본 연구의 목적은 복강경 수술환경에서 2D와 3D 내시경 비디오 영상이 수술에 미치는 영향을 평가하기 위한 연구이며, 이를 위해 3D 내시경 시스템을 구성하고 성능 평가를 수행하였다. 결과적으로 본 연구에서 제안한 3D 방식이 기존의 전자셔터 방식에 의한 3D 영상에 비해 화질과 시야각이 우수하며, 2종류의 모의 수술 실험 비교를 한 결과, 제안한 방식의 디지털 영상을 이용하는 경우가 성능이 가장 우수함을 정량적으로 확인하였다.

The role of radiology department has been greatly increased in the past few years as the technology in the medical imaging devices improved and the introduction of PACS (Picture Archiving and Communications System) to the conventional film-based diagnostic structure is a truly remarkable factor to the medical history. In addition, the value of using digital information in medical imaging is highly expected to grow as the technology over the computer and the network improves. However, the current medical practice, using PACS is somewhat limited compared to the film-based conventional one due to a poor image quality. The image quality is the most important and inevitable factor in the PACS environment and it is one of the most necessary steps to more wide practice of digital imaging. The existing image quality control tools are limited in controlling images produced from the medical modalities, because they cannot display the real image changing status. Thus, the image quality is distorted and the ability to diagnosis becomes hindered compared to the one of the film-based practice. In addition, the workflow of the radiologist greatly increases; as every doctor has to perform his or her own image quality control every time they view images produced from the medical modalities. To resolve these kinds of problems and enhance current medical practice under the PACS environment, we have developed a program to display a better image quality by using the ROI optical density of the existing gray level values. When the LUT is used properly, small detailed regions, which cannot be seen by using the existing image quality controls are easily displayed and thus, greatly improves digital medical practice. The purpose of this study is to provide an easier medical practice to physicians, by applying the technology of converting the H-D curves of the analog film screen to the digital imaging technology and to preset image quality control values to each exposed body part, modality and group of physicians for a better and easier medical practice. We have asked to 5 well known professional physicians to compare image quality of the same set of exam by using the two different methods: existing image quality control and the LUT technology. As the result, the LUT technology was enormously favored over the existing image quality control method. All the physicians have pointed out the far more superiority of the LUT over the existing image quality control method and highly praised its ability to display small detailed regions, which cannot be displayed by existing image quality control tools. Two physicians expressed the necessity of presetting the LUT values for each exposed body part. Overall, the LUT technology yielded a great interest among the physicians and highly praised for its ability to overcome currently embedded problems of PACS. We strongly believe that the LUT technology can enhance the current medical practice and open a new beginning in the future medical imaging.

This thesis describes the effective interfacing methods of PACS Modality based on the system installation and operating experiences. PACS(Picture Archiving and Communication Systems) is a system for medical image archiving and communication using large storage device and high-speed network. The standard communication protocol of PACS is DICOM(Digital Imaging and Communication in Medicine) based on TCP/IP and point-to-point protocol. However, there are many Non-DICOM Modalities and DICOM Modalities having problems. First, we had interfaced almost modalities, Fuji CR, GE CT, MRI, Angio, Fluoro, Phillips Angio, Shimadzu Fluoro, Ultrasound PACS, with the main PACS in the Seoul S Hospital as large scale hospital. And we manipulated the intelligent image distribution and the CT, MRI Interfaces never experienced before in the Anyang J Hospital and the Chungju C Hospital as mid or small scale hospital. Technically, we developed both the DICOM Interface and the Non-DICOM Interface. At the last, the DICOM Worklist and the DICOM Print Interface were implemented in the Seoul B Hospital, the Bucheon SJ Hospital and the Seoul K Hospital independently with PACS. The Oracle, Sybase and MS-SQL are used as database, and UNIX, Macintosh, MS Windows as operating systems. And the Visual C++ and UNIX C are the main programming tools. We have used UTP, coaxial and fiber optic Gable under 10/100 mbps LAN for networking.

DR은 방사선과 뿐만 아니라 병원전체의 생산성 및 업무의 효율성에서 중요한 요소로 자리잡아가고 있다. DR환경은 CR보다 다양한 Parameter를 가지고 있어 양질의 의료서비스 제공이 가능하다. 현재 각 병원의 방사선과는 Film-Screen system에서 Full-PACS를 통한 DR 환경으로 변화하고 있다. Full-PACS를 사용하고 있는 본원에서는 DR환경에서의 일반촬영 System중 CR과 DDR의 최적노출조건과 그에 따른 Image quality가 어떻게 표현되는 지 알아보고자 본 연구에 임하게 되었다. 본 실험을 통하여 CR과 DDR의 Image quality는 같은 노출조건 하에서는 DDR이 더욱 우수하다는 것을 알 수 있었다. 그리고 DDR system에서도 AEC를 사용했을 때의 Image에 대한 점수가 사용하지 않았을 때보다 조금 더 높은 것을 알 수 있다. 특히 Skull, Chest부분에서는 DDR의 AEC기능이 Image quality를 향상시키는데 유용함을 간접적으로 알 수 있었다. (AEC기능이란 피사체를 통과한 X선을 Detector내에 있는 Ion chamber를 이용하여 전리전류를 검출하는 기구로서 적정농도 도달 시 X선의 조사를 제어하도록 되어있다.) 이 기능은 다양한 피사체의 두께에 따른 노출조건을 고려하지 않아도 적정농도를 나타낼 수 있기 때문에 보다 손쉬운 촬영이 이루어질 수 있다. 이 실험결과로 좋은 Image quality를 얻기 위해서는 적절한 노출조건의 선정이 중요함을 알 수 있었다. 앞으로도 무한한 발전 가능성이 있는 DDR system에 대한 연구가 좀 더 필요하겠다.

To evaluate the relative time required to perform a CT(computed tomography) examination in a filmless versus a film-based system and helical versus nonhelical studies. Time and Motion studies were performed in 175 consecutive CT examinations. Images from 85 examinations were electronically transferred to a PACS, and 90 were printed to film. The time required to obtain and electronically transfer the images or print the images to film and make the current and previous studies available to the radiologists for interpretation was recorded. The time required for a radiological technologist to complete a CT examination was reduced by 43% with the PACS compared with the film-based system and nonhelical was reduced 10-20% with helical studies. This reduction was due to the elimination of a transfer and printing, such as the printing at window or level settings. The use of PACS can result in the elimination of time tasks for the radiological technologist, resulting in marked reduction in examination time. This reduction can result in decreased cost and increased productivity in PACS operation.

Information concerning a patient visit is to be sent from the OCS(Order Communication System) to the PACS(Picture archiving and Communication System) and when the image acquisition is completed, information regarding the procedures also actually preformed should be sent back to the OCS. It should be possible to present related medical information from the OCS at the same image workstation in a coherent way with the images in the PACS, Examples of the related medical information are: the report of a diagnostic image procedure, data on medication, laboratory results, admission and discharge letters, and surgery reports, because we could maximize the efficiency of Radiological Work, like decrease examination time and human mistakes, though the integration of PACS and OCS, Therefore, We research some hospitals to find integral lists of PACS and OCS but there are no sufficient ingredients. Further, the percentage of Integral lists of PACS and OCS is different in all hospitals because there is no such standard yet like HL7(Healthcare Level 7) and DICOM(Digital Imaging and Communications in Medicine). Accordingly, if all hospital would follow national standard like HL7 and DICOM, the integration of OCS and PACS would be efficient but in this situation radiological technician should take part in construction integration system of PACS and OCS positively, so we could improve efficiency of radiological work and our status.

대조도와 관용도사이의 손실 교환은 투사 방사선 촬영에 있어서 잘 알려져 있고 또한 오랫동안 지속되어온 영상의 질에 있어서의 제약이었다. 전자적인 영상획득의 도입으로 한 영상 내에 넓은 영역의 X-Tay 노출을 포획하는 것이 가능해 졌다. 그러나, 진단에 필요한 세부영역 들을 위해 적절한 대조도를 유지하는 반면, 일반적으로 기대되는 관용도 범위 이외의 정보가 시각화 되어지는 것과 같은 영상의 rendering과 displaying의 문제가 남아 있었다. 이 문서에 묘사되는 EVP(Enhanced Visualization Processing)는 이 문제를 중점적으로 다룬다. 방대한 진단용 CR 영상 데이터베이스로부터 선택된 14개의 검사유형 당 각각 5개의 영상들을 포함한, 총 70개의 영상들을 사용하여 임상 보고서가 제출되었다. 각 영상에 대해, control rendering은 현재 개발되어 있는 automatic tone scaling algorithm(자동 톤 스케일 알고리즘)에 의해 생성되었고, test rendering은 그 control of image에 EVP를 인가함에 의해 생성되었다. 10명의 radiologist들은 각자 개별적으로 140개의 이미지들(70개의 test renderings와 70개의 control renderings)을 9점의 진단 상의 품질 척도로 평가했다. EVP는 세부 대조도의 부당한 손실 없이 증가된 노출 관용도를 제공했다. 많은 영상에서 EVP는 과소 투과 영역에서의 정보의 손실을 줄여주고, 반면 과다 투과 영역의 밝게 빛나는 현상을 실제적으로 감소시켰다. 진단상의 품질 평가는 EVP image와 control image 모두 평균적으로 높았다. 그럼에도 EVP images의 평균 등위는 control image의 그것보다 1 단계 완전히 높은 범위에 있는 것으로 평가되었다. 쌍으로 그 영상들을 보면, EVP images의 76%가 일치하는 control images의 평가 단계보다 1 또는 그 이상 높은 범주인 것으로 평가되었고, 반면 control image의 6% 만이 일치하는 EVP 영상보다 우수한 것으로 평가되었다. 유사한 결과가 연구된 14개의 검사유형에 대해 획득되었다.

One of current trends of medical technology is analog to digital. Moreover, The Government put a premium on PACS(Picture Archiving and Communication System) for Medical Insurance in November, 1999. Therefore many hospitals are installing(or planning to install) PACS facilities on their buildings. However most of hospitals didn't consider PACS facilities in the beginning of construction. In particular, the Networking is one of the most difficult things for PACS installation. There is no space for network equipments, and no path for network lines, etc. To solve these problems, wireless network is proposed. The wireless network is divided to three parts mainly. One is the wireless communication for Local Area Network, another is the data transmission through a satellite for Tele-Radiology, and the last one is the technology using Bluetooth for each sub-system of PACS. But there are other problems in wireless systems, i.e., network bandwidth, system stability, interference with other devices. The purpose of this paper is to suggest the future and new trend of PACS including all the problems.

During the period from may to June 2000, a questionnaire study was carried out on 65 male radiological technologist who had been engaged at VDT work, to find out correlation their symptoms to VDT syndrome factors, work environment and condition. The results were as follows : 1. The mean age was 41.0 years, the mean relay working time was 3.75 hours and the mean duration of using computer monitor was 5.9 years, the satisfactory of working was 44.6% the others 55.4%, among these, 3.1% had symptoms before using the VDT and the others had not. 2. The prevalence of symptoms was the highest on wholebody tired, followed by eye, neck, low back, in decreased order and the lowest was fatique of wrist. 3. There was not significant correlation of symptoms to age, but significant to working time, working duration. 4. There was not significant correlation of symptoms to satisfactory. 5. Working desk, monitor, illuminations, temperature, and noise were significantly related to symptoms. 6. There was significant relation of symptoms to CT, MRI workers.