• Knee surgery & related research
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• 제30권4호
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• pp.348-355
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• 2018

Purpose: To evaluate the clinical effects of using anatomical bony landmarks (Parsons' knob and the medial intercondylar ridge) and minimal ablation of the tibial footprint to improve knee anterior instability and synovial graft coverage after double-bundle anterior cruciate ligament reconstruction. Materials and Methods: We performed a retrospective comparison of outcomes between patients who underwent reconstruction with minimal ablation of the tibial footprint, using an anatomical tibial bony landmark technique, and those who underwent reconstruction with wide ablation of the tibial footprint. Differences between the two groups were evaluated using second-look arthroscopy, radiological assessment of the tunnel position, postoperative anterior knee joint laxity, and clinical outcomes. Results: Use of the anatomical reference and minimal ablation of the tibial footprint resulted in a more anterior positioning of the tibial tunnel, with greater synovial coverage of the graft postoperatively (p=0.01), and improved anterior stability of the knee on second-look arthroscopy. Both groups had comparable clinical outcomes. Conclusions: Use of anatomical tibial bony landmarks that resulted in a more anteromedial tibial tunnel position improved anterior knee laxity, and minimal ablation improved synovial coverage of the graft; however, it did not significantly improve subjective and functional short-term outcomes.

• Clinics in Shoulder and Elbow
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• 제22권1호
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• pp.29-36
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• 2019

Background: The execution of fibular allograft augmentation in unstable proximal humerus fractures (PHFs) was technically demanding. In this study, the authors evaluated the clinical and radiographic outcomes after tricortical iliac allograft (TIA) augmentation in PHFs. Methods: We retrospectively assessed 38 PHF patients treated with locking-plate fixation and TIA augmentation. Insertion of a TIA was indicated when an unstable PHF showed a large cavitary defect and poor medial column support after open reduction, regardless of the presence of medial cortical comminution in preoperative images. Radiographic imaging parameters (humeral head height, HHH; humeral neck-shaft angle, HNSA; head mediolateral offset, HMLO; and status of the union), Constant score, and range of motion were evaluated. Patients were grouped according to whether the medial column support after open reduction was poor or not (groups A and B, respectively); clinical outcomes were compared for all parameters. Results: All fractures healed radiologically (average duration to complete union, 5.8 months). At final evaluation, the average Constant score was 73 points and the mean active forward flexion was $148^{\circ}$. Based on the Paavolainen assessment method, 33 patients had good results and 5 patients showed fair results. The mean loss of reduction was 1.32 mm in HHH and 5.02% in HMLO. None of the parameters evaluated showed a statistically significant difference between the two groups (poor and not poor medial column support). Conclusions: In unstable PHFs, TIA augmentation can provide good clinical and radiological results when there are poor medial column support and a large cavitary defect after open reduction.

• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.46-52
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• 2019

Objective : The aim of this nationwide study was to analyze the current state of patients with newly diagnosed metastatic spine tumors according to surgical methods. Methods : Data was extracted from the Korean Health Insurance Review and Assessment Service database. Surgery was categorized into three methods : fusion, decompression, and vertebroplasty. Data included patient age, sex, health insurance type, and co-morbidities. Survival rates of metastatic spine tumor patients according to each surgical method were evaluated. Results : Among 1677 patients who had an operation, 823 patients were treated by fusion, 141 patients underwent decompression, and 713 patients were treated by vertebroplasty. The three most prevalent primary tumor sites were the lung, breast, and liver & biliary. On the other hand, the three most prevalent primary tumor sites of patients who underwent surgery were the lung, liver & biliary, and the prostate. The median survival periods for each surgical method in the metastatic spine tumor patients were 228 days for those who underwent surgery, 249 days for decompression, and 154 days for vertebroplasty. Age, sex, and comorbidities significantly affected survival rate. Conclusion : For every primary tumor site, decompression was the least common surgical method during the study period. Although the three surgical methods did not significantly affect the survival period, patients with a poor prognosis tended to undergo vertebroplasty.

• Imaging Science in Dentistry
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• 제52권1호
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• pp.93-101
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• 2022

Purpose: This study compared the effectiveness of complementary metal-oxide semiconductors (CMOS) and photostimulable phosphor (PSP) plates as intraoral imaging systems in terms of time efficacy, patient comfort, and subjective image quality assessment in real clinical settings. Materials and Methods: Fifty-eight patients (25 women and 33 men) were included. Patients were referred for a full-mouth radiological examination including 1 bitewing radiograph (left and right) and 8 periapical radiographs for each side (left maxilla/mandible and right maxilla/mandible). For each patient, 1 side of the dental arch was radiographed using a CMOS detector, whereas the other side was radiographed using a PSP detector, ensuring an equal number of left and right arches imaged by each detector. Clinical application time, comfort/pain, and subjective image quality were assessed for each detector. Continuous variables were summarized as mean±standard deviation. Differences between detectors were evaluated using repeated-measures analysis of variance. P<0.05 was accepted as significant. Results: The mean total time required for all imaging procedures with the CMOS detector was significantly lower than the mean total time required for imaging procedures with PSP (P<0.05). The overall mean patient comfort scores for the CMOS and PSP detectors were 4.57 and 4.48, respectively, without a statistically significant difference (P>0.05). The performance of both observers in subjectively assessing structures was significantly higher when using CMOS images than when using PSP images for all regions (P<0.05). Conclusion: The CMOS detector was found to be superior to the PSP detector in terms of clinical time efficacy and subjective image quality.

• Journal of Radiation Protection and Research
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• 제47권2호
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• pp.93-98
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• 2022

Background: This study aims to derive the characteristics of each work type for industrial radiography based on empirical evidence through expert advice and a survey of radiation workers of various types of industrial radiography. Materials and Methods: According to a Korean report, work types of industrial radiography are classified into indoor tests, underground pipe tests, tests in a shielded room (radiographic testing [RT] room test), outdoor field tests, and outdoor large structure tests. For each work type, exposure geometry and radiation sources were mainly identified through the expert advice and workers' survey as reliable empirical evidence. Results and Discussion: The expert advice and survey results were consistent as the proportion of the work types were high in the order of RT room test, outdoor large structure test, underground pipe test, outdoor field test, and indoor test. The outdoor large structure test is the highest exposure risk work type in the industrial radiography. In most types of industrial radiography, radiation workers generally used ¹⁹²Ir as the main source. In the results of the survey, the portion of sources was high in the order of ¹⁹²Ir, X-ray generator, ⁶⁰Co, and ⁷⁵Se. As the exposure geometry, the antero-posterior geometry is dominant, and the rotational and isotropic geometry should be also considered with the work type. Conclusion: In this study, through expert advice and a survey, the external exposure characteristics for each work type of industrial radiography workers were derived. This information will be used in the reconstruction of organ dose for health effects assessment of Korean radiation workers.

• Journal of Trauma and Injury
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• 제35권3호
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• pp.215-218
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• 2022

The rectum is the least frequently injured organ in trauma, with an incidence of about 1% to 3% in trauma cases involving civilians. Most rectal injuries are caused by gunshot wounds, blunt force trauma, and stab wounds. A 46-year-old male patient was crushed between two vehicles while he was working. He was hemodynamically unstable, and the Focused Assessment with Sonography for Trauma showed hemoperitoneum and hemoretroperitoneum; therefore, damage control surgery with pelvic packing was performed. A subsequent whole-body computed tomography scan showed a displaced pelvic bone and sacrum fracture. There was evidence of an anorectal full-thickness laceration and urethral laceration. In second-look surgery performed 48 hours later, the pelvis was stabilized with external fixators, and it was decided to proceed with loop sigmoid colostomy. A tractioned rectal probe with an internal balloon was positioned in order to approach the flaps of the rectal wall laceration. On postoperative day 13, a radiological examination with endoluminal contrast injected from the stoma after removal of the balloon was performed and showed no evidence of extraluminal leak. Rectosigmoidoscopy, rectal manometry, anal sphincter electromyography, and trans-stomic transit examinations showed normal findings, indicating that it was appropriate to proceed with the closure of the colostomy. The postoperative course was uneventful. The optimal management for extraperitoneal penetrating rectal injuries continues to evolve. Primary repair with fecal diversion is the mainstay of treatment, and a conservative approach to rectal lacerations with an internal balloon in a rectal probe could provide a possibility for healing with a lower risk of complications.

• 한국방사선학회논문지
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• 제16권5호
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• pp.619-625
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• 2022

영상의학 분야에서 컴퓨터단층촬영(Computed Tomography, CT) 검사는 가장 보편화된 검사 방법 중의 하나이고 병원에서 이용 빈도가 매우 높은 검사 방법 중의 하나이다. 그러나 다른 검사 방법에 비해 매우 높은 방사선 피폭을 동반한다. 피폭 저감화를 위해서 CT 검사가 꼭 필요한 경우만 검사를 시행하는 방법과 꼭 필요해서 검사를 시행하는 경우에도 검사의 목적에 부합하고 적은 선량으로 검사를 시행할 수 있는 프로토콜을 사용해야 한다. 본 연구에서는 지역의 대표적 종합병원에서 사용하고 있는 가장 최신의 방사선량 사용정보를 알아보고 진단기준수준(Dignostic Reference Level, DRL)을 개발하고자 하였다. 실험결과 두부 CT, 복부 CT검사에서 DLP는 NRPB(U.K) 와 Korea DRL보다 높게 나타났다. 흉부 CT의 사용 DLP 값은 CT장치 3종 모두 낮게 나타났다. 해당 병원에서는 CT 검사 시 피폭 저감화를 위한 노력을 해야 하는 것을 알 수 있었고 특히 두부 CT, 복부 CT에서 피폭 저감의 노력이 필요하다고 판단한다.

• Nuclear Engineering and Technology
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• 제55권8호
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• pp.2802-2811
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• 2023

In a first-of-its-kind study, terrestrial radionuclide concentrations were measured in 35 topsoil samples from the outskirts of Dhaka using HPGe gamma-ray spectrometry to assess the radiological consequences of such a vast number of brick kilns on the plant workers, general as well as dwelling environment. The range of activity concentrations of ²²⁶Ra, ²³²Th, and ⁴⁰K is found at 19 ± 3.04 to 38 ± 4.94, 39 ± 5.85 to 57 ± 7.41, and (430 ± 51.60 to 570 ± 68.40) Bq/kg, respectively. ²³²Th and ⁴⁰K concentrations were higher than the global averages. Bottom ash deposition in lowlands, fly ash buildup in soils, and the fallout of micro-particles are all probable causes of the elevated radioactivity levels. ¹³⁷Cs was found in the sample, which indicates the migration of ¹³⁷Cs from nuclear accidents or nuclear fallout, or the contamination of feed coal. Although the effective dose received by the general public was below the recommended dose limit but, most estimates of hazard parameters surpass their respective population weighted global averages, indicating that brick kiln workers and nearby residents are not safe due to prolonged exposures to terrestrial radiation. In addition, the soil around sampling sites is found to be unsuitable for agricultural purposes.

• 대한족부족관절학회지
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• 제27권4호
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• pp.137-143
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• 2023

Purpose: Autologous osteochondral transplantation (AOT) is indicated for patients with a large osteochondral lesion of the talus (OLT), accompanying subchondral cyst, and the failure of bone marrow stimulation (BMS) procedures. Despite the many reports on the clinical results of surgical treatment for medial osteochondral lesions, those of lateral lesions are rare. This paper reports the intermediate-term clinical outcomes after AOT for lateral OLTs. Materials and Methods: Twenty-one patients with lateral OLTs were followed up for at least three years after AOT. The clinical evaluations comprised the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). The radiographic assessment included the irregularity of the articular surface (subchondral plate), the progression of degenerative arthritis, and the changes in talar tilt angle and anterior talar translation. Results: The mean FAOS and FAAM scores improved significantly from 42.1 to 89.5 and 39.5 to 90.6 points, respectively, at the final follow-up (p<0.001). The radiological evaluation revealed two cases (9.5%) of articular step-off ≥2 mm and 1 case (4.8%) of progressive arthritis. The mean talar tilt angle and anterior talar translation improved significantly. As postoperative complications, there was one case of a local wound problem, one case of superficial peroneal nerve injury, and one case of donor site morbidity. At a mean follow-up of 62.3 months, no patient showed a recurrence of instability or required reoperation for OLT. Conclusion: AOT for the lateral OLTs demonstrated satisfactory intermediate-term clinical outcomes, including daily and sports activity abilities. Most OLT could be accessed through lateral ligament division and capsulotomy, and the incidence of iatrogenic complications, such as recurrent sprains or chronic instability, was minimal. AOT appears to be an effective and relatively safe treatment for patients with large lateral osteochondral lesions unresponsive to conservative therapy, with subchondral cysts, or with failed primary BMS.

• Korean Journal of Radiology
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• 제22권5호
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• pp.840-860
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• 2021

Imaging plays a key role in the diagnosis and characterization of thyroid diseases, and the information provided by imaging studies is essential for management planning. A referral guideline for imaging studies may help physicians make reasonable decisions and minimize the number of unnecessary examinations. The Korean Society of Thyroid Radiology (KSThR) developed imaging guidelines for thyroid nodules and differentiated thyroid cancer using an adaptation process through a collaboration between the National Evidence-based Healthcare Collaborating Agency and the working group of KSThR, which is composed of radiologists specializing in thyroid imaging. When evidence is either insufficient or equivocal, expert opinion may supplement the available evidence for recommending imaging. Therefore, we suggest rating the appropriateness of imaging for specific clinical situations in this guideline.