In this study, we intend to evaluate image quality and provide to clinical basic data by applying to 2D TSE (RT) and 3D GRASE (BH) techniques using Fast MRCP testing methods for application to patients in poor patient condition. Data were analyzed for 30 patients (15 males, 15 females, and 64±4.26 average age) who underwent MRCP tests. The equipment used was Ingenia CX 3.0 T equipment and Ds anterior coil was used for data acquisition. SNR and CNR of each image were measured through quantitative analysis, and the quality of the image was evaluated by dividing it into 5 grades for qualitative evaluation. The image evaluation was performed on the paired t-test and the Wilcoxon test, and when the p value was 0.05 or less, it was considered to be significant. As a result of quantitative analysis of SNR and CNR, 3D GRASE (BH) was measured high when comparing the two techniques, 2D TSE (RT) MRCP and 3D GRASE (BH) (p<0.05). The qualitative analysis result is a sharpness of the bile duct: 3D GRASE(BH): 4.12±0.03, Overall image quality: 3D GRASE(BH): 4.21±0.91 was high (p=0.001). The motion artifact of the bile duct showed no significant difference with two techniques(2D TSE(RT): 4.41±0.04, 3D GRASE(BH): 4.53±0.14(p=0.067). However, the background suppression obtained significant results with 2D TSE(RT) of 4.14±0.55(p=0.001). In conclusion, as a result of using the Fast MRCP testing method, MRCP images obtained by 3D GRASE (BH) had an advantage over MRCP images using 2D TSE (RT). However, there will be useful results of 2D TSE(RT) MRCP technique in patients who have difficulty holding their breath.
Objectives : Living donor liver transplantation (LDLT) is a life-saving therapy for patients with terminal liver disease. Many studies have focused on recipients rather than donors. The aim of this study was to assess the emotional status and personality characteristics of LDLT donors. Methods : We evaluated 218 subjects (126 male, 92 female) who visited Daegu Catholic University Medical Center from August 2012 to July 2018. A retrospective review of their preoperative psychological evaluation was done. We investigated epidemiological data and the Minnesota Multiphasic Personality Inventory-2 questionnaire. Subanalysis was done depending on whether subjects actually underwent surgery, relationship with the recipient, and their gender. Results : Mean age of subjects was $32.19{\pm}10.91years$. 187 subjects received LDLT surgery (actual donors) while 31 subjects didn't (potential donors). Donor-recipient relationship included husband-wife, parent-children, brother-sister etc. Subjects had statistical significance on validity scale L, F, K and all clinical scales compared to the control group. Potential donors had significant difference in F(b), F(p), K, S, Pa, AGGR, PSYC, DISC and NEGE scales compared to actual donors. F, D and NEGE scales were found to be predictive for actual donation. Subanalysis on donor-recipient relationship and gender also showed significant difference in certain scales. Conclusions : Under-reporting of psychological problems should be considered when evaluating living-liver donors. Information about the donor's overall psychosocial background, mental status and donation process should also be acquired.
Clouds are composed of tiny water droplets, ice crystals, or mixtures suspended in the atmosphere and cover about two-thirds of the Earth's surface. Cloud detection in satellite images is a very difficult task to separate clouds and non-cloud areas because of similar reflectance characteristics to some other ground objects or the ground surface. In contrast to thick clouds, which have distinct characteristics, thin transparent clouds have weak contrast between clouds and background in satellite images and appear mixed with the ground surface. In order to overcome the limitations of transparent clouds in cloud detection, this study conducted cloud detection focusing on transparent clouds using machine learning techniques (Random Forest [RF], Convolutional Neural Networks [CNN]). As reference data, Cloud Mask and Cirrus Mask were used in MOD35 data provided by MOderate Resolution Imaging Spectroradiometer (MODIS), and the pixel ratio of training data was configured to be about 1:1:1 for clouds, transparent clouds, and clear sky for model training considering transparent cloud pixels. As a result of the qualitative comparison of the study, bothRF and CNN successfully detected various types of clouds, including transparent clouds, and in the case of RF+CNN, which mixed the results of the RF model and the CNN model, the cloud detection was well performed, and was confirmed that the limitations of the model were improved. As a quantitative result of the study, the overall accuracy (OA) value of RF was 92%, CNN showed 94.11%, and RF+CNN showed 94.29% accuracy.
One of the most popular pre-reinforcement methods of tunnel heading in cohesionless soils would be the fore-polling of grouted pipes, known as RPUM (reinforced protective umbrella method) or UAM (umbrella arch method). This technique allows safe excavation even in poor ground conditions by creating longitudinal arch parallel to the tunnel axis as the tunnel advances. Some previous studies on the reinforcing effects have been performed using numerical methods and/or laboratory-based small scale model tests. The complexity of boundary conditions imposes difficulties in representing the tunnelling procedure in laboratory tests and theoretical approaches. Full-scale study to identify reinforcing effects of the tunnel heading has rarely been carried out so far. In this study, a large scale model testing for a tunnel in granular soils was performed. Reinforcing patterns considered are four cases, Non-Reinforced, Crown-Reinforced, Crown & Face-Reinforced, and Face-Reinforced. The behavior of ground and pipes as reinforcing member were fully measured as the surcharge pressure applied. The influences of reinforcing pattern, pipe length, and face reinforcement were investigated in terms of stress and displacement. It is revealed that only the Face-Reinforced has decreased sufficiently both vertical settlement in tunnel heading and horizontal displacement on the face. Vertical stresses along the tunnel axis were concentrated in tunnel heading from the test results, so the heading should be reinforced before tunnel advancing. Most of maximum axial forces and bending moments for Crown-reinforced were measured at 0.75D from the face. Also it should be recommended that the minimum length of the pipe is more than l.0D for crown reinforcement.
The traditional Korean society has been classified as an Eastern collectivist culture, but in the flow of globalization and digitalization along with the post-Cold War era of the 1970s, Western individualistic culture and values quickly permeated the Korean younger generation. Since rapid changes occurred within a short period of time, there may be differences in cultural self-construal between generations living in the same era. Due to this, psychological problems related to emotional expression and suppression may appear differently depending on generations. Therefore, in the current study, 1,000 Korean adult men and women from their 20s to 60s were investigated for their level of independent and interdependent self-construal, alexithymia, ambivalence over emotional expression(AEE) and emotional suppression(ES). Then the relationship between the variables(self-construal and alexithymia,) and the mediating process of AEE and ES were examined. The generation of participants were divided into the industrialization cohort (birth year < 1970) and the digitalization cohort (birth year starting from 1970). Using the PROCESS macro(Hayes, 2022), we tested a serial mediation model of AEE and ES between the relative independent self-construal(RIS) and alexithymia. The results indicate that the level of alexithymia increases by the serial increase of AEE and ES when RIS decreases. Next, we examined a moderation effect of generatione on the mediation process of AEE and ES, and found that generation moderates the relationship between ES and alexithymia. That is, the effect of ES on alexithymia is significant for the digitalization cohort, while it is not significant for the industrialization cohort. The current results imply that emotion regulation strategies of Koreans have been differently developed according to prevailing cultural values in each generation, and that the negative influence of emotion suppression could be different according to the cultural background of each generation.
With the development of sensor and satellite technology, numerous high-resolution and multi-spectral satellite images have been available. Due to their wavelength-dependent reflection, transmission, and scattering characteristics, multi-spectral satellite images can provide complementary information for earth observation. In particular, the short-wave infrared (SWIR) band can penetrate certain types of atmospheric aerosols from the benefit of the reduced Rayleigh scattering effect, which allows for a clearer view and more detailed information to be captured from hazed surfaces compared to the visible band. In this study, we proposed a multi-resolution transform-based image fusion method to combine visible and SWIR satellite images. The purpose of the fusion method is to generate a single integrated image that incorporates complementary information such as detailed background information from the visible band and land cover information in the haze region from the SWIR band. For this purpose, this study applied the Laplacian pyramid-based multi-resolution transform method, which is a representative image decomposition approach for image fusion. Additionally, we modified the multiresolution fusion method by combining a haze-guided weight map based on the prior knowledge that SWIR bands contain more information in pixels from the haze region. The proposed method was validated using very high-resolution satellite images from Worldview-3, containing multi-spectral visible and SWIR bands. The experimental data including hazed areas with limited visibility caused by smoke from wildfires was utilized to validate the penetration properties of the proposed fusion method. Both quantitative and visual evaluations were conducted using image quality assessment indices. The results showed that the bright features from the SWIR bands in the hazed areas were successfully fused into the integrated feature maps without any loss of detailed information from the visible bands.
Yeong Jun Lee;Se Hyeon Myeong;Hyun Woo Moon;Seo Hyun Woo;Sun Jung Kim
Health Policy and Management
/
v.34
no.1
/
pp.48-58
/
2024
Background: The purpose of this study was to investigate the association between external medical service use and the characteristics of Chungcheongnam-do patients. We aimed to provide evidence of external medical service use enhance the healthcare delivery system in Chungcheongnam-do. Methods: We used the Health Insurance Cohort DB 2.0 of 2016-2019, and 2,570,439 patients were included in the study. Multivariate logistic regression and multinomial logistic regression were used to identify the association between external medical service use and each patient characteristic. Generalized linear model was used to identify the association between medical costs and external medical service use area. Results: During the study period, 32.2% of inpatients and 12.5% of outpatients had external medical service use in Chungcheongnam-do. In comparison to patients living in Cheonan and Asan, the odds ratio (OR) for external medical services use was higher across all regions. Specifically, hospitalized patients from Gyeryong, Nonsan, and Geumsan (OR, 116.817) and Gongju, Buyeo, and Cheongyang (OR, 72.931) demonstrated extremely high likelihood of external medical service use in the Daejeon area. Furthermore, compared to medical expenses incurred within Chungcheongnam-do, patients with external medical service use in the capitol area (outpatient=17.01%, inpatients=22.11%) and Daejeon area (outpatient=16.63%, inpatients=15.41%) spent more on healthcare services. Conclusion: This study found the evidence of external medical service use among Chungcheongnam-do patients. Further study should be conducted taking into account variables including satisfaction of local medical services, different types of patient diseases, and others. The study's findings may serve as a foundation for policy proposals aimed at ensuring the financial stability of our health insurance system, ensuring the efficient delivery of medical care, and localization of medical care.
Koh, Youn-Suck;Hybertson, Brooks M.;Jepson, Eric K.;Kim, Mi-Jung;Lee, In-Chul;Lim, Chae-Man;Lee, Sang-Do;Kim, Dong-Soon;Kim, Won-Dong;Repine, John E.
Tuberculosis and Respiratory Diseases
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v.43
no.3
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pp.308-322
/
1996
Background : Neutrophils are considered to play critical roles in the development of acute respiratory distress syndrome. Histamine, which is distributed abundantly in lung tissue, increases the rolling of neutrophills via increase of P-selectin expression on the surface of endothelial cells and is known to have some interrelationships with IL-1, IL-8 and TNF-$\alpha$. We studied to investigate the effect of the histamine on the acute lung injury of the rats induced by intratracheal insufflation of TNF-$\alpha$ which has less potency to cause lung injury compared to IL-1 in rats. Methods : We intratracheally instilled saline or TNF(R&D, 500ng), IL-1(R&D, 50ng)or histamine of varius dose(1.1, 11 and $55\;{\mu}g/kg$) with and without TNF separately in Sprague-Dawley rats weighing 270-370 grams. We also intratracheally treated IL-1(50ng) along with histamine($55\;{\mu}g/kg$). In cases, there were synergistic effects induced by histamine on the parameters of TNF-induced acute lung injury, antihistamines(Sigma, mepyramine as a $H_1$ receptor blockade and ranitidine as a $H_2$ receptor blockade, 10 mg/kg in each)were co-administered intravenously to the rats treated TNF along with histamine($1.1\;{\mu}g/kg$) intratraeheally. Then after 5 h we measured lung lavage neutrophil numbers, lavage cytokine-induced neutrophil chemoattractants(CINC), lung myeloperoxidase activity(MPO) and lung leak. We also intratracheally insufflated TNF with/without histamine($11\;{\mu}g/kg$), then after 24 h measured lung leak in rats. Statistical analyses were done by Kruskal-Wallis nonparametric ANOVA test with Dunn's multiple comparison test or by Mann-Whitney U test. Results : We found that rats given TNF, histamine alone(11 and $55\;{\mu}g/kg$), and TNF with histamine(l.1, 11, and $55\;{\mu}g/kg$) intratracheally had increased (p<0.05) lung MPO activity compared with saline-treated control rats. TNF with histamine $11\;{\mu}g/kg$ had increased MPO activity (P=0.0251) compared with TNF-treated rats. TNF and TNF with histamine(1.1, 11, and $55\;{\mu}g/kg$) intratracheally had all increased (p<0.05) lung leak, lavage neutophil numbers and lavage CINC activities compared with saline. TNF with histamine $1.1\;{\mu}g/kg$ had increased (p=0.0367) lavage neutrophil numbers compared with TNF treated rats. But there were no additive effect of histamine with TNF compared with TNF alone in acute lung leak on 5 h and 24 h in rats. Treatment of rats with the $H_1$ and $H_2$ antagonists resulted in inhibitions of lavage neutrophil accumulations and lavage CINC activity elevations elicited by co-treated histamine in TNF-induced acute lung injury intratracheally in rats. We also found that rats given IL-1 along with histamine intratracheally did not have increase in lung leak compared with IL-1 treated rats. Conclusion : Histamine administered intratracheally did not have synergistic effects on TNF-induced acute lung leak inspite of additive effects on increase in MPO activity and lavage neutrophil numbers in rats. These observations suggest that instilling histamine intratracheally would not play synergistic roles in neutrophil-mediated acute lung injury in rats.
Background: Numerous surgical devices for mitral repair have been used in the past with good results. In this study we describe a simple annuloplasty technique with using a new device ($Mitracon^{(R)}$). The aim of this study was to assess its efficacy and surgical results with using $Mitracon^{(R)}$. Material and Method: From May 2003 to October 2005, 46 patients (21 women and 25 men (mean age of $51.4{\pm}17.8$ years) with mitral regurgitation from various causes were treated with either the $Mitracon^{(R)}$ (the $Mitracon^{(R)}$ group) or the Capentier Edward rigid ring (the CE group). The median follow-up duration was 18.9 months. Result: The mean grade of mitral regurgitation before and immediately after surgery in the $Mitracon^{(R)}$ group and the CE group decreased from $3.2{\pm}0.8$ to $0.6{\pm}0.7$ and $3.4{\pm}0.7$ to $0.3{\pm}0.5$, respectively. There were no significant changes in the ejection fraction either between the two groups or before and immediately after surgery. No deaths were seen in either group. Early postoperative echocardiography of all 46 patients showed only trivial mitral regurgitation or none at all. Echocardiography at a median of 18.9 months also showed no progression in mitral regurgitation. The mean grade of mitral regurgitation in the $Mitracon^{(R)}$ group at this time point decreased from $3.2{\pm}0.8$ to $0.8{\pm}0.7$ (p<0.05). The CE group also showed a similar degree of decrease from $3.4{\pm}0.7$ to $0.3{\pm}0.6$ (p<0.05). The mitral valve area in the $Mitracon^{(R)}$ group at 1 year follow-up was $3.3{\pm}0.9cm^2$. The mitral valve area in the CE group was $2.7{\pm}0.6cm^2$. The mean mitral pressure gradient in the $Mitracon^{(R)}$ group at 1 year follow-up was $3.1{\pm}1.3$ mmHg. The mean pressure gradient in the CE group was $4.5{\pm}2.1$ mmHg, although any statistical significant difference for this between the groups was not reached. Conclusion: The present study showed the described technique to be safe and effective in the intermediate term. Because long term results are unavailable, a more extensive prospective randomized multicenter trial may be warranted to determine whether this procedure should be generally applied for repair of mitral valve disease.
Background : Spontaneous pneumothoraces(SP) are divided into primary spontaneous pneumothoraces (PSP) which develop in healthy individuals without underlying pulmonary disorders and secondary spontaneous pneumothoraces(SSP) which occur in those who have underlying disorders such as tuberculosis or chronic obstructive lung diseases. Yet there is no established standard therapeutic approach to this disorder, i.e., from the spectrum of noninvasive treatment such as clinical observation with or without oxygen therapy, to aggressively invasive thoracoscopic bullectomy or open thoracotomy. Although chest tube thoracostomy has been most widely used, the patients should overcome pain in the initiation of tube insertion or during indwelling it potential infection and subcutaneous emphysema. Thus smaller-caliber tube has been challenged for the treatment of pneumothorax. Previously, we studied the therapeutic efficacy of 8 French catheter for spontaneous pneumothorax. But there has been few data for effectiveness of small-caliber catheterization in comparison with that of chest tube. In this study, we intended to observe the long-term effectiveness of 8 French catheter for the treatment of spontaneous pneumothoraces in comparison with that of chest tube thoracostomy. Method : From January, 1990 to January, 1996, sixty two patients with spontaneous pneumothoraces treated at Chung-Ang University Hospital were reviewed retrospectively. The patients were sub-divided into a group treated with 8 French catheter(n=23) and the other one with chest tube insertion(n=39). The clinical data were reviewed(age, sex, underlying pulmonary disorders, past history of pneumothorax, size of pneumothorax, follow-up period). And therapeutic effect of two groups was compared by treatment duration(duration of indwelling catheter or tube), treatment-associated complications and recurrence rate. Results : The follow-up period(median) of 8 French catheter group and chest tube group was 28 and 22 months, which had no statistical significance. Ther was no statistically significant difference of clinical characteristics between two groups with SP, PSP, SSP. The indwelling time of 8 French catheter group was $6.2{\pm}3.8$ days, which was significantly shorter than that of chest tube group in SP, $9.1{\pm}7.5$ days(p=0.047). In comparison of treatment-related complication in PSP, 8 French catheter group as 6.25% of complication showed lower tendency than the other group as 23.8% (p=0.041 ; one-tailed, p=0.053; two-tailed). The recurrence rate in each group of SP was 17.4%, 10.3%, which did not show any statistically significant difference. Conclusion : Treatment with 8 French catheter resulted in shorter indwelling time in sponteous pneumothorax, and lower incidence of treatment-related complication in primary spontaneous pneumothorax. And the recurrence rate in each of treatment group showed no statistically significant difference. So, we can recommend the 8 French small-caliber catheter for the initial therapy for spontaneous pneumothorax for the replacement of conventional chest tube thoracostomy. But further prospective study with more subjects of spontaneous pneumothorax will be needed for the evaluation of effectiveness of 8 French cateter.
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