• Journal of Chest Surgery
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• v.51 no.4
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• pp.254-259
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• 2018

Background: Primary spontaneous pneumothorax (PSP) affects patients without clinically apparent lung disorder found in tall and thin young male. Scoliosis refers to curves exceeding $10^{\circ}$ Cobb angle observed through chest X-ray and affects 2% to 4% of adolescents. Both conditions are commonly encountered in primary health care setting. The aim of this study is to access the correlation of thoracic scoliosis and PSP in adolescent. Methods: A retrospective analysis was conducted for patients diagnosed for PSP in Konyang University Hospital between January 2010 and March 2017. Chest X-rays of 222 patients and 155 normal control (NC) cases were reviewed to measure the Cobb angle. Greater than $10^{\circ}$ of Cobb angle is diagnosed as scoliosis. Results: Scoliosis in patient with PSP has higher incidence than that of NC group (p<0.001). Median value of Cobb angle is $12.9^{\circ}$ in PSP group and $14.7^{\circ}$ in NC group. Directional relationship between scoliosis and pneumothorax in PSP group is also observed; 40.5% cases are ipsilateral and 59.5% are contralateral. Conclusion: PSP patients tend to have thoracic scoliosis more commonly compared with normal healthy adolescent. Scoliosis may contribute to heterogeneity of alveolar pressure which exacerbates subpleural bleb formation that can cause pneumothorax. The causal relationship is unclear and further studies are needed in the future.

• Journal of Radiation Protection and Research
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• v.45 no.4
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• pp.163-170
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• 2020

Background: Gut microflora contributes to the nutritional metabolism of the host and to strengthen its immune system. However, if the intestinal barrier function of the living body is destroyed by radiation exposure, the intestinal bacteria harm the health of the host and cause sepsis. Therefore, this study aims to trace short-term radiation-induced changes in the mouse gut microflora-dominant bacterial genus, and analyze the degree of intestinal epithelial damage. Materials and Methods: Mice were irradiated with 0, 2, 4, 8 Gy X-rays, and the gut microflora and intestinal epithelial changes were analyzed 72 hours later. Five representative genera of Actinobacteria, Firmicutes, and Bacteroidetes were analyzed in fecal samples, and the intestine was pathologically analyzed by Hematoxylin-Eosin and Alcian blue staining. In addition, DNA fragmentation was evaluated by the TdT-mediated dUTP nick-end labeling (TUNEL) assay. Results and Discussion: The small intestine showed shortened villi and reduced number of goblet cells upon 8 Gy irradiation. The large intestine epithelium showed no significant morphological changes, but the number of goblet cells were reduced in a radiation dose-dependent manner. Moreover, the small intestinal epithelium of 8 Gy-irradiated mice showed significant DNA damaged, whereas the large intestine epithelium was damaged in a dose-dependent manner. Overall, the large intestine epithelium showed less recovery potential upon radiation exposure than the small intestinal epithelium. Analysis of the intestinal flora revealed fluctuations in lactic acid bacteria excretion after irradiation regardless of the morphological changes of intestinal epithelium. Altogether, it became clear that radiation exposure could cause an immediate change of their excretion. Conclusion: This study revealed changes in the intestinal epithelium and intestinal microbiota that may pave the way for the identification of novel biomarkers of radiation-induced gastrointestinal disorders and develop new therapeutic strategies to treat patients with acute radiation syndrome.

• Tuberculosis and Respiratory Diseases
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• v.87 no.4
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• pp.514-523
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• 2024

Background: The government of Korea implemented a strategy of prevention and early diagnosis in high-risk groups to reduce the tuberculosis (TB) burden. This study aims to investigate the TB epidemiology and gap in understanding of TB prevalence among homeless individuals by analyzing active TB chest X-ray (CXR) screening results in Korea. Methods: The Korean National Tuberculosis Association conducted active TB screening with CXR for homeless groups from January 1 to December 31, 2021. Sputum acid-fast bacilli smear and culture were performed for the subjects suggestive of TB on CXR. We performed a cross-sectional analysis of the data in comparison with the national health screening results from the general population. Results: Among 17,713 homeless persons, 40 (0.23%), 3,077 (17.37%), and 79 (0.45%) were categorized as suggested TB, inactive TB, and observation required, respectively. Prevalence of suggested TB in the homeless was significantly higher (3-5 fold) than in the national general health screening based on age category (p<0.005). Twenty-nine cases were confirmed as TB, yielding a prevalence of 164 cases per 100,000 individuals; 19 of these 29 cases showed inactive TB on CXR. Body mass index (p=0.0478) and CXR result (p<0.001) significantly correlated with confirmed TB based on multivariable analysis. Conclusion: Nutrition status and CXR results, especially that of inactive TB, should be considered in active TB screening of the homeless population, where TB prevalence is higher than the general population.

• Tuberculosis and Respiratory Diseases
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• v.71 no.1
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• pp.30-36
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• 2011

Background: Pneumonia is commonly seen in outpatient clinics. it is widely known as the most common cause of death from infectious disease. Pneumonia has been diagnosed by its typical symptoms, chest X-ray and blood tests. However, both chest X-rays and blood tests have limitations in diagnosis. Thus primary care clinicians usually have been constrained due to a lack of adequate diagnostic tools. Vibration response imaging (VRI) is a newly emerging diagnostic modality, and its procedure is non-invasive, radiation-free, and easy to handle. This study was designed to evaluate the diagnostic usefulness of the VRI test among pneumonia patients and to consider its correlation with other conventional tests such as Chest X-ray, laboratory tests and clinical symptoms. Methods: VRI was performed in 46 patients diagnosed with pneumonia in Konkuk University Medical Center. VRI was assessed in a private and quiet room twice: before and after the treatment. Sensors for VRI were placed on a patient's back at regular intervals; they detected pulmonary vibration energy produced when respiration occurred and presented as specific images. Any modifications either in chest X-ray, C-reactive protein (CRP), white blood cell count (WBC) or body temperature were compared with changes in VRI image during a given time course. Results: VRI, chest X-ray and CRP scores were significantly improved after treatment. Correlation between VRI and other tests was not clearly indicated among all patients. But relatively severe pneumonia patients showed correlations between VRI and chest X-ray, as well as between VRI and CRP. Conclusion: This study demonstrates that VRI can be safely applied to patients with pneumonia.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.10-14
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• 2013

Purpose: Due to developed simultaneous PET/MRI, it has become possible to obtain more anatomical image information better than conventional PET/CT. By the way, in the PET/CT, the linear absorption coefficient is measured by X-ray directly. However in case of PET/MRI, the value is not measured from MRI images directly, but is calculated by dividing as 4 segmentation ${\mu}-map$. Therefore, in this paper, we will evaluate the SUV's difference of attenuation correction PET images from PET/MRI and PET/CT. Materials and Methods: Biograph mCT40 (Siemens, Germany), Biograph mMR were used as a PET/CT, PET/MRI scanner. For a phantom study, we used a solid type $^{68}Ge$ source, and a liquid type $^{18}F$ uniformity phantom. By using VIBE-DIXON sequence of PET/MRI, human anatomical structure was divided into air-lung-fat-soft tissue for attenuation correction coefficient. In case of PET/CT, the hounsfield unit of CT was used. By setting the ROI at five places of each PET phantom images that is corrected attenuation, the maximum SUV was measured, evaluated %diff about PET/CT vs. PET/MRI. In clinical study, the 18 patients who underwent simultaneous PET/CT and PET/MRI was selected and set the ROI at background, lung, liver, brain, muscle, fat, bone from the each attenuation correction PET images, and then evaluated, compared by measuring the maximum SUV. Results: For solid $^{68}Ge$ source, SUV from PET/MRI is measured lower 88.55% compared to PET/CT. In case of liquid $^{18}F$ uniform phantom, SUV of PET/MRI as compared to PET/CT is measured low 70.17%. If the clinical study, the background SUV of PET/MRI is same with PET/CT's and the one of lung was higher 2.51%. However, it is measured lower about 32.50, 40.35, 23.92, 13.92, 5.00% at liver, brain, muscle, fat, femoral head. Conclusion: In the case of a CT image, because there is a linear relationship between 511 keV ${\gamma}-ray$ and linear absorption coefficient of X-ray, it is possible to correct directly the attenuation of 511 keV ${\gamma}-ray$ by creating a ${\mu}$map from the CT image. However, in the case of the MRI, because the MRI signal has no relationship at all with linear absorption coefficient of ${\gamma}-ray$, the anatomical structure of the human body is divided into four segmentations to correct the attenuation of ${\gamma}-rays$. Even a number of protons in a bone is too low to make MRI signal and to localize segmentation of ${\mu}-map$. Therefore, to develope a proper sequence for measuring more accurate attenuation coefficient is indeed necessary in the future PET/MRI.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8553-8557
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• 2016

Background: Accurate dose assessment and correct identification of irradiated from non-irradiated people are goals of biological dosimetry in radiation accidents. Objectives: Changes in the FDXR and the RAD51 gene expression (GE) levels were here analyzed in response to total body exposure (TBE) to a 6 MV x-ray beam in rats. We determined the accuracy for absolute quantification of GE to predict the dose at 24 hours. Materials and Methods: For this in vivo experimental study, using simple randomized sampling, peripheral blood samples were collected from a total of 20 Wistar rats at 24 hours following exposure of total body to 6 MV X-ray beam energy with doses (0.2, 0.5, 2 and 4 Gy) for TBE in Linac Varian 2100C/D (Varian, USA) in Golestan Hospital, in Ahvaz, Iran. Also, 9 rats was irradiated with a 6MV X-ray beam at doses of 1, 2, 3 Gy in 6MV energy as a validation group. A sham group was also included. After RNA extraction and DNA synthesis, GE changes were measured by the QRT-PCR technique and an absolute quantification strategy by taqman methodology in peripheral blood from rats. ROC analysis was used to distinguish irradiated from non-irradiated samples (qualitative dose assessment) at a dose of 2 Gy. Results: The best fits for mean of responses were polynomial equations with a R2 of 0.98 and 0.90 (for FDXR and RAD51 dose response curves, respectively). Dose response of the FDXR gene produced a better mean dose estimation of irradiated "validation" samples compared to the RAD51 gene at doses of 1, 2 and 3 Gy. FDXR gene expression separated the irradiated rats from controls with a sensitivity, specificity and accuracy of 87.5%, 83.5% and 81.3%, respectively, 24 hours after dose of 2 Gy. These values were significantly (p<0.05) higher than the 75%, 75% and 75%, respectively, obtained using gene expression of RAD51 analysis at a dose of 2 Gy. Conclusions: Collectively, these data suggest that absolute quantification by gel purified quantitative RT-PCR can be used to measure the mRNA copies for GE biodosimetry studies at comparable accuracy to similar methods. In the case of TBE with 6MV energy, FDXR gene expression analysis is more precise than that with RAD51 for quantitative and qualitative dose assessment.

• Journal of Radiation Protection and Research
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• v.41 no.2
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• pp.167-171
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• 2016

Background: TlBr is of considerable technological importance for radiation detection applications where detecting high-energy photons such as X-rays and ${\gamma}$-rays are of prime importance. However, there were few reports on investigating optical properties of TlBr itself for deeper understandings of this material and for making better radiation detection devices. Thus, in this paper, we report on the optical characterizations of TlBr single crystals. Spectroscopic ellipsometry (SE) and photoluminescence (PL) measurements at RT were performed for this work. Materials and Methods: A 2-inch TlBr single crystalline ingot was grown by using the vertical Bridgman furnace. SE measurements were performed at RT within the photon energy range from 1.1 to 6.5 eV. PL measurements were performed at RT by using a home-made PL system equipped with a 266 nm-laser and a spectrometer. Results and Discussion: Dielectric responses from SE analysis were shown to be slightly different among the different samples possibly due to the different structural/optical properties. Also from the PL measurements, it was observed that the peak intensities of the middle samples were significantly higher than those of the other two samples. With the given values for permittivity of free space (${\varepsilon}_0=8.854{\times}10^{-12}F{\cdot}m^{-1}$), thickness (d = 1 mm), and area ($A=10{\times}10mm^2$) of the TlBr sample, capacitances of TlBr were 6.9 pF (at $h{\nu}=3eV$) and 4.4 pF (at $h{\nu}=6eV$), respectively. Conclusion: SE and PL measurement and analysis were performed to characterize TlBr samples from the optical perspective. It was observed that dielectric responses of different TlBr samples were slightly different due to the different material properties. PL measurements showed that the middle sample exhibited much stronger PL emission peaks due to the better material quality. From the SE analysis, optical, dielectric constants were extracted, and calculated capacitances were in the few pF range.

• Journal of Chest Surgery
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• v.46 no.2
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• pp.130-134
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• 2013

Background: Rib fractures are the most common type of thoracic trauma and cause other complications. We explored the risk factors for pneumonia in patients with multiple rib fractures. Materials and Methods: Four hundred and eighteen patients who visited our hospital with multiple rib fractures between January 2002 and December 2008 were retrospectively reviewed. Chest X-rays and chest computed tomography were used to identify injury severity. Patients with only a single rib fracture or who were transferred to another hospital within 2 days were excluded. Results: There were 327 male patients (78%), and the median age was 53 years. The etiologies of the patients' trauma included traffic accidents in 164 cases (39%), falls in 78 cases (19%), slipping and falling in 90 (22%), pedestrian accidents in 30 (7%), industrial accidents in 41 (10%), and assault in 15 (4%). The median number of rib fractures was 4.8. Pulmonary complications including flail chest (2.3%), lung contusion (22%), hemothorax (62%), pneumothorax (31%), and hemopneumothorax (20%) occurred. Chest tubes were inserted into the thoracic cavity in 216 cases (52%), and the median duration of chest tube insertion was 10.26 days. The Injury Severity Score (ISS) and rib score had a median of 15.27 and 6.9, respectively. Pneumonia occurred in 18 cases (4.3%). Of the total cases, 33% of the cases were managed in the intensive care unit (ICU), and the median duration of stay in the ICU was 7.74 days. Antibiotics were administered in 399 patients (95%) for a median of 10.53 days. Antibiotics were used for more than 6 days in 284 patients (68%). The factors affecting pneumonia in patients with multiple rib fractures in multivariate analysis included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). The use of antibiotics was not associated with the occurrence of pneumonia (p=0.28). In-hospital mortality was 5.3% (n=22). Conclusion: The factors affecting risk of pneumonia in patients with multiple rib fractures included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). Elderly patients with multiple traumas have a high risk of pneumonia and should be treated accordingly.

• Archives of Plastic Surgery
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• v.39 no.6
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• pp.612-617
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• 2012

Background Packing after closed reduction of a nasal bone fracture causes inconvenient nasal obstruction in patients. We packed the superior meatus with Vaseline gauze to support the nasal bone, and packed the middle nasal meatus with a Doyle Combo Splint consisting of an airway tube, a silastic sheet, and an expandable sponge to reduce the inconvenience. In addition, we aimed to objectively identify whether this method not only enables nasal respiration but also sufficiently supports the reduced nasal bone. Methods Nasal ventilation was measured via spirometry 1 day before surgery and compared to 1 day after surgery. To compare support of the reduced nasal bone by the 2 methods, 2 plastic surgeons assessed the displacementon X-rays taken after the surgery and after removing the packing. The extent of nasal obstruction, dry mouth, sleep disturbance, headache, and swallowing difficulty were compared with visual analog scales (VAS) on a pre-discharge survey. Results In the experimental group, the nasal respiration volume 1 day after surgery remained at $71.3%{\pm}6.84%$ on average compared to 1 day prior to surgery. Support of the reduced bone in the experimental group ($2.80{\pm}0.4$) was not significantly different from the control group ($2.88{\pm}0.33$). The VAS scores for all survey items were lower in the experimental group than in the control group, where a lower score indicated a lower level of inconvenience. Conclusions The nasal cavity packing described here maintained objective measures of nasal respiration and supported the reduced bone similar to conventional methods. Maintaining nasal respiration reduced the inconvenience to patients, which demonstrates that this packing method is useful.

• Tuberculosis and Respiratory Diseases
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• v.81 no.3
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• pp.233-240
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• 2018

Background: Non-conversion of sputum smear and culture prolongs the infectivity of the patient and has been associated with unfavorable outcomes. We aimed to evaluate factors associated with persistent sputum positivity at the end of two months of treatment of new case pulmonary tuberculosis (TB). Methods: Data of 87 human immunodeficiency virus-negative patients with culture-positive drug-susceptible pulmonary TB admitted to local university hospital between September 2015 and September 2016 were reviewed. Factors associated with sputum smear and/or culture positivity at the end of the second month of treatment were analyzed. Results: Twenty-two patients (25.3%) remained smear and/or culture-positive. Male sex, lower body mass index (BMI), unemployment, alcohol abuse, higher number of lobes involved and cavities on chest X-rays, shorter time to detection (TTD) on liquid cultures, higher respiratory sample smear grading and colony count in solid cultures, higher C-reactive protein, erythrocyte sedimentation rate, leukocytosis, thrombocytosis, and anemia were all significantly associated with persistent sputum positivity. However, in the logistic regression analysis only male sex, lower BMI, alcohol abuse, higher radiological involvement, cavitation, higher smear grading, higher colony count in solid cultures and shorter TTD were determined as independent factors associated with persistent sputum positivity at the end of 2 months of treatment. Conclusion: In conclusion, higher sputum smear and culture grading at diagnosis, shorter TTD, higher number of lobes involved, cavitation, male sex, alcohol abuse, and lower BMI were independently associated with persistent sputum positivity. These factors should be sought when distinguishing which patients will remain infectious longer and possibly have worse outcomes.