• Journal of Korean Neurosurgical Society
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• 제29권5호
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• pp.644-649
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• 2000

저자들의 방법으로 급성 수두증이 지속되는 환자를 치료한다면 첫째, 뇌압이 상승된 환자에서 요추지주막하 배액의 가장 우려되는 합병증인 탈뇌의 가능성을 미리 예측 할 수 있고 둘째, 뇌실외배액을 뇌실염 발생 이전에 요추지주막하배액으로 대치하여 뇌실염을 예방할 수 있으며 셋째, 뇌실외배액으로 인하여 뇌실염이 이미 발생한 경우에는 요추지주막하 배액으로 치환하여, 이물질(foreign body)로 작용하여 감염치료를 저해하는 뇌실내 카테터를 제거할 수 있고 동시에 경막내 항생제 투여로 뇌실염의 치료를 기대할 수 있으며 넷째, 요추지주막하 배액은 뇌실외배액에 비해 반복적 시술에 따른 두개강내 출혈, 경련 등의 위험으로부터 안전하며 천자가 가능한 부위가 많아 기간이 오래되거나 혹은 천자가 실패하여 다른 부위로 옮겨야할 때 위치 변경이 용이하다는 등의 장점이 기대된다. 본 교실에서는 여러 가지 원인으로 인하여 발생한 급성 수두증이 조기에 해결되지 않고 잔존혈괴나 감염 등의 이유로 단락술을 바로 시행할 수도 없는 경우에 간단한 시험을 통하여 탈뇌의 가능성을 배제한 다음 뇌실외배액을 요추지주막하 배액으로 치환하여 치료함으로써 좋은 결과를 얻었기에 이러한 곤란한 경우의 치료법의 한가지 대안으로 제안하고자 한다.

• 대한방사선기술학회지:방사선기술과학
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• 제37권3호
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• pp.169-175
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• 2014

2013년 국민건강보험심사평가원의 의료기관 데이터베이스에 따르면 1118개의 병.의원에 영상의학과가 개설되어있다. 이들 병원에는 CT, 투시촬영장치, 일반촬영장치와 같은 의료용 방사선 발생장치가 운영되고 있다. 이 중에서도 일반촬영장치는 가장 많은 병원에서 운영되고 있는 장비이다. 일반촬영장치의 경우 film-screen 장치에서 digital radiography 로 급격하게 변하고 있다. 하지만 그 촬영기법은 films-screen 기법을 그대로 사용하고 있어 디지털 장치의 맞는 촬영기법의 개발을 위한 전반적인 실태 조사가 필요하다. 이에 본 연구에서는 국내 의료기관의 일반촬영기법에 관한 조사를 시행하여 실제 병원에서 사용하고 있는 일반촬영기법의 기술적 항목에 대한 현황을 파악하여 보았다. 본 연구에서는 의료기관에서 일반적으로 사용되는 일반촬영기법 26개에 대한 촬영기법의 전국 단위 조사에서 흉부, 두부, 척추, 골반에 해당하는 검사에 대한 분석을 시행하였다.

• Journal of Trauma and Injury
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• 제23권1호
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• pp.38-42
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• 2010

Purpose: The clinical utility of brain computed tomography (CT) in detecting temporal bone fracture is not well established. We performed this study to determine the utility of brain computed tomography (CT) in detecting fractures of the temporal bones in correlation with fracture patterns. We used high resolution computed tomography (HRCT) as the gold standard for diagnosing temporal bone fracture and its pattern. Methods: From January 2007 to December 2009, patients who underwent both brain CT and HRCT within 10 days of head trauma were investigated. Among them, 58 cases of temporal bone fracture confirmed by HRCT were finally included. Fracture patterns (transverse or non-transverse, otic capsule sparing or otic capsule violating) were determined by HRCT. Brain CT findings in correlation with fracture patterns were analyzed. Results: Among 58 confirmed cases of temporal bone fracture by HRCT, 14 cases (24.1%) were not detected by brain CT. Brain CT showed a significantly lower ability to detect temporal bone fracture with transverse component than without transverse component (p=0.020). Moreover, brain CT showed lower ability to detect otic capsule violating pattern than otic capsule sparing pattern (p=0.015). Among the 14 cases of temporal bone fracture that were not detected by brain CT, 4 cases lacked any objective physical findings (facial palsy, hemotympanum, external auditory canal bleeding) suggesting fractures of the temporal bones. Conclusion: Brain CT showed poor ability to detect temporal bone fracture with transverse component and otic capsule violating pattern, which is associated with a poorer clinical outcome than otic capsule sparing pattern. Routine use of HRCT to identify temporal bone fracture is warranted, even in cases without evidence of temporal bone fracture on brain CT scans or any objective physical findings suggestive of temporal bone fracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권2호
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• pp.118-126
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• 2006

In oral and maxillofacial surgery, bone graft is very important procedure for functional and esthetic reconstruction. So, many researcher studied about bone graft material like autogenous bone, allograft bone and artificial bone materials. The purpose of this study is to evaluate the quantity of bone generation induced by $Grafton^{(R)}$ graft, human allogenic demineralized bone matrix. Total 24 sites of artificial bony defects prepared using trephin bur(diameter 8 mm) on parietal bone of six adult New Zealand White rabbits. Experimental group had six defect sites which grafted $Grafton^{(R)}$(0.1 cc). Active control group had nine defect sites, into which fresh autogenous bone harvested from own parietal bone was grafted and passive control group had nine defect sites without bone graft. After six weeks postoperatively, the rabbits were sacrificed. The defects and surrounding tissue were harvested and decalcified in 10% EDTA, 10% foamic-acid. Specimens were stained with H&E. New bone area percentage in whole defect area was measured by IMT(VT) image analysis program. Quantity of bone by $Grafton^{(R)}$ graft was smaller than that of autograft and larger than that of empty defects. In histologic view $Grafton^{(R)}$ graft site and autograft site showed similar healing progress but it was observed that newly formed bone in active control group was more mature. In empty defect, quantity and thickness of new bone formation was smaller than in $Grafton^{(R)}$-grafted defect. $Grafton^{(R)}$ is supposed to be a useful bone graft material instead of autogenous bone if proper maintenance for graft material stability and enough healing time were obtained.

• 대한치과교정학회지
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• 제39권2호
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• pp.72-82
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• 2009

본 연구는 골격성 III급 개방교합자의 악교정 수술 전, 후 설골과 상기도의 변화를 3D-CT를 이용하여 관찰하고 이를 정상교합자와 비교하기 위하여 시행하였다. 전치부 개방교합을 동반한 골격성 III급 부정교합으로 진단되어 악교정 수술을 받은 환자 중 12명을 선정 후, 3D-CT를 통해 설골과 상기도의 3차원 입체영상을 분석하여, 악교정 수술 전, 후의 설골의 위치 변화 및 상기도의 부피 변화를 살펴보고, 이의 결과를 정상교합자 10명과 비교하였다. 설골은 골격성 III급 개방교합군에서 악교정 수술 전에 정상교합군의 설골에 비해 전방에 위치하고 있었고 악교정 수술 후 설골은 후, 상방으로 변화하였으나 유의성은 관찰되지 않았다. Hyoid plane과 mandibular plane이 이루는 각은 악교정 수술전의 골격성 III급 개방교합군이 정상교합군보다 큰 값을 나타내었고, 악교정 수술 후에는 그 차이가 더욱 증가하였다. 골격성 III급 개방교합군의 상기도 부피는 정상교합자보다 작으며 이는, 악교정수술 후에 더욱 감소하였다. 3차원 영상 분석 결과, 골격성 III급 개방교합자의 상기도는 정상교합자에 비해 좁으며, 하악골 후퇴술 이후 더욱 감소하기 때문에 이는 수술적 개선의 안정성에 영향을 줄 수 있음을 알 수 있었다.

• 치과방사선
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• 제24권1호
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• pp.115-124
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• 1994

The purpose of this study was to examine the differences in representation of a globular radiopaque mass on the pantomograms and Waters' views and to compare the efficacy of periapical radiograms, pantomograms and Waters' views in detection of defects on the internal walls of the maxillary sinus. This study was performed with dried human skull. For the study of difference of radiopaque mass shadow in the two views, rubber ball with a diameter of 10㎜ was used as the experimental lesion. It was placed successively on the internal wall of the anterior, posterior, medial, lateral walls and floor of the maxillary sinus. To examine the detectability of defects for radiographic techniques, defects were formed in the anterior, posterior, medial, lateral walls, and floor of the maxillary sinus. They were formed with 0.5㎜, 0.75㎜, 1.0㎜, 2.0㎜ and 3.0㎜ sized steel round burs with a slow speed dental handpiece. By subsequently plugging the holes with zinc oxide eugenol paste, radiopaque defects were produced. After that the periapical radiograms, the pantomograms and the Waters' views were taken each and every defect. The obtained results were as follows: 1. Rubber balls placed on each internal wall of the maxillary sinus were correctly depicted on the posterior wall and the floor in case of the pantomogram, and on the anterior wall and the medial wall in case of the Waters' view. 2. On the detectability of defects for each radiographic technique, radiolucent defects were detected in different places for each technique. Periapical radiogram could detect 1.0㎜ defect on the floor of the maxillary sinus, pantomogram could detect 2.0㎜ defect on every internal wall of the maxillary sinus, and Waters' view could detect 3.0㎜ defect on the anterior wall of the maxillary sinus. 3. On the detectability of defects for each radiographic technique, radiopaque defects were detected in different places for each technique. Periapical radiogram could clearly detect 0.5㎜ defect on the floor of the maxillary sinus, pantomogram could detect 0.5㎜ defect on every internal wall of the maxillary sinus, and finally Waters' view could detect 0.5㎜defect on the anterior wall of the maxillary sinus but 0.75㎜ defect on the anterior wall, lateral wall and floor of the maxillary sinus. As the result, the periapical radiogram is the most simple and satisfactory method for investigating in the maxillary sinus. The pantomogram is suitable method for screening of changes in the maxillary sinus. And the Waters' view is available for detect of lesion in the anterior wall of the maxillary sinus. For the purpose of accurate diagnosis and evaluation of lesion in the maxillary sinus, these techniques supplement each other.

• Imaging Science in Dentistry
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• 제46권3호
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• pp.203-210
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• 2016

Purpose: The purpose of this study was to investigate appropriate contrast reference values (CRVs) by comparing the contrast in phantom and clinical images. Materials and Methods: Phantom contrast was measured using two methods: (1) counting the number of visible pits of different depths in an aluminum plate, and (2) obtaining the contrast-to-noise ratio (CNR) for 5 tissue-equivalent materials (porcelain, aluminum, polytetrafluoroethylene [PTFE], polyoxymethylene [POM], and polymethylmethacrylate [PMMA]). Four panoramic radiographs of the contrast phantom, embedded in the 4 different regions of the arch-form stand, and 1 real skull phantom image were obtained, post-processed, and compared. The clinical image quality evaluation chart was used to obtain the cut-off values of the phantom CRV corresponding to the criterion of being adequate for diagnosis. Results: The CRVs were obtained using 4 aluminum pits in the incisor and premolar region, 5 aluminum pits in the molar region, and 2 aluminum pits in the temporomandibular joint (TMJ) region. The CRVs obtained based on the CNR measured in the anterior region were: porcelain, 13.95; aluminum, 9.68; PTFE, 6.71; and POM, 1.79. The corresponding values in the premolar region were: porcelain, 14.22; aluminum, 8.82; PTFE, 5.95; and POM, 2.30. In the molar region, the following values were obtained: porcelain, 7.40; aluminum, 3.68; PTFE, 1.27; and POM, - 0.18. The CRVs for the TMJ region were: porcelain, 3.60; aluminum, 2.04; PTFE, 0.48; and POM, - 0.43. Conclusion: CRVs were determined for each part of the jaw using the CNR value and the number of pits observed in phantom images.

• 전자공학회논문지
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• 제50권2호
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• pp.203-209
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• 2013

Digital Radiography(DR)는 film/screen(F/S)과 비교하여 넓은 계조와 높은 Detective Quantum Efficiency(DQE), Modulation Transfer function(MTF)를 바탕으로 화질의 개선과 저 선량으로 검사가 가능할 것으로 예상됐지만 기대와는 다르게 과노출이 Signal to Noise Ratio(SNR)향상을 가져 오면서 환자 피폭선량의 증가를 가져오게 되었으며 이는 Dose Creep이라는 개념으로 설명 된다. DR에서의 선량 증가 이유는 F/S의 촬영에서 사용했던 관전압(kVp)을 고정 적용하여 Auto Exposure Control(AEC)를 사용하기 때문에 과노출을 유발 할 수 있다. 이에 본 논문은 DR에서 적합한 일반촬영 방법을 제안하고자 관전압이 대조도에 주는 영향, 관전류(mA)변화에 따른 MTF 측정, 머리 모형을 촬영한 영상의 Peak Signal to Noise Ratio(PSNR) 측정을 통해 정량적 평가를 시행 하였다. 그 결과 관전압에 의한 대조도 변화는 후보정 이후 개선이 가능하며, 관전류에 의한 MTF 측정 결과 50%영역은 1.41~1.39 lp/mm, 10% 영역은 3.19~2.8 lp/mm로 관전류 변화에 따른 초점크기 변화는 영상의 해상력에 영향을 주지 않는다. 영상의 PSNR측정 결과는 관전압과 관전류가 증가 하여도 90kVp를 제외하고 30dB 이상으로 시각에 의한 영상의 차이를 인지하기 어렵다. 실험결과를 바탕으로 디지털 일반촬영에서 관전압은 80kVp 이상 100kVp이하, 관전류는 선예도와 상관 관계가 없으므로 선량과 조사시간을 단축 시킬 수 있는 방향으로 사용하기를 제안한다.

• Journal of Periodontal and Implant Science
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• 제46권4호
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• pp.220-233
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• 2016

Purpose: The aim of this study was to present new a model that allows the study of the bone healing process, with an emphasis on the biological behavior of different graft-to-host interfaces. A standardized "over-inlay" surgical technique combined with a differential histomorphometric analysis is presented in order to optimize the use of critical-size calvarial defects in pre-clinical testing. Methods: Critical-size defects were created into the parietal bone of 8 male Wistar rats. Deproteinized bovine bone (DBBM) blocks were inserted into the defects, so that part of the block was included within the calvarial thickness and part exceeded the calvarial height (an "over-inlay" graft). All animals were sacrificed at 1 or 3 months. Histomorphometric and immunohistochemical evaluation was carried out within distinct regions of interest (ROIs): the areas adjacent to the native bone (BA), the periosteal area (PA) and the central area (CA). Results: The animals healed without complications. Differential morphometry allowed the examination of the tissue composition within distinct regions: the BA presented consistent amounts of new bone formation (NB), which increased over time ($24.53%{\pm}1.26%$ at 1 month; $37.73%{\pm}0.39%$ at 3 months), thus suggesting that this area makes a substantial contribution toward NB. The PA was mainly composed of fibrous tissue ($71.16%{\pm}8.06%$ and $78.30%{\pm}2.67%$, respectively), while the CA showed high amounts of DBBM at both time points ($78.30%{\pm}2.67%$ and $74.68%{\pm}1.07%$, respectively), demonstrating a slow remodeling process. Blood vessels revealed a progressive migration from the interface with native bone toward the central area of the graft. Osterix-positive cells observed at 1 month within the PA suggested that the periosteum was a source of osteoprogenitor elements. Alkaline phosphatase data on matrix deposition confirmed this observation. Conclusions: The present model allowed for a standardized investigation of distinct graft-to-host interfaces both at vertically augmented and inlay-augmented sites, thus possibly limiting the number of animals required for pre-clinical investigations.

• 대한간호학회지
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• 제5권1호
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• pp.133-143
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• 1975

Most of mothers place their babies in either supine or prone position without change of position. Studies comparing supine and prone position of the newborn infants -have already been performed with the result that the prone position is relatively better than the supine position. However, one kind of position recommended to the mothers is not sufficient for the good rearing practice of children, because the same position placed for period long of time may bring out physical, mental tension and fatigue, and deformities of the skull and the thorax. For this reason nurses have to find out other position which has identical or more advantages than prone position so as to perform the position change for the babies. Main purpose of this study is to identify the differences of vital signs, the number of urination, defecation, diaper rash, crying and amount of feeding of the newborn infants with prone position or lateral position during the first three days of life. Sixty two newborn infants who were delivered at Seoul National University Hospital during the period from July 1 to September 5, 1974 were chosen as subjects for this study. The criteria for the choice of subjects were the babies born with vaginal delivery; body weight 2.5kg or over at birth; Apgar score Seven or over; and gestation period between thirty-eight months ana forty- two months. Of these subjects, by random sampling, thirty-one newborn infants were placed in the prone position and the other thirty-one in the lateral position. The results of this study reviewed in a statistical analysis of the t-test to obtain the following findings : 1. The heart rates of babies in the prone position were the mean heart rates of 135.03 and those in the lateral position 135.98 without any statistically significant difference. 2. There was no significant difference of respiration rate between two groups : a group in the prone position showed the mean respiration rates of 45,57 and the other in the lateral position 46.49. 3. There was no significant difference of body temperature between two groups: the mean body temperature of a group placed in the prone position was 98$^{\circ}$18'F(36$^{\circ}$77'C) and that of the other group 98$^{\circ}$20'F(36$^{\circ}$78'C). 4. One baby showed diaper rash only in a group of infants in the prone position. 5. The number of crying of the babies in the prone position were 23.70 and those in the lateral position 30.00 with a statistical difference at 5 percent level. 6, There was no difference of frequency of urination between two groups: the mean frequency of a group placed in tile prone position was 5.44 and that of the other group 5.06, 7. There was no significant difference of frequency of defecation between two groups : the mean frequency of a group placed in the prone position was 4.20 and that of tile other group 4.21, 8. There was no significant difference of feeding amount between two groups : the average amount of a group in the prone position showed 325.03 and that of the other group in the lateral position 291.51. All the above results mean that we may substitute tile lateral position for the Prone position or utilize both position for tile rearing practice of the babies.