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PET/CT검사에서 Dose Modulation Technic 적용시 BMI에 따른 선량 감소율 분석
김정욱,박세윤,조영준,박종엽,Kim, Jung Wook,Park, Se Yun,Jo, Young Jun,Park, Jong Yeop 대한핵의학기술학회 2012 핵의학 기술 Vol.16 No.2
PET/CT에서의 환자의 피폭선량을 줄이기 위한 많은 연구가 진행되고 있다. 본 연구는 2012년 2월부터 2012년 3월까지 PET/CT검사를 위해 본원 핵의학과에 내원한 환자 149명(평균연령 $58{\pm}12.4$세)을 대상으로 하였고 장비는 Biograph True Point 40 (Siemens, USA)과 Gemini TF 64 (Philips, Cleveland)를 사용하였다. SIEMENS사의 Care Dose 4D를 사용하여 75명의 환자를 BMI 지수에 따라 세 집단으로 나누어 선량 감소율과 CTDI를 측정하였고 PHILIPS사의 D-dom을 이용하여 74명의 환자를 세 집단으로 나누어 선량 감소율과 CTDI를 측정하였다. 각 장비별로 세 집단 간의 측정값들이 유의한 차이를 보이는지 알아보기 위하여 SPSS Ver.18.0 통계분석프로그램을 이용하였다. 각각의 집단별로 평균값을 비교한 결과 Care Dose 4D를 사용했을 때 선량 감소율, CTDI 모두 p-value가 0.000으로서 통계적으로 유의한 차이가 있었다. D-dom을 사용했을 때 집단 간의 p-value는 선량 감소율 0.284, CTDI 0.226으로서 p>0.05이므로 집단 간의 유의한 차이가 없었다. 집단별로 평균 선량 감소율과 CTDI를 분석한 결과 Care Dose 4D를 사용했을 때 각각 정상집단에서 53.4%, 5.3 mGy, 과체중집단에서 49.5%, 5.8 mGy, 비만 집단에서 42.0%, 6.6 mGy로 나타났다. 반면에 D-dom을 사용하였을 때는 각각 정상 집단에서 22.7%, 4.5 mGy, 과체중 집단에서 22.1%, 4.6 mGy, 비만 집단에서 22.9%. 4.5 mGy로 나타났다. D-dom의 원리인 투사각도에 따른 선량조절은 환자의 비만도에 영향이 많지 않음을 알 수 있었다. 그리고 Care Dose 4D의 경우에는 투사각도에 따른 선량조절뿐만 아니라 환자 장축의 감쇠계수에 따른 선량조절, 환자 사이즈에 따른 선량조절 원리를 사용하고 있다. 그러므로 환자 장축의 감쇠계수에 따른 선량조절과 환자 크기에 따른 선량조절 원리가 환자의 비만도에 영향이 있다고 생각된다. 비록 같은 BMI 집단 간에 환자의 체형에 따른 오차가 있다고 여겨지지만, 앞으로 더욱더 많은 연구가 이루어진다면 Dose Modulation Technic이 PET/CT검사에서 환자의 피폭선량을 줄이는데 많은 도움이 될 것으로 생각된다. Purpose : It is important to reduce radiation dose associated with computed tomography (CT) scanning to as low as reasonably achievable (ALARA). With Dose Modulation Technic, user select a desired image quality and the system adapts tube current to obtain the desired image quality with greater radiation dose efficiency. In this paper, we presents a comprehensive description of fundamentals, clinical applications and radiation dose benefits of Dose Modulation Technic depending on Body Mass Index(BMI). Materials and Methods : In this study, 149 patients were examined(The mean age : $58{\pm}12.4$ years old). Biograph True Point 40 (Siemens, USA) and Gemini TF 64 (Philips. Cleveland) were used for equipment. When we used Care Dose 4D (Siemens, USA) and D-dom (Philips, Cleveland), we measured dose reduction and Computed Tomography Dose Index (CTDI) depending on BMI. Then we analyze data using SPSS Ver.18. Results : When we used Care Dose 4D, p-value is considered statistically significant by groups with the result that we compared Care Dose 4D with D-dom. On the other hand, p-value isn't considered statistically significant by groups using D-dom. Conclusion : Dose modulation based on the projection angle didn't affect degree of obesity. And When using Care Dose 4D, dose reduction rate in the normal patients were higher than the obese. In this study, there are errors on somato type. So I think more research have to be done. Then application of Dose Modulation technic can help in maintaining acceptable image quality while reducing radiation dose by 20-60% in most instances.
김정욱 ( Jung Wook Park ),박성욱 ( Sung Wook Kim ),왕한영 ( Han Young Wang ) 대한피부과학회 2003 대한피부과학회지 Vol.41 No.2
Background: Nail abnormalities may be associated with alopecia areata and nail abnormalities in alopecia areata are reported to range from 10%-66%. Objectives: This study investigates the clinical characteristics of nai1 abnormalities in alopecia areata,
김정욱 ( Jung Wook Kim ),오두진 ( Doo Jin Oh ),박정훈 ( Jeong Hoon Park ),이드보라 ( De Bo Rah Lee ),황선욱 ( Seon Wook Hwang ),박성욱 ( Sung Wook Park ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.1
Recurrent cutaneous eosinophilic vasculitis (RCEV) is a rare cutaneous disease characterized by necrotizing vasculitis of small vessels, with exclusive eosinophilic infiltration and minimal, or no leukocytoclasis. It presents with recurrent erythematous or purpuric papules or plaques, or angioedema associated with peripheral eosinophilia. This disease follows a benign chronic course without evidence of systemic involvement. Systemic corticosteroid therapy is effective but the disease commonly pursues a relapsing and remitting course. Herein, we report a case of RCEV that was effectively treated with systemic corticosteroids and dapson(R) (diaminodiphenylsulphone). Furthermore, the patient did not show a relapse of the disease in spite the tapering the systemic corticosteroid dose. (Korean J Dermatol 2007;45(1):47~50)
부패성 아스페르길루스증을 동반한 제 1형 선천성 폐기도 기형 1예
김정욱 ( Jung Wook Kim ),정호연 ( Ho Yeon Chung ),김은영 ( Eun Young Kim ),김현수 ( Hyun Soo Kim ),강경환 ( Kyung Hwan Kang ),박지영 ( Ji Young Park ),이은정 ( Eun Jung Lee ),위정국 ( Jung Kook Wi ),조경민 ( Kyoung Min Cho ),정회 전북대학교 의과학연구소 2011 全北醫大論文集 Vol.35 No.1
Congenital pulmonary airway malformation (CPAM) of the lung, also known as congenital cystic adenomatoid malformation, is an uncommon fetal developmental anomaly and presentation in adult is very rare. We experienced an unusual manifestation of CPAM with colonization of Aspergillus organisms in a 57-year-old male. Only one case of CPAM with aspergilloma has been reported to date.
전신성 홍반성 루프스와 이차성 항인지질 항체 증후군 환자에서 발생한 망상 청피반
김정욱 ( Jung Wook Kim ),오두진 ( Doo Jin Oh ),조경종 ( Kyung Jong Cho ),홍순권 ( Soon Kwon Hong ),이드보라 ( De Bo Rah Lee ),황선욱 ( Seon Wook Hwang ),박성욱 ( Sung Wook Park ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.6
Antiphospholipid syndrome is defined as the presence of lupus anticoagulant antibodies or anticardiolipin antibodies with vascular thrombosis or specific pregnancy complications. Antiphospholipid syndrome can be associated with autoimmune, malignant or infectious diseases. Cutaneous manifestations of antiphospholipid syndrome are variable and can be a first clue to the syndrome or other associated diseases. We report a case of systemic lupus erythematosus and secondary antiphospholipid syndrome presenting as livedo reticularis on both legs of a patient. We recommend that patients with livedo reticularis should be examined for systemic lupus erythematosus or antiphospholipid syndrome. (Korean J Dermatol 2007;45(6):622∼625)
김정욱 ( Jung Wook Kim ),김상현 ( Sang Hyun Kim ),이드보라 ( Deborah Lee ),이상석 ( Sang Seok Lee ),박성욱 ( Sung Wook Park ),황선욱 ( Seon Wook Hwang ) 대한피부과학회 2008 大韓皮膚科學會誌 Vol.46 No.10
Background: Dualight(TM) is a recently developed phototherapeutic device that is used for targeted phototherapy. However, the efficacy of Dualight(TM) therapy for vitiligo has not been evaluated nor has it been reported on in the Korean medical literature. Objective: This study was conducted to evaluate the efficacy of Dualight(TM) therapy for treating localized vitiligo and we wanted to determine the clinical parameters that could affect the therapeutic outcome. Methods: Eighty-three lesions from thirty-eight patients were treated by using Dualight(TM) once or twice a week. The repigmentation grade of each treated lesion was evaluated on a 5-point scale from 0 (no repigmentation), 1 (1∼24%), 2 (25∼49%), 3 (50∼74%), to 4 (75∼100%). Results: Thirty-four lesions of the 83 lesions (40.9%) improved to 50% repigmentation after Dualight(TM) therapy. The clinical parameters that affected the therapeutic outcome were the lesions` anatomical location and the clinical subtype of vitiligo. Yet a history of previous treatment and the skin type did not affect the therapeutic result. Perilesional hyperpigmentation (47.4%) was the most common side effect, but the other adverse effects were limited and transient. Conclusion: Dualight(TM) therapy is an effective, safe therapeutic modality for localized vitiligo. However, similar to other non-surgical therapeutic modalities, the therapeutic outcome is mainly dependent on the anatomical location. (Korean J Dermatol 2008;46(10):1369∼1375)
김정욱 ( Jung-wook Kim ),박경로 ( Kyungro Park ) 서강대학교 시장경제연구소(구 서강대학교 경제연구소) 2016 시장경제연구 Vol.45 No.3
‘소유와 지배의 분리’는 주로 전문경영인 체제의 확립이나 주주와 경영자 사이의 이해상충이라는 측면에서 이해되고 있다. 그러나 Berle and Means(1932)는, 소유가 분산된 상태에서 기업 지배자가 주식회사 제도의 법적 장치들을 통해 지배 레버리지를 높여 비교적 소수의 지분으로 기업의 핵심적인 의사결정을 행하게 됨으로써 사회의 재산을 소수가 지배하게 된 새로운 시대에 대한 대책 마련을 촉구하기 위해 이 개념을 제안했다. 이 논문은 Berle and Means (1932)의 개념을 복원시키는 관점에서 영국에서 소유와 지배의 분리과정을 재검토함으로써 다음과 같은 결과를 얻는다. 첫째, 영국에서 소유와 지배의 분리에 대한 이제까지의 논의는 소유와 지배의 괴리를 발생시키는 법적 장치들을 고려하지 않음으로써 소유의 분산과 지배의 분산을 동일시하였음을 확인한다. 둘째, 차등의결권과 상장방식을 고려하면 영국에서 소유와 지배의 분리과정에 대한 새로운 설명이 가능함을 확인한다. 셋째, 이제까지의 지배적인 인식과 달리 영국 국내에서도 1950년 이전에 지주회사를 통한 피라미드식 기업집단이발달하였을 가능성을 보여주는 증거들을 제시한다. 미국에서 소유와 지배의 분리에 대한 연구[김정욱·박경로(2015)]와 함께 이 논문은, 소유와 지배의 분리에 대한 Berle and Means(1932)의 시각을 복원하는 것이 중요함을 보여준다. The “separation of ownership and control” has been largely interpreted as the “separation of ownership and management.” However, the real intention of Berle and Means (1932) behind the phrase was to warn about the birth of the modern corporation wherein the controllers’ fiduciary duties to the owners of firms are hard to be performed. In this study, we examine the separation of ownership and control in the United Kingdom through Berle and Means (1932)’s perspective. First, we review the recent literature on U.K. corporations and demonstrate that most studies have neglected the mechanism of the control leverage. Second, by considering voting rules and flotation methods, we suggest a new interpretation of the process of share ownership diffusion. Third, we provide initial evidence that indicates the possibility of a substantial development of pyramidal business groups based on holding companies within the U.K. before 1950, which is rarely discussed in the extant literature.
심한 임신과다구토에 의해 Wernicke 뇌증과 각기병이 동반되었던 급성 신부전
석현정 ( Hyun Jung Seok ),최정 ( Choi Jung ),김정욱 ( Jung Wook Kim ),김순배 ( Soon Bae Kim ),박수길 ( Su Kil Park ),박정식 ( Jung Sik Park ),이상구 ( Sang Koo Lee ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.2
Severe hyperemesis gravidarum (HG) is a rare but potentially devastating complication of pregnancy. It can cause dehydration, electrolyte imbalance, malnutrition (especially, thiamine deficiency), and compromised renal function. We report a case of acute renal failure (ARF) with Wernicke`s encephalopathy and beriberi due to severe HG. A 35-year-old woman at 16 weeks of gestation presented with confused mentality, quadriparesis, nystagmus, peripheral neuropathy, and tachycardia after prolonged nausea and vomiting. Her initial serum creatinine and blood urea were 2.6 mg/dL and 100 mg/dL, respectively. FLAIR image of the initial MR examination demonstrated bilateral symmetric high signal intensities in the medial and dorsal thalami. Echocardiography showed left ventricular dilatation and dysfunction. We thought that ARF, Wernicke`s encephalopathy and beriberi were resulted from dehydration and thiamine deficiency due to HG. She was managed with intravenous fluid and 100-200 mg of parenteral thiamine. ARF was improved within one week and echocardiographic findings were normalized within 1 month. MR examination at the 21st week of pregnancy showed a decreased size of the lesion. After 4 months, her neuroloic status was recovered.