• 대한방사선기술학회지:방사선기술과학
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• 제40권3호
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• pp.433-441
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• 2017

골 모델제작에 사용되는 3차원 프린팅 선택적 레이저 소결(selective laser sintering; SLS) 방식과 광 경화 조형(stereo lithography apparatus; SLA) 방식은 정밀도와 해상도는 좋으나 프린터가 고가이며 운용에 전문지식이 필요하고, 전산화단층 DICOM(digital imaging and communications in medicine)영상을 STL(stereolithography)로 변환하는 프로그램도 고가여서 3차원 프린팅 업체에서 모델을 제작하여 많은 시간과 비용이 소요되므로 일반적으로 골절수술에 사용하지 못하고 있다. 골절환자의 골 모델을 제작하려면 3차원 영상변환프로그램과 3차원 프린팅시스템의 사용이 편리하고 구입 및 운용비용이 저렴해야 하며 큰 골 모델제작이 가능하여야 수술에 사용할 수 있다. 이에 본 연구에서는 DICOM Viewer OsiriX와 와이어형태의 열가소성 재료를 사용하는 용융적층조형(Fused Deposition Modeling; FDM) 방식의 3차원 프린터를 이용하여 출력 크기에 제한이 없고 적은 비용으로 유지와 제작을 할 수 있도록 일반화하여 많은 병원에서 골절수술에 사용할 수 있도록 골절수술환자의 맞춤형 골 모델을 제작할 수 있는 3차원 프린팅 시스템을 개발하였으며 정형외과학의 교육, 연구, 진료의 전 분야에 걸쳐 광범위하게 응용될 것으로 예상되며, 대학병원뿐 아니라 일반병원에서도 편리하게 사용될 것으로 기대된다.

• Journal of Gastric Cancer
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• 제18권3호
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• pp.242-252
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• 2018

Purpose: Surgical resection for gastric adenocarcinoma is associated with significant post-operative morbidity and mortality. The aim of this study was to assess the prognostic significance of sarcopenia in patients undergoing resection for gastric adenocarcinoma with respect to post-operative morbidity and survival. Materials and Methods: A retrospective analysis was conducted on a cohort of consecutive patients who underwent surgical resection for gastric adenocarcinoma between 2008 and 2014. Patient demographics, radiological parameters, and pathological data were collected. OsiriX software (Pixmeo) was used to measure skeletal muscle area, which was normalized for height to calculate skeletal muscle index. Results: A total of 56 patients (41 male, 15 female; mean age, $68.4{\pm}11.9years$) met the inclusion criteria. Of these, 36% (20 of 56) of the patients were sarcopenic pre-operatively. Both sarcopenic and non-sarcopenic patient groups were equally matched with the exception of weight and body mass index (P=0.036 and 0.001, respectively). Sarcopenia was associated with a decreased overall survival (log-rank P=0.003) and was an adverse prognostic predictor of overall survival in multivariate analysis (hazard ratio, 10.915; P=0.001). Sarcopenia was a predictor of serious in-hospital complications in multivariate analysis (odds ratio, 3.508; P=0.042). Conclusions: In patients undergoing curative resection for gastric cancer, there was a statistically significant association between sarcopenia and both decreased overall survival and serious post-operative complications. The measurement and reporting of skeletal muscle index on pre-operative computed tomography should be considered.

• 대한방사선기술학회지:방사선기술과학
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• 제41권1호
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• pp.61-66
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• 2018

The recent 3D printing technology is used in various medical, manufacturing, and education fields and is more efficient in terms of production process, time, and cost than existing production. Especially in fracture surgery, interest and research have been focused on improving accuracy, shortening of operation time and recovery time, and reducing reoperation. However, because of the financial and technical problems of the 3D printer and the file conversion program, the 3D printing is made directly at the hospital, and it is not generally used for diagnosis of fracture and surgical research. In this study, to solve those problems, clavicle CT imaging was switched into Osirix Open Source DICOM Viewer, Stereolithography file conversion programs and commercial Terarecon 3D DICOM Viewer, file conversion programs, and then clavicle fracture model was directly made through 3D printer of fused filament fabrication wire additive processing method, and then the accuracy of the shape was compared and analyzed. Clavicle fracture models printed in two methods were blind-tested on clinicians of general hospitals' orthopedics and radiologic technicians with over 10 years of experiences, and then their analysis opinions of resolution reviews were analyzed. The result showed no difference. The 3D printing model with open source DICOM STL file conversion program used was applicable to clinical, so it is considered useful in precision diagnosis of fracture and operation plans.