Background: The new Multidetector Computed Tomography (MDCT) is useful in visualization of complex coronary artery anatomy. We investigated usefulness comparing of invasive coronary angiography with noninvasive MDCT in judgment of functional degree of coronary arteries grafts after coronary artery bypass graft operation. Material and Method: We analyzed the patency of 52 conduits from 15 patients whom consented to take both 32 Channel MDCT and coronary angiography from November 2003 to November 2004. Comparisons were performed for sensitivity, specificity, positive prediction value and negative prediction value between coronary angiography and 3 dimensional reconstruction image using MDCT. Result: The average graft used was 3.4 $\pm$ 0.8 per patient. Average heart rate during MDCT was 86/minute (Range, 60$\∼$110/minute) without administration of $\beta$-blocker. All patients could hold breath as much as necessary. The average graft patency obtained through corollary angiography was 96.2$\%$. In MDCT group, the sensitivity, the specificity, the positive predictive value and the negative predictive value for diagnosis was 100$\%$, 98.0$\%$, 100$\%$ and 66.6$\%$ respectively. Conclusion: The effectiveness of 32 Channel MDCT may be compared to coronary angiography in grasping about patency and bloodstream of graft conduits after coronary artery bypass graft. Also MDCT has the advantage of noninvasiveness and inexpensiveness compared to coronary angiography.
Application of the left lateral tilt position has been recommended during cardiopulmonary resuscitation (CPR) of pregnant patients. However, the left lateral tilt could displace the left ventricle (LV) besides the gravid uterus and may compromise the cardiac pump mechanism of CPR. Thus, we investigated the effect of left lateral tilt on the spatial relationship between the anterior-posterior axis (AP axis), which represents the direction of sternal displacement during CPR, and the LV. We retrospectively reviewed the medical records and multidetector computed tomography (MDCT) scans of 90 patients who underwent virtual gastroscopy using MDCT. Virtual gastroscopy was performed with the patient both in the left lateral tilt position and in the supine position. On an axial image showing the maximal area of the LV, the angle between the AP axis and the LV axis ($Angle_{AP-LV}$), the shortest distance between the AP axis and the mid-point of LV cavity ($D_{AP-MidLV}$) and the shortest distance between the AP axis and the LV apex ($D_{AP-Apex}$) were measured. In the supine scans, the LV was situated on the left side of the AP axis in 87 patients (96.7%). On the left lateral tilt scans, the mean tilt angle was $43.4{\pm}11.0^{\circ}$. $D_{AP-MidLV}$ and $D_{AP-Apex}$ were significantly longer in the left lateral tilt position (p<0.001), but $Angle_{AP-LV}$ was comparable between the positions. This study indicates that the left lateral tilt position may compromise the cardiac pump mechanism of chest compression in pregnant cardiac arrest patients.
Kim, Ji Eun;Lee, Hyun Jeong;Rhee, Chin Kook;Yoon, Hyung Kyu;Song, Jeong Sup
Tuberculosis and Respiratory Diseases
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v.64
no.3
/
pp.224-229
/
2008
Erdheim-Chester disease (ECD) is a rare disease that is characterized by multi-organ involvement of foamy histiocytes. It causes systemic inflammation, and also demonstrates various clinical manifestations and has a poor prognosis. We encountered a case of ECD in a patient that had been treated for underlying polycythemia vera. As far as we know, this is the first reported case worldwide where ECD developed in association with polycythemia vera. A 59-year-old man visited our hospital due to pleuric pain at the right side of the chest. Pleural tissue that was obtained following a thoracoscopic biopsy showed non-Langerhan's cell histiocytosis, suggesting the presence of ECD. The histiocytes stained positively for CD68, but were negative for S-100 and CD1a. The patient also complained of pain at both hips and the right shoulder area. An X-ray and magnetic resonance image demonstrated that the lesion showed sclerosis and osteolysis in both the proximal femur and right humerus. Treatment was started with predinisolone, and subsequently cyclophosphamide was added. ECD is a very rare multi-systemic disease, and its cause and therapeutic options have not yet been defined. ECD has a poor prognosis. Therefore, we believe that additional case studies are needed prior to the determination of a novel therapy for ECD.
Journal of the Korean Institute of Intelligent Systems
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v.17
no.3
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pp.380-389
/
2007
In Korea, undoubtedly, the cancer is one of the most common reasons of death, and hepatoma is the second highest fatal cancer regardless of the gender only next to the stomach cancer In the middle and prime-aged between 40 and 60 years, the incidence of hepatoma is the highest in the world, and the death rate due to hepatoma is the highest among OECD countries. In this paper, we propose a novel method for automatic identification of hepatoma from a contrast enhanced CT images, which is used in an expert system that helps medical specialists. First, consecutive $40{\sim}50$ contrail enhanced CT images are photographed by every 5mm from the upper part of the chest, and using position information on the rib, we classify the internal area including only internal organs and the external one that consists of the rib, subcutaneous fat layers, and the background from the CT images. Then, the region of the liver is extracted from the classified internal area by using information on the intensity, the distribution of brightness, and using the regions extracted from consecutive images, we restore information on the 5 mm space occurred between the consecutive two slides tty applying a shape-based interpolation method. Lastly, using the characteristics such as the brightness and the morphology, we are able to extract the regions of hepatoma. The expert system based on our method is sufficiently competitive when it is compared with the diagnoses by specialists in the diagnostic radiology.
Journal of the Korea Academia-Industrial cooperation Society
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v.11
no.11
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pp.4411-4417
/
2010
This study was retrospectively to compare the exposure dose and the imaging quality in coronary CT angiography by using the 64 channel multidetector computed tomography and the 128 channel DSCT. Effective dose was calculated dose length product (DLP) by multiplied the convention factor of chest (0.017). Imaging quality was assessed by radiologists using the 5-point Likert scale. The DLP was ranged from 851 to $1277mGy{\cdot}cm$ (mean: 17.23 mSv) in the 64 channel MDCT and from 82 to $110mGy{\cdot}cm$ (mean: 1.58 mSv) in the of 128 channel DSCT, respectively. The score of imaging quality was respectively $3.31{\pm}0.62$ in 64 channel MDCT and $4.05{\pm}0.46$ in the 128 channel DSCT. The exposure dose of 128 channel DSCT has decreased 1ess 1/10. The score of imaging quality was significant difference between two modalities and the frequency (>4 good) in the 128 channel DSCT is about three times than that of the 64 channel MDCT. Therefore, the 128 channel DSCT in coronary CT angiography is clinically more effective modality for both investigators and patients.
Kim, Min-Young;Ahn, Ji-Yoon;Hwang, Deok-Sang;Lee, Jin-Moo;Jang, Jun-Bock;Lee, Kyung-Sub;Lee, Chang-Hoon
The Journal of Korean Obstetrics and Gynecology
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v.27
no.3
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pp.66-78
/
2014
Objectives: The purpose of this study is to investigate the relationship between vasomotor symptoms with upper-lower body temperature differences, and to identify Kidney Deficiency pattern (腎虛證) in menopausal women. Methods: 51 women who visited Kangnam Kyung-Hee Oriental Hospital from July to December, 2013 were analyzed. The experimental group consisted of 30 patients reported with vasomotor symptoms (Vasomotor symptom group, VG), while the control group consisted of 21 patients without vasomotor symptoms (Control group, CG). According to their chief complaints, VG was further divided into VHG (vasomotor-hot flash group) and VCG (vasomotor-cold hypersensitivity group). The temperature differences between upper and lower body part (CV17-CV4), proximal and distal extremity part (LU4-HT8, ST32-LR3) were checked. All patients reported other complaints such as headache, sweating, anxiety, dyspepsia, leukorrhea, which belong to Kidney Yang Deficiency pattern (腎陽虛證) or Kidney Yin Deficiency pattern (腎陰虛證). The relationship between vasomotor symptom and repetition rate of additional complaints were analyzed. Results: Statistical analysis showed that lower abdomen temperature of experimental group was lower than the control group. Temperature differences of upper and lower body (CV17-CV4) was significantly larger in vasomotor symptom group. VHG had more symptoms of sweating, chest discomfort, constipation, which belong to Kidney Yang Deficiency pattern group. VCG had more symptoms of leukorrhea, diarrhea, and dyspepsia, which belong to Kidney Yin Deficiency pattern group. Conclusions: Climacteric women who suffered from vasomotor symptoms showed lower temperature tendency in [CV4], larger temperature differences in [CV17-CV4] compared to the control group. Among them, VHG showed more symptoms of Kidney Yin Deficiency pattern, whereas VCG showed more symptoms of Kidney Yang Deficiency pattern.
This paper investigates sixteen rock-cut arhat images of the Koryo period at Sungbul-sa (成佛寺) in Chunan (天安), South Chungchung Province. These images, together with a Buddha triad in the center, are carved in thin relief on the large granite wall ($375cm{\times}248cm$), and below them is engraved a huge lotus petal which looks to be supporting all the images above. According to extant textual sources, arhats were popularly worshipped in the Koryo period. The Painting of Five Hundred Arhat Images was brought to Koryo from Later Liang (後梁) of the Five Dynasties (五代) in 923. From that time on, the cult of arhat had become gradually known in Koryo. More than thirty ceremonies worshipping arhats (羅漢齊) were officially held in Koryo court. The Sixteen Arhat images (十六羅漢像) were enshrined in many temples. In Boje-sa (普濟寺), which kings and aristocrats often visited for ritual ceremonies, had its main hall dominated by the Five Hundred Arhats, called Nahan-pocheon (羅漢寶殿). However, a limited number of arhat images of the Koryo period, originally made as sets of sixteen or five hundred arhats, are now extant. The Sixteen Arhat images at Sungbul-sa are unique examples that show all sixteen images in situ. The Sixteen Arhat images, though some of them are abraded, show various postures and gesture. One of them sits with his knee bent, and one arhat is sitting on a chair with his hand held upward. Each image is carved in a niche, just as the arhat images of Northern Song China are normally represented in niches of a cave, and are quite similar in style to the arhat images of the Northern Song period at Qinglindong (靑林洞) cave, Feilaifeng (飛來峰), Zejiang province (浙江省). This similarity between the arhat images of Sungbul-sa and those of Qinglindong certifies the strong impact of Song Buddhist art on Koryo frequently mentioned in texts. The Sixteen Arhat images surround the central Buddha raising his hand up to his chest. This Buddha triad could be ascribed to be either the Maitreya Buddha triad or the Sakyamuni Buddha triad based on the Lotus Sutra (妙法蓮華經). Still, the Sakyamuni Buddha triad was more often represented with sixteen or five hundred arhats in the Koryo period, as was seen in the record of Boje-sa where the Sakyamuni triad was enshrined with five hundred arhat images. The Sixteen Arhat images of Sungbul-sa arc most likely to be a rare example of Koryo Arhat images showing the Sakyamuni Buddha triad and the Sixteen Arhats who were predicted to be Buddhas by Sakyamuni in the Lotus Sutra.
Anseong Cheonryongsa, a temple located in Anseong Seoun Mountain, is a part of the second Jogye Order of Korean Buddhism, under the Yongju Temple, and enshrines a gilt-bronze seated Avalokitesvara Bodhisattva. In this study, X-ray fluorescence (XRF) analysis revealed that this statue is composed of Cu-27.2 wt%, Sn-12.6 wt% and Pb-48 wt%. A gamma (γ) ray (Ir-192) image confirmed damage on the backside of the statue, which was later repaired with wood. The XRF analysis and visual observation determined the boundary between the metal and wood in the statue. In addition, results of standard X-ray peak intensity of gold foil and correlation with thickness helped to derive an equation for calculating the thickness of the Avalokitesvara Bodhisattva's gold foil. It was determined that the gilded chest (21 ㎛) and face (20.7 ㎛) of the statue were the thickest sections, the wooden substratum (11.9 ㎛) was the next-most thick, and the bronze (7.4 ㎛) was the thinnest layer.
Kim, Ye-Seul;Park, Hye-Suk;Park, Su-Jin;Kim, Hee-Joung
Progress in Medical Physics
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v.23
no.1
/
pp.26-32
/
2012
The magnification technique has recently become popular in bone radiography, mammography and other diagnostic examination. However, because of the finite size of X-ray focal spot, the magnification influences various imaging properties with resolution, noise and contrast. The purpose of study is to investigate the influence of magnification and focal spot size on digital imaging system using eDQE (effective detective quantum efficiency). Effective DQE is a metric reflecting overall system response including focal spot blur, magnification, scatter and grid response. The adult chest phantom employed in the Food and Drug Administration (FDA) was used to derive eDQE from eMTF (effective modulation transfer function), eNPS (effective noise power spectrum), scatter fraction and transmission fraction. According to results, spatial frequencies that eMTF is 10% with the magnification factor of 1.2, 1.4, 1.6, 1.8 and 2.0 are 2.76, 2.21, 1.78, 1.49 and 1.26 lp/mm respectively using small focal spot. The spatial frequencies that eMTF is 10% with the magnification factor of 1.2, 1.4, 1.6, 1.8 and 2.0 are 2.21, 1.66, 1.25, 0.93 and 0.73 lp/mm respectively using large focal spot. The eMTFs and eDQEs decreases with increasing magnification factor. Although there are no significant differences with focal spot size on eDQE (0), the eDQEs drops more sharply with large focal spot than small focal spot. The magnification imaging can enlarge the small size lesion and improve the contrast due to decrease of effective noise and scatter with air-gap effect. The enlargement of the image size can be helpful for visual detection of small image. However, focal spot blurring caused by finite size of focal spot shows more significant impact on spatial resolution than the improvement of other metrics resulted by magnification effect. Based on these results, appropriate magnification factor and focal spot size should be established to perform magnification imaging with digital radiography system.
Park, Ji-Koon;Yang, Sung-Woo;Jun, Jae-Hoon;Cho, Su-Yeon;Kim, Kyo-Tae;Heo, Ye-Ji;Kang, Sang-Sik
Journal of the Korean Society of Radiology
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v.11
no.7
/
pp.671-677
/
2017
In this study, scattering factors affecting the quality of medical images were quantitatively analyzed and investigated. MCNPX simulation was conducted by using ANSI phantom, made of tissue equivalent materials, to calculate the scattering ratio occurred by the increase of the object thickness. Then, the result of the simulation was compared with the result of actual radiation measurement. In addition, we evaluated the image quality by the RMS evaluation, RSD and NPS analysis using X-ray images acquired with increasing object thickness. Furthermore, the scattering ratio was analyzed by increasing the thickness of acrylic phantom on chest phantom. The result showed that the scattering ratio was increased to 57.2%, 62.4%, and 66.8% from 48.9%, respectively, when the acrylic phantom thickness was increased by 1 inch from 6.1 inches. The results of MCNPX simulation and the actual measured scattering dose showed similar results. Also, as a result of RMS measurement from acquired x-ray images, the standard deviation decreased as the object thickness increased. However, in the RSD analysis considering the average incident dose, the results were increased from 0.028 to 0.039, 0.051, 0.062 as the acrylic phantom thickness was increased from 6.1 inches to 7.1 inch, 8.1 inch, and 9.1 inch, respectively. It can be seen that the increase of the scattering effect due to the increase of the object thickness reduces the SNR. Also, the NPS results obtained by measuring scattered radiation incident on the detector resulted in the increase of the noise as the object thickness increased.
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