• The Korean Journal of Nuclear Medicine
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• v.31 no.1
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• pp.102-107
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• 1997

Laparoscopic cholecystectorny can be performed safely in most patients with symptomatic cholelithiasis. Preoperative evaluation should assess the potential problems that affect the performance of laparoscopic cholecystectomy. Hepatobiliary scintigraphy or oral cholecystography can assess the gallbladder function and nonvisualization of gallbladder usually indicates acute or severe chronic cholecystitis. The purpose of this study was to evaluate the role of preoperative hepatobiliary scintigraphy or oral cholecystography in predicting the performance of laparoscopic cholecystectorny. The study group consists of 176 patients who underwent both hepatobiliary scintigraphy with Tc-99m DISIDA and oral cholecystography within one month before laparoscopic cholecystectomy. Nonvisualization of gallbladder was defined as persistent nonvisualization of gallbladder until 4 hours on hepatobiliary scintigraphy or 12 hours on oral cholecystography. Among 176 patients, gallbladder was not visualized in 38 patients on hepatobiliary scintigraphy and 41 patients on oral cholecystography. Concordance rate between hepatobiliary scintigraphy and oral cholecystography was 89.2%. The conversion rate to open cholocystectomy was significantly higher in patients with nonvisualization of gallbladder than in patients with gallbladder visualization(15.8% vs 2.9% on hepatobiliary scintigraphy, 12.2% vs 3.7% on oral cholecystography p<0.01 and p<0.05 respectively). The operative complication rate was also significantly higher in patients with nonvisualization of gallbladder (13.2% vs 2.9% on hepatobiliary scintigraphy, 14.6% vs 2.2% on oral cholecystography p<0.01 and p<0.001, respectively). Similarly, operation time was significantly prolonged in patients with nonvisualization of gallbladder ($88.8{\pm}41.9min$ vs $62.5{\pm}23.6min$ on hepatobiliary scintigraphy : p<0.001, $89.4{\pm}41.3$ min vs $61.8{\pm}22.8$ min on oral cholecystography : p<0.001). It is concluded that nonvisualization of gallbladder on hepatobiliary scintigraphy or oral cholecystography is a valuable preoperative clinical risk factor in predicting increased conversion rate to open cholecystectomy, increased operative complication and prolonged operation time.

• Progress in Medical Physics
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• v.17 no.3
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• pp.144-152
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• 2006

The telemedicine using independent client-server system via networks can provide high quality normalized services to many hospitals, specifically to local/rural area hospitals. This will eventually lead to a decreased medical cost because the centralized institute can handle big computer hardware systems and complicated software systems efficiently and economically, Customized cancer radiation treatment planning for each patient Is very useful for both a patient and a doctor because it makes possible for the most effective treatment with the least possible dose to patient. Radiation planners know that too small a dose to the tumor can result in recurrence of the cancer, while too large a dose to healthy tissue can cause complications or even death. The best solution is to build an accurate planning simulation system to provide better treatment strategies based on each patient's computerized tomography (CT) image. We are developing a web-based and a network-based customized cancer radiation therapy simulation system consisting of four Important computer codes; a CT managing code for preparing the patients target data from their CT image files, a parallel Monte Carlo high-energy beam code (PMCEPT code) for calculating doses against the target generated from the patient CT image, a parallel linear programming code for optimizing the treatment plan, and scientific data visualization code for efficient pre/post evaluation of the results. The whole softwares will run on a high performance Beowulf PC cluster of about 100-200 CPUs. Efficient management of the hardware and software systems is not an easy task for a hospital. Therefore, we integrated our system into the client-sewer system via network or web and provide high quality normalized services to many hospitals. Seamless communication with doctors is maintained via messenger function of the server-client system.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.86-89
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• 2002

The purpose is to develop a system to reduce the organ movement from the respiration during the 3DCRT or IMRT. This research reports the experience of utilizing personally developed system for mobile tumors. The patients clinical database was structured for 10 mobile tumors and patient setup error measurement and immobilization device effects were investigated. The RMRD system is composed of the respiratory motion reduction device utilized in prone position and abdominal strip device(ASD) utilized in the supine position, and the analysis program, which enables the analysis on patients setup reproducibility. Dose to normal tissue between patients with RMRDs and without RMRDs was analyzed by comparing the normal tissue volume, field margins and dose volume histogram(DVH) using fluoroscopy and CT images. And, reproducibility of patients setup verify by utilization of digital images. When patients breathed freely, average movement of diaphragm was 1.2 cm in prone position in contrast to 1.6 cm in supine position. In prone position, difference in diaphragm movement with and without RMRDs was 0.5 cm and 1.2 cm, respectively, showing that PTV margins could be reduced to as much as 0.7 cm. With RMRDs, volume of the irradiated normal tissue (lung, liver) reduced up to 20 % in DVH analysis. Also by obtaining the digital image, reproducibility of patients setup verify by visualization using the real-time image acquisition, leading to practical utilization of our software. Internal organ motion due to breathing can be reduced using RMRDs, which is simple and easy to use in clinical setting. It can reduce the organ motion-related PTV margin, thereby decrease volume of the irradiated normal tissue.

• Journal of the Korean Arthroscopy Society
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• v.9 no.1
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• pp.70-76
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• 2005

Purpose: We describe a new technique of arthroscopic repair with using autogenous hamstring tendon graft augmentation for the acute posterior cruciate ligament rupture. Operative technique: A routine arthroscopic examination of the knee joint is initially performed, then the posterior trans-septal portal is prepared with the using the posteromedial and posterolateral portals. The torn tibial stump that is retracted to the posterior compartment is repaired by a suture hook that is introduced through the anteromedial portal; visualization during this procedure is done with the arthroscope via the posteromedial portal. Using the retrieved suture, both suture ends are brought out to the anteromedial portal. The torn tibial stump is pulled to the intercondylar notch and then repaired with stitches at the anterior compartment. After the tibial and femoral tunnels are prepared without damaging the remnant PCL bundle, the combined torn PCL fibers and the autogenous single-bundle semitendinosus and gracilis tendon grafts are passed through the femoral tunnel and fixed together Conclusion: Arthroscopic repair of the torn tibial stump and autogenous hamstring tendon graft augmentation after preparing the tibial and femoral tunnels by using the trans-septal portal, without damaging the remnant PCL bundle, seems to be a very effective method for the treatment for acute PCL injuries, and especially for tears at the femoral attachment.

• Proceedings of the KOSOMBE Conference
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• v.1997 no.11
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• pp.357-360
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• 1997

For medical students and doctors, knowledge of the 3-dimensional (3D) structure of the heart is very important in diagnosis and treatment of the heart diseases. 2-dimensional (2D) tools (e.g. anatomy book) or classical 3D tools (e.g. plastic model) are not sufficient or understanding the complex structures of the heart. Moreover, it is not always guaranteed to dissect the heart of cadaver when it is necessary. To overcome this problem, virtual dissection systems of the heart have been developed. But these systems are not satisfactory since they are made of radiographs; they are not true 3D images; they can not be used to dissect freely; or they can only be operated on the workstation. It is also necessary to make the dissection systems incorporating the various races and tribes because of the organ's difference according to race and tribe. This study was intended to make the 3D image of the heart from a Korean cadaver, and to establish a virtual dissection system of the heart with a personal computer. The procedures or manufacturing this system were as follows. 1. The heart from a Korean adult cadaver was embedded with gelatin solution, and serially cross-sectioned at 1mm-thickness on a meat slicer. Pictures or 153 cross-sectioned specimens were inputted into the computer using a digital camera ($756{\times}504$ resolution, true color). 2. The alignment system was established by means of the language of IDL, and applied to align 2D images of the heart. In each of 2D images, closed curves lining clean and dirty blood pathways were drawn manually on the CorelDRAW program. 3. Using the language of IDL, the 3D image and the virtual dissection system of the heart were constructed. The virtual dissection system of the heart allowed or ree rotation, any-directional sectioning, and selected visualization of the heart's structure. This system is expected to become more advanced, and to be used widely through Internet or CD-title as an educational tool for medical students and doctors.

• Clinical and Experimental Reproductive Medicine
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• v.24 no.3
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• pp.335-340
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• 1997

Fluorescence in situ hybridization (FISH) techniques allow the enumeration of chromosome abnormalities and from a great potential for many clinical applications. In order to produce quantitative and reproducible results, expensive tools such as a cooled CCD camera and a computer software are required. We have developed a Chromosome Image Processing System (Chips) using FISH that allows the detection and mapping of the genetic aberrations. The aim of our study, therefore, is to evaluate the capabilities of our original system using a black-and-white video camera. As a model system, three repetitive DNA probes (D18Z1, DXZ1, and DYZ3) were hybridized to variety different clinical samples such as human metaphase spreads and interphase nuclei obtained from uncultured peripheral blood lymphocytes, uncultured amniocytes, and germ cells. The visualization of the FISH signals was performed using our system for image acquisition and pseudocoloring. FISH images were obtained by combining images from each of probes and DAPI counterstain captured separately. Using our original system, the aberrations of single or multiple chromosomes in a single hybridization experiment using chromosomes and interphase nuclei from a variety of cell types, including lymphocytes, amniocytes, sperm, and biopsied blastomeres, were enabled to evaluate. There were no differences in the image quality in accordance with FISH method, fluorochrome types, or different clinical samples. Always bright signals were detected using our system. Our system also yielded constant results. Our Chips would permit a level of performance of FISH analysis on metaphase chromosomes and interphase nuclei with unparalleled capabilities. Thus, it would be useful for clinical purposes.

• Childhood Kidney Diseases
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• v.6 no.1
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• pp.68-74
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• 2002

Purpose: Suprapubic bladder aspiration(SBA) of urine is the most reliable method to obtain urine avoiding contamination in non-toilet trained infants. Ultrasonography is a useful tool for guiding the anatomic location as well as for direct visualization during procedure. We evaluated the success rate and complication of ultrasound(US) assisted SBA Methods. Sixty infants who visited Ewha Womans University Mokdong Hospital, with suspected urinary tract infection were randomly divided into the US assisted (n=32) and blind SBA(control, n=28) group. In US assisted SBA group, the anteroposterior(AP), transverse, and sagittal diameters and the volume of the bladder were measured. In the blind SBA group, urine was blindly aspirated when the urinary bladder was palpated at the suprapubic area. The rate of successful urine aspiration, the number of attempts until successful aspiration, aspirated urine volume were compared between the two groups. Results: The success rate was $100\%$(32/32) in the US assisted group, which was significantly higher than $85.7\%$(24/28) of the control group (P<0.05). The aspirated urine volume in the US assisted group was $7.4{\pm}3.7\;mL$, which was significantly higher than $4.5{\pm}3.4\;mL$ of the control group (P<0.05), The diameters and volume of bladder in successful aspiration were $2.1{\pm}0.7\;cm$ in AP diameter, $3.1{\pm}0.6\;cm$ in transverse diameter, $4.2{\pm}1.0\;cm$ in sagittal diameter and $15.2{\pm}10.4\;mL$ in volume, which were significantly higher than those ($1.7{\pm}0.3\;cm,\;1.7{\pm}0.3\;cm,\;1.8{\pm}0.7\;cm,\;2.4{\pm]0.6\;cm,\;3.9{\pm}2.5$) of the control group (P<0.05) The correlations between the AP(r=0.78), transverse (r=0.72), sagittal(r=0.91) diameter and bladder volume were significant (P<0.05). SBA was $100\%$ successful in the AP diameter >3 cm, transverse diameter >4 cm, depth >4 cm and bladder volume >5 mL. Conclusion: US assistance can significantly improve the success rate of SBA in infant with suspected urinary tract infection. (J Korean Soc Pediatr Nephrol 2002 ; 6 : 68-74)

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.18-23
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• 2010

Purpose: PET/CT combines functional and morphologic data and increases diagnostic accuracy in a variety of malignancies. Especially reconstructed Fusion PET/CT images or MIP (Maximum Intensity Projection) images from a 2-dimensional image to a 3-dimensional one are useful in visualization of the lesion. But in Fusion & MIP 3D reconstruction image, due to hot uptake by urine or urostomy bag, lesion is overlapped so it is difficult that we can distinguish the lesion with the naked eye. This research tries to improve a distinction by removing parts of hot uptake. Materials and Methods: This research has been conducted the object of patients who have went to our hospital from September 2008 to March 2009 and have a lot of urine of remaining volume as disease of uterus, bladder, rectum in the result of PET/CT examination. We used GE Company's Advantage Workstation AW4.3 05 Version Volume Viewer program. As an analysis method, set up ROI in region of removal in axial volume image, select Cut Outside and apply same method in coronal volume image. Next, adjust minimum value in Threshold of 3D Tools, select subtraction in Advanced Processing. It makes Fusion & MIP images and compares them with the image no using Region Cut Definition. Results: In Fusion & MIP 3D reconstruction image, it makes Fusion & MIP images and compares them by using Advantage Workstation AW4.3 05's Region Cut Subtraction, parts of hot uptake according to patient's urine can be removed. Distinction of lesion was clearly reconstructed in image using Region Cut Definition. Conclusion: After examining the patients showing hot uptake on account of volume of urine intake in bladder, in process of reconstruction image, if parts of hot uptake would be removed, it could contribute to offering much better diagnostic information than image subtraction of conventional method. Especially in case of disease of uterus, bladder and rectum, it will be helpful for qualitative improvement of image.

• Clinical and Experimental Reproductive Medicine
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• v.10 no.2
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• pp.25-37
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• 1983

As the cytogenetic developed, cytogenetic study has also developed progressively. This study is a systematical cytogenetic and clinico-hormonal analysis of 20 cases Wp.ere gonadal dysgenesis was diagnosed and deferred to the Dept. of obstetrics and Gynecology, Yonsei University, Medical School from Jan. 1974 to Aug. 1983. Twenty patients with the diagnosis of gonada dysgenesis have been assesed as to possible correlations between clinical, homonal and cytogenic findings. The desults were as follows; l. Gonadal dysgenesis were found in 20 cases, consisting of 15 cases (75%) of turnurs syndrome, 4 case of pure gonadal dysgenesis (20%), 46. XX and 1 case of mixed gonadal dysgenesis, 45,XO/46,XY. 2. Patients with XO karyotype, turner's ryndorme, have a resonably constant clinical picture of sexual infantilism with streak gonads, short status and webbed neck. 3. 17 cases were found primary amenorhea and two cases were noted with 2 ndary amenorrhea. one case has been presented with menstruation. 4. The rudimentary streak gonads were found in 7 cases of 8 cases and one case has a rudimentary streak gonad on one side and a testis on the contralateral side. 5. The study showed that potients with gonadal dysgenesis had an average of about 4-8 times higher basal FSH and about 3-7 times higher basal LH than that of the early follicular phase of normal menstrual cycle. 6. Two cases of three gonadal dysgenesis patieats, who performed LH-RH challage test, showed that the serum FSH levels reached the maximal level at 30 min after injection of CHRH and the serum LH level reached the maximal level at 60 min ofter injection of LHRH one case showed no significant response to LH-RH injection. Thus, bu studying simultoneously the clinical, cytogenic, hormonal aspects and visualization of gonads, we have gained some practical insight into the requirements for proper disgnosis and treatment.

• Journal of the Korea Society of Computer and Information
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• v.25 no.3
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• pp.117-127
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• 2020

Recently, proving insurance fraud has become increasingly difficult because it occurs intentionally and secretly via organized and intelligent conspiracy by specialists such as medical personnel, maintenance companies, insurance planners, and insurance subscribers. In the case of car accidents, it is difficult to prove intentions; in particular, an insurance company with no investigation rights has practical limitations in proving the suspicions. This paper aims reveal that the detection of organized and conspired insurance fraud, which had previously been difficult, could be dramatically improved through conspiring insurance fraud detection modeling using social network analysis and visualization of the relation between suspected group entities and by seeking developmental research possibilities of data analysis techniques.