• Journal of the Korean Society of Radiology
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• v.15 no.7
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• pp.1041-1047
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• 2021

In this study, the effective dose for frequently general radiography among the diagnostic reference level (DRL) for examinations provided by the government in Korea was evaluated using the Monte Carlo N-Particle eXtended (MCNPX) simulation tool. We were selected to evaluate for a total of 5 examination sites which included head anterior-posterior, chest (posterior-anterior, lateral), abdomen anterior-posterior and pelvis anterior-posterior. Physical conditions such as tube voltage and tube current used in MCNPX simulation were used in domestic conditions of the Korea Disease Control and Prevention Agency (KDCA). To evaluate domestic medical radiation exposure, we used the HDRK-Man computerized human phantom manufactured based on the international standard ICRP 103 that was applied to the MCNPX simulation. The phantom could represent the standard body shape of Koreans. As a results, the effective dose corresponding to the DRL based on adult males of head anterior-posterior position was 0.086 mSv, chest posterior-anterior position was 0.05 mSv, chest lateral was 0.354 mSv, abdomen anterior-posterior position was 0.548 mSv, and pelvis anterior-posterior position was 0.451 mSv.

• Tuberculosis and Respiratory Diseases
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• v.84 no.4
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• pp.282-290
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• 2021

Background: Radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB) has improved the diagnostic yield of bronchoscopic biopsy of peripheral pulmonary lesions (PPLs). The diagnostic yield and complications of RP-EBUS-TBLB for PPLs vary depending on the technique, such as using a guide sheath (GS) or fluoroscopy. In this study, we investigated the utility of RP-EBUS-TBLB using a GS without fluoroscopy for diagnosing PPLs. Methods: We retrospectively reviewed data from 607 patients who underwent RP-EBUS of PPLs from January 2019 to July 2020. TBLB was performed using RP-EBUS with a GS without fluoroscopy. The diagnostic yield and complications were assessed. Multivariable logistic regression analyses were used to identify factors affecting the diagnostic yields. Results: The overall diagnostic accuracy was 76.1% (462/607). In multivariable analyses, the size of the lesion (≥20 mm; odds ratio [OR], 2.06; 95% confidence interval [CI], 1.27-3.33; p=0.003), positive bronchus sign in chest computed tomography (OR, 2.30; 95% CI, 1.40-3.78; p=0.001), a solid lesion (OR, 2.40; 95% CI, 1.31-4.41; p=0.005), and an EBUS image with the probe within the lesion (OR, 6.98; 95% CI, 4.38-11.12; p<0.001) were associated with diagnostic success. Pneumothorax occurred in 2.0% (12/607) of cases and chest tube insertion was required in 0.5% (3/607) of patients. Conclusion: RP-EBUS-TBLB using a GS without fluoroscopy is a highly accurate diagnostic method in diagnosing PPLs that does not involve radiation exposure and has acceptable complication rates.

• Journal of the Korean Society of Radiology
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• v.15 no.2
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• pp.165-171
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• 2021

To prevent the secondary hospital-acquired infection (cross-infection) from occurring in the general radiographic room in the department of radiology, the microbial measurement was conducted at the points making direct close contact with radiologists and patients. For the case of radiologists, the microbial measurement and incubation were focused on the x-ray tube handle of the radiation generating device, and, for the case of patients, the microbial measurement and incubation were focused on the chin supporting device, chest-contact point, and handle. Once disinfected with Aniosurf, the sterilized media were gathered and identified, and the microorganisms were confirmed. Based on the identification results, it was confirmed that the points making direct close contact with radiologists showed a value of 103 CFU for Proteus mirabilis, Staphylococcus epidermidis, Bacillus spp. and Candida spp., and that the points making direct close contact with patients showed a value of 103~5 CFU for Proteus mirabilis, Enterococcu faecium, Pseudomonas aeruginosa, NTM(Non-Tuberculosis Mycobacteria) and Candida spp.. It was also confirmed that the types and number of microorganisms gathered from the points making direct close contact with patients were greater. Fortunately, most of the involved microorganisms were observed to be on the skin surface and are known to become extinct when disinfected in accordance with the hospital-acquired infection control rules. However, since even minor exposure to such microorganisms may be lethal for patients with reduced immunity, caution must be taken. In particular, since the points making contact with patients showed a high level of microbial measurement, it was thought that it would be necessary for radiologists and personnel having frequent access to strictly disinfect the parts, such as instruments and handles, making frequent contact with patients. The purpose of this study was to announce the importance of safe microbial control in the radiographic inspection room in hospital, and this study is expected to be used as the baseline data for preventing hospital-acquired secondary infection and Nth infectious diseases.

• Journal of Korean Society of Spine Surgery
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• v.25 no.4
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• pp.185-195
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• 2018

Study Design: Literature review. Objective: Ultrasound-guided injections are a common clinical treatment for lower lumbosacral pain that are usually performed before surgical treatment if conservative treatment fails. The aim of this article was to review ultrasound-guided injections in the lumbar and sacral spine. Summary of Literature Review: Ultrasound-guided injections, unlike conventional interventions using computed tomography or C-arm fluoroscopy, can be performed under simultaneous observation of muscles, ligaments, vessels, and nerves. Additionally, they have no radiation exposure and do not require a large space for the installation of equipment, so they are increasingly selected as an alternative method. Materials and Methods: We searched for and reviewed studies related to the use of ultrasound-guided injections in the lumbar and sacral spine. Results: In order to perform accurate ultrasound-guided injections, it is necessary to understand the patient's posture during the intervention, the relevant anatomy, and normal and abnormal ultrasonographic findings. Facet joint intra-articular injections, medial branch block, epidural block, selective nerve root block, and sacroiliac joint injections can be effectively performed under ultrasound guidance. Conclusions: Ultrasound-guided injections in the lumbar and sacral spine are an efficient method for treating lumbosacral pain.

• The Journal of the Korea Contents Association
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• v.19 no.8
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• pp.284-292
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• 2019

To evaluate the usefulness of pediatric chest CT scans by comparing the dose, examination time, and image quality by applying Helical mode, High-pitch mode, and Volume Axial mode to minimize the radiation exposure and obtain high diagnostic value. Revolution (GE Healthcare, Wisconsin USA) was used to divide PBU-70 phantom into Helical mode, High-pitch mode, and Volume Axial mode. After acquiring images, ROI is set for each image, heart, bone, lung, and back-ground air, and the average value is obtained by measuring CT number (HU) and noise (SD). SNR and CNR were measured and compared with DLP values provided directly by the equipment. Determining statistical significance Statistical analysis was performed using ONE-WAY-ANAOVA using SPSS 21.0. In this experiment, it was possible to inspect at a short time without deterioration of image quality with the lowest dose when using volume axial mode. Although the detector coverage of 16 cm is limited to all pediatric chest CT scans, it is recommended to be actively used in pediatric patients, and further study is needed to apply other test sites in volume axial mode.

• Journal of the Korean Society of Radiology
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• v.15 no.1
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• pp.9-14
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• 2021

Recently, magnetic resonance imaging (MRI), which can acquire images with good contrast without exposure to radiation, has been widely used for diagnosis. However, noise that reduces the accuracy of diagnosis is essentially generated when acquiring the MR images, and by adjusting the parameters, the noise problem can be solved to obtain an image with excellent characteristics. Among the parameters, the number of excitation (NEX) can acquire images with excellent characteristics without additional degradation of image characteristics. In contrast, appropriate NEX setting is required since the scan time increases and motion artifacts may occur. Therefore, in this study, after fixing all MRI parameters through the MRiLab simulation program, we tried to evaluate the tendency of image characteristics according to changing NEX through quantitative evaluation of brain T2 weighted images acquired by adjusting only NEX. To evaluate the noise level and similarity of the acquired image, signal to noise ratio (SNR), contrast to noise ratio (CNR), root mean square error (RMSE) and peak signal to noise ratio (PSNR) were calculated. As a result, both noise level and similarity evaluation factors showed improved values as NEX increased, while the increasing width gradually decreased. In conclusion, we demonstrated that an appropriate NEX setting is important because an excessively large NEX does not affect image characteristics improvement and cause motion artifacts due to a long scan.

• Journal of the Korean Society of Radiology
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• v.14 no.7
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• pp.975-980
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• 2020

Cervical neural foraminal stenosis is a very common spinal disease that affects a relatively large number of people of all ages. However, since imaging methods that quantitatively provide neural foraminal stenosis are lacking, this study attempts to present quantitative measurement results by reconstructing 3D computed tomography images. Using a 3D reconstruction software, the surrounding bones were removed, including the spinous process, transverse process, and lamina of the cervical spine so that the neural foramen were well observed. Using Image J, a region of interest including the neural foramen area of the 3D image was set, and the number of pixels of the neural foramen area was measured. The neural foramen area was calculated by multiplying the number of measured pixels by the pixel size. In order to measure the widest area of the neural foramen, it was measured between 40-50 degrees in the opposite direction and 15-20 degrees toward the head. The measured cervical neural foramen area showed consistent measurement values. The largest measured area of the right neural foramen C5-6 was 12.21 ㎟, and after 2 years, the area was measured to be 9.95 ㎟, indicating that 18% stenosis had progressed. Since 3D reconstruction using axial CT scan images, no additional radiation exposure is required, and the area of stenosis can be objectively presented. In addition, it is good to explain to patients with neural stenosis while viewing 3D images, and it is considered a good method to be used in the evaluation of the progression of stenosis and post-operative evaluation.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.1
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• pp.65-75
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• 2022

The aim of this study was to evaluate QLF (quantitative light-induced fluorescence) technology for the caries detection in primary teeth and validate the relationships between the cavity volume of carious lesions and QLF analysis results. Total 125 tooth surfaces include 53 occlusal surfaces, and 72 proximal surfaces were investigated with the portable QLF device for detection of dental caries in primary molars. Micro-CT radiograph was also performed to classify carious lesions and calculate the cavity volume. QLF showed good accuracy and reliability (sensitivity 0.75 - 0.94, specificity 0.82 - 0.95, and AUROC 0.88 - 0.98) for the caries detection in primary teeth except 𝚫R average results of proximal caries which showed relatively low values. Statistically significant relationships were found between 𝚫F average, QS-Index and the cavity volume according to Spearman rank-order correlation coefficients (r = 0.805 - 0.832, p < 0.001). QLF detection method would be a harmless and reliable way for children to diagnose dental caries without the concern about radiation exposure.

• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.103-116
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• 2021

The use of 3-dimensional (3D) printing is becoming more common, and its use is increasing in the orthopedic surgery. Currently, there are four major methods of using 3D printing technology in orthopedic surgery. First, surgical planning simulation using 3D printing model; second, patient-specific surgical instruments; third, production of customized prosthesis using 3D printing technique; fourth, patient-specific prosthesis produced by 3D printing. The areas of orthopedic surgery where 3D printing technology can be used are shoulder joint, spine, hip and pelvis, knee joints, ankle joint, and tumors. Since the diseases and characteristics handled by each area are different, the method of using 3D printing technology is also slightly different in each area. However, using 3D printing technology in all areas can increase the efficiency of surgery, shorten the surgery time, and reduce radiation exposure intraoperatively. 3D printing technology can be of great help in treating patients with particularly complex and difficult orthopedic diseases or fractures. Therefore, the orthopedic surgeon should make the most of the benefits of the 3D printing technology so that patient can be treated effectively.

• Journal of the Korean Society of Radiology
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• v.16 no.1
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• pp.7-13
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• 2022

This study compared the aortic root image by using the ECG gating and non-ECG gating methods. We observed the presence or absence of progression of the aortic root image in the images examined by the high pitch (flash) chest pain protocol method and in the patients tested without ECG gating by the conventional method. The AAPM phantom was scanned by using high pitch (flash) chest pain protocol and general chest pain protocol. CTDI values were compared. By ECG gating, the blurring of ascending aorta was significantly reduced compared to the existing non-ECG gating test method, and the image quality of the aortic root was improved. Within the parametar range that did not show differences in noise, uniformity, and high contrast resolution, CTDI values were lower when tested with the high-pitch chest pain protocol. It was found that there is an advantage in dose reduction, and if it is applied and applied to diagnostic fields such as dissection using the dose reduction mode in the cardiac field, it is a very important test for patients who need rapid diagnosis and prompt treatment as well as a dramatic reduction in exposure dose. It is presumed to be a method.