• Journal of Korean Neurosurgical Society
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• 제52권6호
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• pp.534-540
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• 2012

Objective : Brainstem arteriovenous malformation (AVM) is rare and radiosurgical management is complicated by the sensitivity of the adjacent neurological structures. Complete obliteration of the nidus is not always possible. We describe over 20 years of radiosurgical procedures for brainstem AVMs, focusing on clinical outcomes and radiosurgical techniques. Methods : Between 1992 and 2011, the authors performed gamma knife radiosurgery (GKRS) in 464 cerebral AVMs. Twenty-nine of the 464 patients (6.3%) reviewed had brainstem AVMs. This series included sixteen males and thirteen females with a mean age of 30.7 years (range : 5-71 years). The symptoms that led to diagnoses were as follows : an altered mentality (5 patients, 17.3%), motor weakness (10 patients, 34.5%), cranial nerve symptoms (3 patients, 10.3%), headache (6 patients, 20.7%), dizziness (3 patients, 10.3%), and seizures (2 patients, 6.9%). Two patients had undergone a previous nidus resection, and three patients had undergone a previous embolization. Twenty-four patients underwent only GKRS. With respect to the nidus type and blood flow, the ratio of compact type to diffuse type and high flow to low flow were 17 : 12 and 16 : 13, respectively. In this series, 24 patients (82.8%) had a prior hemorrhage. The mean target volume was 1.7 $cm^3$ (range 0.1-11.3 $cm^3$). The mean maximal and marginal radiation doses were 38.5 Gy (range 28.6-43.6 Gy) and 23.4 Gy (range 18-27 Gy), and the mean isodose profile was 61.3% (range 50-70%). Results : Twenty-four patients had brainstem AVMs and were followed for more than 3 years. Obliteration of the AVMs was eventually documented in 17 patients (70.8%) over a mean follow-up period of 77.5 months (range 36-216 months). With respect to nidus type and blood flow, the obliteration rate of compact types (75%) was higher than that of diffuse types (66.7%), and the obliteration rate of low flow AVMs (76.9%) was higher than that of high flow AVMs (63.6%) (p<0.05). Two patients (6.9%) with three hemorrhagic events suffered a hemorrhage during the follow-up period. The annual bleeding rate of AVM after GKRS was 1.95% per year. No adverse radiation effects or delayed cystic formations were found. Conclusion : GKRS has an important clinical role in treatment of brainstem AVMs, which carry excessive surgical risks. Angiographic features and radiosurgical techniques using a lower maximal dose with higher isodose profiles are important for lesion obliteration and the avoidance of complications.

• 대한의용생체공학회:의공학회지
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• 제43권5호
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• pp.341-352
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• 2022

Medical image segmentation is the most important task in radiation therapy. Especially, when segmenting medical images, the liver is one of the most difficult organs to segment because it has various shapes and is close to other organs. Therefore, automatic segmentation of the liver in computed tomography (CT) images is a difficult task. Since tumors also have low contrast in surrounding tissues, and the shape, location, size, and number of tumors vary from patient to patient, accurate tumor segmentation takes a long time. In this study, we propose a method algorithm for automatically segmenting the liver and tumor for this purpose. As an advantage of setting the boundaries of the tumor, the liver and tumor were automatically segmented from the CT image using the 2D CoordConv DeepLab V3+ model using the CoordConv layer. For tumors, only cropped liver images were used to improve accuracy. Additionally, to increase the segmentation accuracy, augmentation, preprocess, loss function, and hyperparameter were used to find optimal values. We compared the CoordConv DeepLab v3+ model using the CoordConv layer and the DeepLab V3+ model without the CoordConv layer to determine whether they affected the segmentation accuracy. The data sets used included 131 hepatic tumor segmentation (LiTS) challenge data sets (100 train sets, 16 validation sets, and 15 test sets). Additional learned data were tested using 15 clinical data from Seoul St. Mary's Hospital. The evaluation was compared with the study results learned with a two-dimensional deep learning-based model. Dice values without the CoordConv layer achieved 0.965 ± 0.01 for liver segmentation and 0.925 ± 0.04 for tumor segmentation using the LiTS data set. Results from the clinical data set achieved 0.927 ± 0.02 for liver division and 0.903 ± 0.05 for tumor division. The dice values using the CoordConv layer achieved 0.989 ± 0.02 for liver segmentation and 0.937 ± 0.07 for tumor segmentation using the LiTS data set. Results from the clinical data set achieved 0.944 ± 0.02 for liver division and 0.916 ± 0.18 for tumor division. The use of CoordConv layers improves the segmentation accuracy. The highest of the most recently published values were 0.960 and 0.749 for liver and tumor division, respectively. However, better performance was achieved with 0.989 and 0.937 results for liver and tumor, which would have been used with the algorithm proposed in this study. The algorithm proposed in this study can play a useful role in treatment planning by improving contouring accuracy and reducing time when segmentation evaluation of liver and tumor is performed. And accurate identification of liver anatomy in medical imaging applications, such as surgical planning, as well as radiotherapy, which can leverage the findings of this study, can help clinical evaluation of the risks and benefits of liver intervention.

• 한국농림기상학회지
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• 제25권4호
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• pp.284-301
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• 2023

본 연구에서는 1km 고해상도 앙상블 신기후변화 시나리오(공통사회 경제경로 시나리오) 자료를 기반으로 하여 남한을 포함한 한반도 전체의 벼 기후생산성(CYP) 변화를 평가하였다. 이때, 기후변화 시나리오자료에서 제공하는 제한적인 변수를 활용하기 위해 일조시간을 대신하여 일사량을 이용하였다. 연구 결과에 따르면, 현재 기후에 비해 온난화된 미래 기후조건에서 CYPmax 값은 감소하고 최적출수일은 점차 늦춰지는 경향이 나타났다. 이는 고도가 높은 한반도 북동부의 산악 지역을 제외하고 모든 지역에서 나타나는 현상이며, 특히 온난화가 빠르게 진행되는 SSP585시나리오 일수록 더욱 뚜렷하게 나타났다. 이러한 결과는 낮은 배출 시나리오의 이점을 보여주는 동시에 온실 가스 배출을 제한하기 위해 더 많은 노력을 기울일 필요가 있음을 강조한다. 한편, CYPmax의 시계열에서 넓은 폭의 앙상블 스프레드가 나타났는데, 이는 단일모형 혹은 작은 수의 모형을 선택하였을 때 미래 변화 분석에 내재된 불확실성을 보여주며 앙상블 예측의 중요성을 보여준다. 본 연구를 통해 분석된 장기간의 기온 및 일사 조건의 변화에 따른 기후학적 벼 생산성 변화 및 불확실성에 대한 분석은 기후변화 대응을 위한 기초정보로써 가치가 있다.

• 대한영상의학회지
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• 제83권1호
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• pp.54-69
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• 2022

심장 돌연사 환자들은 종종 흉통 또는 운동성 호흡곤란 등의 전조증상이 나타나지 않기 때문에 잠재적인 무증상 관상동맥 질환을 조기에 발견하는 것이 매우 중요하다. 관상동맥 전산화단층촬영 혈관조영술은 방사선 노출로 인한 위험성 때문에 무증상 환자에서 스크리닝 검사로 정당화되지 못했었지만 최근에 전산화단층촬영 기술의 비약적인 발전으로 방사선량을 1 mSv 미만으로 최소화함으로써 무증상 환자의 관상동맥 질환 선별 검사의 유용성에 대한 많은 연구가 진행되어 왔다. 그러나, 여전히 무증상 정상인 또는 환자의 관상동맥 질환 선별 검사에 대한 관상동맥 전산화단층촬영 혈관조영술의 유용성에 대해서는 다양한 의견들이 있다. 이 종설에서는 무증상 정상인 또는 환자들에게 관상동맥 질환 선별 검사로 관상동맥 칼슘 점수와 관상동맥 전산화단층촬영 혈관조영술 유용성에 대해서 다양한 문헌고찰을 통해서 알아보았다. 관상동맥 전산화단층촬영 혈관조영술상 무증상 정상인의 2.6%에서 70% 이상의 유의한 관상동맥 협착이 발견되었고, 선별 목적의 관상동맥 전산화단층촬영 혈관조영술이 무증상 건강한 사람의 미래의 심혈관 질환 발생을 예측할 수 있다. 그러나 현재 미국국립보건원에서 진행하고 있는 SCOT-HEART 2 연구가 끝나면 관상동맥 전산화단층촬영 혈관조영술이 무증상 성인의 심혈관 예방에 선별 검사로 적절한지 결정을 내릴 수 있을 것으로 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4791-4796
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• 2016

Objectives: The purpose of this investigation was to examine the association between endometrial cancer and possible etiological agents. Methods: A case-control study was conducted in Iran between March 2012 and May 2016. The demographic and reproductive factors of 205 women with endometrial cancer were compared, and 590 healthy cases were participated in the control group. For each endometrial cancer case, there were three controls, who were matched in terms of age and residence. The data were considered significant at $p{\leq}0.05$. Results: After adjusting the variables, the nulliparity (OR 6.23, 95% CI 2.86-13.59), the nulligravidity (OR 5.94, 95% CI 2.51-14.06), the positive family history of reproductive cancer (OR 4.97, 95% CI 2.33-10.59), the infertility history (OR 2.38, 95%CI 1.32-4.31), the obesity ($BMI{\geq}25$) (OR 1.71, 95% CI 1.16-2.52), the early menarche age (<12 years) (OR 2.10, 95% CI 1.17-3.75), and the hormonal contraception use (OR 1.69, 95% CI 1.15-2.49) were found to be associated with an increased risk of endometrial cancer. Nevertheless, the education level, the job of women, the marital age, the leisure activities, and the breast feeding were not found to be associated with the endometrial cancer after adjusting the variables. Conclusion: Scheduling of the screening program is vitally indispensable to identify endometrial cancer in women with nulliparity, nulligravidity and the positive family history of cancer. In addition, women with early menarche, those with the history of infertility, the obese ones, and those who use contraception pills need to be particularly aware of the potential risks.

• 한국방사선학회논문지
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• 제6권2호
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• pp.115-120
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• 2012

레이저 기술의 발전과 더불어 다양한 의료영역에서 레이저가 사용되고 있으며 그로 인한 위험성도 증가하고 있다. 레이저를 안전하게 사용하기 위해서는 레이저의 안전에 관한 지식을 가지고 관리할 수 있는 사람이 지정될 필요가 있다. 이에 따라 많은 나라에서 레이저안전관리자 체제를 운영하고 있다. 의료레이저안전관리자는 레이저의 안전사용과 관련하여 교육과 훈련 등의 권한과 책임을 가진다. 본 연구에서는 의료레이저안전관리자의 미국의 운영현황을 살펴보고 의료레이저안전관리자의 역할과 국내 도입 방안을 살펴보았다.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제14권6호
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• pp.2480-2496
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• 2020

Considering that high-dose X-ray radiation during CT scans may bring potential risks to patients, in the medical imaging industry there has been increasing emphasis on low-dose CT. Due to complex statistical characteristics of noise found in low-dose CT images, many traditional methods are difficult to preserve structural details effectively while suppressing noise and artifacts. Inspired by the deep learning techniques, we propose a densely connected residual network (DCRN) for low-dose CT image noise cancelation, which combines the ideas of dense connection with residual learning. On one hand, dense connection maximizes information flow between layers in the network, which is beneficial to maintain structural details when denoising images. On the other hand, residual learning paired with batch normalization would allow for decreased training speed and better noise reduction performance in images. The experiments are performed on the 100 CT images selected from a public medical dataset-TCIA(The Cancer Imaging Archive). Compared with the other three competitive denoising algorithms, both subjective visual effect and objective evaluation indexes which include PSNR, RMSE, MAE and SSIM show that the proposed network can improve LDCT images quality more effectively while maintaining a low computational cost. In the objective evaluation indexes, the highest PSNR 33.67, RMSE 5.659, MAE 1.965 and SSIM 0.9434 are achieved by the proposed method. Especially for RMSE, compare with the best performing algorithm in the comparison algorithms, the proposed network increases it by 7 percentage points.

• 비파괴검사학회지
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• 제28권1호
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• pp.64-69
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• 2008

압력용기 및 구조물 용접부의 내부결함을 검출하기 위해서는 방사선투과시험과 초음파탐상시험을 시행한다. 그러나 방사선투과시험은 방사선 노출 위험성과 필름 현상처리 소요 등으로 결과의 확인에 상대적으로 긴 시간이 소요되어 제작 공정에 영향을 준다. 일반적인 수동 초음파탐상시험은 결과의 재현이 용이하지 않으며 검사자의 기량에 대한 의존도가 높다는 문제점을 가지고 있다. 이에 대한 대안으로 자동 초음파탐상시험 기법의 하나인 TOFD의 적용이 확산되고 있다. 본 연구는 결함을 포함한 시험편에 대하여 방사선투과 시험과 TOFD 기법을 적용하고 비교한 결과를 기술하였다. TOFD 기법은 초음파 시험기법의 객관적 신뢰도 향상에 기여하게 될 것으로 판단된다.

• Design & Manufacturing
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• 제16권4호
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• pp.52-59
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• 2022

Currently, Korea is an aging society and is expected to become a super-aged society in about four years. X-ray devices are widely used for early diagnosis in hospitals, and many X-ray technologies are being developed. The development of X-ray device technology is important, but it is also important to increase the reliability of the device through accurate data management. Sensor nodes such as temperature, voltage, and current of the diagnosis device may malfunction or transmit inaccurate data due to various causes such as failure or power outage. Therefore, in this study, the temperature, tube voltage, and tube current data related to each sensor and detection circuit of the diagnostic X-ray imaging device were measured and analyzed. Based on QC data, device failure prediction and diagnosis algorithms were designed and performed. The fault diagnosis algorithm can configure a simulator capable of setting user parameter values, displaying sensor output graphs, and displaying signs of sensor abnormalities, and can check the detection results when each sensor is operating normally and when the sensor is abnormal. It is judged that efficient device management and diagnosis is possible because it monitors abnormal data values (temperature, voltage, current) in real time and automatically diagnoses failures by feeding back the abnormal values detected at each stage. Although this algorithm cannot predict all failures related to temperature, voltage, and current of diagnostic X-ray imaging devices, it can detect temperature rise, bouncing values, device physical limits, input/output values, and radiation-related anomalies. exposure. If a value exceeding the maximum variation value of each data occurs, it is judged that it will be possible to check and respond in preparation for device failure. If a device's sensor fails, unexpected accidents may occur, increasing costs and risks, and regular maintenance cannot cope with all errors or failures. Therefore, since real-time maintenance through continuous data monitoring is possible, reliability improvement, maintenance cost reduction, and efficient management of equipment are expected to be possible.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제50권1호
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• pp.41-48
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• 2024

Objectives: Botulinum toxin type A (BTX), a powerful neurotoxin, can be an effective treatment choice for diverse muscular disorders and can reduce abnormal muscle activities. Abnormal movements of the mandible can be caused by involuntary and uncontrolled contractions of the lateral pterygoid muscle (LP) in various pathological situations. Previous reports have shown that BTX can reduce abnormal contractions of the LP. However, needle placement into the LP for BTX injection requires skill, experience, and sufficient anatomical knowledge. To place the needle precisely into the LP, ultrasonography (USG) can be used as an effective needle-guidance modality. USG is a non-invasive imaging modality able to create real-time images without any potential risks, including radiation exposure. Patients and Methods: The patients who had been performed USG-guided BTX injection into the LP using an intraoral approach were included in this study with a literature review and case presentations. Using the USG, four patients received BTX injections to treat recurrent temporomandibular dislocation and oromandibular dystonia resulting from involuntary LP activity. Result: Involuntary movements of the mandible were improved successfully in all patients, and showed satisfactory results without significant complication. Conclusion: The intraoral approach could prevent potential complications during needle placement. USG-guided BTX injection is an effective, convenient, and safe method that provides real-time imaging without unnecessary pain to the patient.