The purpose of this case report is to review the possibility of utilizing Jeokseokji-uyeoryang-tang as a therapy of seborrheic dermatitis, and to consider clinical using possibility of Shanghanlun.method Patient's Diagnosis and progress of seborrheic dermatitis was evaluated based on the patient's chart and picture. And diagnosis based on Shanghanlun was organized by table.results When analyzing the patient's history and symptoms, it can be found in article No. 159 in Shanghanlun. The area and intentsiy of erythema were reduced when viewed photos findings, so diagnosis and therapies used in this case showed valid results in seborrheic dermatitis.conclusion Jeokseokji-uyeoryang-tang is efficient to patient of this case report as a treatment.

Small Incision and Dual-Top Screws for Treatment of Simple Depressed Anterior Frontal Sinus Fractures (소절개 및 Dual-top screw를 이용한 전두동 전벽 단순 함몰골절의 치료)

  • Moon, Suk Ho;Oh, Deuk Young;Seo, Byung Chul;Rhie, Jong Won;Ahn, Sang Tae
    • Archives of Plastic Surgery
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    • v.35 no.3
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    • pp.345-348
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    • 2008
  • Purpose: Fracture of the frontal sinus accounts for 5-15% of all facial fractures. Only anterior table fracture occupies one third of the frontal sinus fracture. Conventional coronal approach is the standard treatment, but this method is very aggressive, especially in patient with simple, depressed, anterior frontal sinus wall fracture. We introduce new, simple technique for these patients, using small incision and Dual-top screws. Methods: A 27-year-old male patient was introduced to our department under the impression of fracture of frontal sinus, involving only anterior table. Under general anesthesia, 1.5 cm-sized, small incision was made on the suprabrow area. We reduced fractured fragment with two dual-top screws and 25G wires. Fixation was not necessary Results: The operation took about forty minutes, and the patient discharged 2 days after the operation. Postoperative 2 months follow up CT shows maintenance of reduction site. Gross depression of the forehead and visible scar was not observed. Conclusion: Although the indication of this procedure is limited, less aggressive, simple and very effective to the patient with simple. depressed, anterior frontal sinus fracture.

Radiation Dose Reduction of Lens by Adjusting Table Height and Magnification Ratio in 3D Cerebral Angiography (삼차원 뇌혈관조영술에서 테이블 높이와 확대율 조절에 따른 수정체 선량 감소에 대한 연구)

  • Yoon, Jong-Tae;Lee, Ki-Baek
    • Journal of radiological science and technology
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    • v.45 no.4
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    • pp.313-320
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    • 2022
  • Both angiography and interventional procedures accompanied by angiography provide many diagnostic and therapeutic benefits to patients and are rapidly increasing. However, unlike general radiography or computed tomography using the same X-ray, the amount of radiation is quite high, but the dose range can vary considerably for each patient and operator. The high sensitivity of the lens to radiation during cerebral angiography and neurointervention is already well known, and although there are many related studies, it is insufficient to easily reduce radiation in diagnosis and treatment. In this situation, in particular, by adding three-dimensional rotational angiography (3D-RA) to the existing two-dimensional (2D) angiography, it is now possible to make an accurate diagnosis. However, since this 3D-RA acquires images through projection of more radiation than before, the exposure dose of the lens may be higher. Therefore, we tried to analyze whether the radiation dose of the lens can be reduced by moving the lens out of the field range by adjusting the table height and magnification ratio during the examination using 3D-RA. The surface dose was measured using a rando phantom and a radiophotoluminescent glass dosimeter (PLD) and the radiation dose was compared by adjusting the table height and magnification ratio based on the central point. As a result, it was found that the radiation dose of the lens decreased as the table height increased from the central point, that is, as the lens was out of the field of view. In conclusion, in 3D-RA, moving the table position of about 2 cm in height will make a significant contribution to the dose reduction of the lens, and it was confirmed that adjusting the magnification ratio can also reduce the surface dose of the lens.