• Journal of Magnetics
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• v.21 no.1
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• pp.115-124
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• 2016

The present study analyzes T1 TSE and T1 slice sel. IR (dark_fluid) signal strength according to the degree of gadolinium contrast agent dilution and analyzes the turbo factors with regard to changes in the maximum and overall signal strength to study correlations between changes and signal-to-noise ratios (SNRs) and compare peak-to-peak SNR (PSNR) enhancement in order to improve the quality of T1-weighted images. Enhancement TR (600 msec) evaluated to determine the T1 TSE turbo factor and obtain the maximum signal strength, T1WI were used sequentially to experiment with turbo factors_1-4. T1 slice sel. IR (dark-fluid) was used to sequentially test turbo factors_2-5 but not turbo factor_1 at a TR (1500 msec) and compare data at an increase in T1 of 900 msec. The T1 TSE was reduced according to the contrast agent concentration. Phantom signal strength increased, whereas turbo factors_1-4 exhibited maximum signal strength at a concentration of 3 mmol, followed by a gradual decrease. In the turbo factors_2-5, the signal strength increased sharply to maximum signal strength at 0.7 mmol, followed by a reduction. T1 TSE had a greater maximum signal strength than did T1 slice sel. IR (dark_fluid). A comparison of SNR found that T1 TSE imaging was superior (33.3 dB) in turbo factor_1 and T1 slice sel. IR (dark_fluid) was highest (33.9 dB) at turbo factor_5. A PSNR comparison analysis was not sufficient to distinguish between the images obtained with both techniques at 30 dB or higher under all experimental conditions.

• The Journal of Korean Society for School & Community Health Education
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• v.8 no.1
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• pp.69-77
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• 2007

Background & Objectives: International radiation protection committee recognized the importance of radiation protection from medical practices because the exposure to the radiation in medical practice is higher than any other exposure. The factors on knowledge, attitude and practice of radiation safety of the medical workers engaged in radiation were analyzed in order to improve radiation safety technology. Method: Questionnaires were used for 1200 radiation workers in medical institution from July 23 through September 4 and collected for analysis. Results: Different level of safety measures were practiced by age, marital status, career, and medical facility. The difference was statistically significant. Higher levels of safety measures were practiced in the age group of 50s and married persons. The workers who have more than 20 years experience have higher level of safety measures. The workers of health centers have higher level of safety measures to compare with other workers. The factors which give more concerns on safety practice were self efficacy, practice and knowledge in order. Conclusion: Safety conscious operators should get additional education program to maintain higher level of safety. The operators who do not have much safety concern should be intensive training program for self efficacy and safety.

• Health Policy and Management
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• v.7 no.1
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• pp.125-154
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• 1997

The hospital, clinical department and the physician factor in explaining variations of hospital resource use in surgically admitted patients was compared. This analysis was based on 6, 361 discharges in 28 hospitals for three surgical conditions - lens procedures anal and stomal procedures, uterine and ovarian procedures using medical insurnce claim data. The results were as follows: 1. Regression analysis indicated that the hospital and clinical department characteristics, such as hospital ownership and size, were more significant predictors of the resource use indicators than the physician and patients' social characteristics. 2. Regarding to the physician factors, the hospital where the physician received the residency training and the medical shool where he/she graduated had less effect compared to the hospitals where he/she currently works. Between the residency trained hospital and medical school, the is more important than the latter. 3. When the hospital charges were divided into type of service provided i. e. room, drug, laboratory & radiologic, procedure & operation, and anesthesic charges, variance due to the hospital factor was larger than that due to the physician factor in each item. In summary, the hospital and clinical departmental factor played an important role than physician factor ; indicating to reduce the variation in hospital resource use, the policy that affects hospital behavior would be more effective than that targets individual physician behavior.

• Journal of Korean Neurosurgical Society
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• v.61 no.1
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• pp.1-9
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• 2018

Posttraumatic delayed vertebral collapse, known as Kummell's disease, is increasing in number of patients. This disease is already progressive kyphosis due to vertebral collapse at the time of diagnosis and it causes intractable pain or neurologic deficit due to intravertebral instability. Treatment is very difficult after progression of the disease, and the range of treatment, in hospital day, and cost of treatment are both increased. Clinical features, pathogenesis and radiologic findings of these disease groups were reviewed to determine risk factors for delayed vertebral collapse. The purpose of this article is to suggest appropriate treatment before vertebral collapse for patients with osteoporotic vertebral compression fracture who have risk factors for posttraumatic delayed vertebral collapse.

• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.119-124
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• 2016

Background: The purpose of this study is to evaluate the functional outcomes of reverse total shoulder arthroplasty (RTSA) and to assess factors affecting the patients' subjective satisfaction after RTSA. Methods: Forty-three patients (mean age, $75.0{\pm}5.2years$) who underwent RTSA for cuff tear arthropathy or irreparable cuff tears with preoperative magnetic resonance imaging and pre- and postoperative radiographs at 1 year, and whose various functional outcomes including pain visual analogue scale (VAS), simple shoulder test, Constant score, American Shoulder and Elbow Surgeons score, and active range of motion were evaluated preoperatively and at the last follow-up (>12 months) were enrolled. The outcome parameter was set as a satisfaction scale. Various clinical and radiographic factors were analyzed, and their correlations with postoperative satisfaction were evaluated. Results: All functional scores, VAS pain score, and active forward flexion showed significant improvement after surgery (all p<0.001). Twenty-nine patients were satisfied with the results and 14 were dissatisfied. The presence of pseudoparalysis (p=0.028) and worse preoperative function (all p<0.05) were related with higher satisfaction. Any radiologic parameters did not affect patients' postoperative satisfaction. Conclusions: All patients showed a good functional outcome after RTSA, however the patients' subjective postoperative satisfaction was affected by preoperative functional status (higher satisfaction in poor preoperative function), not by radiological findings.

• Journal of Korean Neurosurgical Society
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• v.38 no.6
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• pp.445-449
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• 2005

Objective : This study is performed to evaluate the clinical manifestations and prognostic factors among patients with pyogenic spinal infections. Methods : The records and radiologic data of 27 patients treated between 2001 and 2003 were retrospectively evaluated. Results : All patients [mean age, 55.2yrs] were treated with i.v. antibiotics and 13[48.1%] required surgical treatment. Mean follow up duration was 38.9 weeks. The sixteen patients[59.2%] had previous surgical procedure on spine and six patients[22.0%] had local injections. The ten patients had predisposing factor [such as, diabetes mellitus, UTI, liver cirrhosis, septic condition]. The most common symptoms are lower back pain and motor weakness. Causative organisms determined only in ten patients[37%] and Staphylococcus aureus[50%] was most common. C-reactive protein[CRP] and white blood cell[WBC] count were more correlated with clinical outcome than erythrocyte sedimentation rate[ESR]. Conclusion : CRP and WBC level can be significant parameters of treatment and prognosis in pyogenic spinal infection.

• Journal of Korean Neurosurgical Society
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• v.62 no.5
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• pp.586-593
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• 2019

Objective : To study risk factors of secondary lumbar discectomy (LD) for recurrent herniated lumbar disc (HLD) and identify methods to lower the rate of recurrence. Methods : Data from 160 patients who underwent primary LD were collected retrospectively. Demographic features, radiologic findings including Pfirrmann disc degeneration, and surgical information were analyzed to compare risks between revision and non-revision patients. Results : The revision rate was 15% (24 patients), and the mean follow-up was 28.3 months. HLD recurrence was not related to any demographic characteristics. Primary and secondary LD were most common at the L4-5 level, but the level of operation was not significantly associated with revision. Primary LD most commonly had a Pfirrmann disc degeneration grade of 3, followed by 4. For recurrent HLD, Pfirrmann grade 4 was most common and was statistically significant (p<0.05). A body mass index (BMI) over 30 was considered obese and was significantly related with HLD revision (p<0.05). Conclusion : Patients with high BMI or severe disc degeneration should be informed of HLD revision.

• Journal of radiological science and technology
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• v.21 no.2
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• pp.19-25
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• 1998

By analyzing each part of expsure condition and the status of an entrance dose which is exposed to patients, this study reached the following conclusion. Since there is no standard in setting up an exposure condition, the technology practiced in each facility varies tremendously, and the entrance dose increased especially due to the improper selection of screen and grid and the shortage of a total amount of filtration in leaching the standard filtration amount. Entrance dose was, generally, turned out to be $2{\sim}3$ times as much as that of advanced countries, and there was big difference between facilities ; approximately 52 times inlateral of cervical vertebrae, 35 times in A-P of femur, 33 times in chest A-P, and 11 times in lumber A-P. Therefore, to minimize the entrance dose of a patient with thegreatest amount of image information, acquirement of technological know-how necessary for standardization of exposure condition for each part can be an important research task.

• Clinical Pain
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• v.19 no.2
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• pp.111-115
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• 2020

We report a case of a healthy 38-year-old man presenting with insufficiency fracture of proximal tibia associated with unrecognized osteoporosis. Radiologic bone DEXA (Dual Energy X-ray Absorptiometry) assessment revealed osteoporosis, but the patient displayed no apparent risk factors for insufficiency fractures and osteoporosis except for a history of smoking. Following right proximal tibial open reduction and internal fixation, the patient commenced smoking cessation and began taking alendronate. The patient was treated for gait rehabilitation, which included quadriceps strengthening exercises and his condition improved with independent walking. This report highlights an unusual site of proximal tibial insufficiency fractures and the potential effect of smoking on low bone mineral density in a young male patient.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1055-1062
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• 2000

Objectives : Burst fracture of the lower lumbar spine(L3-L5) is rare and has some different features compare to that of thoracolumbar junction. Lower lumbar spine is flexible segments located deeply, and has physiologic lordosis. All of these contribute to making surgical approach difficult. Generally, lower lumbar burst fracture is managed either anteriorly or posteriorly with various fixation and fusion methods. But there is no general guideline or consensus regarding the proper approach for such lesion. We have tried to find out the influencing factors for selecting the surgical approach through the analysis of lower lumbar burst fractures treated for last 4 years(1994.3-1998.3). Method : This study includes 15 patients(male : 10, female : 5, age range 20-59 years with mean age of 36.7 years, L3 : 8 cases, L4 : 5 cases, L5 : 2 cases). Patients were classified into anterior(AO) and posterior operated(PO) groups. We investigated clinical findings, injured column, operation methods, and changes in follow-up radiologic study (kyphotic angle) to determine the considerable factors in selecting the surgical approaches. Results : There were 5 AO and 10 PO patients. Anterior operation were performed with AIF with Kaneda or Z-plate and posterior operation were done with pedicle screw fixation with PLIF with cages or posterolateral fusion. Canal compression was 46.6% in AO and 38.8% in PO. The degree of kyphotic angle correction were 10.7 degree(AO) and 8.5 degree(PO), respectively. There was no statistical difference between anterior and posterior operation group. All patients showed good surgical outcome without complications. Conclusion : Anterior operation provided good in kyphotic angle correction and firm anterior strut graft, but it difficulty arose in accessing the lesions below L4 vertebra. While posterior approach showed less correction of kyphotic angle, it required less time and provided better results for accompanied adjacent lesion and pathology such as epidural hematoma. The level of injury, canal compression, biomechanics, multiplicity, and pathology are considered to be important factors in selection of the surgical approach.