• Journal of the Korean Orthopaedic Association
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• v.56 no.3
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• pp.208-214
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• 2021

Purpose: Verifying a reliable predictor of the progression of vertebral deformity in patients with acute osteoporotic fractures of the lumbar spine may be useful. A qualitative analysis of the muscle near the spine was performed using magnetic resonance imaging (MRI), and its correlation with a spinal deformity was determined under the hypothesis that the causes of the kyphotic deformity are associated with muscle reduction in the multifidus and erector spinae. Materials and Methods: The study was performed in a retrospective manner using the electronic medical records of patients who presented to the author's institution between January 2007 and March 2018, and were diagnosed with an acute lumbar fracture. The fat infiltration rates of the multifidus and erector spinae were measured using MRI taken at the time of injury, and the mean value was defined as the total fat infiltration rate (TFI). Based on lateral radiographs of the lumbar spine at the one-year follow-up, the loss of height of the vertebral body, the kyphotic angle and the wedge angle were measured. The statistical significance was confirmed by calculating the Pearson correlation coefficient. Results: One hundred twenty-nine patients, of which 30 were male and 99 were female, were examined. The mean age was 71.28 years. The mean T-score was -3.53±0.79 g/cm², and the mean fat infiltration was 15.20%±11.99%. TFI was positively correlated with age (R=0.373, p<0.001), compression rate (R=0.369, p<0.001), and Cobb's angle (R=0.386, p<0.001) after a one year follow-up, but negatively correlated with the BMD score (R=-0.252, p=0.004). As the fracture progressed to the lower lumbar level, the compression rate (R=-0191, p=0.030) and wedge angle (R=-0.428, p<0.001) at the time of injury tended to decrease. Conclusion: In patients with osteoporotic vertebral fractures, the fat infiltration rate may be an important predictor of conservative treatment. The prognosis of patients with a high-fat infiltration rate should be explained during patient education, and the patients must be monitored closely through short-term outpatient follow-up.

• Journal of the Korean Society of Fisheries and Ocean Technology
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• v.57 no.4
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• pp.316-333
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• 2021

In order to understand basic data for improving the fishing system and fishing vessel structure in coastal improved stow net fishery, a questionnaire survey and on-site hearing were conducted from May 10 to June 11, 2019 to analyze opinions on the improvement of operation status and fishing vessel structure. The questionnaire survey consisted of ten questions on the operation status of coastal improved stow net fishery and six questions on the improvement of fishing vessel structure, and the results of each question were analyzed by the region, the captain's age, the captain's career and the age of fishing vessel. As a result of analyzing opinions on the operation status of the coastal improved stow net fishery, it was found that the average time required for casting net was 32.8 to 33.0 minutes and that the average time required for hauling net was 41.0 to 42.2 minutes which took 10 to 12 minutes more than for casting net. The most important work requiring improvement during fishing operation (the first priority) were 'hauling net operation,' 'readjustment and storage of fishing gear,' and 'fish handling' and the hardest factor in fishing management were in the order of 'reduction of catch,' 'labor shortage' and 'rising labor costs.' The most institutional improvement that is most needed in coastal improved stow net fishery was an 'using fine mesh nets.' Most of the respondent to the questions on the experience in hiring foreign crews was 'either hiring or willing to hire foreign crews,' and the average number of foreign crews employed was found to be 2.3 to 2.4 persons. The most important reason for hiring (or considering employment) foreign crews was 'high labor costs.' The degree of communication with foreign crews during fishing operation were 'moderate' or 'difficult to direct work.' The most important problem in hiring foreign crews (the first priority) was an 'illegal departure.' As the survey results on the opinion of structural improvement of coastal improved stow net fishing vessel, the degree of satisfaction with fishing vessel structure related to fishing operation was found to be somewhat unsatisfactory, with an average of 3.3 points on a five-point scale. The inconvenient structure of fishing vessel in possession (the first priority), the space needed most for the construction of new fishing vessel (the first priority) and the space considered important for the construction of new fishing vessel (the first prioprity) was a 'fish warehouse.' The most preferred equipment for the construction of new fishing vessel were 'engine operation monitoring' and 'navigation safety devices.' The average size (tonnage class), the average horse power and the average total length of fishing vessel for proper profit and safety fishing operation was between 13.8 and 14.0 tonnes, 808.3 to 819.5 H.P. and 23.4 to 23.5 meters, respectively. The results of the operation status of coastal improved stow net fishery and the requirement for improving the fishing vessel structure are expected to be provided as basic data for reference when we build or improve the fishing vessel.

• Journal of Preventive Medicine and Public Health
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• v.5 no.1
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• pp.57-95
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• 1972

This study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less apportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the socioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child health, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean-while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision as the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent' such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendance (8%) by maternity aid in study area. But, I expect that more maternity sids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I am sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if suck facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and post-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a 'notification' system instead of formal registration ststem, it would be improved significantly compared to present system. B. Effect of the project Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't want to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculaton, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate in the former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.

• Journal of Chest Surgery
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• v.35 no.7
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• pp.523-529
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• 2002

Background: Previous reports present that the early results of coronary artery bypass grafting (CABG) has been improving with the accumulation of surgical experience. We conducted a retrospective analysis of the patients who received CABG to evaluate the recent results of CABG. Material and Method: Between January 1996 and August 2001, 154 patients underwent CABG at Hanyang University Hospital. There were 47 patients(group I) who were operated between 1996 and 1998, and 107 patients(group II) who were operated thereafter. The preoperative diagnosis, operative procedure, mortality, and complications were analyzed retrospectively. Result: There were 35 males and 12 females in group I, and 78 males and 29 females in group II, which shows similar ratio of sexes between the two groups. The average age of patients for group I and group II was $55.9{\pm}6.2$ years and $61.0{\pm}8.0$ years, respectively, showing a significant increase in group II(p<0.05). The average left ventricular ejection fraction(LVEF) for group I and group II was $54.6{\pm}11.8$% and $56.9{\pm}13.0$%, respectively. The number of patients who had previous MI in group I and group II were 13 patients(27.7%) and 14 patients(13.1%), respectively, which shows a significant difference (p<0.05). All procedures were performed using the cardiopulmonary bypass(CPB) and moderate systemic hypothermia. Myocardial protection was achieved using intermittent hypothermic ischemia under ventricular fibrillation state or cold crystalloid cardioplegic solution for most of group I patients, whereas cold blood cardioplegic solution was used for group II patients. The mean CPB times for group I and group II were $149.2{\pm}48.7$ minutes and $113.1{\pm}30.6$ minutes, respectively. The mean aortic cross clamp times for group I and group II were $81.3{\pm}26.5$ minutes $72.2{\pm}23.9$ minutes, respectively. These figures show that CPB and aortic cross clamp times were significantly reduced in group II(p<0.05). The use of the left internal thoracic artery(LITA) was increased from 42%(20/47) for group I to 81% (87/107) for group II. The mean number of grafts also significantly increased from $2.5{\pm}0.6$ for group I to $3.0{\pm}1.1$ for group II(p<0.05). Intra-aortic balloon pump(IABP) was applied in 7 cases in group I and 17 cases in group II. Of these, 28.6%(2/7) and 52.9%(9/17) were broadly applied preoperatively in patients with LVEF<40% or congestive heart failure. The operative mortalities for group I and II were 10.6%(5/47) and 0.9%(1/107), respectively, which shows significant decrease for group II(p.0.05). Conclusion: This report suggest that CABG using CPB can recently be performed more safely in virtue of the accumulation of surgical experience with reduction in CPB and aortic cross clamp times and improved surgical techniques and myocardial protection. And we think that the optimal treatment of patients with left ventricular dysfunction associated with congestive heart failure and the extended application of IABP, especially have contributed to the reduction of operative mortality and morbidity.

• The Journal of Korean Society for Radiation Therapy
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• v.34
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• pp.73-82
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• 2022

Purpose: The purpose of this study is to evaluate the effectiveness of reducing the absorbed dose to the ovaries and the quality of the CBCT image when using the Halcyon^TM Fast kV CBCT of cervical cancer patients of child-bearing age who performed ovarian transposition Materials and Methods : Contouring of the cervix and ovaries required for measurement was performed on the computed tomography images of the human phantom (Alderson Rando Phantom, USA), and three Optically Stimulated Luminescence Dosimeter(OSLD) were attached to the selected organ cross-section, respectively. In order to measure the absorbed dose to the cervix and ovaries in the Truebeam^TM pelvis mode (Hereinafter referred to as TP), The Halcyon^TM Pelvis mode (Hereinafter referred to as HP) and The Halcyon^TM Pelvis Fast mode (Hereinafter referred to as HPF), An image was taken with a scan range of 17.5 cm and also taken an image that reduced the Scan range to 12.5cm. A total of 10 cumulative doses were summed, It was replaced with a value of 23 Fx, the number of cervical cancer treatments, and compared In additon, uniformity, low contrast visibility, spatial resolution, and geometric distortion were compared and analyzed using Catphan 504 phantom to compare CBCT image quality between equipment. Each factor was repeatedly measured three times, and the average value was obtained by analysing with the Doselab (Mobius Medical Systems, LP. Versions: 6.8) program. Results: As a result of measuring absorbed dose by CBCT with OSLD, TP and HP did not obtain significant results under the same conditions. The mode showing the greatest reduction value was HPF versus TP. In HPF, the absorbed dose was reduced by 39.8% in the cervix and 19.8% in the ovary compared to the TP in the scan range of 17.5 cm. the scan range was reduced to 12.5 cm, absorbed dose was reduced by 34.2% in the cervix and 50.5% in the ovary. In addition, result of evaluating the quality of the image used in the above experiment, it complied with the equipment manufacturer's standards with Geometric Distortion within 1mm (SBRT standard), Uniformity HU, LCV within 2.0%, Spatial Resolution more than 3 lp/mm. Conclusion: According to the results of this experiment, Halcyon^TM can select more various conditions than Truebeam^TM in treatment of fertility woman who have undergone ovarian Transposition , because it is important to reduce the radiation dose by CBCT during radiation therapy. So finally we recommend Halcyon^TM Fast kV CBCT which maintains image quality even at low mAs. However, it is consider that the additional exposure to low doses can be reduced by controlling the imaging range for patients who have undergone ovarian transposition in other treatment machines.

• Clinical and Experimental Reproductive Medicine
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• v.2 no.2
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• pp.27-36
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• 1975

The success of the family planning program in Korea is reflected in the decrease in the growth rate from 3.0% in 1962 to 2.0% in 1971, and in the decrease in the fertility rate from 43/1,000 in 1960 to 29/1,000 in 1970. However, it would be erroneous to attribute these reductions entirely to the family planning program. Other socio-economic factors, such as the increasing age at marriage and the increasing use of induced abortions, definitely had an impact on the lowered growth and fertility rate. Despite the relative success of the program to data in meeting its goals, there is no room for complacency. Meeting the goal of a further reduction in the population growth rate to 1.3% by 1981 is a much more difficult task than any one faced in the past. Not only must fertility be lowered further, but the size of the target population itself will expand tremendously in the late seventies; due to the post-war baby boom of the 1950's reaching reproductive ages. Furthermore, it is doubtful that the age at marriage will continue to rise as in the past or that the incidence of induced abortion will continue to increase. Consequently, future reductions in fertility will be more dependent on the performance of the national family planning program, with less assistance from these non-program factors. This paper will describe various approaches to help to the solution of these current problems. 1. PRACTICE RATE IN FAMILY PLANNING In 1973, the attitude (approval) and knowledge rates were quite high; 94% and 98% respectively. But a large gap exists between that and the actual practice rate, which is only 3695. Two factors must be considered in attempting to close the KAP-gap. The first is to change social norms, which still favor a larger family, increasing the practice rate cannot be done very quickly. The second point to consider is that the family planning program has not yet reached all the eligible women. A 1973 study determineded that a large portion, 3096 in fact, of all eligible women do not want more children, but are not practicing family planning. Thus, future efforts to help close the KAP-gap must focus attention and services on this important large group of potential acceptors. 2. CONTINUATION RATES Dissatisfaction with the loop and pill has resulted in high discontinuation rates. For example, a 1973 survey revealed that within the first six months initial loop acceptance. nearly 50% were dropouts, and that within the first four months of inital pill acceptance. nearly 50% were dropouts. These discontinuation rates have risen over the past few years. The high rate of discontinuance obviously decreases the contraceptive effectiveness. and has resulted in many unwanted births which is directly related to the increase of induced abortions. In the future, the family planning program must emphasize the improved quality of initial and follow-up services. rather than more quantity, in order to insure higher continuation rates and thus more effective contraceptive protection. 3. INDUCED ABORTION As noted earlier. the use of induced abortions has been increase yearly. For example, in 1960, the average number of abortions was 0.6 abortions per women in the 15-44 age range. By 1970. that had increased to 2 abortions per women. In 1966. 13% of all women between 15-44 had experienced at least one abortion. By 1971, that figure jumped to 28%. In 1973 alone, the total number of abortions was 400,000. Besides the ever incre.sing number of induced abortions, another change has that those who use abortions have shifted since 1965 to include- not. only the middle class, but also rural and low-income women. In the future. in response to the demand for abortion services among rural and low-income w~men, the government must provide and support abortion services for these women as a part of the national family planning program. 4. TARGET SYSTIi:M Since 1962, the nationwide target system has been used to set a target for each method, and the target number of acceptors is then apportioned out to various sub-areas according to the number of eligible couples in each area. Because these targets are set without consideration for demographic factors, particular tastes, prejudices, and previous patterns of acceptance in the area, a high discontinuation rate for all methods and a high wastage rate for the oral pill and condom results. In the future. to alleviate these problems of the methodbased target system. an alternative. such as the weighted-credit system, should be adopted on a nation wide basis. In this system. each contraceptive method is. assigned a specific number of points based upon the couple-years of protection (CYP) provided by the method. and no specific targets for each method are given. 5. INCREASE OF STERILIZA.TION TARGET Two special projects. the hospital-based family planning program and the armed forces program, has greatly contributed to the increasing acceptance in female and male sterilization respectively. From January-September 1974, 28,773 sterilizations were performed. During the same time in 1975, 46,894 were performed; a 63% increase. If this trend continues, by the end of 1975. approximately 70,000 sterilizations will have been performed. Sterilization is a much better method than both the loop and pill, in terms of more effective contraceptive protection and the almost zero dropout rate. In the future, the. family planning program should continue to stress the special programs which make more sterilizations possible. In particular, it should seek to add the laparoscope techniques to facilitate female sterilization acceptance rates. 6. INCREASE NUMBER OF PRIVATE ACCEPTORS Among the current family planning users, approximately 1/3 are in the private sector and thus do not- require government subsidy. The number of private acceptors increases with increasing urbanization and economic growth. To speed this process, the government initiated the special hospital based family planning program which is utilized mostly by the private sector. However, in the future, to further hasten the increase of private acceptors, the government should encourage doctors in private practice to provide family planning services, and provide the contraceptive supplies. This way, those do utilize the private medical system will also be able to receive family planning services and pay for it. Another means of increasing the number of private acceptors, IS to greatly expand the commercial outlets for pills and condoms beyond the existing service points of drugstores, hospitals, and health centers. 7. IE&C PROGRAM The current preferred family size is nearly twice as high as needed to achieve a stable poplation. Also, a strong boy preference hinders a small family size as nearly all couples fuel they must have at least one or more sons. The IE&C program must, in the future, strive to emphasize the values of the small family and equality of the sexes. A second problem for the IE&C program to work. with in the: future is the large group of people who approves family planning, want no more children, but do not practice. The IE&C program must work to motivate these people to accept family planning And finally, for those who already practice, an IE&C program in the future must stress continuation of use. The IE&C campaign, to insure highest effectiveness, should be based on a detailed factor analysis of contraceptive discontinuance. In conclusion, Korea faces a serious unfavorable sociodemographic situation- in the future unless the population growth rate can be curtailed. And in the future, the decrease in fertility will depend solely on the family planning program, as the effect of other socio-economic factors has already been maximumally felt. A second serious factor to consider is the increasing number of eligible women due to the 1950's baby boom. Thus, to meet these challenges, the program target must be increased and the program must improve the effectiveness of its current activities and develop new programs.

• Clinical and Experimental Pediatrics
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• v.49 no.9
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• pp.959-965
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• 2006

Purpose : The purpose of this study was to investigate the effect of prophylactic indomethacin on reduction of patent ductus arteriosus(PDA) and intraventricular hemorrhage(IVH) in extremely low birth weight infants(ELBWI). Methods : Retrospective review of 84 ELBWI who were admitted to our neonatal intensive care unit from June 2004 to April 2006 was performed. Patients were divided into prophylactic group(n=28) and control group(n=56), where prophylactic indomethacin were given within 6 hours after birth. Clinical outcomes were compared between these groups. Results : There were no significant differences in gestational age, birth weight, incidence of hemodynamically significant PDA and severe IVH, and mortality between prophylactic group and control group. However, there were more frequent indications for therapeutic indomethacin, higher incidence of intestinal perforation, and longer time to achieve full enteral feeding in prophylactic group than control group. The incidence of other adverse events attributed to indomethacin prophylaxis did not differ between two groups. Conclusions : Prophylactic indomethacin may not prevent hemodynamically significant PDA and severe IVH in ELBWI. On the contrary, it may be associated with increased risk of adverse events. Further efforts should be investigated to decrease PDA and severe IVH in ELBWI.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.154-164
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• 1998

Medication is widely accepted as an effective method to reduce the problem of attention deficit, hyperactivity, impulsivity, resistance and violence of ADHD children. However, it does not provide us with the solution on the conflicting routinized behavioral patterns to gain a high level of self-control and acceptable behavior. As a way of replacing medication, this study applies the social skills training program for ADHD children and measures the level of improvement of social skills and the change of the behavioral patterns. The experiment is carried out on 16 children ranged from 6 to 13 years of age for 10 weeks. The patients are divided into three groups：a pure ADHD group, an ADHD group with conduct disorder, an ADHD group with mental retardation and other symptoms. The change of symptoms and the change of social skills are measured by the Child Behavior Checklist(CBCL), the ADD-H Comprehensive Teacher’s Rating Scale(ACTeRS) and the Social Skills Rating Scale(SSRS), and finally Mastson Evaluation of Social Skills for Youth(MESSY). Wilcoxon signed ranks test is used to evaluate the effect of the treatment, and Kruskal-Wallis test is also used to measure the change after the treatment in each of the three groups. In the ADHD group with conduct disorder, the examination of the effect of the treatment shows a significant reduction of violence in the area of behavior(p<.05), and a significant difference of activity and social skills in the area of social competent(p<.001). In the ADHD group with mental retardation and other symptoms, a significant rise of social skills is found in the area of social skills evaluation (p<.05). However, there is no significant difference of effect by the treatment among the three groups. In addition, the current examination shows that the social skills training program does not make a statistically significant contribution to the social skills of the ADHD children. On the other hand, the training helps some children, when it is suitable for the characteristics and accompanying symptoms of the children：it reduces the level of violence in the ADHD group with conduct disorder, and it raises the social skills in the ADHD group with mental retardation. In other words, the social skills training program will reduce the conduct disorder and helps peer relation for ADHD children.

• Journal of the Korean Society of Radiology
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• v.5 no.5
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• pp.303-308
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• 2011

Background/Aims : The increasing use of diagnostic and therapeutic interventional radiology calls for greater consideration of radiation exposure risk to radiologist and radiological technician, and emphasizes the proper system of radiation protection. This study was designed to assess the effect of a protective grass shield. Methods : A protective grass was following data depth, 0.8 cm; width, 100 cm; length, 100 cm, lead equivalent, 1.6 mmPb. The protective shield was located between the patient and the radiologist. Thirty patients (13 male and 17 female) undergoing interventional radiology between September 2010 and December 2010 were selected for this study. The dose of radiation exposure was recorded with or without the protective grass shield at the level of the head, chest, and pelvis. The measurement was made at 50 cm and 150 cm from the radiation source. Results : The mean patient age was 69 years. The mean patient height and weight was $159.7{\pm}6.7$ cm and $60.3{\pm}5.9$ kg, respectively. The mean body mass index (BMI) was $20.5{\pm}3.0$ kg/m2. radiologists received $1530.2{\pm}550.0$ mR/hr without the protective lead shield. At the same distance, radiation exposure was significantly reduced to $50.3{\pm}85.2$ mR/hr with the protective lead shield (p-value<0.0001). The radiation exposure to radiologist and radiological technician was significantly reduced by the use of a protective lead shield (p value <0.0001). The amount of radiation exposure during interventional radiology was related to the patient' BMI (r=0.749, p=0.001). Conclusions : This protective shield grass is effective in protecting radiologist and radiological technician from radiation exposure.

• Tuberculosis and Respiratory Diseases
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• v.51 no.3
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• pp.232-239
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• 2001

Background : Asthmatic patients frequently suffer cold-weather-associated respiratory symptoms. The sensitivity, specificity, accuracy and diagnostic value of isocapnic hyperventilation of cold air(IHCA) using a multistep method, was investigated in patients suspected to have asthma. Method : One hundred and 29 adult patients who had an IHCA performed between july 1999 and December 2000, had an methacholine bronchoprovocation test because of a clinical suspicion of asthma. Results : According to strict criteria, 50 were defined as asthmatics and 79 as symptomatic nonasthmatics. There were no differences in age, sex and smoking state between the asthmatic and symptomatic nonasthmatic groups. There was a significant decrease in the percentage reduction in the forced expiratory volume in 1 second($FEV_1$) after the IHCA between the asthmatics($-10.0{\pm}6.8%$) and the symptomatic nonasthmatics($-2.3{\pm}2.5%)$. The factors associated with a reactivity to IHCA were $FEV_1$/FVC, $FEF_{25-75}$%/FVC and $FEV_1$(% of predicted). The accuracy was highest using a 7% fall in $FEV_1$ ; the sensitivity was 76% and the specificity 96%. Conclusion : IHCA is a specific, although not a sensitive, test for diagnosing asthma in adult patients. Furthermore, the diagnostic cut-off value of the different methods of IHCA need to be determined.