• Title/Summary/Keyword: Digital medicine

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3D Histology Using the Synchrotron Radiation Propagation Phase Contrast Cryo-microCT (방사광 전파위상대조 동결미세단층촬영법을 활용한 3차원 조직학)

  • Kim, Ju-Heon;Han, Sung-Mi;Song, Hyun-Ouk;Seo, Youn-Kyung;Moon, Young-Suk;Kim, Hong-Tae
    • Anatomy & Biological Anthropology
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    • v.31 no.4
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    • pp.133-142
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    • 2018
  • 3D histology is a imaging system for the 3D structural information of cells or tissues. The synchrotron radiation propagation phase contrast micro-CT has been used in 3D imaging methods. However, the simple phase contrast micro-CT did not give sufficient micro-structural information when the specimen contains soft elements, as is the case with many biomedical tissue samples. The purpose of this study is to develop a new technique to enhance the phase contrast effect for soft tissue imaging. Experiments were performed at the imaging beam lines of Pohang Accelerator Laboratory (PAL). The biomedical tissue samples under frozen state was mounted on a computer-controlled precision stage and rotated in $0.18^{\circ}$ increments through $180^{\circ}$. An X-ray shadow of a specimen was converted into a visual image on the surface of a CdWO4 scintillator that was magnified using a microscopic objective lens(X5 or X20) before being captured with a digital CCD camera. 3-dimensional volume images of the specimen were obtained by applying a filtered back-projection algorithm to the projection images using a software package OCTOPUS. Surface reconstruction and volume segmentation and rendering were performed were performed using Amira software. In this study, We found that synchrotron phase contrast imaging of frozen tissue samples has higher contrast power for soft tissue than that of non-frozen samples. In conclusion, synchrotron radiation propagation phase contrast cryo-microCT imaging offers a promising tool for non-destructive high resolution 3D histology.

Performance Evaluation of Reconstruction Algorithms for DMIDR (DMIDR 장치의 재구성 알고리즘 별 성능 평가)

  • Kwak, In-Suk;Lee, Hyuk;Moon, Seung-Cheol
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.2
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    • pp.29-37
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    • 2019
  • Purpose DMIDR(Discovery Molecular Imaging Digital Ready, General Electric Healthcare, USA) is a PET/CT scanner designed to allow application of PSF(Point Spread Function), TOF(Time of Flight) and Q.Clear algorithm. Especially, Q.Clear is a reconstruction algorithm which can overcome the limitation of OSEM(Ordered Subset Expectation Maximization) and reduce the image noise based on voxel unit. The aim of this paper is to evaluate the performance of reconstruction algorithms and optimize the algorithm combination to improve the accurate SUV(Standardized Uptake Value) measurement and lesion detectability. Materials and Methods PET phantom was filled with $^{18}F-FDG$ radioactivity concentration ratio of hot to background was in a ratio of 2:1, 4:1 and 8:1. Scan was performed using the NEMA protocols. Scan data was reconstructed using combination of (1)VPFX(VUE point FX(TOF)), (2)VPHD-S(VUE Point HD+PSF), (3)VPFX-S (TOF+PSF), (4)QCHD-S-400((VUE Point HD+Q.Clear(${\beta}-strength$ 400)+PSF), (5)QCFX-S-400(TOF +Q.Clear(${\beta}-strength$ 400)+PSF), (6)QCHD-S-50(VUE Point HD+Q.Clear(${\beta}-strength$ 50)+PSF) and (7)QCFX-S-50(TOF+Q.Clear(${\beta}-strength$ 50)+PSF). CR(Contrast Recovery) and BV(Background Variability) were compared. Also, SNR(Signal to Noise Ratio) and RC(Recovery Coefficient) of counts and SUV were compared respectively. Results VPFX-S showed the highest CR value in sphere size of 10 and 13 mm, and QCFX-S-50 showed the highest value in spheres greater than 17 mm. In comparison of BV and SNR, QCFX-S-400 and QCHD-S-400 showed good results. The results of SUV measurement were proportional to the H/B ratio. RC for SUV is in inverse proportion to the H/B ratio and QCFX-S-50 showed highest value. In addition, reconstruction algorithm of Q.Clear using 400 of ${\beta}-strength$ showed lower value. Conclusion When higher ${\beta}-strength$ was applied Q.Clear showed better image quality by reducing the noise. On the contrary, lower ${\beta}-strength$ was applied Q.Clear showed that sharpness increase and PVE(Partial Volume Effect) decrease, so it is possible to measure SUV based on high RC comparing to conventional reconstruction conditions. An appropriate choice of these reconstruction algorithm can improve the accuracy and lesion detectability. In this reason, it is necessary to optimize the algorithm parameter according to the purpose.

The Effects of the Revised Elderly Fixed Outpatient Copayment on the Health Utilization of the Elderly (노인외래정액제 개선이 고령층의 의료이용에 미친 영향)

  • Li-hyun Kim;Gyeong-Min Lee;Woo-Ri Lee;Ki-Bong Yoo
    • Health Policy and Management
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    • v.34 no.2
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    • pp.196-210
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    • 2024
  • Background: In January 2018, revised elderly fixed outpatient copayment for the elderly were implemented. When people ages 65 years and older receive outpatient treatment at clinic-level medical institutions (clinic, dental clinic, Korean medicine clinic), with medical expenses exceeding 15,000 won but not exceeding 25,000 won, their copayment rates have decreased differentially from 30%. This study aimed to examine the changes of health utilization of elderly after revised elderly fixed outpatient copayment. Methods: We used Korea health panel data from 2016 to 2018. The time period is divided into before and after the revised elderly fixed outpatient copayment. We conducted Poisson segmented regression to estimate the changes in outpatient utilization and inpatient utilization and conducted segmented regression to estimate the changes in medical expenses. Results: Immediately after the revised policy, the number of clinic and Korean medicine outpatient visits of medical expenses under 15,000 won decreased. But the number of clinic outpatient visits in the range of 15,000 to 20,000 won and Korean medicine clinic in the range of 20,000 to 25,000 won increased. Copayment in outpatient temporarily decreased. The inpatient admission rates and total medical expenses temporarily decreased but increased again. Conclusion: We confirmed the temporary increase in outpatient utilization in the medical expense segment with reduced copayment rates. And a temporary decrease in medical expenses followed by an increase again. To reduce the burden of medical expense among elderly in the long run, efforts to establish chronic disease management policies aimed at preventing disease occurrence and deterioration in advance need to continue.

Effects of Nasal Continuous Positive Airway Pressure Application on Sympathetic Activation : Power Spectrum Analysis of Electrocardiogram in Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증에서 지속적 상기도 양압술 시행이 교감신경계 활성도에 끼치는 영향 : 심전도 스펙트럼 분석)

  • Youn, Tak;Park, Hae-Jeong;Kim, Eui-Joong;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.7 no.1
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    • pp.43-50
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    • 2000
  • Objectives: Obstructive sleep apnea syndrome(OSAS) is known to be associated with the changes of autonomic nervous system (ANS). Nasal continuous positive airway pressure(nCPAP) treatment was found to correct abnormal ANS changes in OSAS but it remains to be further clarified. We aimed to assess the effects of nCPAP on ANS manifested on electrocardiogram, using spectrum analysis in the subjects with OSAS. Methods: Digital polysomnography was performed in 18 patients with OSAS(mean age $43.7{\pm}16.6$ years ; 17 males, 1 female ; mean respiratory disturbance index (RDI) $48.6{\pm}20.9$) for one baseline and another CPAP nights. From each night, 300 continuous beats of ECGs without artifact were chosen from both stage 2 sleep and REM sleep and they were used for power spectrum analysis. We compared between baseline and CPAP nights the heart rate variability including VLF(very low frequency power), LF (low frequency power), HF(high frequency power), R-R means, R-R variance, and LF/HF ratio, using Wilcoxon signed ranks test. Results: In all patients, nCPAP proved to be effective in relieving apneas and snoring. During nCPAP night compared with baseline night, decreases in VLF(p<0.05), LF(p<0.01), and R-R variance(p<0.05) were found in stage 2 sleep, and decreased LF(p<0.05) was found in REM sleep. No significant differences in each sleep stage were found in other variables between the two nights. Conclusion: Our findings suggest that OSAS increases the activity of sympathetic nervous system and nCPAP application effectively decreases the activity. And nCPAP does not appear to influence the parasympathetic nervous activity in OSAS.

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The effect of guided flapless implant procedure on heat generation from implant drilling (수술가이드를 이용한 무피판 임플란트 술식에서 임플란트 드릴링이 열발생에 미치는 효과)

  • Yoo, Je-Hyeon;Jeong, Seung-Mi;Choi, Byung-Ho;Joo, Sang-Don
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.1
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    • pp.11-19
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    • 2013
  • Purpose: The aim of this study was to evaluate the heat generation in bone in vitro during the guided flapless drilling procedure and the effect of drilling methods on the heat generation. Materials and methods: A model that has missing the first and second mandibular molars bilaterally was used. In group A, classical flap implant surgery was performed. In group B, flapless implant surgery using surgical guide was performed. In group C, flapless implant surgery using surgical guide without up-and-down pumping motion was performed. Temperature was measured with k-type thermocouple and a real-time digital thermometer. The thermocouples were placed at 0.5 mm away from the osteotomy area at the depths of 3 mm and 6 mm. The measured values were evaluated with independent t-test. Results: The mean temperature generated was $27.2^{\circ}C$ ($SD{\pm}2.1^{\circ}C$) and $27.5^{\circ}C$ ($SD{\pm}2.3^{\circ}C$) for groups A and B, respectively. These differences were not statistically significant. In group C, the mean temperature was $37.0^{\circ}C$ ($SD{\pm}3.4^{\circ}C$). There were statistically significant differences between groups B and C with respect to the mean temperature. Conclusion: These findings suggest that guided flapless drilling with up-and-down pumping motion may not significantly increase the bone temperature.

Morphometric Study on the Arterial Palmar Arch of the Hand (손바닥 동맥활에 관한 형태계측 연구)

  • Park, Bong Kwon;Jang, Soo Won;Choi, Seung Suk;Ahn, Hee Chang
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.691-701
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    • 2009
  • Purpose: Deviations of arterial palmar arches in the hand can be explained on the embryological basis. The purpose of this study was to provide new information about palmar arches through cadaver's dissection. The values of the location and diameter in these vessels were analyzed in order to support anatomical research and clinical correlation in the hand. Methods: The present report is based on an analysis of dissections of fifty - three hands carried out in the laboratory of gross anatomy. A reference line was established on the distal wrist crease to serve as the X coordinate and a perpendicular line drawn through the midpoint between middle and ring fingers, which served as the Y coordinate. The coordinates of the x and y values were measured by a digimatic caliper, and statistically analyzed with Student's t - test. Results: Complete superficial palmar archs were seen in 96.2 % of specimens. In the most common type of males, the superficial arch was formed only by the ulnar artery. In the most common type of females, the superficial arch was formed anastomosis between the radial artery and the ulnar artery. The average length of the superficial and deep palmar arch is $110.3{\pm}33.0mm$ and $67.9{\pm}14.0mm$ respectively. Regarding the superficial palmar arch, ulnar artery starts $-16.1{\pm}5.1mm$ on X - line, and $2.5{\pm}24.5mm$ on Y - line. Radial artery appears on palmar side $7.7{\pm}3.2mm$ on X - line, and $20.9{\pm}10.9mm$ on Y - line. But radial artery starts on $6.3{\pm}3.6mm$ on X - line, and $3.4{\pm}5.1mm$ on Y - line. Digital arteries of superficial palmar arch starts on $6.1{\pm}3.7mm$, $33.9{\pm}8.8mm$ on index finger, $1.8{\pm}3.4mm$, $40.1{\pm}7.3mm$ on middle finger, $-3.2{\pm}4.9mm$, $42.6{\pm}7.0mm$ on ring finger, and $-8.9{\pm}5.1mm$, $42.5{\pm}80mm$ on little finger in respective X and Y coordinates. Radial artery of deep palmar arches measured at the palmar side perforating from the dorsum of hand. It's coordinates were $9.7{\pm}4.8mm$ on X - line, $21.7{\pm}10.2mm$ on Y - line. Ulnar artery was measured at hypothenar area, and it's coordinates were $-20.4{\pm}6.3mm$ on X - line, and $30.6{\pm}7.4mm$ on Y - line. Conclusions: Anatomically superficial palmar arch can be divided into a complete and an incomplete type. Each of them can be subdivided into 4 types. The deep palmar arch is less variable than the superficial palmar arch. We believe these values of the study will be used for the vascular surgery of the hand using the endoscope and robot in the future.

Changes of Radiation Dose and Image Quality Due to Additional Filtration Material in Computed Radiography (Computed Radiography에서 Additional Filtration Material에 따른 Radiation Dose와 Image Quality의 변화)

  • Kwon, Soon-Mu;Cho, Hyung-Wook;Kang, Yeong-Han;Kim, Boo-Soon;Kim, Jung-Su
    • Journal of radiological science and technology
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    • v.37 no.4
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    • pp.239-246
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    • 2014
  • Filter absorbs low-energy X-ray to increase the average energy and reduces patient exposure dose. This study investigates if the materials of Mo and W could be used for the digital imaging device CR by conducting image assessment and dose measurement of SNR, FOM and histogram. In addition, measurement of beam quality was conducted depending on the material of the filter, and at the same time, a proper combination of filters was examined depending on the change in tube voltage (kVp). In regard to entrance skin dose, Mo filter showed the dose reduction by 42~56%, compared to Cu filter. Moreover, Mo filter showed higher transmission dose by around 1.5 times than that of Cu filter. In image assessment, it was found that W was unsuitable to be used as a filter, whereas Mo could be used as a filter to reduce dose without decline in image quality at the tube voltage of 80 kVp or higher. As tube voltage increased, 2.0 mm Al+0.1 mm Mo almost had a similar histogram width to that of 2.0 mm Al+0.2 mm Cu. Therefore, Mo filter can be used at relatively high tube voltage of 80 kVp, 100 kVp and 120 kVp. The SNR of 2.0 mm Al+0.1 mm Mo did not show any significant difference from those of 2.0 mm Al+0.2 mm Cu and 2.0 mm Al+0.1 mm Cu. As a result, if Mo filter is used to replace Cu filter in general radiography, where 80 kVp or higher is used for digital radiation image, patient exposure dose can be reduced significantly without decline in image quality, compared to Cu filter. Therefore, it is believed that Mo filter can be applied to chest X-ray and high tube voltage X-ray in actual clinical practice.

Anatomical study on The Arm Greater Yang Small Intestine Meridian Muscle in Human (수태양소장경근(手太陽小腸經筋)의 해부학적(解剖學的) 연구(硏究))

  • Park, Kyoung-Sik
    • Journal of Pharmacopuncture
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    • v.7 no.2
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    • pp.57-64
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    • 2004
  • This study was carried to identify the component of Small Intestine Meridian Muscle in human, dividing the regional muscle group into outer, middle, and inner layer. the inner part of body surface were opened widely to demonstrate muscles, nerve, blood vessels and the others, displaying the inner structure of Small Intestine Meridian Muscle. We obtained the results as follows; 1. Small Intestine Meridian Muscle is composed of the muscle, nerve and blood vessels. 2. In human anatomy, it is present the difference between a term of nerve or blood vessels which control the muscle of Meridian Muscle and those which pass near by Meridian Muscle. 3. The inner composition of meridian muscle in human arm is as follows ; 1) Muscle ; Abd. digiti minimi muscle(SI-2, 3, 4), pisometacarpal lig.(SI-4), ext. retinaculum. ext. carpi ulnaris m. tendon.(SI-5, 6), ulnar collateral lig.(SI-5), ext. digiti minimi m. tendon(SI-6), ext. carpi ulnaris(SI-7), triceps brachii(SI-9), teres major(SI-9), deltoid(SI-10), infraspinatus(SI-10, 11), trapezius(Sl-12, 13, 14, 15), supraspinatus(SI-12, 13), lesser rhomboid(SI-14), erector spinae(SI-14, 15), levator scapular(SI-15), sternocleidomastoid(SI-16, 17), splenius capitis(SI-16), semispinalis capitis(SI-16), digasuicus(SI-17), zygomaticus major(Il-18), masseter(SI-18), auriculoris anterior(SI-19) 2) Nerve ; Dorsal branch of ulnar nerve(SI-1, 2, 3, 4, 5, 6), br. of mod. antebrachial cutaneous n.(SI-6, 7), br. of post. antebrachial cutaneous n.(SI-6,7), br. of radial n.(SI-7), ulnar n.(SI-8), br. of axillary n.(SI-9), radial n.(SI-9), subscapular n. br.(SI-9), cutaneous n. br. from C7, 8(SI-10, 14), suprascapular n.(SI-10, 11, 12, 13), intercostal n. br. from T2(SI-11), lat. supraclavicular n. br.(SI-12), intercostal n. br. from C8, T1(SI-12), accessory n. br.(SI-12, 13, 14, 15, 16, 17), intercostal n. br. from T1,2(SI-13), dorsal scapular n.(SI-14, 15), cutaneous n. br. from C6, C7(SI-15), transverse cervical n.(SI-16), lesser occipital n. & great auricular n. from cervical plexus(SI-16), cervical n. from C2,3(SI-16), fascial n. br.(SI-17), great auricular n. br.(SI-17), cervical n. br. from C2(SI-17), vagus n.(SI-17),hypoglossal n.(SI-17), glossopharyngeal n.(SI-17), sympathetic trunk(SI-17), zygomatic br. of fascial n.(SI-18), maxillary n. br.(SI-18), auriculotemporal n.(SI-19), temporal br. of fascial n.(SI-19) 3) Blood vessels ; Dorsal digital vein.(SI-1), dorsal br. of proper palmar digital artery(SI-1), br. of dorsal metacarpal a. & v.(SI-2, 3, 4), dorsal carpal br. of ulnar a.(SI-4, 5), post. interosseous a. br.(SI-6,7), post. ulnar recurrent a.(SI-8), circuirflex scapular a.(SI-9, 11) , post. circumflex humeral a. br.(SI-10), suprascapular a.(SI-10, 11, 12, 13), first intercostal a. br.(SI-12, 14), transverse cervical a. br.(SI-12,13,14,15), second intercostal a. br.(SI-13), dorsal scapular a. br.(SI-13, 14, 15), ext. jugular v.(SI-16, 17), occipital a. br.(SI-16), Ext. jugular v. br.(SI-17), post. auricular a.(SI-17), int. jugular v.(SI-17), int. carotid a.(SI-17), transverse fascial a. & v.(SI-18),maxillary a. br.(SI-18), superficial temporal a. & v.(SI-19).

Analysis of alveolar molding effects in infants with bilateral cleft lip and palate when treated with pre-surgical naso-alveolar molding appliance (양측성 순구개열 신생아 환자의 수술전 비치조 정형장치 치료에 의한 치조골 조형(molding) 효과의 분석)

  • Nahm, Dong-Seok;Yang, Won-Sik;Baek, Seung-Hak;Kim, Sukwha
    • The korean journal of orthodontics
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    • v.29 no.6 s.77
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    • pp.649-661
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    • 1999
  • The goals of this study were 1) to present pre-surgical naso-alveolar molding (PNAM) appliance for bilateral cleft lip and palate treatment and 2) to evaluate the effects of the PNAM appliance on the alveolar molding of the premaxilla and the lateral segments. Subjects consisted of 8 bilateral cleft lip and palate infants (7 males and 1 female, mean age at first visit = 61.6 days after birth) who were treated with PNAM appliances in Department of Orthodontics, Seoul National University Dental Hospital. Average alveolar cleft gap between the premaxilla and the lateral segment was $8.09{\pm}5.03mm$ and average duration of alveolar molding treatment was $8.8{\pm}3.1$ weeks. These patients' models were obtained at initial visit (T0) and after alveolar molding (T1). 20 linear and 14 angular variables were measured by using photometry and digital caliper, All statistical analyses were performed by Microsoft Excel 97 program. Paired t-test was used to discriminate the effect of alveolar molding by PNAM appliance. 1. Closure of the alveolar cleft gap in bilateral cleft cases by molding therapy was completed successfully, 2. Alveolar molding inhibited outward growth of lateral segments and produced inward bending of lateral segments. 3. By bending the anterior part of the vomer, the premaxilla could be rotated and moved. posteriorly via alveolar molding. Conclusion This appliance can be applied to bilateral cleft lip and palate infants with satisfactory results before cheiloplasty.

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Evaluation of Cerebral Aneurysm with High Resolution MR Angiography using Slice Interpolation Technique: Correlation wity Digital Subtraction Angiography(DSA) and MR Angiography(MRA) (Slice Interpolation기법의 고해상도 자기공명혈관조영술을 이용한 뇌동맥류의 진단 : 디지탈 감산 혈관조영술과 자기공명 혈관조영술의 비교)

  • ;;;Daisy Chien;Gerhard Laub
    • Investigative Magnetic Resonance Imaging
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    • v.1 no.1
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    • pp.94-102
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    • 1997
  • Purpose: There have been some efforts to diagnose intracranial aneurysm through a non-invasive method using MRA, although the process may be difficult when the lesion is less than 3mm. The present study prospectively compares the results of high resolution, fast speed slice interpolation MRA and DSA thereby examing the potentiality of primary non-invasive screening test. Materials and Methods: A total of 26 cerebral aneurysm lesions from 14 patients with subarachnoid hemorrhage from ruptured aneurysm (RA) and 5 patients with unruptured aneurysm(UA). In all subjects, MRA was taken to confirm the vessel of origin, definition of aneurysm neck and the relationship of the aneurysm to nearby small vessels, and the results were compared with the results of DSA. The images were obtained with 1.5T superconductive machine (Vision, Siemens, Erlangen, Germany) on 4 slabs of MRA using slice interpolation. The settings include TR/TE/FA=30/6.4/25, matrix $160{\times}512$, FOV $150{\times}200$, 7minutes 42 seconds of scan time, effective thickness of 0.7 mm and an entire thickness of 102. 2mm. The images included structures from foramen magnum to A3 portion of anterior cerebral artery. MIP was used for the image analysis, and multiplanar reconstruction (MPR) technique was used in cases of intracranial aneurysm. Results: A total of 26 intracranial aneurysm lesions from 19 patients with 2 patients having 3 lesion, 3 patients having 2 lesions and the rest of 14 patients having 1 lesion each were examined. Among those, 14 were RA and 12 were UA. Eight lesions were less than 2mm in size, 9 lesions were 3-5mm, 7 were 6-9mm and 2 were larger than IOmm. On initial exams, 25 out of 26 aneurysm lesions were detected in either MRA or DSA showing 96% sensitivity. Specificity cannot be estimated since there was no true negative of false positive findings. When MRA and MPR were used concurrently for the confirmation of size and shape, the results were equivalent to those of DSA, while in the confirmation of aneurysm neck and parent vessels, the concurrent use of MRA and MPR was far superior to the sole use of either MRA or DSA. Conclusion: High resolution MRA using slice interpolation technique showed equal results as those of DSA for the detection of intracranial aneurysm, and may be used as a primary non-invasive screening test in the future.

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