• Title/Summary/Keyword: Diagnostic Reference Level

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Relationship between disk displacement of temporomandibular joint and dentofacial asymmetry (측두하악관절 원판 변위와 치열 및 안면부 비대칭의 관계에 대한 연구)

  • Nahm, Kyoung-Soo;Kim, Tae-Woo
    • The korean journal of orthodontics
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    • v.33 no.3 s.98
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    • pp.211-222
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    • 2003
  • The purpose of this study was to determine whether there is an association between disk displacement of the Temporomandibular Joint (TMJ) and dentofacial asymmetry In orthodontic patients. The subjects consisted of 60 female orthodontic patients between the ages of 18 and 38 years (mean age 23.3 years) who had visited the Department of Orthodontics at Seoul National University Dental Hospital from January 2000 to April 2002. On the basis of magnetic resonance imaging (MRI) of their bilateral TMJs, the subjects were divided Into four groups'. bilateral normal group (twenty-one persons); disk displacement of right TMJ group (six persons); disk displacement of left TMJ group (nine persons); and disk displacement of both TMJs group (twenty-four persons) Postero-anterior (PA) cephalograms and diagnostic models which had been taken before orthodontic treatment were measured. In the linear measurements, a line connecting the right and left Latero-Orbitale (Lo) represented the horizontal reference line (H). The vertical reference line (V) was constructed as a line bisecting and running perpendicular to H. One-way analysis of variance (ANOVA) was used to test whether the mean values of measurements between groups were significantly different. In addition, Bonferronil's multiple comparison test was performed at a level of 0.05. The results were as follows; 1 In the diagnostic model analysis, the overjet, nght molar relationship, and left molar relationship were significantly different among the four groups. 2. In the PA cephalometric analysis, differences in the right and left vertical position of the lower first molar and Ag were significantly dissimilar among the four groups. 3. If the disk displacement of TMJ was present on one side, the ipsilateral ramus was shorter, resulting in asymmetry in the vertical position of Ag. This study indicated that dentofacial asymmetry might be related to the disk displacement of TMJ.

Entrance Skin Dose According to Age and Body Size for Pediatric Chest Radiography (소아 흉부촬영 시 나이와 체격에 따른 입사피부선량)

  • Shin, Gwi-Soon;Min, Ki-Yeul;Kim, Doo-Han;Lee, Kwang-Jae;Park, Ji-Hwan;Lee, Gui-Won
    • Journal of radiological science and technology
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    • v.33 no.4
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    • pp.327-334
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    • 2010
  • Exposure during childhood results in higher risk for certain detrimental cancers than exposure during adulthood. We measured entrance skin dose (ESD) under 7-year children undergoing chest imaging and compared the relationship between ESD and age, height, weight, chest thickness. Though it is important to measure chest thickness for setting up the exposure condition of chest examination, it is difficult to measure chest thickness of children. We set up exposure parameters according to age because chest thickness of children has correlation with age. In the exposure parameters, for chest A-P examination under 2 year-children, tube voltage (kVp) in hospital A was higher than that in hospital B while tube current (mAs) was higher in hospital B, thus the ESD values were about 1.7 times higher in hospital B. However, for chest P-A examination over 4 year-children, the tube voltage was 7 kVp higher in hospital B, the tube current were same in all two systems, and focus to image receptor distance (FID) in hospital B (180 cm) was longer than that in hospital A (130 cm), thus the ESD values were 1.4 times higher in hospital A. For same ages, the ESD values for chest A-P examinations were higher than those for chest P-A examinations. Comparing ESD according to age, ESD values were $154{\mu}Gy$, $194{\mu}Gy$ and $138{\mu}Gy$ for children under 1 year, 1 to under 4 years and 4 to under 7 years of age, respectively. These values were lower than reference level ($200{\mu}Gy$) recommended in JART (japan association of radiological technologists), however these were higher than reference values recommended by EC (european commission), NRPB (national radiological protection board) and NIFDS (national institute of food & drug safety evaluation). In conclusion, the values of ESD were affected by exposure parameters from radiographer's past experience more than x-ray system. ESD values for older children were not always higher than those for younger children. Therefore we need to establish our own DRLs (diagnostic reference levels) according to age of the children in order to optimize pediatric patient protection.

Report on the Stability of Freeze-dried Standard Solution (동결건조표준액의 안정성에 관한 보고)

  • Park, Jun Mo;Yoo, Hye Jung;Kim, Han Chul;Han, Geul Soon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.139-148
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    • 2012
  • Purpose : Since standard solution is the one that knows its exact concentration, the curve of the dissolution has been determined according to the amount of the solution, compared to the amount of the unknown sample. Therefore, the antigen that makes up standard materials should be made in a pure form. The configuration of the standard substance solution in the kit we use is a freeze-dried material, or made and comes as a liquid. Lyophilized reference material is used after dissolving in usually D.W. (Distilled Water), and if the antigen to use is too sensitive, reagents should be freeze-dried. Furthermore, when freeze-dried reference has to be frozen again after being dissolved, it should be kept under $-20^{\circ}C$ until the expiration date according to the reports. Since it is not expressed in the experiment if it is safe or stable to reuse the solution which was dissolved a few times, thus, this time it is tested and evaluated that the changes of the standard solution by freezing and melting several times, and its results and the effectiveness of it were compared to the solution which was kept in a fridge. Materials and Methods : Among Vitro diagnostic kits on the market made by radioimmunoassay, parathyroid hormone (PTH), adrenocorticotropic hormone (ACTH), luteinizing hormone (LH) are made of freeze-dried standard solution and all composed of the same Lot.NO. These hormones melted in D.W. and were separated into three groups. In the first group, melting and freezing were repeated, and in the second group, The solution only for one time use was put into a test tube after melting and freeze it. The third group was kept in the refrigerator. This experiment has been conducted from January to February in 2012. January to 2012. PH test was employed because ph is prone to changing depending on the change of protein. Each group of the standard solution, cpm (counter per minute), and the patient relative concentration values were compared by date, and Through the correlation coefficient and Paired t-test, the significant level of each group was analyzed. Results : ACTH, PTH, LH pH values were too subtle denaturation rather than numerical changes in the protein. In addition, when the standard solution of ACTH, PTH, LH was refrigerated, after 3 days and 7 days, there was a significant difference observed between the solution being kept in a refrigerator and a freezer within a significance level. Conclusion : Standard solution should be kept in a freezer, and being kept in a fridge, it is recommended to use the solution as soon as possible.

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Analysis of Exposure Dose According to Chest and Abdomen Combine CT Exam Method (CT 흉·복부 통합검사 시 선량분석)

  • Mo, KyeongHwan;Han, DongKyoon;Lim, HyunSoo;Jeon, WooJin
    • Journal of the Korean Society of Radiology
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    • v.8 no.7
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    • pp.401-408
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    • 2014
  • The purpose of this study is confirmed to usefulness between division exam and combine exam of chest and abdomen according to comparing chest and abdomen radiation dose of division exam and combine exam in CT exam method. This study was conducted on patients who were admitted to the E hospital from July 2013 to March 2014 underwent CT studies for the diagnosis of chest and abdomen disease. In study result, male dose were more higher than female dose according to gender analysis of exposure dose that combine exam effective dose were male $33.10{\pm}2.75mSv$, female $31.66{\pm}3.12mSv$ and chest exam effective dose were male $9.07{\pm}2.62mSv$, female $8.30{\pm}2.18mSv$(p<0.05). And, division exam dose and combine exam dose were similar in gender comparison (p>0.05). And, combine exam effective dose, only chest exam effective dose, only abdomen exam effective dose were more higher than DRL(Diagnostic Reference Level) in comparison of patient exposure dose with DRL (p<0.05). In conclusion, chest-abdomen combine exam dose and division exam dose were similar. The chest-abdomen combine study can be used as follow-up and emergency trauma patients. That study will be reduce exam time and the occurrence risk of side effect of the contrast medium.

Image Evaluation Via $SUV_{LBM}$ for Normal Regions of VOI by Using Whole Body Images Obtained from PET/MRI and PET/CT (F-18 FDG PET/MRI와 PET/CT 전신 영상에서 VOI를 이용한 정상부위의 $SUV_{LBM}$-최대치에 의한 영상평가)

  • Park, Jeong-Kyu;Kim, Sung-Kyu;Cho, Ihn-Ho;Kong, Eun-Jung;Park, Meyong-Hwan
    • Progress in Medical Physics
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    • v.24 no.1
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    • pp.68-75
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    • 2013
  • The purpose of this research is to compare and analyze $SUV_{LBM}$-maximum of normal regions using VOI (the volume of interest) in order to enhance the diagnostic level in whole body images of PET/CT and PET/MRI for 26 health check-up participants. In particular, we try to set up $SUV_{LBM}$-maximum data that can be used in synchronous evaluation for PET/CT and PET/MRI without contrast media. The evaluation of $SUV_{LBM}$-maximum for normal regions of whole body PET/CT and whole body PET/MRI shows that the image of PET/MRI differs very significantly from the reference image of PET/CT (p<0.0001). However, they exhibit high correlations in view of statistics (R>0.8). From this research, we suggest that the decision in the evaluation of $SUV_{LBM}$-maximum for PET/MRI should be made with the reduction of about 26.3%, while one should decide with the reduction of about 29.3% when the contrast media is used. It is helpful to interpret all image of PET/CT and PET/MRI using $SUV_{LBM}$-maximum for convenience and efficiency.

A Study on Patients Dose and Image Quality according to Source to Image receptor Distance in Abdomen Radiography: comparison of ESD measured and DRLs in other countries (복부일반촬영시 선원과 검출기간의 거리변화에 따른 영상 화질 및 피폭선량에 관한 연구)

  • Jang, Ji-Sung;Choi, Weon-Keun;Jung, Jae-Yon;Lee, Kwan-Sub;Ha, Dong-Yoon
    • Korean Journal of Digital Imaging in Medicine
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    • v.14 no.2
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    • pp.39-46
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    • 2012
  • Purpose : The purpose of this study was to reduce Entrance Surface Dose and maintain image quality by changing Source to Image receptor Distance. And we'd like to compare ESD on this study to DRLs in other contries. Materials and Methods : We used indirect DR system(Definium 8000, General Electric, USA)and phantom(ART-200X, Flukebiomedical, USA),glass dosimeters(GD-352M, Asahi Techno Glass, Japan)for this study. The imagies were obtained throuh 80kVp fixed, and different tube currents using AEC mode in $16{\times}16$(inch) field size and changing Source to Image receptor Distance from 100 cm to 130 cm per 10 cm unit. The phantom with attaching 5 glass dosimeters on abdomonal skin was set at supine and erect position as a anterioposterial projection on detector For measuring Entrance Surface Dose. Image analysis was conducted by histograms of Image J(1.46r) which was given from National Institutes of Health(NIH). Results : Due to inverse square law of distance, the tube currents were increasing 42.6 % in supine position and 32.6 % in erect position according to the change of Source to Image receptor Distance. While Entrance Surface Doses were rapidly decreasing 14.2 % in supine position and 29.4 % in erect position according to the change of Source to Image receptor Distance. As the results of histogram using Image J, pixel mean values from 100 cm to 110 cm, 120 cm and 130 cm were decreasing each 1.4%, 2.5%, 2.7%, 4.5%, 2.2 %, 5.8 % in supine, erect position. While standard deviations from 100 cm to 110 cm, 120 cm and 130 cm were increasing each 1.4 %, 2.5 %, 2.5 %, 4.0 %, 2.0 %, 4.9 % Consequently, there are no significant differences in abdomen images taken. Conclusion: As the results described above, we strongly recommend using long Sourceto Image receptor Distance than 100cm that we have been using. So, we should deliver less Entrance Surface Dose to the patients while maintaining image quality in abdomen radiography.

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Assessment of Effective Dose by using additional Filters in Dental Radiography: PC-Based Monte Carlo Program Analysis Subjected on Intraoral Radiography (치과 방사선 촬영의 부가 필터 사용에 따른 유효선량 평가: 구내 촬영에 대한 PC-Based Monte Carlo Program 분석)

  • Kwak, Jong Hyeok;Kim, A Yeon;Kim, Gyeong Rip;Cho, Hee Jung;Moon, Sung Jin;Kil, Sang Hyeong;Lee, Jong Kyu
    • Journal of the Korean Society of Radiology
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    • v.15 no.4
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    • pp.491-498
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    • 2021
  • In this study, the effective dose was measured using the PCXMC v2.0 program by examining the conditions used to set the diagnostic reference level for intraoral imaging recommended by the government, and the effect of the Al additive filter was confirmed. In oral imaging, the largest effective dose was calculated from the oral mucosa among 11 organs. The effect of the Al additive filter showed an excellent radiation reduction effect at 2mm rather than 1mm. In the case of children aged 5 years, the overall effective dose was calculated to be high in all 11 organs because they are more sensitive to radiation than adults. And as a result of evaluating the image quality according to the use of an additional filter during intraoral imaging, there was no significant difference in SNR and CNR changes compared to before the additional filter was used. Based on this study, it is thought that additional filter settings can be recommended for intraoral imaging.

Image Evaluation according to Tube Current of X-ray Device for Intraoral Imaging (구내 촬영용 엑스선 장치의 관전류에 따른 영상 평가)

  • A Yeon Kim;Byungdu Jo;Seung-Jae Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.4
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    • pp.515-521
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    • 2023
  • The radiation dose received by the patient varies according to the tube current and time used during dental intraoral imaging. A large amount of tube current is required for image quality, but the radiation dose to the patient increases accordingly. Therefore, in this study, the optimal amount of tube current that can reduce the radiation dose received by the patient while securing the image quality was calculated through the evaluation of the image quality according to the tube current used during intraoral imaging through simulation. The average tube current, time, and tube voltage presented in the Guidelines for Diagnostic Reference Level for intraoral radiography were used as basic imaging conditions, and images were obtained when only the tube current was changed, and then the optimal tube current was compared and analyzed with the basic image quantity was calculated. Images were obtained by changing the tube current to 0.1, 0.5, 1, 2, 3, 4 and 5 mA under the basic conditions of 63 kV, 6 mA, and 0.29 s. The obtained image was evaluated for structural similarity index with the image taken under the condition of 6 mA using the ICY program. As a result, even under the condition of 0.5 mA tube current, the index of structural similarity with the image of 6 mA was evaluated to be high. Based on these results, it is considered that the radiation dose given to the patient can be greatly reduced if imaging is performed at 0.5 mA instead of 6 mA during dental intraoral imaging.

A Study on the Patient Exposure Doses from the Panoramic Radiography using Dentistry (치과 파노라마 촬영에서 환자의 피폭선량에 관한 연구)

  • Park, Ilwoo;Jeung, Wonkyo;Hwang, Hyungsuk;Lim, Sunghwan;Lee, Daenam;Im, Inchul;Lee, Jaeseung;Park, Hyonghu;Kwak, Byungjoon;Yu, Yunsik
    • Journal of the Korean Society of Radiology
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    • v.7 no.1
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    • pp.17-24
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    • 2013
  • This study estimate radiation biological danger factor by measuring patient's exposed dose and propose the low way of patient's exposed dose in panoramic radiography. We seek correcting constant of OSL dosimeter for minimize the error of exposed dose's measurement and measure the Left, Right crystalline lens, thyroid, directly included upper, lower lips, the maxillary bone and the center of photographing that indirect included in panoramic radiography by using the human body model standard phantom advised in ICRP. In result, the center of photographing's level of radiation maximum value is $413.67{\pm}6.53{\mu}Gy$ and each upper, lower lips is $217.80{\pm}2.98{\mu}Gy$, $215.33{\pm}2.61{\mu}Gy$. Also in panoramic radiography, indirect included Left, Right crystalline lens's level of radiation are $30.73{\pm}2.34{\mu}Gy$, $31.87{\pm}2.50{\mu}Gy$, and thyroid's level of measured exposed dose can cause effect of radiation biological and we need justifiable analysis about radiation defense rule and substantiation advised international organization for the low way of patient's exposed dose in panoramic radiography of dental clinic and we judge need the additional study about radiation defense organization for protect the systematize protocol's finance and around internal organs for minimize until accepted by many people that is technological, economical and social fact by using panoramic measurement.

A Case of Late-onset Episodic Myopathic Form with Intermittent Rhabdomyolysis of Very-long-chain acyl-coenzyme A Dehydrogenase (VLCAD) Deficiency Diagnosed by Multigene Panel Sequencing (유전자패널 시퀀싱으로 진단된 성인형 very-long-chain acyl-coenzyme A dehydrogenase (VLCAD) 결핍증 증례)

  • Sohn, Young Bae;Ahn, Sunhyun;Jang, Ja-Hyun;Lee, Sae-Mi
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.19 no.1
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    • pp.20-25
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    • 2019
  • Very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency (OMIM#201475) is an autosomal recessively inherited metabolic disorder of mitochondrial long-chain fatty acid oxidation. The clinical features of VLCAD deficiency is classified by three clinical forms according to the severity. Here, we report a case of later-onset episodic myopathic form of VLCAD deficiency whose diagnosis was confirmed by plasma acylcarnitine analysis and" multigene panel multigene panel sequencing. A 34-year old female patient visited genetics clinic for genetic evaluation for history of recurrent myopathy with intermittent rhabdomyolysis. She suffered first episode of rhabdomyolysis with acute renal failure requiring hemodialysis at twelve years old. After then, she suffered several times of recurrent rhabdomyolysis provoked by prolonged exercise or fasting. Physical and neurologic exam was normal. Serum AST/ALT and creatinine kinase (CK) levels were mildly elevated. However, according to her previous medical records, her AST/ALT, CK were highly elevated when she had rhabdomyolysis. In suspicion of fatty acid oxidation disorder, multigene panel sequencing and plasma acylcarnitine analysis were performed in non-fasting, asymptomatic condition for the differential diagnosis. Plasma acylcarnitine analysis revealed elevated levels of C14:1 ($1.453{\mu}mol/L$; reference, 0.044-0.285), and C14:2 ($0.323{\mu}mol/L$; 0.032-0.301) and upper normal level of C14 ($0.841{\mu}mol/L$; 0.065 -0.920). Two heterozygous mutation in ACADVL were detected by multigene panel sequencing and confirmed by Sanger sequencing: c.[1202G>A(;) 1349G>A] (p.[(Ser 401Asn)(;)(Arg450His)]). Diagnosis of VLCAD deficiency was confirmed and frequent meal with low-fat diet was educated for preventing acute metabolic derangement. Fatty acid oxidation disorders have diagnostic challenges due to their intermittent clinical and laboratorial presentations, especially in milder late-onset forms. We suggest that multigene panel sequencing could be a useful diagnostic tool for the genetically and clinically heterogeneous fatty acid oxidation disorders.

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