• Journal of Chest Surgery
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• v.34 no.7
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• pp.534-538
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• 2001

Background: Knowledge of size and morphology of the normal trachea is important for airway management and tracheal reconstruction. Conventional radiography is a simple method used to measure the tracheal diameter, but it is not accurate because of the artifacts related to image magnification and overlapping by the shoulder. The purpose of this study was to provide the normal values of the tracheal size and anatomy in Korean adults using Computerized Topography. Material and Method: There were 43 men and 34 women included in this study. They were divided into three age groups(group 1, 20-39 years ; group 2, 40-59 yeas , groups 3, $\geq$60 years). The anteroposterior and transverse diameters and cross - sectional areas of the trachea were measured at the level of the thoracic inlet(Level 1) and the aortic arch(Level 2). These values obtained at each level were compared between age groups and sexes. Result: In 43 men, the anteroposterior / transverse diameters(mean SD in millimeters) of the trachea at levels 1 and 2 were 19.95$\pm$2.99 / 17.72$\pm$2.13 and 19.77$\pm$2.57 / 18.02$\pm$2.19, respectively. In 34 women, those values at levels 1 and 2 were 15.56$\pm$2.12 / 14.18$\pm$2.07 and 15.35$\pm$1.82 / 15.00$\pm$1.60, respectively. At both levels, the anteroposterior and transverse diameters were significantly greater in men than in women (p<0.05). The cross-sectional area of the trachea at levels 1 and 2 were 279.14$\pm$61.37 / 281.93$\pm$63.97 $\textrm{mm}^2$ in men and 173.29$\pm$35.81 / 181.88$\pm$34.74 in women, respectively. They also showed significantly greater values in men than in women(P<0.05). There was no significant difference in diameters and cross-sectional areas of the trachea between age groups. Conclusion: There are significant differences in the internal diameter and cross- sectional area of the trachea between men and women in normal Korean adults, while the age difference was insignificant. We believed CT is a relatively accurate and safe way to measure the internal diameter and cross-sectional areas of the trachea.

• Tuberculosis and Respiratory Diseases
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• v.66 no.1
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• pp.13-19
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• 2009

Background: The interferon-gamma assay is reported to have high sensitivity and specificity for making the diagnosis of latent tuberculosis infection. The clinical usefulness of this essay for detecting active tuberculosis has not fully defined. We evaluated the diagnostic value of the commercial interferon-gamma assay kit (QuantiFERONTB GOLD) for patients with suspected tuberculosis. Methods: From January to August 2007, we recruited 52 patients with suspected tuberculosis infection. We performed chest X-ray, sputum smear, culture, PCR and the QuantiFERON-TB GOLD test. Pleural fluid analysis and pleural biopsy were also done for the patients with pleural effusion. Results: Of the 52 patients we studied, 30 patients had a positive QuantiFERON-TB GOLD test result. 35 patients were finally diagnosed with active tuberculosis: twenty-five with a positive QuantiFERON-TB GOLD test and 10 with a negative QuantiFERON-TB GOLD test. The sensitivity of the QuantiFERON-TB GOLD test was 71.4% and the specificity was 64.7%. The positive predictive value was 0.83 and the negative predictive value was 0.50. There was no significant difference of any of the clinical and laboratory characteristics between the two groups of patients except the C-reactive protein (CRP) level. The CRP level was 29.2${\pm}$27.3 mg/dL in the pulmonary tuberculosis patients with a positive QuantiFERON-TB GOLD test and 72.9${\pm}$67.9 mg/dL in the patients with a negative QuantiFERON-TB GOLD test (p<0.05). Conclusion: The sensitivity and specificity of the QuantiFERON-TB GOLD test were inadequate for making the diagnosis of active tuberculosis. We suggest that the QuantiFERON-TB GOLD test should not be used by itself to exclude the diagnosis of active tuberculosis. The relationship of the QuantiFERON-TB GOLD test and the CRP level in patients with TB would be further investigated.

• Progress in Medical Physics
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• v.16 no.1
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• pp.10-15
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• 2005

IAEA's guidance levels have been provided for western people to the end. Guidance levels lower than the IAEA'S will be necessary in view of Korean people's proportions. Therefore, we need to develope the standard doses for Korean people. And we conducted a nationwide survey of patient dose from x-ray examinations in Korea. In this study, the 278 institutions were selected from Members Book of Korean Hospital Association. The valid response rate was approximately 57.9%. Doses were calculated from the questionnaires by NDD method. We obtained the results were as follows; 1) General radiographic equipments were distributed for 42.0%, fluoroscopic equipments 29.4%, dental equipments 13.2%, CT units 8.1 % and mamographic units 7.2%. 2) According to classification by rectification, three-phase equipments were 29.9%, inverter-type generators 29.5%, single-phase equipments 25.5%, constant voltage units 9.0% and unknown units 6.0%. 3) According to classification by receptor system, film-screen types were 46.8%, CR types 26.8%, DR types 17.7% and unknown types 8.9%. 4) The number of examinations were chest 49.2%, spine 16.8% and abdomen 12.7%. 5) Patient doses were head AP 3.44 mGy, abdomen AP 4.25 mGy and chest PA 0.39 mGy.

• Progress in Medical Physics
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• v.23 no.1
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• pp.26-32
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• 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.

• 한국해양학회지
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• v.24 no.3
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• pp.132-147
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• 1989

A total of 83 surface sediments and 55 sea water samples, collected from the southwestern sea of Cheju Island, were analyzed in order to understand their textural characteristics, geochemical composition and the clay mineralogical features. The sediments were subdivided into ten textural classes, namely clayey sand, slightly gravelly muddy sand, sandy clay, clay and mud. The coarse and fine-grained mixed sediments are distributed in the northern part and around the Island, whereas the fine-grained deposits are mainly distributed in the central and southern parts of the study area; small scale mud patches are distributed in the southwestern and northern parts of Cheju Island. The high concentration of total suspended matter in study area gradually increase toward the southwestern and northwestern offshore area. The concentration of geochemical elements is as follow: the content of Mn, Al, Zn, Cr, Cu and Sn increase toward the southern part which is covered mainly with fine-grained deoposits, whereas the content of Ca, Mg and Ag is higher in the northern area; the elements such as Ni, Na, Fe and Pb are more concentrated relatively in muddy deposits rather than in sandy sediments. The light minerals such as Na-Ca feldspars show a high content around the Socotra Rock, toward the Soheugsan and Cheju Islands, but the K-feldspars are relatively high around the Cheju Island. It was noticed that the provenance of these sediments is partly influenced by the geological characteristics near the island. X-ray diffractogram for clay minerals from the southeastern mud patch and around the Soheugsan Island shows the diagnostic calcite peak indicating that the greater part of these clay fraction may have been derived from present and ancient Hwangho River. The high concentration of smectite in the northern part near the Cheju and around the Soheugsan Islands, eastern side of Socotra Rock probably result from supplies smectite altered from volcanic materials distributed in the Cheju Island and Socotra Rock, whereas the samples near the Chuja and northern parts of the Cheju Island contain weak calcite peak and high concentration of kaolinite and chlorite which is closely related to the geolgical characteristics on the adjacenting land area.

• Journal of Chest Surgery
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• v.36 no.7
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• pp.497-503
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• 2003

Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

• Journal of radiological science and technology
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• v.30 no.1
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• pp.25-32
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• 2007

This study is to evaluate the factors that affect to the bone mineral density(BMD) of postpartum women by comparing BMD between postpartum and general women who are ages from 20 to 39, and to identify correlation between various factors weight, height, body mass index(BMI), hemoglobin(Hb) and BMD. Study subjects were postpartum(n=159) and general(n=180) women. We checked the BMD of femoral neck and lumbar spine by using dual energy X-ray bone densitometry. The mean age was $30.69{\pm}3.32$ in postpartum care group and $31.22{\pm}5.66$ in general women group. In postpartum care group, the mean BMD of femoral neck and lumbar spine were -0.187 and -0.076. In general women group, the mean BMD of femoral neck and lumbar spine were -0.029, and -0.169. According to BMI level, each group was divided into two subgroups. One was 23 or more BMI subgroup, and the other was under 23 BMI subgroup. There was a significant difference in BMD of femoral neck and lumbar spine between two subgroups in general women group, but only a significant difference in BMD of lumbar spine is noted between two subgroups of postpartum group. According to Hb level, each group was divided into two subgroups. One was 11g/dl or more subgroup, and the other was under 11g/dl subgroup. There was not a statistically significant difference of BMD in all subgroups. BMD of femoral neck and lumbar spine showed a significant correlation with weight, height, BMI in both groups. There was a significant correlation between BMD and Hb level in postpartum care group, but a significant correlation was not noted in general women group. The postpartum women showed a significant correlation between BMD and various factors such as weight, height, BMI just like in general women. There was a significant correlation between BMD and Hb in postpartum women, but not in general women.

• Progress in Medical Physics
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• v.17 no.3
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• pp.173-178
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• 2006

The purpose of this study was to evaluate the radiation dose for clinical PET/CT protocols in clinical environments using Alderson phantom and TLDs. Radiation doses were evaluated for both Philips GEMINI 16 slice PET/CT system and GE DSTe 16 slice PET/CT system. Specific organ doses with $^{137}Cs$ transmission scan, high quality CT scan and topogram in philips GEMINI PET/CT system were measured. Specific organ doses with CT scan for attenuation map, CT scan for diagnosis and topogram in GE DSTe PET/CT system were also measured. The organs were selected based on ICRP60 recommendation. The TLDs used for measurements were selected for within an accuracy of ${\pm}5%$ and calibrated in 10 MV X-ray radiation field. The effective doses for $^{137}Cs$ transmission scan, high qualify scan, and topogram in Philips GEMINI PET/CT system were $0.14{\pm}0.950,\;29.49{\pm}1.508\;and\;0.72{\pm}0.032mSv$ respectively. The effective doses for CT scan to make attenuation map, CT scan to diagnose and topogram in GE DSTe PET/CT system were $20.06{\pm}1.003,\;24.83{\pm}0.805\;and\;0.27{\pm}0.008mSv$ respectively. We evaluated the total effective dose by adding effective dose for PET Image. The total PET/CT doses for Philips GEMINI PET/CT (Topogram+$^{137}Cs$ transmission scan+PET, Topogram+high qualify CT+PET) and GE DSTe PET/CT (Topogram +CT for attenuation map+ PET, Topogram+diagnostic CT+ PET) are $7.65{\pm}0.951,\;37.00{\pm}1.508,\;27.12{\pm}1.003\;and\;31.89{\pm}0.805mSv$ respectively. Further study may be needed to be peformed to find optimal PET/CT acquisition protocols for reducing the patient exposure with good image qualify.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.442-447
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• 1999

Introduction: Understanding the normal distribution of the tracheal diameter and crross- sectional area is one of the key elements in the management of various tracheal pathologies or tracheal reconstruction for the patients in growing age. However, data for Korean standard has been lacking. This study was designed to analyze retrospectively the distribution of tracheal diameter and cross-sectional area in young Koreans, which can afford fundamental data for the management of tracheal diseases. Material and Method: Of the patients who underwent computerized tomogram of the chest between May 1996 and August 1998, one hundred six young patients(age range: 0-20 years) were included. Patients with any conditions which might affect the tracheal cross-sectional area or diameter, such as tracheal disease, previous operation, mediastinal tumor, or obstructive lung disease were excluded from the study. Gender distribution was 69 males and 37 females. Tracheal diameters, anterior-posterior and transverse, were measured at the level of the thoracic inlet(level I) and the aortic arch(level II). Types of the trachea were divided into round, oval, or horseshoe shaped on cross-sectional view, and the dimension was calculated by using the equation of A=1/4$\pi$ab(A; area, $\pi$; 3.14, a; anterior-posterior diameter, b; transverse diameter). We analyzed the distribution of the diameter at each level and compared the cross-sectional area with respect to age and gender. A p-value lower than 0.05 wa considered significant. Result: The trachea of patients less than 5 years old were round in shape at both of level I and II, and no differences in cross-sectional area was observed between the levels(p=NS). As the age increased, the trachea become oval in shape at level I while it remained round in shape at level II(p=0.020). The tracheal diameter and cross-sectional area increased as the age increased with a linear correlation(r>0.9). In patients less than 5 years of age, female patients showed larger cross-sectional area than male patients (p=0.020), and it was reversed in patients older than 15 years of age(p=0.002). Conclusion: From the above results, we suggest chest computerized tomogram as a safe and reliable tool in measuring the tracheal diameter and cross-sectional area. We also provide the data as a standard for distribution of the tracheal diameter and cross-sectional area in young Korean population.

• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1217-1223
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• 2003

Purpose : This study was conducted to assess clinical practices related to the evaluation and treatment of patients with acute gastrointestinal infection(AGI) in infants and children. This survey also evaluated the current opinion regarding the use of rotavirus vaccine. Methods : This survey was conducted using a self-administered questionnaire provided to 82 pediatricians in private clinics of Jeonbuk province. From April to June, 2002, 63 of 82 pediatricians(76.8 %) responded to the survey. Results : The annual proportion of patients with AGI was 13%. The highest proportion of patients with diarrhea were reported for the months of October through December. For the treatment of diarrhea, pediatricians preferred to prescribe lactobacillus products, oral rehydration solution, enzyme products, anti-emetics, anti-diarrheal formula, nothing by mouth(NPO) and bowel movement inhibitors in descending order of frequency. Most pediatricians(79.4%) prescribed antibiotics in less than 20% of patients with AGI. Amoxicillin was the most commonly prescribed antibiotics followed by trimethoprim/sulfamethoxazole(TMP/SMX) and amoxicillin/clavulanate. Clinical manifestations that pediatricians considered as important factors in prescribing antibiotics were bloody diarrhea, mucoid diarrhea, high fever, persisting disease and abdominal pain. Diagnostic procedures that pediatricians preferred for AGI patients were stool examination(rotavirus antigen, RBC, WBC), abdominal X-ray, and serum electrolytes. Pediatricians had a strong interest in rotavirus vaccine(71.4%). Conclusion : Acute gastrointestinal illness remains a common problem, especially during the winter months in Korea. AGI manifesting as watery diarrhea is appropriately treated with commonly available agents but pediatricians appear ready to consider additional approaches to decrease the sizable disease burden of AGI among children in Korea.