• 대한방사선기술학회지:방사선기술과학
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• 제31권2호
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• pp.171-175
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• 2008

본 연구는 두부 전산화 단층촬영 시 차폐용 bismuth를 사용하여 수정체 선량의 감소와 차폐용 bismuth의 유용성을 평가하기 위해 수행되었다. 인체모형 팬텀과 열형광 선량계를 이용하여 (a) 안구를 포함한 두부 CT촬영 (b) 두부 전체가 포함된 CT촬영 (c) 안구를 배제하고 $20^{\circ}$를 준 두부 CT촬영 시의 수정체 선량을 평가하였다. 수정체 선량의 감소효과는 안구를 포함한 두부 CT촬영에서 43.2%, 두부 전체가 포함된 CT촬영에서 36.0%, $20^{\circ}$ 각도를 준 두부 CT촬영에서 1.4%로 나타나 두부 전체가 포함된 CT촬영과 안구를 포함한 두부 CT촬영에서는 상당한 감소효과가 있지만 안구를 제외한 $20^{\circ}$ 각도를 준 두부촬영에서는 감소효과가 적었다. 즉, 차폐용 bismuth를 사용한 수정체 선량감소는 안구가 촬영부위에 포함된 경우에는 유의한 것으로 나타났으나 안구가 포함되지 않은 두부 CT촬영일 경우에는 유의하지 않은 것으로 나타났다. 따라서 두부 CT촬영 시차폐용 bismuth의 사용은 안구가 포함되는 일부의 CT촬영에서만 제한적으로 사용되는 것이 바람직하다.

• 한국방사선학회논문지
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• 제5권4호
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• pp.171-178
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• 2011

성인 남성들이 2002년부터 2006년 까지 건강검진을 받기위해 대학병원을 내원한 성인 남성 80명을 개인별 골밀도를 5년간 관찰하여 분석하였다. 연구 대상자 성인 남성 80명의 평균연령은 $43.15{\pm}4.82$세였다. 대퇴경부의 골밀도는 1차 측정에서 -0.61에 비하여 4차 및 5차 측정에서 유의하게 감소하였으며, 척추 골밀도는 1차 측정 -0.67에서 2차 측정에서 유의한 감소를 나타냈지만 3~5차 측정에서 유의한 차이를 보이지 않았다. 생활습관에 따른 음주, 흡연, 운동, 식습관에 따른 군 간의 대퇴경부 및 척추 골밀도 변화 값의 차이는 보이지 않았다. 1차 측정에서의 대퇴경부 골밀도를 기준으로 골밀도 상($0{\leqq}BMD$), 중($-1.0{\leqq}BMD<0$), 하(BMD < -1.0) 집단에서 1차 측정과 5차 측정 골밀도의 차이를 비교하였을 때, 상 집단에서 대퇴경부 골밀도가 1차 $0.67{\pm}0.76$에서 $0.42{\pm}0.93$로 유의하게 감소하였다. 다른 집단에서는 전후 비교에서 유의한 차이를 보이지 않았다. 대상자들의 나이에 관계없이 젊어서부터 골밀도가 낮은 사람들은 대퇴경부 및 척추의 골밀도가 낮아 있었으며, 골밀도가 높은 사람들은 1차 측정 때부터 5차 측정 때까지 높았다. 대퇴경의 골밀도는 1차 측정에 비해 5차에서 유의한 감소를 나타내어 척추보다는 대퇴경부의 골밀도에 주의하도록 한다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권5호
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• pp.413-422
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• 2021

Intestinal lymphangiectasia is a rare disease which is causing protein-losing enteropathy. Treatment of intestinal lymphangiectasia can be a challenge for clinicians because of the lack of specific guidelines regarding pharmacological indications. We sought to introduce a diagnostic approach and suggest guidelines for treatment. After exclusion of secondary intestinal lymphangiectasia, magnetic resonance lymphangiography is a promising tool for the assessment of abnormal lymphatic lesions in primary intestinal lymphangiectasia. Determining the extent of the lesion provides direction for treatment options. Focal short-segment intestinal lymphangiectasia can be treated via intestinal resection or radiologic embolization after dietary therapy failure. Diffuse intestinal lymphangiectasia and extensive lymphangiectasia should be treated with several drugs with a full understanding of their mechanisms.

• Clinical Pain
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• 제19권2호
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• pp.111-115
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• 2020

We report a case of a healthy 38-year-old man presenting with insufficiency fracture of proximal tibia associated with unrecognized osteoporosis. Radiologic bone DEXA (Dual Energy X-ray Absorptiometry) assessment revealed osteoporosis, but the patient displayed no apparent risk factors for insufficiency fractures and osteoporosis except for a history of smoking. Following right proximal tibial open reduction and internal fixation, the patient commenced smoking cessation and began taking alendronate. The patient was treated for gait rehabilitation, which included quadriceps strengthening exercises and his condition improved with independent walking. This report highlights an unusual site of proximal tibial insufficiency fractures and the potential effect of smoking on low bone mineral density in a young male patient.

• 대한족부족관절학회지
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• 제13권1호
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• pp.85-90
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• 2009

Purpose: Nonunion of intra-articular fractures of calcaneus is rarely reported complication. We present our experiences with 4 patients (5 cases) treated operatively for nonunion after intra-articular fracture of calcaneus. Materials and Methods: 4 patients (5 cases) with nonunion of intra-articular fracture of calcaneus after operative treatment were followed for 4 years (from 2002 to 2006). For assessment, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Visual Analogue Scale (VAS) were assessed for clinical outcome and the union of fracture site, the talocalcaneal height and the angle of talar declination were determined for radiologic outcome. Results: The mean talocalcaneal height was 6.94 cm (range, 5.9${\sim}$7.6 cm) preoperatively and 7.34 cm (range, 6.0${\sim}$8.3 cm) at last follow-up. The mean angle of talar declination was 5.68 degrees (range, 4.6${\sim}$8 degrees) preoperatively and 13.1 degrees (range, 5.7${\sim}$21 degrees) at last follow-up. The mean preoperative AOFAS score and VAS were 20.4 (range, 14${\sim}$36) and 4 (range, 3${\sim}$6), respectively. At last follow-up, these scores improved to a mean of 59.6 (range, 54${\sim}$68) and 3 (range, 2${\sim}$4), respectively. Unions of previous nonunion site of intra-articular fracture of calcaneus were achieved in all 4 patients (5 cases). Conclusion: The reconstructive procedure for nonunion of intra-articular fracture of calcaneus showed good results in terms of bone union, radiologic results and functional improvement than preoperative state. Because the plantar pain for the inferior angular formation in nonunion site may happen, we will pay attention to reduction of fragment.

• Journal of Korean Neurosurgical Society
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• 제56권3호
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• pp.230-236
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• 2014

Objective : The technique of short segment pedicle screw fixation (SSPSF) has been widely used for stabilization in thoracolumbar burst fractures (TLBFs), but some studies reported high rate of kyphosis recurrence or hardware failure. This study was to evaluate the results of SSPSF including fractured level and to find the risk factors concerned with the kyphosis recurrence in TLBFs. Methods : This study included 42 patients, including 25 males and 17 females, who underwent SSPSF for stabilization of TLBFs between January 2003 and December 2010. For radiologic assessments, Cobb angle (CA), vertebral wedge angle (VWA), vertebral body compression ratio (VBCR), and difference between VWA and Cobb angle (DbVC) were measured. The relationships between kyphosis recurrence and radiologic parameters or demographic features were investigated. Frankel classification and low back outcome score (LBOS) were used for assessment of clinical outcomes. Results : The mean follow-up period was 38.6 months. CA, VWA, and VBCR were improved after SSPSF, and these parameters were well maintained at the final follow-up with minimal degree of correction loss. Kyphosis recurrence showed a significant increase in patients with Denis burst type A, load-sharing classification (LSC) score >6 or DbVC >6 (p<0.05). There were no patients who worsened to clinical outcome, and there was no significant correlation between kyphosis recurrence and clinical outcome in this series. Conclusion : SSPSF including the fractured vertebra is an effective surgical method for restoration and maintenance of vertebral column stability in TLBFs. However, kyphosis recurrence was significantly associated with Denis burst type A fracture, LSC score >6, or DbVC >6.

• 보건행정학회지
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• 제30권4호
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• pp.433-437
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• 2020

Cancer is a disease which has the huge burden in worldwide, and cancer is the number one cause of death in Korea. At this point, the new framework for cancer monitoring index is required for regional cancer monitoring. Especially, cancer survivors are the important target which is rapidly increasing recently, also cancer survivor's quality of care should be considered in the cancer monitoring index framework. To develop the Multidimensional Cancer Monitoring Index considering cancer survivor's quality of care, we took into account cancer continuum which including prevention, detection, diagnosis, treatment, survivorship, assessment of quality of care and monitoring cancer patient, and end-of life care for stage. For target, components of health care delivery system such as patient, family, provider, payer, and policy maker are included. Also, Donabedian model which is a framework for examining health services and evaluating quality of health care such as structure, process, and outcome is applied to contents. This new cancer monitoring framework which includes multidimensional components could help to develop regional cancer monitoring index, and to make national cancer management and prevention policy in the future.

• 대한방사선기술학회지:방사선기술과학
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• 제45권3호
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• pp.255-262
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• 2022

In this study, by analyzing the examination time for each procedure, the appropriate workload of radiologic technologist is analyzed based on the actual examination time in the current clinical setting by comparing with the examination time in the radiology field setting of the health insurance review and assessment service. In addition, this result is introduced into the calculation of relate value units; it was attempted to provide accurate and objective evidence in the field of radiology. From May 2020 to December 2021, the study retrospectively investigated the examination times recorded in the electronic medical record and picture archiving and communication system at 5 tertiary general hospitals and 1 general hospital. The total of 16 examination parts are applied in this study, including the head, sinuses, chest, ribs, abdomen, pelvis, cervical, thoracic, lumbar, shoulder, elbow, wrist, hip, femur, knee, and ankle. The minimum number of images that could be obtained per radiation generator was 3.6 images for one hour, and the maximum was 6.4 images. When 50% median of procedure time is calculated, the minimum number of images that could be obtained was 16.7 images and maximum was 35.3 images; in addition, minimum examination time is 1.7 minutes, and maximum time is 3.6 minutes. In conclusion, it is judged that there will be insufficient explanation time for basic infection instructions such as hand hygiene during the examinations in current clinical practice. It is believed that radiologic technologists will contribute to providing higher-quality of radiation examination services to the public by complying with guidelines for work and setting appropriate workload on their own.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2137-2140
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• 2016

Background: Gall bladder cancer (GBC) usually presents as unresectable or metastatic disease. We conducted a feasibility study to evaluate the effect of neoadjuvant therapy (NAT) on radiologic downstaging and resectability in unresectable GBC cases. Materials and Methods: Patients with locally advanced disease were treated with chemoradiotherapy [CTRT] ( external radiotherapy (45Gy) along with weekly concurrent cisplatin $35mg/m^2$ and 5-FU 500 mg) and those with positive paraaortic nodes were treated with neoadjuvant chemotherapy [NACT (cisplatin $25mg/m^2$ and gemcitabine $1gm/m^2$ day 1 and 8, 3 weekly for 3 cycles). Radiological assessment was according to RECIST criteria by evaluating downstaging of liver involvement and lymphadenopathy into complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Results: A total of 40 patients were evaluated from January 2012 to December 2014 (CTRT=25, NACT=15). Pretreatment CT scans revealed involvement of hilum (19), liver infiltration (38), duodenum involvement (n=22), colon involvement (n=11), N1 involvement (n=11), N2 disease (n=8), paraaortic LN (n=15), and no lymphadenopathy (n=6). After neoadjuvant therapy, liver involvement showed CR in 11(30%), PR in 4 (10.5%), SD in 15 (39.4%) and lymph node involvement showed CR in 17 (50%), PR in 6 (17.6%), SD in 4 (11.7 %). Six patients (CTRT=2, NACT=4) with 66.6 % and 83% downstaging of liver and lymphnodes respectively underwent extended cholecystectomy. There was 16.6 % and 83.3% rates of histopathological CR of liver and lymph nodes. All resections were R0. Conclusions: Neoadjuvant therapy in unresectable gall bladder cancer results in a 15% resectability rate. This approach has a strong potential in achieving R0 and node negative disease. Radiologic downstaging (CR+PR) of liver involvement is 40.5% and lymphadenopathy is 67.5%. Nodal regression could serve as a predictor of response to neoadjuvant therapy.

• 한국방사선학회논문지
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• 제9권7호
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• pp.473-478
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• 2015

사회 인구학적 특성을 보정 하였을 때 대사 증후군의 예측에 가장 높은 연관이 남녀 모두에서 비만-복부 비만군이라고 보고되고 있으며, 의료기기의 발전과 더불어 방사선에 대한 피폭선량이 증가하고 있는 추세이다. 이에 흉부 X선 검사에서 복부의 비만정도를 가정하여 흉부팬텀에서 앞쪽방향(forward)으로 각도를 부여한 후 기준영상과 비교하여 입사표면선량과 영상의 왜곡 정도를 평가하였다. 흉부팬텀의 각도가 앞쪽방향으로 $5^{\circ}$ 증가할 때 마다 폐의 가로직경은 1.22%, 세로직경은 0.44% 증가하였다. 심장직경은 앞쪽방향으로 $5^{\circ}$ 증가할 때 마다 1.01% 증가, CTR은 0.27% 감소가 관찰되었다. 그 중 폐의 가로직경이 가장 큰 증가, 폐의 세로직경이 가장 작은 증가를 보였고 CTR은 작은 감소를 보였다. 그러나 팬텀에 입사하는 표면선량 측정의 경우, 흉부팬텀의 각도가 앞쪽방향으로 $5^{\circ}$ 증가할 때 마다 6.12%의 비교적 큰 증가를 보였다. 임상에서 흉부 X-선 후전방향촬영을 시행하는 경우, 복부비만 등으로 인해 흉부의 각도가 기울어짐에 따라 영상의 왜곡뿐만 아니라 환자에게 노출되는 선량이 증가되고 재촬영으로 추가적인 방사선 피폭이 발생될 수 있으므로 올바른 위치잡이에 주의를 기울여 환자의 방사선피폭 감소에 노력을 해야 할 것이다.