• Journal of the Korean Society of Radiology
• /
• v.1 no.2
• /
• pp.13-22
• /
• 2007

The purpose of this study was to survey a development of the wireless transmission system of medical images for ubiquitous medicine. There have been many changes in medical equipments and medical record medical treatment and medical record within hospital and PACS(Picture Archiving Communication System) which is picture management system for patients can be typical cases. It is difficult to use these automated medical systems unless they are within hospital and in case of rapid image reading in the emergency cases or in absence of doctor, it is difficult to perform it immediately. The present study implemented an image transmission system using CDMA connection so that images in the server can be viewed at any time and in any place. Remote wireless diagnosis based on medical images using PDA is applicable to medical areas that require mobility, and the use of PDA can be an ideal alternative for point of care. The use of PDA enables prompt and accurate access to digital medical images, which in turn reduces medical accidents and improves the quality of medical services through high productivity and efficiency of medical practitioners' works. It also enables quick response to patients' demands and high-quality medical services and, consequently, patients' high satisfaction.

• Journal of Korean Society of Occupational and Environmental Hygiene
• /
• v.19 no.3
• /
• pp.213-232
• /
• 2009

This document was prepared to review and summarize the analytical methods for airborne and bulk asbestos. Basic principles, shortcomings and advantages for asbestos analytical instruments using phase contrast microscopy(PCM), polarized light microscopy(PLM), X-ray diffractometer (XRD), transmission electron microscopy(TEM), scanning electron microscopy(SEM) were reviewed. Both PCM and PLM are principal instrument for airborne and bulk asbestos analysis, respectively. If needed, analytical electron microscopy is employed to confirm asbestos identification. PCM is used originally for workplace airborne asbestos fiber and its application has been expanded to measure airborne fiber. Shortcoming of PCM is that it cannot differentiate true asbestos from non asbestos fiber form and its low resolution limit ($0.2{\sim}0.25{\mu}m$). The measurement of airborne asbestos fiber can be performed by EPA's Asbestos Hazard Emergency Response Act (AHERA) method, World Health Organization (WHO) method, International Standard Organization (ISO) 10312 method, Japan's Environmental Asbestos Monitoring method, and Standard method of Indoor Air Quality of Korea. The measurement of airborne asbestos fiber in workplace can be performed by National Institute for Occupational Safety and Health (NIOSH) 7400 method, NIOSH 7402 method, Occupational Safety and Health Administration (OSHA) ID-160 method, UK's Health and Safety Executive(HSE) Methods for the determination of hazardous substances (MDHS) 39/4 method and Korea Occupational Safety and Health Agency (KOSHA) CODE-A-1-2004 method of Korea. To analyze the bulk asbestos, stereo microscope (SM) and PLM is required by EPA -600/R-93/116 method. Most bulk asbestos can be identified by SM and PLM but one limitation of PLM is that it can not see very thin fiber (i.e., < $0.25{\mu}m$). Bulk asbestos analytical methods, including EPA-600/M4-82-020, EPA-600/R-93/116, OSHA ID-191, Laboratory approval program of New York were reviewed. Also, analytical methods for asbestos in soil, dust, water were briefly discussed. Analytical electron microscope, a transmission electron microscope equipped with selected area electron diffraction (SAED) and energy dispersive X-ray analyser(EDXA), has been known to be better to identify asbestiform than scanning electron microscope(SEM). Though there is no standard SEM procedures, SEM is known to be more suitable to analyze long, thin fiber and more cost-effective. Field emission scanning electron microscope (FE-SEM) imaging protocol was developed to identify asbestos fiber. Although many asbestos analytical methods are available, there is no method that can be applied to all type of samples. In order to detect asbestos with confidence, all advantages and disadvantages of each instrument and method for given sample should be considered.

• Journal of the Korea Computer Graphics Society
• /
• v.24 no.1
• /
• pp.9-16
• /
• 2018

In this paper, we introduce a visualization framework for cell image data obtained from optical diffraction tomography (ODT), including a method for representing cell morphology in 3D virtual environment and a color mapping protocol. Unlike commonly known volume data sets, such as CT images of human organ or industrial machinery, that have solid structural information, the cell image data have rather vague information with much morphological variations on the boundaries. Therefore, it is difficult to come up with consistent representation of cell structure for visualization results. To obtain desired visual representation of cellular structures, we propose an interactive visualization technique for the ODT data. In visualization of 3D shape of the cell, we adopt a volume rendering technique which is generally applied to volume data visualization and improve the quality of volume rendering result by using empty space jittering method. Furthermore, we provide a layer-based independent rendering method for multiple transfer functions to represent two or more cellular structures in unified render window. In the experiment, we examined effectiveness of proposed method by visualizing various type of the cell obtained from the microscope which can capture ODT image and fluorescence image together.

• Journal of Korean Neurosurgical Society
• /
• v.54 no.4
• /
• pp.329-335
• /
• 2013

Objective : Brain metastases in primary breast cancer patients are considerable sources of morbidity and mortality. Gamma knife radiosurgery (GKRS) has gained popularity as an up-front therapy in treating such metastases over traditional radiation therapy due to better neurocognitive function preservation. The aim of this study was to clarify the prognostic factors for local tumor control and survival in radiosurgery for brain metastases from primary breast cancer. Methods : From March 2001 to May 2011, 124 women with metastatic brain lesions originating from a primary breast cancer underwent GKRS at a tertiary medical center in Seoul, Korea. All patients had radiosurgery as a primary treatment or salvage therapy. We retrospectively reviewed their clinical outcomes and radiological responses. The end point of this study was the date of patient's death or the last follow-up examination. Results : In total, 106 patients (268 lesions) were available for follow-up imaging. The median follow-up time was 7.5 months. The mean treated tumor volume at the time of GKRS was 6273 $mm^3$ (range, 4.5-27745 mm3) and the median dose delivered to the tumor margin was 22 Gy (range, 20-25 Gy). Local recurrence was assessed in 86 patients (216 lesions) and found to have occurred in 36 patients (83 lesions, 38.6%) with a median time of 6 months (range, 4-16 months). A treated tumor volume >5000 $mm^3$ was significantly correlated with poor local tumor control through a multivariate analysis (hazard risk=7.091, p=0.01). Overall survival was 79.9%, 48.3%, and 15.3% at 6, 12, and 24 months, respectively. The median overall survival was 11 months after GKRS (range, 6 days-113 months). Multivariate analysis showed that the pre-GKRS Karnofsky performance status, leptomeningeal seeding prior to initial GKRS, and multiple metastatic lesions were significant prognostic factors for reduced overall survival (hazard risk=1.94, p=0.001, hazard risk=7.13, p<0.001, and hazard risk=1.46, p=0.046, respectively). Conclusion : GKRS has shown to be an effective and safe treatment modality for treating brain metastases of primary breast cancer. Most metastatic brain lesions initially respond to GKRS, though, many patients have further CNS progression in subsequent periods. Patients with poor Karnofsky performance status and multiple metastatic lesions are at risk of CNS progression and poor survival, and a more frequent and strict surveillance protocol is suggested in such high-risk groups.

• The Korean Journal of Nuclear Medicine
• /
• v.32 no.2
• /
• pp.137-142
• /
• 1998

Purpose: $^{99m}Tc$-tetrofosmin(TF) is a recently proposed myocardial imaging agent which has similar biokinetic characteristics to $^{99m}Tc$-sestamibi(MIBI). The aim of this study was to compare TF and MIBI myocardial perfusion SPECTs in detecting coronary artery disease. Materials and Methods: One hundred and sixty patients(101 males, 59 females, mean age $57{\pm}9yr$) who had undergone both myocardial perfusion SPECT(M-SPECT) and coronary angiography within 1 month were studied. M-SPECT was performed using TF in 115 patients and MIBI in 45 patients. Stress-rest one day protocol was used in all patients. A coronary stenosis was considered significant when the luminal diameter ${\geq}$50% was compromised. The chi square test was used to compare differences in sensitivity and specificity between the two groups. Results: There was no difference in age and diseased coronary artery branches between the two groups. There were more male patients in TF group: Male-to-female ratios of TF and MIBI groups were 78:37 and 23:22, respectively(p<0.05). The overall sensitivity of TF study was 92% and specificity 36%. The overall sensitivity and specificity of MIBI study were 93% and 30%, respectively. There was no difference between TF and MIBI groups in identifying individual diseased coronary artery branches. Conclusion: One day stress-rest myocardial SPECT using either TF or MIBI was comparable and was a very sensitive test in detecting coronary artery disease.

• Journal of Acupuncture Research
• /
• v.21 no.6
• /
• pp.177-186
• /
• 2004

Introduction : Recent studies Suggested that there is a strong correlation between acupuncture stimulation and its related cortical activation. Anther study showed that either positive or negative BOLD effects could be observed depending on anatomical structure in acupuncture stimulation. In ttis study, we investigated a new acupoint $KI_6$ (照海), which was known as motor-related acupoint and obtained an evidence that the stimulation of $KI_6$ resulted in either negative or positive BOLD response to stimulation. Methods & Results : 1. Subjects and paradigms : Two separate stimulation paradigms were performed on five healthy (aged 22-23 yrs) in this study. First, the paradigm of acupuncture stimulation was that the acupuncture needle was inserted in acupoints $KI_6$, which is located in lateral side of the foot and then continuously twisted(補瀉를 除外한 捻轉法) for 70 seconds for 10 cycles of activation. During rest period (70 seconds), the needle was completed removed from acupoint. Total 60 cycles were performed and 10 images were obtained per cycle. Second, nonacupoint was randomly selected and the same paradigm was performed as acupoint stimulation. The stimulation protocol comprised 10 cycles of alternating. activation and rest (10 images per cycle). Total 60 cycles were performed and each cycle take about 1.5 sec for motor task. Subjects take an at least 15 minutes break before starting anther paradigm. 2. fMRI mapping : Multi-slice functional images were obtained on a 1.5T Magnetom Vision MRI scanner (Simens Medical, Erlangen, Germany) equipped with high performance whole-body gradients. The BOLD T2 * - weighted images were acquired with acho planar imaging sequence (TR = 1.2 sec, TE = 60 msec, and flip angle = $90_{\circ}$). The other sequence parameter are : FOV = 210 mm, matrix=$64{\times}128$ or $64{\times}64$, slice number=10 and slice thickness = 5 or 8 mm. the anatomic images were obtained with Spin-echo T1-weighted images. The resulting images were then anaiyzed with STIMULATE (CMRR, U. of Minnesota) to generate functional maps using a student T-test (p < 0.005) and cluster analysis. Both positive and negative response were evaluated. Conclusions : We have observed the activation of the motor cortex by stimulating motor-related acupoint ($KI_6$). Among five subjects, negative BOLD response was shown in four and positive response in one. All subjects showed positive response to conventional finger flexion-extension task. To understand the detailed mechanisms of correlation between acupuncture stimulation and BOLD fMRI changes and two typs of response, further study strongly required.

• Journal of Korean Foot and Ankle Society
• /
• v.26 no.2
• /
• pp.95-102
• /
• 2022

Purpose: This study was based on the Korean Foot and Ankle Society (KFAS) member survey and aimed to report the current trends in the management of syndesmotic injuries over the last few decades. Materials and Methods: A web-based questionnaire containing 36 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experiences in the treatment of patients with syndesmotic injuries. Answers with a prevalence ≥50% of respondents were considered a tendency. Results: Seventy-six (13.8%) of the 550 members responded to the survey. The results showed that the most preferred method to diagnose a syndesmotic injury was magnetic resonance imaging (MRI). Intraoperatively, the external rotation stress test and the Cotton test were most frequently used to confirm syndesmotic diastasis. The reduction was usually done by a reduction clamp. One 3.5-mm screw was used most frequently over three cortices at 2~4 cm above the ankle joint. The preferred ankle position during fixation was 0° dorsiflexion. Removal of the syndesmotic screw was routinely done by most surgeons, mainly because of the limitation of movement and risk of screw breakage. Factors that affect suture button selection included non-rigid fixation which enables adequate fixation, early weight-bearing, and an infrequent need to remove the hardware. Inadequate reduction was considered the main factor that affects poor prognosis. Conclusion: This study proposes updated information about the current trends in the management of syndesmotic injuries in Korea. Consensuses in both the diagnostic and therapeutic approach to patients with syndesmotic injury were identified in this survey study. This study may raise the awareness of the various possible approaches toward the injury and should be used to further establish a standard protocol for the management of syndesmotic injuries.

• Journal of the Korean Society of Radiology
• /
• v.16 no.6
• /
• pp.761-769
• /
• 2022

Pads with high dielectric materials have been used in a variety of applications to locally improve the field sensitivity and homogeneity of RF pulses in clinical MRI studies. In this study, we aimed to improve such pads in consideration of the practical problems associated with the application of actual clinical images. A high permittivity pad to increase the attenuated B1 field strength was fabricated and tested in 7T MRI. Sim4Life simulation and experimental results show stronger and relatively uniform B1 near field. In order to improve the image quality in the whole cerebellum, known as a region with low sensitivity, a guide was made to reduce the mechanical change of the pad. In order to improve the wearing comfort, the pad was designed by dividing it into upper and lower parts. The facial pad showed an overall signal increase effect in areas such as the turbinate in the nasal cavity. Signal increase was expected in areas such as the frontal lobe and eyes, but the effect was either insignificant or it was difficult to see the effect in the imaging protocol. In conclusion, this paper showed a cerebellar-optimized pad with an improved nasal signal while maintaining its effectiveness.

• Journal of the Korean Society of Radiology
• /
• v.83 no.6
• /
• pp.1312-1326
• /
• 2022

Purpose To investigate the added value of right down decubitus (RDD) CT when determining adjacent organ invasion in cases of advanced gastric cancer (AGC). Materials and Methods A total of 728 patients with pathologically confirmed T4a (pT4a), surgically confirmed T4b (sT4b), or pathologically confirmed T4b (pT4b) AGCs who underwent dedicated stomach-protocol CT, including imaging of the left posterior oblique (LPO) and RDD positions, were included in this study. Two radiologists scored the T stage of AGCs using a 5-point scale on LPO CT with and without RDD CT at 2-week intervals and recorded the presence of "sliding sign" in the tumors and adjacent organs and compared its incidence of appearance. Results A total of 564 patients (77.4%) were diagnosed with pT4a, whereas 65 (8.9%) and 99 (13.6%) patients were diagnosed with pT4b and sT4b, respectively. When RDD CT was performed additionally, both reviewers deemed that the area under the curve (AUC) for differentiating T4b from T4a increased (p < 0.001). According to both reviewers, the AUC for differentiating T4b with pancreatic invasion from T4a increased in the subgroup analysis (p < 0.050). Interobserver agreement improved from fair to moderate (weighted kappa value, 0.296-0.444). Conclusion RDD CT provides additional value compared to LPO CT images alone for determining adjacent organ invasion in patients with AGC due to their increased AUC values and improved interobserver agreement.

• Korean Journal of Radiology
• /
• v.25 no.5
• /
• pp.438-448
• /
• 2024

Objective: To evaluate the therapeutic outcomes of no-touch radiofrequency ablation (NT-RFA) using twin cooled wet (TCW) electrodes in patients experiencing recurrent hepatocellular carcinoma (HCC) after undergoing locoregional treatments. Materials and Methods: We conducted a prospective, single-arm study of NT-RFA involving 102 patients, with a total of 112 recurrent HCCs (each ≤ 3 cm). NT-RFA with TCW electrodes was implemented under the guidance of ultrasonography (US)-MR/CT fusion imaging. If NT-RFA application proved technically challenging, conversion to conventional tumor puncture RFA was permitted. The primary metric for evaluation was the mid-term cumulative incidence of local tumor progression (LTP) observed post-RFA. Cumulative LTP rates were estimated using the Kaplan-Meier method. Multivariable Cox proportional hazard regression was used to explore factors associated with LTP. Considering conversion cases from NT-RFA to conventional RFA, intention-to-treat (ITT; including all patients) and per-protocol (PP; including patients not requiring conversion to conventional RFA alone) analyses were performed. Results: Conversion from NT-RFA to conventional RFA was necessary for 24 (21.4%) out of 112 tumors. Successful treatment was noted in 111 (99.1%) out of them. No major complications were reported among the patients. According to ITT analysis, the estimated cumulative incidences of LTP were 1.9%, 6.0%, and 6.0% at 1, 2, and 3 years post-RFA, respectively. In PP analysis, the cumulative incidence of LTP was 0.0%, 1.3%, and 1.3% at 1, 2, and 3 years, respectively. The number of previous locoregional HCC treatments (adjusted hazard ratio [aHR], 1.265 per 1 treatment increase; P = 0.004), total bilirubin (aHR, 7.477 per 1 mg/dL increase; P = 0.012), and safety margin ≤ 5 mm (aHR, 9.029; P = 0.016) were independently associated with LTP in ITT analysis. Conclusion: NT-RFA using TCW electrodes is a safe and effective treatment for recurrent HCC, with 6.0% (ITT analysis) and 1.3% (PP analysis) cumulative incidence of LTP at 2 and 3-year follow-ups.