• Journal of Korean Neurosurgical Society
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• v.60 no.2
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• pp.225-231
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• 2017

Objective : Solid bone fusion is an essential process in spinal stabilization surgery. Recently, as several minimally invasive spinal surgeries have developed, a need of artificial bone substitutes such as demineralized bone matrix (DBM), has arisen. We investigated the in vivo bone growth rate of DBM as a bone void filler compared to a local autologous bone grafts. Methods : From April 2014 to August 2015, 20 patients with a one or two-level spinal stenosis were included. A posterior lumbar interbody fusion using two cages and pedicle screw fixation was performed for every patient, and each cage was packed with autologous local bone and DBM. Clinical outcomes were assessed using the Numeric Rating Scale (NRS) of leg pain and back pain and the Korean Oswestry Disability Index (K-ODI). Clinical outcome parameters and range of motion (ROM) of the operated level were collected preoperatively and at 3 months, 6 months, and 1 year postoperatively. Computed tomography was performed 1 year after fusion surgery and bone growth of the autologous bone grafts and DBM were analyzed by ImageJ software. Results : Eighteen patients completed 1 year of follow-up, including 10 men and 8 women, and the mean age was 56.4 (32-71). The operated level ranged from L3/4 to L5/S1. Eleven patients had single level and 7 patients had two-level repairs. The mean back pain NRS improved from 4.61 to 2.78 (p=0.003) and the leg pain NRS improved from 6.89 to 2.39 (p<0.001). The mean K-ODI score also improved from 27.33 to 13.83 (p<0.001). The ROM decreased below 2.0 degrees at the 3-month assessment, and remained less than 2 degrees through the 1 year postoperative assessment. Every local autologous bone graft and DBM packed cage showed bone bridge formation. On the quantitative analysis of bone growth, the autologous bone grafts showed significantly higher bone growth compared to DBM on both coronal and sagittal images (p<0.001 and p=0.028, respectively). Osteoporotic patients showed less bone growth on sagittal images. Conclusion : Though DBM alone can induce favorable bone bridging in lumbar interbody fusion, it is still inferior to autologous bone grafts. Therefore, DBM is recommended as a bone graft extender rather than bone void filler, particularly in patients with osteoporosis.

• Progress in Medical Physics
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• v.17 no.2
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• pp.67-76
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• 2006

We evaluated the accuracy of a patient setup error correction due to reference image quality for a 2D-2D matching process. Digitally reconstructed radiographs (DRRs) generated by use of the Pinnacle3 and the Eclipse for various regions of a humanoid phantom and a patient for different CT slice thickness were employed as a reference images and kV X-ray Images from the On-Board Imager were registered to the reference DRRs. In comparison of the DRRs and profiles, DRR image quality was getting worse with an increase of CT image slice thickness. However there were only slight differences of setup errors evaluation between matching results for good and poor reference DRRs. Although DRR image quality did not strongly affect to the 2D-2D matching accuracy, there are still potential errors for matching procedure, therefore we recommend that DRR images are needed to be generated with less than 3mm slice thickness for 2D-2D matching.

• The Journal of Korean Society for Radiation Therapy
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• v.18 no.1
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• pp.43-51
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• 2006

Purpose: To resolution of A hospital-handmade modification double tilt angle immobilization system (DTAB immobilization system) and to report the clinical results of it. Material and Methods: It was developed in conjunction with the breast board for patients unable to achieve and maintain the desired uncomfortable respiration and position of set-up needed in the treatment of RT (This custom design provides an alternative to accomplishing this desired head angle needed to relax position treatment area, realizing that the lenses totally protected eye-ball out) By using the angled breast board and SBDD(small bowel device), reproducibility of set-up and patient comfort were addressed throughout the simulation, computed tomography planning and treatment process. Results: Usually patients the error range-within 5 mm. When use of Aqua patients error range-within 3 mm. Conclusion: It was constructed in tandem with a unique custom-built double tilt angle board (DTAB). It was designed to eliminate clinical set-up problems with head immobilization and instability during treatment, thus providing for a more comfortable head rest for the patient.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.135-140
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• 2013

We report a case of recurrent shoulder dislocation and combined proximal humerus fracture in neurofibromatosis type I. A twenty-year-old male patient with known neurofibromatosis type I presented with right shoulder dislocation and proximal humerus fracture following a minor trauma. His injured arm also had large plexiform neurofibromas on the elbow, and the dislocation of the shoulder joint was proven to be recurrent. Bony deformation of the humerus and scapula were revealed on X-ray and computed tomography, as well as multiple neurofibromatic changes of the deltoid and periscapular muscles were noted on magnetic resonance imaging. Open reduction and capsular reconstruction were performed and humeral fracture was stabilized with a reconstruction plate. Satisfactory union and functional result were achieved and the dislocation did not recur until the 7-month followup after the procedure. Recurrent shoulder dislocation and combined proximal humerus fracture in neurofibromatosis type I are rare complications. However, it should still be considered in the orthopaedic evaluation process of the diseases.

• Korean Journal of Digital Imaging in Medicine
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• v.16 no.2
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• pp.9-14
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• 2014

Purpose: The purpose of this study has attempted to evaluate and compare the image evaluation and exposure dose by respectively applying Filtered Back Projection(FBP), the existing test method, and Adaptive Statistical Iterative Reconstruction(ASIR) with different values of tube voltage during the Low Dose Computed Tomography(LDCT). Materials and Methods: With the image reconstruction method as basis, Chest Phantom was utilized with the FBP and ASIR set at 10%, 20% respectively, and the change of Tube Voltage (100kVp, 120kVp). For image evaluation, Back ground noise, Signal to Noise ratio(SNR) and Contrast to Noise ratio(CNR) were measured, and, for dose evaluation, CTDIvol and DLP were measured respectively. The statistical analysis was tested with SPSS(ver. 22.0), followed by ANOVA Test conducted after normality test and homogeneity test. (p<0.05). Results: In terms of image evaluation, there was no outstanding difference in Ascending Aorta(AA) SNR and Infraspinatus Muscle(IM) SNR with the different values of ASIR application(p<0.05), but a significant difference with the different amount of tube voltage(p>0.05). Also, there wasn't noticeable change in CNR with ASIR and different amount of Tube Voltage (p<0.05). However, in terms of dose evaluation, CTDIvol and DLP showed contrasting results(p<0.05). In terms of CTDIvol, the measured values with the same tube voltage of 120kVp were 2.6mGy with No-ASIR and 2.17mGy with 20%-ASIR respectively, decreased by 0.43mGy, and the values with 100kVp were 1.61mGy with No-ASIR and 1.34mGy with 20%-ASIR, decreased by 0.27mGy. In terms of DLP, the measured values with 120kVp were $103.21mGy{\cdot}cm$ with No-ASIR and $85.94mGy{\cdot}cm$ with 20%-ASIR, decreased by $17.27mGy{\cdot}cm$(about 16.7%), and the values with 100kVp were $63.84mGy{\cdot}cm$ with No-ASIR and $53.25mGy{\cdot}cm$ with 20%-ASIR, a decrease by $10.62mGy{\cdot}cm$(about 16.7%). Conclusion: At lower tube voltage, the rate of dose significantly decreased, but the negative effects on image evaluation was shown due to the increase of noise. For the future, through the result of the experiment, it is considered that the method above would be recommended for follow-up patients or those who get health checkup as long as there is no interference on the process of diagnosis due to the characteristics of Low Dose examination.

• Imaging Science in Dentistry
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• v.39 no.3
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• pp.163-168
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• 2009

Purpose : To assess the clinical findings and hard tissue changes of osteomyelitis of the jaws using computed tomographic (CT) image analysis. Materials and Methods : We reviewed and interpreted the CT images of 163 patients (64 males and 99 females, age range from 10 to 87 years) who visited the Seoul National University Dental Hospital from April 23, 2006 to December 31, 2008 and were diagnosed as osteomyelitis of the jaws through clinical, radiologic, and histopathologic examination. Each CT findings was investigated for frequency, correlation with age and gender. Results : Of the 163 patients, 31 (19.0%) were affected on the maxilla, 135 (82.8%) were affected on the mandible, and 3 (1.8%) were affected on the both jaws simultaneously. The mean age of the patients who were affected on the maxilla was 61.0 years and that of the patients who were affected on the mandible was 56.2 years. On the maxilla, the most frequent site of disease was the posterior area (83.9%) and on the mandible, mandibular body (83.0%), followed by angle (48.1%), ramus (38.5%), condyle (13.3%), incisal area (9.6%), and coronoid process (3.0%). Among the 31 maxillary osteomyelitis, defect in the trabecular bone was observed in 28 (90.3%), osteosclerosis 20 (64.5%), defect in the cortical bone 27 (87.1%), sequestrum 17 (54.8%), and periosteal reaction 2 (6.5%). Among the 135 mandibular osteomyelitis, defect in the trabecular bone was observed in 100 (74.1%), osteosclerosis 104 (77.0%), defect in the cortical bone 116 (85.9%), sequestrum 36 (26.7%), and periosteal reaction 67 (49.6%). Conclusion : Of our cases, the maxillary osteomyelitis was visibly observed more frequently in females than males. The incidence is the highest in seventies (28.8%) and the lowest in teens (3.1%). The osteomyelitis of the jaws was observed more frequently in males than females before the age of 50, and observed more frequently in females after the age of 50. The most noticeable point was that the sequestrum was observed more often on maxillary osteomyelitis and the periosteal reaction was observed more often on mandibular osteomyelitis.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.3
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• pp.178-185
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• 2015

Purpose: The purpose of this study was to conduct a comparative assessment on the satisfaction level for the two interfaces of surgical guide system (SimPlant and R2GATE), the design and convenience of manufactured surgical guides and the importance of using the surgical guides thereof by means of survey. Materials and Methods: Hereupon, they simulated the implant surgical process by mounting the two manufactured systems of surgical guide on a dental mold, respectively. The study subjects were instructed to complete the questionnaire as to the satisfaction level upon completion of the simulated surgery. This study summarized the data of each question after collecting the completed questionnaires. Then, this study analyzed the summarized data by utilizing statistical program SPSS 20.0 (IBM). Results: R2GATE had a higher value of the satisfaction level on the design and convenience of manufactures surgical guides. R2GATE group ($7.33{\pm}1.26$) was found to have a higher value in terms of the overall satisfaction level compared to SimPlant group ($6.67{\pm}1.26$) (${\alpha}$ = 0.05). Conclusion: The user satisfaction level on the surgical guide manufactured for R2GATE system was to such an extent as it can be widely used in clinical environment. Moreover, the surgical guide manufactured as R2GATE system can guide both the length and direction of a drill simultaneously. As a result, it is highly recommended for those beginners who do not have a lot of experience in implant placement.

• Journal of Magnetics
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• v.21 no.2
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• pp.293-297
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• 2016

For mastectomy patients, sufficient doses of radiation should be delivered to the surface of the chest wall to prevent recurrence. A bolus is used to increase the surface dose on the chest wall, whereby the surface dose is confirmed with the use of a virtual bolus during the computerized treatment-planning process. The purpose of this study is an examination of the difference between the dose of the computerized treatment plan and the dose that is measured on the bolus. Part of the left breast of an Anderson Rando phantom was removed, followed by the attainment of computed tomography (CT) images that were used as the basis for computerized treatment plans that were established with no bolus, a 3 mm-thick bolus, a 5 mm-thick bolus, and a 10 mm-thick bolus. For the computerized treatment plan, a prescribed dose regimen was dispensed daily and planning target volume (PTV) coverage was applied according to the RTOG 1304 guidelines. Using each of the established computerized treatment plans, chest-wall doses of 5 points were measured; this chest-wall dose was used as the standard for the analysis of this study, while the level of significance was set at P < 0.05. The measurement of the chest-wall dose with no bolus is 1.6 % to 10.3 % higher, and the differences of the minimum average and the maximum average of the five measurement points are -13.8 and -1.9, respectively (P < 0.05); however, when the bolus was used, the dosage was measured as 3.7 % to 9.2 % lower, and the differences of the minimum average and the maximum average are 7.4 and 9.0, -1.2 and 17.4, and 8.1 and 19.8 for 3 mm, 5 mm, and 10 mm, respectively (P < 0.05). As the thickness of the bolus is increased, the differences of the average surface dose are further increased. There are a variety of factors that affect the surface dose on the chest wall during post-mastectomy radiation therapy, for which verification is required; in particular, a consideration of the appropriate thickness and the number of uses when a bolus is used, and which has the greatest effect on the surface dose on the chest wall, is considered necessary.

• Journal of the Korean Society of Radiology
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• v.13 no.6
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• pp.825-830
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• 2019

A detector module measuring a depth of interaction was developed using silicon photomultiplier (SiPM) and two layers of scintillation crystal array treated with multiple reflectors. When reconstructing an image based on a signal obtained by using different types of reflector of each layer, the interaction positions of scintillation pixels and gamma rays could be tracked by utilizing the feature that all scintillation pixels were recorded at different positions. The bottom layer uses a specular reflector, and the top layer uses a diffuse reflector to differently process the size of the signal obtained from the SiPM. The optical grease was used to recude the sharp refractive index change between the layers of scintillator and the SiPM. The signals obtained from the 16 SiPMs were reduced to four signals using the Anger equations, and the images were reconstructed using them. All the scintillation pixels composed of the two layers appeared in the reconstructed image, which distinguished the layer where the scintillation pixels and gamma rays interacted. If the detectors, which measure the interaction depth of two layers using different reflectors, will be applied to preclinical positron emission tomography, the degradation of spatial resolution appearing outside the field of interest could be solved.

• The Korean Journal of Nuclear Medicine
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• v.24 no.1
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• pp.29-36
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• 1990

Most of the diagnostic methods currently used for the detection of neoplastic masses provide indirect evidence. To obtain greater specificity in the interpretation of neoplasias by in vivo methods, the immunological approach appears to be most promising. Two problems that interfered with progress in this field were the lack of tumor specific antigen and the lack of well-defined and reproducible antibodies. To improve the sensitivity and specificity of radioimmunoscintigraphy as a technique for tumor localization, the use of monoclonal antibodies, fragments of antibodies and single photon emission computerized tomography (SPECT) are reasonable. The obvious advantages of monoclonal antibodies are their homogeneity, their specificity for the immunizing antigen and the reaction with a single determinant-thus no large immunecomplexes with antigen are formed. Monoclonal antibody technique has recently provided an opportunity to reevaluate the role of nuclear medicine for the diagnosis of malignant diseases by using the immunological approach. Out first results by means of radioimmunoscintigraphy of CEA and CA 19-9 producing tumors using a cocktail of fragments F $(ab')_2$, of mocolonal antibodies to CA 19-9 and CEA labeled with $^{131}I$ (IMACIS-1) are reported. The aims of this investigation was to evaluate the role of immunoscintigraphy in patients with colorectal and other cancers for diagnosis of local recurrences and metastasis. This report contains results of the first 8 colorectal and pancreas cancer patients with the elevation of the level of serum CEA and/or CA 19-9. IMACIS-1 was injected intravenously during 30 minutes in 100 ml saline solution after skin test. Planar scintigrams were recorded 3, 5 and 7 days after the injection of the IMACIS-1. Anterior, lateral and posterior views of the liver as well as anterior and posterior views of the pelvis were obtained in each patients as an $^{131}I-antibody$ image. We were able to localize exactly the malignant process with the double-nuclide double-compound $^{99m}Tc\;^{131}I$ (Tc+l) scintigrams. In Tc & I double-nuclide scintigraphy, computer subtraction display provided more clear localization of the tumor. We compared the results of radioimmunoscintigraphy with CT, ultrasonograms, conventional scintigrams. The results were as follows: 1) The sensitivity and specificity of radioimmunoscintigraphy using the fragments $F(ab')_2$ of the cocktails of CEA and CA 19-9 monoclonal antibodies were 80% and 100% respectively. 2) Tumor detection rate was not proportionated to the level of serum tumor markets. 3) Second tracer technique was essential for tumor localization as an anatomic landmark using double-nuclide scintigraphy. 4) A slow infusion of the antibodies was necessary to prevent the formation of large immune complexes. 5) Tumor/non-tumor radioactivity was most elevated at 7 days delayed imaging. 6) Using planar scintigraphic technique of $^{131}I$ labeled monoclonal antibodies are possible for imaging most of the tumors.