Slot-Scan Digital Radiography of the Lower Extremities: a Comparison to Computed Radiography with Respect to Image Quality and Radiation Dose

OBJECTIVE: To compare the slot-scan digital radiography (SSDR) of the lower extremity region and the computed radiography (CR) method with respect to the image quality and radiation exposure. MATERIALS AND METHODS: We enrolled 54 patients who underwent both the SSDR and CR of the lower extremities. The study evaluated and statistically compared the image quality of four features (outer cortex, inner cortex, trabeculae and intermuscular fat) at six different levels (pelvis, hip, femur, knee, tibia and ankle) between each method. The image quality was evaluated using a visibility scale, and the entrance skin dose was measured using a dosimeter at three different levels of a phantom (hip, knee, and ankle). RESULTS: The mean image visibility scale values for the SSDR method were significantly higher than for the CR method. The entrance skin dose for the SSDR method was 278 micro Gy at each level, compared to the entrance skin doses of the CR method, which were 3,410 micro Gy for the hip, 1,152 micro Gy for the knee, and 580 microGy for the ankle. CONCLUSION: Both the image quality and patient entrance skin dose data suggest that the SSDR method is superior to the CR method for the lower extremity musculoskeletal examination.

The Crowned Dens Syndrome: A Case Report / 대한척추외과학회지

Patients with Crowned dens syndrome typically present with severe neck pain and have calcification around the axial odontoid process on radiographs. To our knowledge, Crowned dens syndrome is unreported in the Korean literature and the clinical features remain unclear. We present Crowned dens syndrome as a cause of acute cervical pain and review the literature.

Comparison of two in vitro assays for serum house dust mite - specific IgE with skin testiong in allergic subjects / 천식및알레르기

BACKGROUND: The skin prick test and in vitro allergen-specific IgE assays are commonly used to diagnose atopic diseases. However, there is still a need for comparison of their diagnostic efficiency. Objective and METHOD: To evaluate their clinical efficiency, the results of UniCAP and multiple antigen simultaneous test (MAST) were compared with skin prick test results. After 51 allergic patients completed skin prick test (SPT), serum sample was collected and UniCAP and MAST were performed to determine specific IgE to house dust mite (Dermatophagoides pteronyssinus : Dp and D. farinae. Df). Result : When SPT was used as a reference standard, UniCAP depicted higher sensitivity of 88.8% to Dp IgE and 91.4% to Df - IgE, but lower specificity of 73.3% to Dp IgE and 75.0% to Df - IgE. However, MAST had lower sensitivity of 75.1% to Dp-IgE and 71.4% to Df - IgE, higher specificity of 93.3% to Dp-IgE and 93.7% to Df - IgE. The values of UniCAP and MAST were significantly correlated with the reactivity grade of skin prick test, respectively. Additionally, the response of SPT was not apparently associated with ECP levels. CONCLUSION: These study results may suggest that both UniCAP and MAST are generally feasible for measuring house dust mite - specific IgE and that they are both replicable.

Developmental Changes of Spectral and Chaotic Indexes of Heart Rate Variability in Normal Fetuses

PURPOSE: The purposes of this study were to determine the normal values of spectral and chaotic indexes and to assess the maturational process of autonomic and chaotic control of fetal heart rate according to gestational age. METHODS: Three hundred and thirty-seven mothers with normal singleton pregnancies, who were 23 weeks or more in gestational age, was randomly chosen. For more than 40 minutes fetal heart rates and fetal movements were recorded and were downloaded to a computer. From each heart rate data, we extracted 25 minutes (3,000 points) worth of time series of dimension were calculated and then 2 weeks' average were compared to find the maturational change of them. RESULTS: LF power and LF/HF ratio which are indexes of cardiac sympathetic tone increased significantly (P=0.0001) with gestational age from 23 to 38 weeks. The HF power did not show significant developmental change. Correlation dimension, an index of chaotic control, tended to decrease with the gestational age (P=0.0001). It was 4.07 +/- 0.13 before 24 weeks and, after it reached the peak of 4.15 +/- 0.14 at 31-32 weeks, it gradually decrease to a slight but significant lower value of 3.67 +/- 0.08 at 41-42 weeks. CONCLUSION: Magnitude of cardiac sympathetic modulation increases until 37-38 weeks. On the average, fetal heart rate is regulated at least by four independent variables throughout the gestation and after 23 weeks of gestation. Complexity of heart rate control system peaks at 31-32 weeks then slightly decreases until term gestation, probably to synchronize the heart rate to other physiologic functions.