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Dose Reduction of the Adolescent Female Breast during Scoliosis Radiography (청소년기 여성의 척추측만증 검사에서 유방입사선량 저감효과)

  • Jin, Gye Hwan
    • Journal of the Korean Society of Radiology
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    • v.12 no.3
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    • pp.373-379
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    • 2018
  • The purpose of this study was to investigate quantitative data on the difference in breast entrance surface dose with changes in focus-film distance, patient posture (anteroposterior-posteroanterior), thoracic wall thickness, rib bone thickness, lung tissue thickness, tube voltage, and high-voltage rectification method in Whole Spine Scanography, which is necessary for the treatment of scoliosis patients. Given a tube voltage of 90 kVp, kerma of 0.1 mGy, focus-film distance of 260 cm, tube voltage ripple rate of 0, filter thickness of 3.5 mm, and thickness of patient's thoracic wall of 120 mm as an X-ray exposure condition, from the simulation results using the Simulation of X-ray Spectra program to confirm the reduction effect of breast entrance surface dose according to the patient's posture (AP and PA), there was a dose reduction effect in aluminum filter thickness of 2.6 times at 3.5 mm, 25.7 times the thoracic wall thickness at 120 mm, 1.43 times higher tube voltage, and 0 to 1.14 times the tube voltage ripple rate. The total dose reduction effect was about 109 times. In order to confirm the dose reduction effect of RANDO phantom posture (AP and PA), from the results of the measurements taken under the conditions that the focus-film distance was 260 cm, the tube voltage was 90 kVp, the tube current was 270 mA, the exposure time was 0.31 sec, and the tube voltage ripple rate of X-ray generators was 0, the entrance surface dose reduction effect of the breast in the PA position was found to be 20.56 times lower than that of the AP position.

Child Health Behaviors and Health Education about Atopic Dermatitis in Ulsan Area (울산지역 초등학생들의 아토피 피부염과 천식 관련 생활습관과 보건교육 실태)

  • Moon, Ki-Nai;Jung, Jong-Hyeon;Pae, Hyang-Sun;Seo, Bo-Soon;Joo, Dong-Jin
    • The Journal of Korean Society for School & Community Health Education
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    • v.11 no.1
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    • pp.135-148
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    • 2010
  • Objectives: In this study, knowledge of environmental disease, experience of environmental health education and necessity of environmental health education of elementary school pupils were compared and analyzed. Methods: The population of this study was from grade 1 to 6 elementary school pupils in Ulsan city, Korea. Five elementary schools were randomly selected from Ulsan City. Seven hundred and twenty-eight responses from the five schools were analyzed (seventy-two were excluded). A self-administered questionnaire measuring sociodemographic variables, Knowledge of environment related disease(atopic dermatitis, asthma etc), as well as educational experience and necessity of environmental health education was analyzed. The survey results were analyzed using SPSS-PC Program 12.0 and the following results by implementing Frequency Analysis, Cross-tabulation Analysis and ANOVA are as follows. Result: Pupils of lower grades more informed than those of higher grades about atopic dermatitis. Among asthma sufferers, many responded that symptoms occurred or improved during the lower grades of elementary school. In terms of the lifestyles of patients with atopic dermatitis or asthma, female pupils, especially those in the lower grades, tended to make changes in their daily habits based on their disease. Also, parents tended to intervene/mediate more in the dietary habits and personal hygiene habits of lower-grade pupils compared to their higher-grade counterparts. Personal hygiene education is currently not provided in schools, and upper-grade pupils have more experience with personal hygiene education compared to lower grade pupils. 430 (59.0%) of pupils replied that education about personal hygiene is necessary in their curriculum. 490 (67.3%) of elementary pupils are aware of the close connection between education in hygiene and human health. When asked if education in hygiene should also be undertaken by teachers and parents, 406 (55.7%) students said that it should be done. Conclusions: Developing a concrete health education program and raising instructors' awareness of the necessity for education in hygiene. Placement of professionals in the personal hygiene education field, is important to provide good health education for elementary school pupils.

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Successful Endoscopic Treatment of Hepatic Duct Confluence Injury after Blunt Abdominal Trauma: Case Report

  • Park, Chan Ik;Park, Sung Jin;Lee, Sang Bong;Yeo, Kwang Hee;Choi, Seon Uoo;Kim, Seon Hee;Kim, Jae Hun;Baek, Dong Hoon
    • Journal of Trauma and Injury
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    • v.29 no.3
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    • pp.93-97
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    • 2016
  • Hepatic duct confluence injury, which is developed by blunt abdominal trauma, is rare. Conventionally, bile duct injury was treated by surgical intervention. In recent decades, however, there had been an increase in radiologic or endoscopic intervention to treat bile duct injury. In a hemodynamically stable patient, endoscopic intervention is considered as the first-line treatment for bile duct injury. A 40 year-old man was transferred to the emergency department of ${\bigcirc}{\bigcirc}$ trauma center after multiple blunt injuries. Contrast-enhanced abdominal computed tomography performed in another hospital showed a liver laceration with active arterial bleeding, fracture of the sacrum and left inferior pubic ramus, and intraperitoneal bladder rupture. The patient presented with hemorrhagic shock because of intra-peritoneal hemorrhage. After resuscitation, angiographic intervention was performed. After angiographic embolization of the liver laceration, emergency laparotomy was performed to repair the bladder injury. However, there was no evidence of bile duct injury on initial laparotomy. On post-trauma day (PTD) 4, the color of intra-abdominal drainage of the patient changed to a greenish hue; bile leakage was revealed on magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Bile leakage was detected near the hepatic duct confluence; therefore, a biliary stent was placed into the left hepatic duct. On PTD 37, contrast leakage was still detected but both hepatic ducts were delineated on the second ERCP. Stents were placed into the right and left hepatic ducts. On PTD 71, a third ERCP revealed no contrast leakage; therefore, all stents were removed after 2 weeks (PTD 85). ERCP and biliary stenting could be effective treatment options for hemodynamically stable patients after blunt trauma.

The result of Radiotherapy in Malignant Thymona (흉선암의 방사선치료 성적)

  • Ahn, Sung-Ja;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.225-230
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    • 1990
  • Twenty one patients of malignant thymoma treated with curative aim at the Department of Therapeutic Radiology of Seoul National University Hospital from 1979 to 1987 were analysed retrospectively. The 3 year overall and relapse free survival rate was $80.5\%\;and\;78.6$, respectively. Myasthenia gravis (MG) was seen in $43.5\%$ at presentation and disappeared in $40\%$ (4/10) after radiotherapy with or without operation. The 3 year cumulative survival rate with and without MG was $90\;and\;78.8\%$, respectively. We could consider that MG was no longer adverse prognostic factor. The complete response rate after partial resection was $100\%$ (3/3), and that after biopsy was $20\%$(3/15). The overall local control rate including complete and partial response rate ($33\;vs\;56\%$)was$89\%$ and the 3 year actuarial survival rate by the response rate was $88.9\%\;and\;81.7\%$, respectively. There was no statistically significant survival difference between two groups. The crude rate of relapse at 3 years was $23.8\%$ (5/21), and $80\%$ (4/5) were locoregional failures. All failures were observed in biopsy only group, while no failure was observed in resected group. The major pattern of the treatment failure was the locoregional failure and the distant metastases was rarely observed.

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The Radiation Effect on Peripheral Blood Cell (방사선치료에 따른 합환자의 말초 혈액상의 변화)

  • Lee, Tae-June;Kwon, Hyoung-Cheol;Kim, Jung-Soo;Im, Sun-Kyun;Choi, Ki-Chul
    • Radiation Oncology Journal
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    • v.6 no.2
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    • pp.253-258
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    • 1988
  • To evaluate radiation effect on the hematopoietic system, we analyzed 44 patients who were treated with conventionally fractionated radiation therapy (RT) at Chonbuk National University Hospital. According to the treatment sites, we classified them into three groups: group I as head and neck, group II as thorax, and group III as pelvis. White blood cell, lymphocyte, platelet and hemoglobin were checked before and during RT The results were as follows; 1. White blood cell (WBC) and lymphocyte count were declined from the first week of RT to the third week, and then slightly recovered after the third or fourth week. There was prominent decrease in lymphocyte counts than WBC. 2. Platelet counts were declined until the second week of the RT, showed slight recovery at fourth week in all groups. Hemoglobin values were slightly decreased in the first week and then recovered the level of pretreatment value, gradually. 3. Lymphocyte count were declined significantly on group III(p<0.05), WBC and platelet counts were decreased on group II but statistically not significant.

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Modified Septal Extension Graft for the Correction of Nasal Tip and Columella (코끝과 코기둥의 교정을 위한 변형된 코중격 연장 이식술)

  • Kim, Jun Sik;Choi, Jae Hoon;Choi, Tae Hyun;Kim, Nam Gyun;Lee, Kyung Suk;Han, Ki Hwan;Son, Dae Gu
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.681-687
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    • 2006
  • Purpose: The nose of most Koreans is characterized as a low nasal dorsum, retracted columella, and an acute columella-labial angle. For the surgical correction of the tip and columella, a modified septal extension graft, along with augmentation rhinoplasty has been developed. Methods: With this technique, a septal extension graft is fixed on the entire caudal margin of the septum (the cephalic-caudal axis) and at the same time, it is placed above the anterior nasal spine, in the membranous portion of the septum and at the base of the columella(the anterior-posterior axis). The present report describes the results obtained in 13 patients and offers an analysis of the results as judged by the columella-labial angle and 4 proportional indices(nose height index, nasal bridge length index, nasal tip projection index, columella length index), measured by photogrammetry. Results: The postoperative values obtained in these 5 categories increased significantly compared to the preoperative ones, thus confirming that the projection of tip was augmented, the nose was lengthened, and the columella was advanced caudally and lengthened. Moreover, these positive outcomes were still maintained during the follow-up period, and no side effects, such as saddle nose deformity, were reported. Conclusion: A modified septal extension graft can be considered as an effective method for the surgical correction of the nasal tip and columella in Koreans.

A Case of Pressure Sore in Congenital Insensitivity to Pain with Anhidrosis (CIPA(Congenital Insensitivity to Pain with Anhidrosis)를 가진 환아에서 욕창의 치험례)

  • Hwang, Jae Ha;Park, Sun Hyung;Yoo, Sung In;Noh, Bok Kyun;Kim, Eui Sik;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.669-671
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    • 2006
  • Purpose: Congenital insensitivity to pain with anhidrosis(CIPA) is a rare form of autosomal recessive peripheral sensory neuropathy. Patients with CIPA show loss of pain sensation, which leads to corneal ulcers and opacities, self-mutilation of the tongue and fingertips, as well as fractures with subsequent joint deformities and chronic osteomyelitis. The purpose of this report is to highlight the fact that pressure sores also are a potential complication of CIPA. Methods: This case report describes a patient presenting with pressure sores resulting from CIPA. A 5-year-old boy was referred to our department for the treatment of a $5{\times}5cm$ sacral pressure sore as a result of a hip spica cast applied for the treatment of a left hip joint dislocation. He had a history suggesting CIPA such as multiple bony fractures, mental retardation, recurrent hyperpyrexia, anhidrosis, and clubbing fingers due to oral mutilation. A microscopic examination of the sural nerve showed mainly large myelinated fibers, a few small myelinated fibers and an almost complete loss of unmyelinated fibers. After wound preparation for two weeks, the exposed bone was covered with two local advancement flaps. Results: Two weeks later, complete wound healing was achieved. A 16-month follow-up showed no recurrence. However, the patient presented with a new pressure sore on the left knee due to orthosis for the treatment of the left hip joint dislocation. Conclusion: The early diagnosis of CIPA and special care of pressure sores are important for preventing and treating pressure sores resulting from CIPA.

Effects of Task-Oriented Training With Functional Electrical Stimulation on Cervical Spinal Cord Injury Patients' Hand Function: A Single-Subject Experimental Design (기능적 전기 자극을 병행한 과제 지향적 훈련이 경수 손상 환자의 손 기능에 미치는 영향: 개별사례 연구)

  • Ko, Seok-Beom;Park, Hae Yean;Kim, Jong-Bae;Kim, Jung-Ran
    • Therapeutic Science for Rehabilitation
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    • v.7 no.1
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    • pp.63-77
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    • 2018
  • Objective : The purpose of this study was to investigate the effects of task-oriented training with functional electrical stimulation on hand function in incomplete cervical cord injury. Method : The subjects of the study were 3 adults diagnosed as incomplete cervical cord injury. The design of this study was ABA single-subject research design to compare dominant hand function of before and after intervention and detect individual effects. The experiment consisted of 30sessions, in which baseline process A1 and A2 were implemented 5 sessions each for 10sessions. Intervention B was implemented 20 sessions. The dependent variable was converted to the change of hand function every session, and Canadian Occupational Performance Measure (COPM), Jebsen-Taylor Hand Function Test(JTHFT), Wolf Motor Function Test(WMFT) were selected for outcome measurements. Result analysis was suggested through visual analysis using a graph and comparison of pre, post and follow-up intervention measurements. Results : As a result, the quality and quantity of dominant hand function increased during intervention B compared to the baseline A1 for all subjects. Baseline A2 was also maintained without training. Additionally, JTHFT, WMFT and COPM scores demonstrated improvement and maintain. The follow up JTHFT and WMFT showed increased required time on all subjects and decrease or maintain task performance and satisfaction in COPM. Conclusion : The task-oriented training with function electrical stimulation in this study has been positive effects on hand function and task performance and satisfaction.

Surgical Treatment of Bronchial Adenoma - Reports of 17 Cases - (기관지 선종의 외과적 치료[17례 보고])

  • 문석환
    • Journal of Chest Surgery
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    • v.25 no.3
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    • pp.247-257
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    • 1992
  • Bronchial adenoma, firstly described by Muller[1882] had been reported on the subject stressed their benign nature prior to 1940`s, but these tumors including carcinoid tumor, mucoepidermoid carcinoma, adenoid cystic carcinoma, pleomorphic adenoma are now known to possess the various degree of malignant natures from benign course, low grade malignant potential to distant lymphatic or hematogenous metastasis or combination. Although histologically diffeerent, four varieties except carcinoid tumor which is a spectrum of neu-roendocrine tumor originating Kulchitsky cell of the bronchial epithelium and form the part of the APUD tumor spectrum, are morphologically and in many respects clinically similar to the corresponding tumor of the salivary gland is a specific varient of adenocarcinoma that occurs most commonly in the major and minor salivary gland and less frequently tra-cheobronchial tree, esophagus etc. To better understand the clinical characteristics and assess more precisely the malignat nature of bronchial adenoma, we studied 17 cases of bronchial adenoma, which had been experienced at the Department of Thoracic and Cardiovascular surgery of Catholic University Medical College from April 1977 to september 1991. Seventeen cases of bronchial adenoma consist of 2 carcinoid tumors, 6 adenoid cystic carcinomas, 8 mucoepidermoid carcinomas and one pleomorphic adenoma. There is a slight predominace of male patients[10/17] and the age of pt studied varied with a higher incidence occurring between the ages of 40 years and 60 years[mean age, 46.5 years]; the youngest being 15 years and oldest 69 years. Their leading complaints were hemoptysis[4], exertional dyspnea[8], fever & chilness [4], and symptoms mimicking the bronchial asthma[4]. Diagnosis was aided by the radiologic studies such as chest X-ray, polytomography, CT scan, brochography and bronchoscopy. The preferred locations of fumor were in the trachea[4], main stem bronchus[3], bronchus intermedius[3], bronchus of RUL[2], LUL[1], RLL[1], LLL[3] with no peripheral location. Modalities of treatments were single or combination of surgical resection, radiation therapy, chemotherapy. Complete resections were permitted in 12 cases with late recurrences of 4 cases ranging from 6 months to 10 years: pneumonectomy[4], lobectomy[4], bil-obectomy[2], sleeve resection[2]. Gross findings of resected specimens in 14 cases showed that 4 cases were polyp-like pedunculated mass[entirely intraluminal mass] with intact mucosa, 8 cases were broad-bas-ed sessile mass[predominatly intraluminal] and the main portions were located below the mucosa similar to tip of iceburg[predominantly extraluminal] in 2 cases. Follow-up information was availble in all 17 cases ; eight were alive without evidence of disese ranging from 1 month to 13 years. But seven cases died of the causes related to tumor[6 cases within 12 months, one case 10 years after pneumonectomy]. We concluded that 8 cases[47%] of 17 cases were metastasizing bronchial adenoma and precise survival rate cannot be answered by the scanty materials available for study.

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A Clinical Study of Isolated Aortic Valve Replacement with CarboMedics and St. Jude Prosthesis (카보메딕스 대동맥판막과 쎈트쥬드 대동맥판막의 임상성적)

  • Kim, Wook-Sung;Kim, Ki-Bong;Anh, Hyuk;Chae, Hurn;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.781-786
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    • 1998
  • Materials and methods: Between 1984 to 1994, 136 patients underwent primary and isolated aortic valve replacement with 79 Carbomedics and 57 St. Jude prostheses. Results: Age ranged from 16 to 67 year(mean : 44.5${\pm}$12.7 years). Statistically significant differences in preoperative clinical characteristics between two groups were not found. There was one early death in the St. Jude group and none in the Carbomedics group. Early prosthetic valve-related complications including death were not significantly different between the two groups(p value= 0.572). One hundred thirty five early survivors were followed for a total of 354.2 patient-years(mean=31.5${\pm}$16 months). In the CarboMedics group, actuarial survial rate at 5 years was 97.1${\pm}$1.9%, and in the St. Jude group, it was 95.9${\pm}$2.8%. In the CarboMedics group, actuarial free rate from all valve-related events at 5 years was 92.1${\pm}$3.1%, and in St. Jude group, it was 89.8${\pm}$5.0%. Conclusion: We conclude that early and late results after performing isolated aortic valve replacement with CarboMedics and St. Jude valve are not significantlly different.

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