• Title/Summary/Keyword: CM at Risk Method

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A Study on Dose and Image Quality according to X-ray Photon Detection Method in Digital Radiography System (Digital Radiography System에서 X선 광자 검출 방식에 따른 선량 및 화질 특성에 관한 연구)

  • Hong, Sun Suk;Kim, Ho Chul
    • Journal of the Institute of Electronics and Information Engineers
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    • v.50 no.12
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    • pp.247-253
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    • 2013
  • The purpose is a comparative evaluation in the DR System according to the dosimetry and image quality of the quantitative and objective via Direct digital radiography, Indirect digital radiography, Image intensifier (Charge Coupled Device type) digital radiography. The experimental method used rando phantom and measured the entrance surface dose. And through using the measured entrance surface dose and then using the PCXMC program were evaluated risk due to irradiation and the effective dose. SNR and NPS and CNR were measured and analyzed by using 21cm acryl phantom. Significance of measured value was evaluated by statistics method. Entrance surface dose, major organ dose, effective dose all of them were measured the lowest rated in direct DR when it is on the basis of direct DR dose, high-dose ratio were measured in I.I DR approximately 1.3 times, indirect DR approximately 2.4 times. Risk in accordance with radiation also was measured same as dose ratio. On the conclusion that SNR measurement result based on direct DR SNR measurements, low-SNR ratio were measured in I.I DR approximately 7.25 times, indirect DR approximately 1.48 times. On the conclusion that CNR measurement result based on direct DR CNR measurements, high-dose ratio were measured in I.I type DR approximately 1.16 tims and low-dose ratio were measured in indirect DR approximately 0.87 times. Therefore Direct DR system using a-selenium sensing element to detect x-ray photon is thought effectively at the examination such as infant to sensitive irradiation and the genital gland. Because quality image is built by low dose. Also when it is necessary that image test requiring many diagnosis information, indirect DR system is thought effectively.

Role of Contrast-Enhanced Ultrasound as a Second-Line Diagnostic Modality in Noninvasive Diagnostic Algorithms for Hepatocellular Carcinoma

  • Hyo-Jin Kang;Jeong Min Lee;Jeong Hee Yoon;Joon Koo Han
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.354-365
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    • 2021
  • Objective: To investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) and its role as a second-line imaging modality after gadoxetate-enhanced MRI (Gd-EOB-MRI) in the diagnosis of hepatocellular carcinoma (HCC) among at risk observations. Materials and Methods: We prospectively enrolled participants at risk of HCC with treatment-naïve solid hepatic observations (≥ 1 cm) of Liver Imaging Reporting and Data System (LR)-3/4/5/M during surveillance and performed Gd-EOB-MRI. A total of one hundred and three participants with 103 hepatic observations (mean size, 28.2 ± 24.5 mm; HCCs [n = 79], non-HCC malignancies [n = 15], benign [n = 9]; diagnosed by pathology [n = 57], or noninvasive method [n = 46]) were included in this study. The participants underwent CEUS with sulfur hexafluoride. Arterial phase hyperenhancement (APHE) and washout on Gd-EOB-MRI and CEUS were evaluated. The distinctive washout in CEUS was defined as mild washout 60 seconds after contrast injection. The diagnostic ability of Gd-EOB-MRI and of CEUS as a second-line modality for HCC were determined according to the European Association for the Study of the Liver (EASL) and the Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) guidelines. The diagnostic abilities of both imaging modalities were compared using the McNemar's test. Results: The sensitivity of CEUS (60.8%) was lower than that of Gd-EOB-MRI (72.2%, p = 0.06 by EASL; 86.1%, p < 0.01 by KLCA-NCC); however, the specificity was 100%. By performing CEUS on the inconclusive observations in Gd-EOB-MRI, HCCs without APHE (n = 10) or washout (n = 12) on Gd-EOB-MRI further presented APHE (80.0%, 8/10) or distinctive washout (66.7%, 8/12) on CEUS, and more HCCs were diagnosed than with Gd-EOB-MRI alone (sensitivity: 72.2% vs. 83.5% by EASL, p < 0.01; 86.1% vs. 91.1% by KCLA-NCC, p = 0.04). There were no false-positive cases for HCC on CEUS. Conclusion: The addition of CEUS to Gd-EOB-MRI as a second-line diagnostic modality increases the frequency of HCC diagnosis without changing the specificities.

Skin Permeability of piroxicam Gel by Phonophoretic Transdermal Drug Delivery (음파영동 경피약물수송에 의한 Piroxicam Gel의 경피투과)

  • Choi Suk-Joo;Oh Myung-Hwa;Kim Tae-Youl
    • The Journal of Korean Physical Therapy
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    • v.14 no.4
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    • pp.147-162
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    • 2002
  • Transdermal permeation enhancer has been used to increased skin absorption. External control of drug release and skin absorption can also be achieved by iontophoresis or phonophoresis. However, because several problems with iontophoresis are that it has a risk to skin damage because of the change of pH and the increase of current density in applying it and that it can be applied only in the form of water solution, This study is to enhance drug permeation via skin following application of ultrasound. For this goal, in gel containing piroxicam, the degree of skin permeation in vitro and anti-inflammatory effect in in vivo were investigated. Permeation study using hairless mouse skin was performed at 37 $^{\circ}C$ using buffer saline as the receptor solution. The amount of piroxicam were quantified using a HPLC system consisting of solvent delivery system. Following adoption of ultrasound 1 MHZ, it showed relatively high permeation rate where it was compared with non treated by ultrasound. The influence of duty cycle having an effect on skin permeation rate was slight higher in the case of using pulsed mode. Skin permeation increase attended by intensity of ultrasound, the permeation of trice was accelerated at 2.0 W/$cm^{2}$ than 1.0 W/$cm^{2}$. The skin permeation of piroxicam was substantially influenced by ultrasound. Anti-inflammatory effects were determined using carrageenan-induced paw swelling method in SD rat. Paw swelling tests showed that pulsed phonophoresis group was more effective than control group and only gel application group. The conclusion of phonophoresis was found to improve significantly the skin permeation in vitro and the anti-inflammatory effect in vivo.

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Comparing the dosimetric impact of fiducial marker according to density override method : Planning study (양성자 치료계획에서 fiducial marker의 density override 방법에 따른 선량변화 비교 : Planning study)

  • Sung, Doo Young;Park, Seyjoon;Park, Ji Hyun;Park, Yong Chul;Park, Hee Chul;Choi, Byoung Ki
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.1
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    • pp.19-26
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    • 2017
  • Purpose: The application of density override is very important to minimize dose calculation errors by fiducial markers of metal material in proton treatment plan. However, density override with actual material of the fiducial marker could make problem such as inaccurate target contouring and compensator fabrication. Therefore, we perform density override with surrounding material instead of actual material and we intend to evaluate the usefulness of density override with surrounding material of the fiducial marker by analyzing the dose distribution according to the position, material of the fiducial marker and number of beams. Materials and Method: We supposed that the fiducial marker of gold, steel, titanium is located in 1.5, 2.5, 4.0, 6.0 cm from the proton beam's end of range using water phantom. Treatment plans were created by applying density override with the surrounding material and actual material of the fiducial marker. Also, a liver cancer patient who received proton therapy was selected. We located the fiducial marker of gold, steel, titanium in 0, 1.5, 3.5 cm from the proton beam's end of range and the treatment plans were created by same method with water phantom. Homogeneity Index(HI), Conformity Index(CI) and maximum dose of Organ At Risk(OAR) in Planning Target Volume(PTV) as the evaluation index were compared according to the material, position of the fiducial marker and number of beam. Results: The HI value was more decreased when density override with surrounding material of the fiducial marker was performed comparing with density override with actual material. Especially the HI value was increased when the fiducial marker was located farther from the proton beam's end of the range for a single beam and the fiducial marker's position was closer to isocenter for two or more beams. The CI value was close to 1 and OAR maximum dose was greatly reduced when density override with surrounding material of the fiducial marker was performed comparing with density override with actual material. Conclusion: Density override with surrounding material can be expected to achieve more precise proton therapy than density override with actual material of the fiducial marker and could increase the dose uniformity and target coverage and reduce the dose to surrounding normal tissues for the small fiducial markers used in clinical practice. Most of all, it is desirable to plan the treatment by avoiding the fiducial marker of metal material as much as possible. However, if the fiducial marker have on the beam path, density override of the surrounding material can be expected to achieve more precise proton therapy.

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Utility of the 16-cm Axial Volume Scan Technique for Coronary Artery Calcium Scoring on Non-Enhanced Chest CT: A Prospective Pilot Study (비 조영증강 흉부 CT에서 관상동맥 칼슘스코어 측정을 위한 16 cm 축상 촬영 기법의 유용성: 전향적 탐색적 연구)

  • So Jung Ki;Chul Hwan Park;Kyunghwa Han;Jae Min Shin;Ji Young Kim;Tae Hoon Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1493-1504
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    • 2021
  • Purpose This study aimed to evaluate the utility of the 16-cm axial volume scan technique for calculating the coronary artery calcium score (CACS) using non-enhanced chest CT. Materials and Methods This study prospectively enrolled 20 participants who underwent both, non-enhanced chest CT (16-cm-coverage axial volume scan technique) and calcium-score CT, with the same parameters, differing only in slice thickness (in non-enhanced chest CT = 0.625, 1.25, 2.5 mm; in calcium score CT = 2.5 mm). The CACS was calculated using the conventional Agatston method. The difference between the CACS obtained from the two CT scans was compared, and the degree of agreement for the clinical significance of the CACS was confirmed through sectional analysis. Each calcified lesion was classified by location and size, and a one-to-one comparison of non-contrast-enhanced chest CT and calcium score CT was performed. Results The correlation coefficients of the CACS obtained from the two CT scans for slice thickness of 2.5, 1.25, and 0.625 mm were 0.9850, 0.9688, and 0.9834, respectively. The mean differences between the CACS were -21.4% at 0.625 mm, -39.4% at 1.25 mm, and -76.2% at 2.5 mm slice thicknesses. Sectional analysis revealed that 16 (80%), 16 (80%), and 13 (65%) patients showed agreement for the degree of coronary artery disease at each slice interval, respectively. Inter-reader agreement was high for each slice interval. The 0.625 mm CT showed the highest sensitivity for detecting calcified lesions. Conclusion The values in the non-contrast-enhanced chest CT, using the 16-cm axial volume scan technique, were similar to those obtained using the CACS in the calcium score CT, at 0.625 mm slice thickness without electrocardiogram gating. This can ultimately help predict cardiovascular risk without additional radiation exposure.

Weight Control and Cardiovascular Risk in Middle-Aged Women (중년여성의 체중관리 실태와 성인병 위험도)

  • Kim, Jeong-Ah;Chaung, Seung-Kyo
    • The Korean Journal of Rehabilitation Nursing
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    • v.7 no.1
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    • pp.33-47
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    • 2004
  • The purpose of this study was to investigate weight control practices and cardiovascular risk in middle-aged women. 304 middle-aged women were selected as subjects from thirties to fifthies living at J city in Chung-Buk Do. Data were collected using a questionnaire, anthropometric measurements, BP & total cholesterol level in serum from April 1, to June 30, 2003. The results of this study were as follows: The middle-aged woman's age is average $43.95{\pm}7.09yr$ and mean BMI(body mass index) was $23.54{\pm}3.09\;kg/m^2$. Underweight, normal weight, overweight, obese women were 3.0%, 39.5%, 27.9% and 29.6%respectively. Subjects perceived own as 'Slim' 5.9%, 'ordinary' 45.7%, 'Fat' 48.4%. Their weight perception coincide their own actual body weight but as many as 41.8% of overweight and 9.0% of obese perceived themselves as being 'ordinary'. Middle age women with past weight control experience were 55.6%, and only 35.5% was doing weight control at present. Of these subjects, 71.4% reported wanting to lose weight and the primary reason of weight control was to improve their appearance(39.53%). The most frequently reported weight control behavior was 'exercise' followed 'dieting', but 39.6% reported using 'diet food', 12.4% 'behavior modification', 12.4% 'fasting', and 'diet-drug'(3.6%) or 'smoking'(3.6%). Effective weight control methods were thought regular exercise(97.1%) & dieting (79.3%). And behavior modification(71.4%) or diet camp(60%) were effective, too. An average waist circumference was $79.80{\pm}9.47cm$, waist/hip ratio was $86.63{\pm}6.78$, waist/height ratio was $50.43{\pm}6.10$. In the index of abdominal obesity, 79.7 % of middle-aged women was waist/height ratio over 0.46, 65.3% was waist/hip ratio over 0.85, 28.4% was waist circumference over 85cm. There were significant differences in the degree of abdominal obesity according to age and BMI. In the index of cardiovascualr risk, 10.9% of middle aged women was systolic hypertension over 140mmHg, 18.7% was diastolic hypertension over 90mmHg and 10.6% was hypercholesterolemia over 200mg/dl. There was significant difference in systolic hypertension ratio according to age. There was significant difference in diastolic hypertension ratio according to age and obesity. There were significant differences in hypercholesterolemia accorting to obesity. The abdominal obesity indices and the levels of T-cholesterol in the serum, systolic and diastolic BP increased significantly according to age. T-cholesterol in serum was predicted 2.6% by waist/height ratio. And systolic BP was predicted 15.2% by waist/height, add BMI to 16.8%. Subject's diastolic BP was predicted 12.1% by BMI. Therefore waist/height ratio and BMI were significant factors for the predictors of cardiovascular risk. There was significant correlation between index of obesity and cardiovascular risk. T-cholesterol in serum had correlation with waist/eight ratio(r=0.174) and waist circumference(r=0.48). Systolic BP had correlation with waist/height ratio(r=0.387), and BMI(=0.371). diastolic BP correlation had correlation with BMI(r=0.343) and waist/height ratio(r=0.327). In conclusion, The prevalence of obesity was 29.6% in 304 cases, and increased as age after menopause increased. Middle-aged women's weight perception and actual BMI coincide but some of them did not. Trial to reduce weight was attempted. But most of them did not actually. Undesirable weight control method such as using drugs, fasting, smoking was used by some women. It is important to educate about health weight control methods and raise their awareness of exact body figures. High frequency of abdominal obesity in middle-aged women had correlation with hypertension and hypercholesterolemia. Abdominal index such as waist/height ratio, waist circumference, waist/hip ratio was used. Women's hypertension, hypercholesterolemia significantly related to body mass index and abdominal obesity.

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A New Method of Approach for Percutaneous Thoracic Vertebroplasty in Vertebral Compression Fracture -Case report- (흉추 압박골절환자를 위한 경피적 척추성형술의 새로운 접근법 -증례 보고-)

  • Shin, Keun-Man
    • The Korean Journal of Pain
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    • v.13 no.2
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    • pp.237-241
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    • 2000
  • Vertebral compression fractures commonly afflict the elderly. Some patients suffer from severe mechanical pain in spite of treatments with strong analgesics and bracing. Vertebroplasty, which was originally used for vertebral hemangioma, is effective for patients who do not respond to these more conservative treatments. However, the procedure has some risk. Leaks of bone cement into perineural tissues can be a serious complication. In contrast to the lumbar vertebrae, the outer margin of the pedicle of the thoracic vertebrae is almost in line with the outer margin of the body. This, combined with the thinner pedicle of the thoracic vertebrae, makes proper needle placement difficult. The posterolateral approach is preferred to the transpedicular approach in order to avoid the danger of destroying the inner cortex of the pedicle. But there can be a problems with the standard posterolateral approach. The rib can be broken, the pleura can be punctured. A new and safer approach is possible. Before penetrating the bone, the needle is positioned at the upper margin of the transverse process, 5 mm away from the pedicle. To achieve this positioning, the needle must puncture the skin 1~1.5 cm laterally and 3~5 mm cranially to the target point on the bone. This approach was used for 10 patients and we achieved good results with no serious complication.

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Effect of Surface Environment on Front Squat of Crossfit Athletes (지면환경이 크로스핏 선수의 프론트 스쿼트에 미치는 영향)

  • Jang, Yootae;Yoon, Sukhoon
    • Korean Journal of Applied Biomechanics
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    • v.32 no.2
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    • pp.49-55
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    • 2022
  • Objective: This study aims to verify the front squat motions using by two different surfaces, thereby elucidating the grounds for effective training environment that can minimize the risk of injury. Method: Total of 10 healthy male crossfit athletes were recruited for this study (age: 32.30 ± 3.05 yrs., height: 173.70 ± 5.12 cm, body mass: 82.40 ± 6.31 kg, 1RM: 160 ± 13.80 kg). All participants are those who know how to do front squats well with more than five years of crossfit athlete experience. All participants have sufficient experience in front squats on two types of surface which are soft surface (SS) and hard surface (HS). In each surface, participant perform 10reps of the front squat with 80% of the pre-measured 1RM. A 3-dimensional motion analysis with 8 infrared cameras and 2 channels of EMG was performed in this study. Paired sample t-test was used for statistical verification between two surfaces. The significant level was set at α=.05. Results: The significantly decreased rectus femoris muscle activation was found in SS compared with that of HS on phase 1 (p<.05). Also, ROM of ankle joint was significantly increased in the SS compare with that of HS on phase 1 (p<.05). The muscle activity ratio of gluteus maximus/rectus femoris showed a significant difference only in SS compared with that of HS on phase 1 (p<.05). Conclusion: In conclusion, Korean crossfit boxes should consider the use of hard surface, which has a relatively less risk of injury than soft surface, in selecting flooring materials. For the Crossfit athletes, they are also considered appropriate to train on a relatively hard surface.

Changes in Impact Characteristics of the Body by Different Heel Strike Patterns during Running (달리기 시 착지 유형에 따른 인체에 미치는 충격의 변화)

  • Young-Seong Lee;Sang-Kyoon Park
    • Korean Journal of Applied Biomechanics
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    • v.33 no.4
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    • pp.164-174
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    • 2023
  • Objective: The aim of this study was to quantitatively analyze the impact characteristics of the lower extremity on strike pattern during running. Method: 19 young subjects (age: 26.53 ± 5.24 yrs., height: 174.89 ± 4.75 cm, weight: 70.97 ± 5.97 kg) participated in this study. All subjects performed treadmill running with fore-foot strike (FFS), mid-foot strike (MFS), and rear-foot strike (RFS) to analyze the impact characteristics in the lower extremity. Impact variables were analyzed including vertical ground reaction force, lower extremity joint moments, impact acceleration, and impact shock. Accelerometers for measuring impact acceleration and impact shock were attached to the heel, distal tibia, proximal tibia, and 50% point of the femur. Results: The peak vertical force and loading rate in passive portion were significantly higher in MFS and FFS compared to FFS. The peak plantarflexion moment at the ankle joint was significantly higher in the FFS compared to the MFS and RFS, while the peak extension moment at the knee joint was significantly higher in the RFS compared to the MFS and FFS. The resultant impact acceleration was significantly higher in FFS and MFS than in RFS at the foot and distal tibia, and MFS was significantly higher than FFS at the proximal tibia. In impact shock, FFS and MFS were significantly higher than RFS at the foot, distal tibia, and proximal tibia. Conclusion: Running with 3 strike patterns (FFS, MFS, and RFS) show different impact characteristics which may lead to an increased risk of running-related injuries (RRI). However, through the results of this study, it is possible to understand the characteristics of impact on strike patterns, and to explore preventive measures for injuries. To reduce the incidence of RRI, it is crucial to first identify one's strike pattern and then seek appropriate alternatives (such as reducing impact force and strengthening relevant muscles) on that strike pattern.

Gender Dfferences in Ground Reaction Force Components

  • Park, Sang-Kyoon;Koo, Seungbum;Yoon, Suk-Hoon;Park, Sangheon;Kim, Yongcheol;Ryu, Ji-Seon
    • Korean Journal of Applied Biomechanics
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    • v.28 no.2
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    • pp.101-108
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    • 2018
  • Objective: The aim of this study was to investigate gender differences in ground reaction force (GRF) components among different speeds of running. Method: Twenty men ($age=22.4{\pm}1.6years$, $mass=73.4{\pm}8.4kg$, $height=176.2{\pm}5.6cm$) and twenty women ($age=20.7{\pm}1.2years$, $mass=55.0{\pm}8.2kg$, $height=163.9{\pm}5.3cm$) participated in this study. All participants were asked to run on an instrumented dual belt treadmill (Bertec, USA) at 8, 12, and 16 km/h for 3 min, after warming up. GRF data were collected from 30 strides while they were running. Hypotheses were tested using one-way ANOVA, and level of significance was set at p-value <.05. Results: The time to passive peaks was significantly earlier in women than in men at three different running speeds (p<.05). Further, the impact loading rates were significantly greater in women than in men at three different running speeds (p<.05). Moreover, the propulsive peak at 8 km/h, which is the slowest running speed, was significantly greater in women than in men (p<.05), and the vertical impulse at 16 km/h, which is the fastest running speed, was significantly greater in men than in women (p<.05). The absolute anteroposterior impulse at 8 km/h was significantly greater in women than in men (p<.05). In addition, as the running speed increased, impact peak, active peak, impact loading rate, breaking peak, propulsive peak, and anteroposterior impulse were significantly increased, but vertical impulse was significantly decreased (p<.05). Conclusion: The impact loading rate is greater in women than in men regardless of different running speeds. Therefore, female runners might be exposed to the risk of potential injuries related to the bone and ligament. Moreover, increased running speeds could lead to higher possibility of running injuries.