Gwaebultaeng is a cultural property of painting, a large Buddhist painting used for special ceremonies in Buddhism. It is stored in an indoor temple environment, and there is a greater risk of contamination and damage due to environmental factors compared to other cultural properties. In 2021, the treasure Hanging Painting of Anguksa Temple and storage chest stored in Geungnakjeon Hall of Anguksa Temple in Muju-gun, Jeollabuk-do were investigated. As a result, one genus and three species fungi, one species bacteria were found on the surface of the painting. In addition, five genera and 11 species fungi, eight genera and 12 species bacteria were confirmed on the surface of the storage chest. Among them, the same three species of Aspergillus genus were identified in both Gwaebultaeng and the storage chest. These results suggest the possibility of introduction and spread from airborne fungi in the indoor air outside the chest. Among the identified microorganisms, one genus and two species fungi in Gwaebultaeng and three genera and four species fungi, four genera and five species bacteria were identified as those that could cause damage to the storage chest. In addition, it was confirmed that one species fungus in Gwaebultaeng and one genus and two species fungi could cause harm to the human body. The results of this study will serve as a basis for careful discussion and management regarding the storage of cultural properties in the future.

Purpose: This study compares the chest compression quality, and the willingness and confidence to perform cardiopulmonary resuscitation (CPR) before and after education between the compression only CPR (COCPR) group and the standard CPR (STCPR) group using manikins. Method: This study employs a randomized controlled trial design. A total of 219 and 214 individuals were randomly assigned to the COCPR and STCPR groups, respectively. Both groups were asked to perform CPR for 2 min before and after education. The willingness and confidence to perform CPR were surveyed through a questionnaire. Results: Before education, the STCPR group had a significantly higher mean chest compression depth and accuracy than the COCPR group for the entire 2 min. After education, the STCPR group had a significantly higher mean chest compression depth for 2 min and higher compression accuracy for late 1 min than the COCPR group. However, no significant difference in the willingness and confidence to perform CPR according to the compression method was evident. Conclusion: Repeated training is required to maintain chest compression quality. CPR education improves willingness and confidence to perform CPR.

Background: Patients with stroke have core muscle weakness and limited rib cage movement, resulting in restrictive lung disease. Objectives: To examine the comparison of effects of rib cage joint mobilization combined with diaphragmatic breathing exercise and diaphragmatic breathing exercise on the pulmonary function and chest circumference in patients with stroke. Design: A cluster randomized controlled trial. Methods: Twenty-four patients were randomly assigned to an experimental group (rib cage joint mobilization combined with diaphragmatic breathing exercise group) and control group (diaphragmatic breathing exercise group). Patients in the experimental group underwent rib cage joint mobilization for 15 min and diaphragmatic breathing exercise for 15 min. The control group underwent diaphragmatic breathing exercise for 30 min. Both groups underwent exercise thrice a week for 4 weeks. The pulmonary function and chest circumference were measured using the MicroLab spirometer and a tape measure, respectively. Results: After the intervention, the pulmonary function and chest circumference significantly improved in both groups. These improvements were significantly higher in the experimental group than those in the control group. Conclusion: Rib cage joint mobilization combined with diaphragmatic breathing exercise improves pulmonary function and chest circumference in patients with stroke.

Shirakawa Shizuka believes that there is a tattoo custom in the Yin culture of the Chinese Shang Dynasty: people in accordance with certain etiquette, respectively, on the forehead, breasts, chest and other body parts to apply tattoos, he proved that this view is mainly based on the Chinese characters at that time. He believes that “text” is the Chinese character that represents the tattoo, “Chan (產), Yan (彥), Yan (顏)” and other words are the Chinese characters that represent people tattooed on the forehead, “Er (爾), Shuang (爽), Shi(奭)” and other words are Chinese characters that represent the tattoo in the breast, and also believe that “Xiong (凶), Xiong (兇), Xiong (匈), Xiong (胸)” are the words that mean the chest tattoo (for the convenience of the writing, the following aunt called “the chest tattoo series”). Shirakawa believes that the Chinese Shang Dynasty Yin culture there is a literary custom of the view is wrong, for this, the author has written a special article to refute, is now intercepting part of it, his release of the bra series of words wrong to start the argument. The author tracks the research process of Shirakawa’s, analyzes the glyphs, contacts the word use, and draws on the relevant research results, proving that he is wrong about the composition of the bra series, the meaning of the expression and the relationship between each other.

The purpose of the study was to determine the effect of joint mobilization with respiratory muscle taping on pulmonary function and chest expansion ability in patients with chronic stroke. Thirty subjects (n=30) were randomly divided into three groups: a joint mobilization group (n=10), a respiratory muscle-taping group (n=10), and a joint mobilization with respiratory muscle-taping group (n=10). Measurements for pulmonary function and chest expansion were performed to assess its effectiveness. A spirometer was used to measure the pulmonary function, and a tape measure was used to assess the chest expansion. In the joint mobilization group, peak expiratory flow (PEF) was increased. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and upper and lower chest expansion were also increased. All of variables of respiratory muscle-taping group also were increased. FEV1 and FVC were significantly different between joint mobilization with respiratory muscle-taping and respiratory muscle-taping group. The results of the present study suggest that mobilization with respiratory muscle taping increase the pulmonary function and chest expansion.

Background:Research efforts to improve the pulmonary function of people with limited chest function have focused on the diaphragmatic ability to control breathing pattern. Real-time ultrasonography is appropriate to demonstrate diaphragmatic mechanism during breathing.Objective:The purpose of this study was to investigate the effects of diaphragmatic breathing training using real-time ultrasonographic imaging (RUSI) on the chest function of young females with limited chest mobility.Methods:Twenty-six subjects with limited chest mobility were randomly allocated to the experimental group (EG) and control group (CG) depending on the use of RUSI during diaphragmatic breathing training, with 13 subjects in each group. For both groups, diaphragmatic breathing training was performed for 30-min, including three 10-min sets with a 1-min rest interval. An extra option for the EG was the use of the RUSI during the training. Outcome measures comprised the diaphragmatic excursion range during quiet and deep breathing, pulmonary function (forced vital capacity; FVC, forced expiratory volume in 1-sec; FEV1, tidal volume; TV, and maximal voluntary ventilation; MVV), and chest circumferences at upper, middle, and lower levels.Results:The between-group comparison revealed that the diaphragmatic excursion range during deep breathing, FVC, and middle and lower chest circumferences were greater at post-test and that the changes between the pretest and post-test values were greater in the EG than in the CG (p<.05). In addition, the subjects in the EG showed increased post-test values for all the variables compared with the pretest values, except for TV and MVV (p<.05). In contrast, the subjects in the CG showed significant improvements for the diaphragmatic excursion range during quiet and deep breathings, FVC, FEV1, and middle and lower chest circumferences after the intervention (p<.05).Conclusion:These results indicate that using RUSI during diaphragmatic breathing training might be more beneficial for people with limited chest mobility than when diaphragmatic breathing training is used alone.

Chest lateral decubitus is a chest examination to determine the persence of pleural fluid in thorax. In this study, we prepare recumbent holding position time standard of chest lateral decubitus. The records of 15 patients with chest lateral decubitus between May and Jun. Recumbent holding time is 30, 60, 90, 120, 180, 210, 240 seconds. The result is fluid level change between 0.88mm to 9.63. Fluid heigh change between 9.9 percent to 42.5 percent. We can confirm fluid level change with chest decubitus image. The proper time for fluid level change is 180 seconds.

The aim of this study was to set up the optimal exposure condition according to detector type considering image quality (IQ) with radiation dose in chest digital radiography. We used three detector type such as flat-panel detector (FP) and computed radiography (CR), and charge-coupled device (CCD). Entrance surface dose (ESD) was measured at each exposure condition combined tube voltage with tube current using dosimeter, after attaching on human phantom, it was repeated 3 times. Phantom images were evaluated independently by three chest radiologists after blinding image informations. Standard exposure condition using each institution was 117 kVp-AEC at FP and 117 kVp-8 mAs at CR, and 117 kVp-8 mAs at CCD. Statistical analysis was performed by One way ANOVA (Dunnett T3 test) using SPSS ver. 19.0. In FP, IQ scores were not significant difference between 102 kVp-4 mAs and 117 kVp-AEC (28.4 vs. 31.1, p=1.000), even though ESD was decreased up to 50% (62.3 μGy vs. 125.1 μGy). In CR, ESD was greatly decreased from 117 kVp-8 mAs to 90 kVp-8 mAs without significant difference of IQ score (p=1.000, 24.6 vs. 19.5). In CCD, IQ score of 117 kVp-8 mAs was similar with 109 kVp-8 mAs (29.6 vs. 29.0), with decreasing from 320.8 μGy to 284.7 μGy (about 11%). We conclude that optimal x-ray exposure condition for chest digital radiography is 102 kVp-4 mAs in FP and 90 kVp-8 mAs in CR, and 109 kVp-8 mAs in CCD.

When performing Chest x-ray examination to pregnant woman, normally we shield back side of abdomen. In this situation, scattered rays made by equipment and surrounding structure can enter front side of abdomen. Therefore, in this study, we evaluate suitability of abdomen shield especially to pregnant woman. In case of One shielding material placed back of abdomen, the measured value is 0.676±0.19 uSv/hr. Two shielding material is 0.764±0.04 uSv/hr. Three is 0.685±0.16 uSv/hr. The exposure dose inferred in this study does not excess annual effective dose limit. But It is not mean absolute safety. So we have to minimize occurrence of stochastic effect of radiosensitivity by shielding front side of abdomen of pregnant woman in clinic.

The number of CT gradually tends to increase, but radiation exposure includes higher exposure dose of patients than other test methods as the rate of 67% in the whole radiology tests. Exposure dose of patients has increased due to it and the second exposure has been done by scattered rays of other organs except for test sites. Especially, special shielding has not been done in gonad which is very sensitive to radiation in brain and chest CT. So this study tries to research the second exposure dose of the gonad and how to shield it in Chest CT which does not include it. It was intended for 20 male adults who are 30 years old and conduct chest CT. SIEMENS’s SOMATOM DEFINITION AS* was used as CT equipment. For the scanning conditions, The tube voltage is 120kv, the tube current is 90mAs, and the slice thickness is 3mm as the general chest CT conditions. CHIYODA TECHNOL CORPORATION’s FGD1000 was used as Glass dosimeter (PLD). A lead pad of 0.25mmPb was produced as the shielding board. For the research method, the shielding rate was compared by measuring exposure dose of the gonad before and after shielding and the usefulness of the shielding board was evaluated. The average exposure dose of symphysis pubica before shielding was 280.5μGy and the average exposure dose of coccyx was measured as 151.5μGy. The average exposure dose of symphysis pubica after shielding the gonad with a lead pad of 0.25mmPb was 42μGy and the average exposure dose of coccyx was measured as 41μGy.

The purpose of this study was an determine whether elastic band on treadmill training might effect the chest expansion and pulmonary function of the 20's men. 40 subjects with experimental group(male: 20) and control group(male: 20) was participated in experiment. During four weeks, each group participated thirty minutes for three times per week. Subjects were assessed using pre-value and postvalue measurement chest length(chest length for resting, chest expansion) and pulmonary function(forced vital capacity, forced expiratory volume at one second, FEV1/FVC, peak expiratory flow, vital capacity, tidal volume, expiratory reserve volume, inspiratory reserve volume) by the CardioTouch 3000S(BIONET, USA). These findings suggest that experimental group can be used to improve chest expansion, pulmonary function than control group. In comparison of both groups, post-test was more improved in experimental group. In conclusion, experimental group helped improving function of pulmonary volume and respiratory muscle, and thus it indicates that the functions will be more improved through the continued respiratory exercise program.

The National Health Insurance Act, the Industrial Health Act and the School Health Act require chest radiography at least once a year. In chest radiographic examination, most group examinations use indirect X-ray primarily aiming at diagnosing diseases and enhancing people's health. This study purposed to minimize radiation exposure dose by comparing it between direct and indirect chest X-ray studies. According to the result of comparing and analyzing radiation exposure dose, the average incident dose and penetrating dose were 0.929μGy and 0.179μGy respectively in direct chest X-ray and 6.807μGy and 1.337μGy in indirect chest X-ray In order to minimize radiation exposure dose at direct and indirect chest X-ray, indirect X-ray should be excluded from group examination if possible. Moreover, it is necessary to control the quality of equipment (Q/A & Q/C) systematically and to avoid using unqualified equipment in order to reduce radiation exposure dose.

The objectives of this study were to investigate the effects of thoracic flexibility exercise on chest function and mobility and to provide the information of physical therapy for patients with idiopathic scoliosis. Forty female subjects who were diagnosed with scoliosis participated in this study and were divided into the experimental and control groups. The experimental group consisted of 20 patients who were treated with thoracic flexibility exercise program during the admission (10 days) ad one month after discharge. The control group consisted of 20 patients who were not treated with thoracic flexibility exercise program. Vital capacity was measured using a respirometer. The chest expansion were calculated using differences of chest circumference between maximum inspiration and maximum expiration measured under armpits, at the junction between the sternum and xyphoid process, and at the waist. All subjects were measured two times: before the admission and at one month after discharge. Data were compared by groups using independent t-test, Vital capacity and chest expansion values (the armpit, chest and waist values) were significantly higher for the experimental group compared to those of the control group (p<.05). The findings of this study show that thoracic flexibility exercise program can lead to an increase in vital capacity and chest expansion and has a positive effects in relieving symptoms and restoring thoracic mobility.

MDCT에서 인체등가형 흉부팬텀과 유리선량계를 이용하여 고해상력 및 저선량 CT로 검사하여 영상의 평가 및 흡수선량 및 유효선량을 측정하여 임상 기초자료를 제공하는데 목표를 두고자한다. 인체등가형 흉부팬텀내부에 유리선량계를 삽입하여 조직선량을 측정하였다. 64-slice CT system (SOMATOM Sensation 64, Siemens AG, Forchheim, Germany)과 CARE Dose 4D를 이용하였고, 고해상력 CT에서의 파라메터는 관전압 120 kVp, Eff. mAs 104, scan time 7.93 sec, slice 1.0 mm (Acq. 64×0.6 mm), convolution kernel (B60f sharp)의 스캔 파라메터가 사용되었고, 저선량 CT는 120 kVp, Eff. mAs 15, scan time 7.41 sec, slice 3.0 mm (Acq. 64× 0.6 mm), convolution kernel B50f medium sharp의 스캔하였다. 인체등가형 흉부팬텀을 이용하여 스캔에 따른 CTDIvol은 고해상력 CT에서 8.01 mGy, 저선량 CT는 1.18 mGy로 측정되었다. 저선량 CT 검사는 고해상력 CT 검사에 비해 흡수선량이 85.49%가 감소하였고 영상의 차이는 없어 임상에서 유용하게 적용할 수 있다.

환자 피폭선량 관리에 입사표면선량(ESD, entrance surface dose)이 국내외적으로 진단참고준위(국내 흉부 촬영 340 μGy)로 사용되고 있지만, ESD측정을 위해서는 선량계가 필요하다. 하지만 대부분 병의원에서는 선량계가 구비되어 있지 않고 정기검사 시 전문 업체 측정에 의해 확인할 수 있다. 따라서 본 연구에서는 흉부 디지털촬영에서 사용자가 쉽게 ESD를 예측할 수 있는 방법에 대해 알아보았다. 흉부 디지털촬영에서 평판형 디텍터(FP, Flat-panel detector)와 IP (Imaging plate detector)를 대상으로 하였고, ESD는 선량계(XI-Plat inum, Unfors, Sweden)를 흉부 팬텀(07-646 Duke QC chest phantom, Supertech, Elkhart, USA)의 중앙 표면에 부착시킨 후, 튜브와 디텍터를 180㎝ 거리를 유지시켜 각 노출조건 조합(관전압과 노출선량)에서 3회 반복 측정한 후 평균값을 얻었다. 흉부 팬텀 영상의 다이콤 헤더 정보에서 FP영상은 선량면적곱(DAP, dose-area product)을 확인하였고, IP영상에서는 노출 지수(EI, exposure index)를 확인하였다. 단순선형회귀분석을 통해 FP촬영에서 DAP로부터, IP촬영에서 EI로부터 ESD를 예측할 수 있는 회귀방정식(y=α+βX, α=직선의 절편, β=직선의 기울기)을 구하였다. FP가 IP 보다 유의하게 낮은 선량을 보였고(85.7 μGy vs. 124.6 μGy, p=0.01 7), 두 디텍터 모두 ESD와 화질 간에 높은 양의 상관성을 보였다. FP에서 수정된 R 제곱(adjusted R2)은 0.9 78로 ESD의 변동은 DAP 변동에 의해 97.8%의 높은 설명력을 보였다. 단순 회귀식은 ESD=0.407+68.810×D AP 이었다. 위의 회귀식을 이용하여 국내 권고선량(340 μGy)과 같은 DAP를 추정한 결과(DAP=0.021+0.014 ×340 μGy), DAP는 4.781 이었다. IP에서 수정된 R 제곱(adjusted R2)은 0.645로 ESD의 변동은 EI 변동에 의 해 64.5%의 설명력을 보였다. 단순 회귀식은 ESD=-63.339+0.188×EI 이었다. 위의 회귀식을 이용하여 국내 권고선량(340 μGy)과 같은 EI를 추정한 결과(EI=565.431+3.481×340 μGy), EI는 1748.97 이었다. 흉부 디지털 촬영에서는 팍스 워크스테이션 영상의 다이콤 헤더 정보에서 ESD를 사용자가 쉽게 예측할 수 있다.

흉부 CT 검사의 스캔 기법의 하나인 VOLUME AXIAL MODE를 이용하여 관전압의 변화에 따라 진단적 으로 가치가 높은 영상을 얻기 위하여 화질을 평가하고 적절한 관전압을 제시하고자 한다. CT 장비는 GE 사의 Revolution(GE Healthcare, Wisconsin USA)모델을 이용하였으며, Phantom은 Pediatric Whole Body Phant om PBU-70을 사용하였다. Heart의 SNR 평균차이분석에서는 70 kvp에서 -4.53 ± 0.26 이었고 80 kvp는 -3.34 ± 0.18 이었으며 100 kvp는 -1.87 ± 0.15이었고 70 kvp가 100kvp 보다 약 -2.66정도 SNR이 높았으며 통계적 으로 유의하였다.(p<0.05) Lung의 SNR 평균차이분석에서는 70 kvp에서 -78.20 ± 4.16이었고 80 kvp는 -79.10 ± 4.39이었으며 100 kvp는 -77.43 ± 4.72이었고 70 kvp가 100 kvp 보다 약 -0.77정도 SNR이 높았으며 통계적 으로 유의하였다.(p<0.05). Lung의 CNR 평균차이분석에서는 70 kvp에서 73.67 ± 3.95이었고 80 kvp는 75.76 ± 4.25이었으며 100 kvp는 75.57 ± 4.62이었고 80 kvp가 70 kvp 보다 약 20.9정도 CNR이 높았으며 통계적으 로 유의하였다.(p<0.05) 관전압 100 kvp에서는 70 kvp와 80k vp를 비교 했을 때 심장 영상의 질을 유지하면 서 SNR이 1에 가까웠다. 하지만 70 kvp와 80kvp에서 는 SNR 차이가 없어 70 kvp 로 소아 흉부 CT 검사를 하여 방사선량을 줄일 수 있을 것이다. 반면에 CNR은 70 kvp에서 가장 1에 근사치를 나타냈었으며 80kvp 와 100kvp에서는 차이가 없어 80 kvp로 소아 흉부 CT 검사를 하여 방사선량을 줄일 수 있을 것이다. 또한 Volume Axial mode 검사 시 0.3초의 짧은 scan time으로 검사 할 수 있어서 움직이거나 진정이 필요한 소아 환자에게 유용할 것으로 사료된다.

흉부 CT스캔에서 공기, 지방, 근육, Background의 HU, 잡음 그리고 신호 대 잡음비의 변화를 측정해 영상 화질에 미치는 지멘스 ADMIRE(Advanced Modeled Iterative Reconstruction)의 영향을 조사했다. 실험 결과에 따르면 ADMIRE Strength가 커질수록 잡음은 감소하고 신호는 증가하여, 결론적으로 신호 대 잡음비는 증가하는 것으로 나타났다. ADMIRE는 기존 영상 재구성 알고리즘인 FBP와 비교하여 잡음을 28~61%까 지 줄일 수 있으며, 신호 대 잡음비는 16~100%까지 향상시킨다.

흉부 및 복부 CT 검사 시 산란선에 의한 안구와 갑상선의 방사선 피폭선량을 측정하고, 피폭선량의 감소를 위해 차폐체를 사용함으로써 방사선 피폭 정도를 조사하였다. 임상에서 사용되는 흉부 및 복부 CT 검사 프로토콜을 적용하여 안구와 갑상선의 차폐체 사용 전과 후의 선량을 측정하여 비교하였다. 안구와 갑상선 의 표면선량은 OSLD를 사용하여 측정하였다. 산란선을 차폐하기 위해 바륨, 텅스텐 시트와 고글과 목차 폐체를 사용하였다. 흉부 CT 스캔 시 차폐를 하지 않고 스캔한 안구는 3.01 mSv，갑상선은 6.21 mSv로 측정 되었고 복부 CT 스캔 시 차폐를 하지 않고 스캔한 안구는 0.55 mSv，갑상선은　3.22 mSv를 나타내었다. 바륨과 텅스텐 시트는 흉부 CT 검사 시 안구와 갑상선의 차폐율이 11～13%이었고, 복부 CT 검사 시에는 34～49%까지　방사선 피폭의 저감 효과가 있었다. 흉부 및 복부 CT 검사　시 방사선 피폭 정도가 상당하기 때문에 검사가 반복, 지속적으로 이루어진다면 방사선 피폭으로 인해 갑상선 암, 백내장 등 방사선 위해가 발생할 가능성이 있어 검사 시 차폐체를 사용하는 것이 요구된다.　

흉부 디지털 단층영상합성장치는 기존 DR의 낮은 깊이 해상도, CT의 높은 피폭선량 문제를 해결할 수 있는 획기적인 영상장치로 대두되고 있다. 그러나 제한된 스캔 각도로 인해 프로젝션이 X 선 소스 동작 방 향으로 흉부를 완전히 포함 할 수 없어 재구성 된 슬라이스의 위, 아래 방향 경계를 따라 강도의 불연속성 이 발생하게 되는데 이러한 현상을 잘림 아티팩트 (Truncation artifact)라고 한다. 이 연구의 목적은 가중 정규화 접근법을 사용하여 잘림 아티팩트를 줄이고 리스템에서 개발한 프로토 타입 흉부 디지털 단층영상합 성장치 시스템에 대한 이 접근법의 성능을 평가하는 것이다. 이 시스템의 source-to-image distance는 1100 m m 이고 X 선원의 회전 중심은 검출기 표면에서 100mm 위로 설정되었다. LUNGMAN 팬텀을 사용하여 ± 20 °의 투영 뷰를 1 ° 간격으로 41장을 얻은 후, filtered back projection 알고리즘으로 재구성했다. 정량적 평가를 위하여 시뮬레이션을 이용하여 기준영상을 재구성 후 peak signal to noise ratio와 structure similarity ind ex 값을 평가하였으며 실제 실험 데이터를 이용하여 mean value of specific direction 값을 평가하였다. 시뮬 레이션 결과로 아티팩트 보정 전 일반적인 filtered back projection 알고리즘으로 재구성 한 영상과 비교하여 peak signal to noise ratio값과 structure similarity index값 모두 각각 증가하였으며, 실제 실험 재구성 영상의 mean value of specific direction 결과는 아티팩트의 영향이 감소됨을 확인할 수 있었다. 결론적으로, 가중 정규화 방법은 잘림 아티팩트를 줄임으로써 진단의 어려움을 발생시키는 가능성을 개선시킬 수 있는 방법으로 사료된다.

대규모 데이터에 기반한 실제 사용 조건의 장기유효선량 분석 연구는 부족하다. 본 연구에서는 국내 324개 의료기관에서 사용하는 흉부 X건 검사의 노출조건에 대해 전산모사를 이용한 장기선량을 계산하고 평가하였다. 실험결과, 저에너지 파라미터 대역에서 유효선량은 0.024 mSv이고 비장, 부신, 폐 순으로 높았다. 고에너지 노출파라미터 대역에서 유효선량은 0.123 mSv이고 신장, 비장, 부신 순으로 높게 나왔다. Park의 연구에서 제안한 화질과 피폭을 고려한 최적의 조건을 사용했을 때 유효선량은 0.017 mSv 로 나타났다. 사용 에너지가 높아질수록 장기 전체의 유효선량이 높아지고 그 중 신장이 가장 크게 증가하였다. 연구결과는 흉부X선 검사 시 참고자료가 되고 환자 피폭저감에 도움을 줄 것이다.