• Title/Summary/Keyword: Radiological Assessment

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Development of an evidence-based clinical imaging diagnostic guideline for implant planning: Joint recommendations of the Korean Academy of Oral and Maxillofacial Radiology and National Evidence-based Healthcare Collaborating Agency

  • Kim, Min-Ji;Lee, Sam-Sun;Choi, Miyoung;Ha, Eun Ju;Lee, Chena;Kim, Jo-Eun;Heo, Min-Suk
    • Imaging Science in Dentistry
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    • v.50 no.1
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    • pp.45-52
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    • 2020
  • Purpose: This study was conducted to develop an evidence-based clinical imaging diagnostic guideline for implant planning, taking into account efficacy, benefits, and risks. Materials and Methods: The guideline development process employed the adaptation methodology used for Korean clinical imaging guidelines(K-CIG). Core databases(Ovid-Medline, Ovid-Embase, National Guideline Clearinghouse, Guideline International Network) and domestic databases (KoreaMed, KMbase, and KoMGI) were searched for guidelines. The retrieved articles were analyzed by 2 reviewers, and articles were selected using well-established inclusion criteria. Results: The search identified 294 articles, of which 3 were selected as relevant guidelines. Based on those 3 guidelines, 3 recommendations for implant planning were derived. Conclusion: We recommend radiography or cone-beam computed tomography (CBCT) scanning for individual patients judged to require a cross-sectional image after reading of a panoramic X-ray image and a conventional intraoral radiological image. Various steps should be taken to raise awareness of these recommendations among clinicians and the public, and K-CIG should be regularly reviewed and revised.

Assessment of Potential Radiation Dose Rates to Marine Organisms Around the Korean Peninsula

  • Lee, Dong-Myung;Lee, Jun-ho
    • Journal of Radiation Protection and Research
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    • v.41 no.1
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    • pp.1-6
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    • 2016
  • Background: It is very difficult to set a regulatory guidance or criteria for the protection of non-human species from the ionizing radiation, because there are no generally or internationally accepted methods for demonstrating the compliance with such criteria. It is needed that Korea develop the primary dose rate standards for the protection of both aquatic and terrestrial biota in the near future. Materials and Methods: The potential dose rates due to both external and internal radiation exposures to marine organisms such as plaice/flounder, gray mullet, and brown seaweed collected within territorial seas around the Korean Peninsula were estimated. Results and Discussion: The total dose rates to plaice/flounder, gray mullet and brown seaweed due to $^{40}K$, a primordial radionuclide in marine environment, were found to be 0.2%, 0.08% and 0.3% of approximately the values of the Derived Consideration Reference Levels (DCRLs, i.e. $1-10mGy{\cdot}d^{-1}$), respectively, as suggested by the International Commission on Radiological Protection (ICRP) publication 124. The total dose rates to marine fishes and brown seaweed due to anthropogenic radionuclides such as $^{90}Sr$, $^{137}Cs$ and $^{239+240}Pu$ were considered to be negligible compared to the total dose rate due to $^{40}K$. The external exposure to benthic fish due to all radionuclides was much higher than that of pelagic fish. Conclusion: From this study, it is recommended that the further study is required to develop a national regulatory guidance for the evaluation of doses to non-human species.

Chronic Low Back Pain in Young Korean Urban Males : The Life-Time Prevalence and Its Impact on Health Related Quality of Life

  • Shim, Jae-Hyun;Lee, Kyeong-Seok;Yoon, Sang-Young;Lee, Chang-Hoon;Doh, Jae-Won;Bae, Hack-Gun
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.482-487
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    • 2014
  • Objective : We assessed the life-time prevalence (LTP) of chronic low back pain (LBP) in young Korean males. We also evaluated the relationship between lumbar spinal lesions and their health related quality-of-life (HRQOL). Methods : A cross-sectional, self-reported survey was conducted in Korean males (aged 19-year-old) who underwent physical examinations for the conscript. We examined 3331 examinees in November 2014. We included 2411 subjects, who accepted to participate this study without any comorbidities. We interviewed using simple binary questions for their LBP experience and chronicity. HRQOL was assessed by Short-Form Health-Survey-36 (SF-36) in chronic LBP and healthy control groups. Radiological assessment was performed in chronic LBP group to determine whether there were any pathological causes of their symptoms. Results : The LTP of chronic LBP was 13.4%. Most (71.7%) of them didn't have any lumbar spinal lesions (i.e., non-specific chronic LBP). The SF-36 subscale and summary scores were significantly lower in subjects with chronic LBP. Between specific and non-specific chronic LBP group, all physical and mental subscale scores were significantly lower in specific chronic LBP group, except mental health (MH) subscale score. In MH subscale and mental component summary score, statistical significant differences didn't appear between two groups (p=0.154, 0.126). Conclusion : In Korean males 19 years of age, the LTP of chronic LBP was 13.4%, and more than two-thirds were non-specific chronic LBP. Chronic LBP had a significant impact on HRQOL. The presence of lumbar spinal pathoanatomical lesions affected mainly on the physical aspect of HRQOL. It influenced little on the mental health.

Anterior Cervical Discectomy and Fusion Using a Stand-Alone Polyetheretherketone Cage Packed with Local Autobone : Assessment of Bone Fusion and Subsidence

  • Park, Jeong-Ill;Cho, Dae-Chul;Kim, Kyoung-Tae;Sung, Joo-Kyung
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.189-193
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    • 2013
  • Objective : It remains debatable whether cervical spine fusion cages should be filled with any kind of bone or bone substitute. Cortical and subcortical bone from the anterior and posterior osteophytes of the segment could be used to fill the cage. The purposes of the present study are to evaluate the clinical outcomes and radiological outcomes including bone fusion and subsidence that occurred after anterior cervical discectomy and fusion using a stand-alone cage packed with local autobone graft. Methods : Thirty-one patients who underwent anterior cervical fusion using a stand-alone polyetheretherketone (PEEK) cage packed with local autobone graft from July 2009 to december 2011 were enrolled in this study. Bone fusion was assessed by cervical plain radiographs and computed tomographic scan. Nonunion was evaluated according to the absence of bony bridge on computed tomographic scan. Subsidence was defined as a ${\geq}2$ mm decrease of the interbody height at the final follow-up compared to that measured at the immediate postoperative period. Results : Subsidence was observed in 7 patients (22.6%). Of 7 patients with subsidence greater 2 mm, nonunion was developed in 3. Three patients with subsidence greater 2 mm were related with endplate damage during intraoperative endplate preparation. Solid bone fusion was achieved in 28 out of 31 patients (90.3%). Conclusion : With proper patient selection and careful endplate preparation, anterior cervical discectomy and fusion (ACDF) using a stand-alone PEEK cage packed with local autobone graft could be a good alternative to the standard ACDF techniques with plating.

Assessment of Image Quality of Dual Energy 256 MDCT Technique Focused on keV Changes for MCA Stroke in Cerebral Angiography : Single Energy CT Standard Reference Mode (뇌혈관 조영 검사 시 중대뇌동맥 뇌졸중에 대한 keV 변화를 중심으로 이중 에너지 256 MDCT 기법의 영상의 질 평가 : 단일에너지 CT 표준방식)

  • Goo, Eun-Hoe
    • Journal of the Korean Society of Radiology
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    • v.13 no.7
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    • pp.961-968
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    • 2019
  • The purpose of this study was to evaluate the usefulness of cerebral angiography in each energy level by using dual energy technique in CT. Methods were performed on 15 DE images and SE images of CT angiography. For the analysis of images, mean value, standard deviation, SNR and CNR value were determined by setting ROI on MCA, brain parenchyma tissue, and back ground. As a result of concurrent visual evaluation with Likert 5 point scale, the clearest MCA image was confirmed at DE 40 keV and SE 120 kVp(p>0.05). The SNR value of the SE image was measured to be similar to the 40 keV energy level of the DE image. The low energy level image of 40 keV and 50 keV was measured with a high SNR and the contrast ratio was higher than that of the high energy image.

Surgical Management of Massive Cerebral Infarction

  • Huh, Jun-Suk;Shin, Hyung-Shik;Shin, Jun-Jae;Kim, Tae-Hong;Hwang, Yong-Soon;Park, Sang-Keun
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.331-336
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    • 2007
  • Objective : The aim of this study was to analyze the treatment results and prognostic factors in patients with massive cerebral infarction who underwent decompressive craniectomy. Methods : From January 2000 to December 2005, we performed decompressive craniectomy in 24 patients with massive cerebral infarction. We retrospectively reviewed the medical records, radiological findings, initial clinical assessment using the Glasgow Coma Scale, serial computerized tomography (CT) with measurement of midline and septum pellucidum shift, and cerebral infarction territories. Patients were evaluated based on the following factors : the pre- and post-operative midline shifting on CT scan, infarction area or its dominancy, consciousness level, pupillary light reflex and Glasgow Outcome Scale. Results : All 24 patients (11 men, 13 women; mean age, 63 years; right middle cerebral artery (MCA) territory, 17 patients; left MCA territory, 7 patients) were treated with large decompressive craniectomy and duroplasty. The average time interval between the onset of symptoms and surgical decompression was 2.5 days. The mean Glasgow Coma Scale was 12.4 on admission and 8.3 preoperatively. Of the 24 surgically treated patients, the good outcome group (Group 2 : GOS 4-5) comprised 9 cases and the poor outcome group (Group1 : GOS 1-3) comprised 15 cases. Conclusion : We consider decompressive craniectomy for large hemispheric infarction as a life-saving procedure. Good preoperative GCS, late clinical deterioration, small size of the infarction area, absence of anisocoria, and preoperative midline shift less than 11mm were considered to be positive predictors of good outcome. Careful patient selection based on the above-mentioned factors and early operation may improve the functional outcome of surgical management for large hemispheric infarction.

The Usability Assessment of Self-developed Phantom for Evaluating Automatic Exposure Control System Using Three-Dimensions Printing (자동노출제어장치 평가를 위한 3D 프린팅 기반의 자체 제작 팬텀의 유용성 평가)

  • Lee, Ki-Baek;Nam, Ki-Chang;Kim, Ho-Chul
    • Journal of Biomedical Engineering Research
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    • v.41 no.4
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    • pp.147-153
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    • 2020
  • This study was to evaluate the usability of self-developed phantom for evaluating automatic exposure control (AEC) using three-dimensions (3D) printer. 3D printer of fused deposition modeling (FDM) type was utilized to make the self-developed AEC phantom and image acquisitions were conducted by two different type of scanners. The self-developed AEC phantom consisted of four different size of portions. As a result, two types of phantom (pyramid and pentagon shape) were created according to the combination of the layers. For evaluating the radiation dose with the two types of phantom, the values of tube current, computed tomography dose index volume (CTDIvol), and dose length product (DLP) were compared. As a result, it was confirmed that the values of tube current were properly reflected according to the thickness, and the CTDIvol and DLP were not significantly changed regardless of AEC functions of different scanners. In conclusion, the self-developed phantom by using 3D printer could assess whether the AEC function works well. So, we confirmed the possibility that a self-made phantom could replace the commercially expensive AEC performance evaluation phantom.

A 3D-printing Bone Model for Surgical Planning of Total Hip Replacement after Failed Triple Pelvic Osteotomy

  • Han, Kyungjin;Park, Jiyoung;Yoon, Jangwon;Lee, Young-Won;Choi, Ho-Jung;Jeong, SeongMok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.463-466
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    • 2017
  • A 3-year-old, 26 kg, castrated male Chow Chow was presented for assessment of weight-bearing lameness of the left hind limb. The patient had a history of triple pelvic osteotomy on the left side to correct hip dysplasia 2 years prior to his presentation of clinical signs and underwent total hip replacement on the right coxofemoral joint 1 year later. Upon physical examination, pain and crepitus were noted on the left hip joint during extension. Radiological examination revealed coxofemoral joint subluxation and moderate degenerative bone changes on the left hip joint and pelvic axis, which relates to acetabular angles that were changed after triple pelvic osteotomy (TPO). Preoperative computed tomography was used for 3-dimensional printing to establish an accurate surgical plan. The changed angles of the acetabulum after TPO were evaluated, and rehearsal surgery was performed using a 3-demensional printing bone model. Three months after the THR surgery, the function of the affected limb had improved, with no lameness. Complications, such as luxation and implant failure, were not observed until 6 months after the operation. Accurate evaluation of acetabulum angles and rehearsal surgery using a 3D-printed bone model is effective for total hip replacement after unsuccessful TPO.

The Effect of Mechanical Traction on Pain and Physical Function in Patients With Knee Osteoarthritis (기계적 견인이 슬관절 골관절염 환자의 통증과 신체 기능에 미치는 효과)

  • Lee, Nam-yong;Kwon, Chun-suk;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.22 no.3
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    • pp.23-32
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    • 2015
  • The purpose of this study was to identify the effects of mechanical traction applied to the knee joint on pain, knee range of motion (ROM), timed up and go (TUG) and Western Ontario and MacMaster Universities Osteoarthritis (WOMAC) in patients with knee osteoarthritis (KOA) of Kellgren-Lawrence radiological rating scale II or III. Twenty three patients participated in the experiment for a period of four weeks. After baseline assessment, the patients with KOA were randomized into two groups: the traction group ($n_1=12$), which received traction with general physical therapy; and the control group ($n_2=11$), which received general physical therapy only on unilateral knee joints. Patients received interventions once a day, three times a week, for four weeks. Wilcoxon signed-rank test was used to analyze the change of dependent variances within the group during pre and post intervention. Mann-Whitney U test was used to analyze the change of dependent variances as TUG and passive ROM between the two groups. Analysis of covariance was used to analyze the change of dependent variances as numeric pain rating scale (NPRS) and WOMAC score between the two groups. In Wilcoxon signed-rank test, the traction group improved significantly with regard to NPRS (p<.01), passive knee flexion ROM (p<.01), passive knee extension (p<.05), TUG (p<.01) and WOMAC scores (p<.01) after intervention for four weeks, but not for the control group. In the Mann-Whitney U test and analysis of covariance, no significant difference was seen among all the dependent variances after intervention for four weeks between the two groups. These outcomes suggest that further studies should be carried out to determine the effects of mechanical traction prior to using it for the treatment of patients with knee osteoarthritis.

Treatment of life-threatening acute osteomyelitis of the jaw during chemotherapy: a case report

  • Jung, Junhong;Kim, Sumin;Park, Jun-Sang;Lee, Choi-Ryang;Jeon, Jae-ho;Kwon, Ik-Jae;Myoung, Hoon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.4
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    • pp.251-259
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    • 2020
  • Oral and maxillofacial infection is a common complication in patients undergoing chemotherapy. The treatment of oral diseases in such patients differs from that administered to healthy patients. This paper reports a case of acute osteomyelitis of odontogenic origin following a recent chemotherapy session. The patient's condition was life-threatening because of neutropenic fever and sepsis that developed during the inpatient supportive care. However, the patient showed prompt recovery within 40 days following the use of appropriate antibiotics and routine dressing, without the requirement for surgical treatment, except tooth extraction. As seen in this case, patients undergoing chemotherapy are more susceptible to rapid progression of infections in the oral and maxillofacial areas. Therefore, accurate diagnosis through prompt clinical and radiological examination, identification of the extent of infection, and assessment of the patient's immune system are crucial for favorable outcomes. It is also necessary to eliminate the source of infection through appropriate administration of antibiotics. In particular, a broad-spectrum antibiotic with anti-pneumococcal activity is essential. Proper antibiotic administration and wound dressing are essential for infection control. Furthermore, close consultation with a hemato-oncologist is necessary for effective infection management based on the professional evaluation of patients' immune mechanisms.