• Journal of Korean Neurosurgical Society
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• 제64권6호
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• pp.933-943
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• 2021

Objective : Percutaneous pedicle screw (PPS) fixation is a needle based procedure that requires fluoroscopic image guidance. Consequently, radiation exposure is inevitable for patients, surgeons, and operation room staff. We hypothesize that reducing the production of radiation emission will result in reduced radiation exposure for everyone in the operation room. Research was performed to evaluate reduction of radiation exposure by modifying imaging manner and mode of radiation source. Methods : A total of 170 patients (680 screws) who underwent fusion surgery with PPS fixation from September 2019 to March 2020 were analyzed in this study. Personal dosimeters (Polimaster Ltd.) were worn at the collar outside a lead apron to measure radiation exposure. Patients were assigned to four groups based on imaging manner of fluoroscopy and radiation modification (pulse mode with reduced dose) : continuous use without radiation modification (group 1, n=34), intermittent use without radiation modification (group 2, n=54), continuous use with radiation modification (group 3, n=26), and intermittent use with radiation modification (group 4, n=56). Post hoc Tukey Honest significant difference test was used for individual comparisons of radiation exposure/screw and fluoroscopic time/screw. Results : The average radiation exposure/screw was 71.45±45.75 µSv/screw for group 1, 18.77±11.51 µSv/screw for group 2, 19.58±7.00 µSv/screw for group 3, and 4.26±2.89 µSv/screw for group 4. By changing imaging manner from continuous multiple shot to intermittent single shot, 73.7% radiation reduction was achieved in the no radiation modification groups (groups 1, 2), and 78.2% radiation reduction was achieved in the radiation modification groups (groups 3, 4). Radiation source modification from continuous mode with standard dose to pulse mode with reduced dose resulted in 72.6% radiation reduction in continuous imaging groups (groups 1, 3) and 77.3% radiation reduction in intermittent imaging groups (groups 2, 4). The average radiation exposure/screw was reduced 94.1% by changing imaging manner and modifying radiation source from continuous imaging with standard fluoroscopy setting (group 1) to intermittent imaging with modified fluoroscopy setting (group 4). A total of 680 screws were reviewed postoperatively, and 99.3% (675) were evaluated as pedicle breach grade 0 (<2 mm). Conclusion : The average radiation exposure/screw for a spinal surgeon can be reduced 94.1% by changing imaging manner and modifying radiation source from real-time imaging with standard dose to intermittent imaging with modified dose. These modifications can be instantly applied to any procedure using fluoroscopic guidance and may reduce the overall radiation exposure of spine surgeons.

• 대한디지털의료영상학회논문지
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• 제15권2호
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• pp.39-44
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• 2013

Purpose : The purpose of this study is the magnification rates depending on the area of patient dose (DAP) and glass dosimeter see the change of the dose according to the dose characteristics of low-magnification aims to raise standards. Materials and Method : Direct DR equipment Sonialvision DAR-8000f, Shimadzu was used, the patient entrance dose measurements to the surface of the Rando Phantom of the neck and the abdomen was placed on the Xi unfors. glass dosimeter for measuring organ doses at the same time the Rando Phantom of the major organs in place by inserting a 9 ", 12", 15 ", 17" and 30 seconds for each magnification were measured according in fluoroscopy. DAP meter area of the patient dose was measured. Result : Esophagography at 17" 143% than 9"magnification the average area dose was increased. Organ dose of Esophagography at 17" was decreased 25.32% than 9" magnification. UGI at 17" was increased 129.73% DAP than 9" magnification. Organ dose of UGI at 17" was decreased 23.32% than 9" magnification. Where the major organs of magnification at 17" were decreased(lung -25.96%, stomach -33.09%, spleen -27.81%, liver -4.92%) than 9" magnification. Conclusion : Expected to get better quality image While using the proper magnification, and have recognition that difference Organ doses and DAP meter in fluoroscopy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권3호
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• pp.234-236
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• 2011

Traditional surgery to remove foreign bodies in the face carries a risk of postoperative morbidity with an injury to various anatomical structures, particularly the facial nerve and parotid duct and gland. Endoscopy can be a great aid in the removal of foreign bodies in the maxillofacial region. Surgical intervention using endoscope and/,or intraoperative images can be minimized, allowing the safe and precise removal of foreign bodies, and saving operating time. We report a case of the use of an endoscope and C-arm fluoroscopy guidance system to remove a very small foreign body.

• The Korean Journal of Pain
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• 제26권2호
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• pp.142-147
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• 2013

Background: Medical doctors who perform C-arm fluoroscopy-guided procedures are exposed to X-ray radiation. Therefore, radiation-protective shields are recommended to protect these doctors from radiation. For the past several years, these protective shields have sometimes been used without regular inspection. The aim of this study was to investigate the degree of damage to radiation-protective shields in the operating room. Methods: This study investigated 98 radiation-protective shields in the operation rooms of Konkuk University Medical Center and Jeju National University Hospital. We examined whether these shields were damaged or not with the unaided eye and by fluoroscopy. Results: There were seventy-one aprons and twenty-seven thyroid protectors in the two university hospitals. Fourteen aprons (19.7%) were damaged, whereas no thyroid protectors (0%) were. Of the twenty-six aprons, which have been used since 2005, eleven (42.3%) were damaged. Of the ten aprons, which have been used since 2008, none (0%) was damaged. Of the twenty-three aprons that have been used since 2009, two (8.7%) of them were damaged. Of the eight aprons used since 2010, one (12.3%) was damaged. Of the four aprons used since 2011, none (0%) of them were damaged. The most common site of damage to the radiation-protective shields was at the waist of the aprons (51%). Conclusions: As a result, aprons that have been used for a long period of time can have a higher risk of damage. Radiation-protective shields should be inspected regularly and exchanged for new products for the safety of medical workers.

• 한국전기전자재료학회:학술대회논문집
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• 한국전기전자재료학회 2004년도 추계학술대회 논문집 Vol.17
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• pp.494-497
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• 2004

본 연구는 방사선 영상센서 적용을 위한 $HgI_2$ 필름의 특성 평가에 관한 것으로서 X-선 조사조건별 인가전압에 따른 검출신호 특성을 조사하였다. 기존의 $HgI_2$ 검출기의 경우 신호량이 크다는 장점이 있으나 노이즈의 양이 크다. 이에 대한 해결책으로 보호층을 삽입하나 이 경우 X-선 조사에 따른 시간 응답 특성이 있어서 전하트랩현상(tailing effect)에 의한 영향이 크게 존재하였다. 따라서 본 논문에서는 이러한 문제점을 해결하고자 보호층으로써 a-Se 을 삽입하여 기존의 $HgI_2$ 검출기에서 사용되어지는 parlyene이 삽입된 검출기와 전기적 특성을 측정, 비교해보고자 한다. 제작방식으로는 대면적 제작이 용이한 스크린 프린팅 방식을 이용하여 두께 $140\;{\mu}m$와 $3\;cm\;{\times}\;2\;cm$ 면적으로 제조하였다. 측정결과, a-Se을 보호층으로 사용한 $HgI_2$ 필름이 민감도는 거의 비슷하나 누설전류가 안정화 되는데 걸리는 감소시간(decay time)이 parlyene을 사용한 구조에 비해 훨씬 낮았다. 또한 X선에 대한 민감도는 기존의 a-Se에 비해 월등히 높아 적은 방사선 조사량(radiation dose)에서도 신호검출이 가능하여 저선량이 요구되는 방사선 투시촬영(digital fluoroscopy) 적용에 유용할 것으로 기대된다.

• Korean Journal of Radiology
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• 제22권7호
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• pp.1124-1131
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• 2021

Objective: To evaluate the feasibility, safety, and effectiveness of CT-guided microcoil localization of solitary pulmonary nodules (SPNs) for guiding video-assisted thoracoscopic surgery (VATS). Materials and Methods: Between June 2016 and October 2019, 454 consecutive patients with 501 SPNs who received CT-guided microcoil localization before VATS in our institution were enrolled. The diameter of the nodules was 0.93 ± 0.49 cm, and the shortest distance from the nodules to the pleura was 1.41 ± 0.95 cm. The distal end of the microcoil was placed less than 1 cm away from the nodule, and the proximal end was placed outside the visceral pleura. VATS was performed under the guidance of implanted microcoils without the aid of intraoperative fluoroscopy. Results: All 501 nodules were marked with microcoils. The time required for microcoil localization was 12.8 ± 5.2 minutes. Microcoil localization-related complications occurred in 179 cases (39.4%). None of the complications required treatment. A total of 463 nodules were successfully resected under the guidance of implanted microcoils. VATS revealed 38 patients with dislocated microcoils, of which 28 underwent wedge resection (21 cases under the guidance of the bleeding points of pleural puncture, 7 cases through palpation), 5 underwent direct lobectomy, and the remaining 5 underwent a conversion to thoracotomy. In 4 cases, a portion of the microcoil remained in the lung parenchyma. Conclusion: CT-guided microcoil localization of SPNs is safe and reliable. Marking the nodule and pleura simultaneously with microcoils can effectively guide the resection of SPNs using VATS without the aid of intraoperative fluoroscopy.

• The Korean Journal of Pain
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• 제32권4호
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• pp.264-270
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• 2019

Background: To develop a rabbit epidural steroid injection (ESI) model for analyzing steroid retention in the tissue, and to assess the difference in steroid retention in the model according to the location and time elapsed after ESI. Methods: Fluoroscopy-guided ESI was performed using the interlaminar approach between the lowest two lumbar segments in 13 female New Zealand white rabbits. Four rabbits were allocated to each of three different groups according to the time of sacrifice: 3, 7, and 15 days post-ESI; the remaining rabbit was sacrificed immediately post-ESI to obtain baseline data. After sacrifice, two segments were harvested: the lowest two lumbar vertebrae and another two lumbar vertebrae immediately above these. The residual steroid amount (RSA) and residual steroid concentration (RSC) in the collected spinal columns were analyzed. A linear mixed model was used to compare RSAs and RSCs between the injected and adjacent segments, and among the number of days until sacrifice; P < 0.05 was considered statistically significant. Results: Both RSA and RSC of the injected segment were significantly higher than those of the adjacent segment (P < 0.001, both). The RSA and RSC significantly decreased over time (P = 0.009 and P = 0.016, respectively). Conclusions: The developed rabbit ESI model verified that significantly more steroid was retained at the injected segment than at the adjacent segment and the residual steroid decreased over time. This model could be useful not only for comparing current steroid medications, but also for developing new, better steroid formulations.

• 제어로봇시스템학회논문지
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• 제20권4호
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• pp.422-427
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• 2014

This study provides a method to detect blood vessels shape using image processing techniques with the help of fluoroscopy equipments, providing high precision information about vessels' location and shape of inner path. It will assist for checking and monitoring the position of operating tools during vascular interventional treatment. The blood vessels shapes are gathered with X-ray images when a fluorescent medications are injected into patient's vessel and those images are processed for getting the boundaries of vessels. Then these data are merged with real-time CT-images. These image processing systems and procedures recognize the catheter, though continued computing algorithms are very useful for observer part on the automatic control system.

• The Korean Journal of Pain
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• 제1권1호
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• pp.28-33
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• 1988

1986년 3월 통증치료실을 개설한 이래 상복부의 불인통을 호소하는 12명의 암환자에서 복강신경총 차단을 시행하였다. 처음 5예는 fluoroscopy의 도움만으로, 나머지 7예는 CT를 이용하여 피부에 천자부위를 정하고 재차 수술실로 옮겨서 시행한 결과 다음과 같은 결론을 얻었다. 1) CT를 이용한 복강신경총 차단을 시행할 경우, 평균 시술시간을 훨씬 단축시킬 뿐 아니라(약 1시간) 초보자에게는 시술이 훨씬 용이하다. 2) Fluoroscopy만 이용한 5예 중 3예에서, CT 및 fluoroscopy틀 동시에 이용한 경우는 7예중 5예에서 양호한 결과를 얻었다. 3) 정확한 위치에서 천자하면 신경파괴제의 양을 줄 일 수 있다. 4) 거대 간장, 심한 복수 등에서는 그 효과가 의문시 된다.

• 한국임상수의학회지
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• 제30권3호
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• pp.193-195
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• 2013

1년 6개월령 몸무게 7.7 kg의 수컷 Cocker Spaniel이 일주일 동안 지속된 역류성 구토를 주 증으로 진료 의뢰되었다. 기본 검사와 X선 투시진단법을 통해 식도운동성 저하로 진단하였다. 치료약물로는 mosapraide를 투여하였고, 습식 사료를 소량씩 자주 일어선 자세로 급여하는 방법을 통해 치료하였다. 3개월 후 재검사에서 임상증상의 개선과 X선 투시진단법 상 식도운동성의 개선이 있었으며, 첫 내원 시 식도 통과 시간이 18초였던 것에서 8초까지로 개선되었다. 본 케이스는 식도거대증을 동반하지 않으면서, 운동성만 저하된 질병으로 한국에서는 첫 보고이다.