• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.562-574
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• 2021

MRI has the advantages of having excellent soft-tissue contrast and providing functional information without any harmful ionizing radiation. Although previous technical limitations restricted the use of chest MRI, recent technological advances and expansion of insurance coverage are increasing the demand for chest MRI. Recognizing the need for guidelines on appropriate use of chest MRI in Korean clinical settings, the Korean Society of Radiology has composed a development committee, working committee, and advisory committee to develop Korean chest MRI justification guidelines. Five key questions were selected and recommendations have been made with the evidence-based clinical imaging guideline adaptation methodology. Recommendations are as follows. Chest MRI can be considered in the following circumstances: for patients with incidentally found anterior mediastinal masses to exclude non-neoplastic conditions, for pneumoconiosis patients with lung masses to differentiate progressive massive fibrosis from lung cancer, and when invasion of the chest wall, vertebrae, diaphragm, or major vessels by malignant pleural mesothelioma or non-small cell lung cancer is suspected. Chest MRI without contrast enhancement or with minimal dose low-risk contrast media can be considered for pregnant women with suspected pulmonary embolism. Lastly, chest MRI is recommended for patients with pancoast tumors planned for radical surgery.

• Korean Journal of Biological Psychiatry
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• v.26 no.1
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• pp.8-13
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• 2019

Objectives Disrupted integrities of the fornix and stria terminalis have been suggested in schizophrenia. However, very few studies have focused on the fornix and stria terminalis comparing first-episode schizophrenia (FESZ), chronic schizophrenia (CS), and healthy controls (HCs) with the application of diffusion-tensor imaging (DTI) technique. The objective of this study is to compare the connectivity of the fornix and stria terminalis among FESZ, CS, and HCs. Methods We included the 44 FESZ patients, 39 CS patients and 20 HCs in this study. Voxel-wise statistical analysis of the fractional anisotropy (FA) data was performed using Tract-Based Spatial Statistics to analyze the connectivity of fornix and stria terminalis. In addition, the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) were used to evaluate clinical symptom severities. Results There were no significant differences between the FESZ, CS, and HCs in age, sex, education years. The SAPS and SANS scores of the schizophrenia groups showed no significant differences. FA values of the right fornix cres/stria terminalis in the CS group were significantly lower than those in FESZ and HCs. There were no significant differences of FA values of the right fornix cres/stria terminalis between the FESZ and the HCs. Pearson correlation analyses revealed that significant correlation between FA values of the right fornix cres/stria terminalies of the the FESZ group and positive, negative symptom scales, and FA values of the right fornix cres/stria terminalis of the CS group and negative symptom scales. Conclusions This study shows that FA values of the fornix and stria terminalis in the CS were lower than in the FESZ and the HCs. These results suggest that the fornix and stria terminalis can play a role in pathophysiology of schizophrenia. Thus current study can broaden our understanding of the pathophysiology of schizophrenia.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.164-171
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• 2018

Objectives : Depression is a common mental illness and a major cause of suicide. Although serum lipids have been associated with depression and suicide, there has been much debate. In this study, we investigated the relationship between depression, suicide, and serum lipids in patients admitted with depressed mood. Methods : A total of 134 subjects were divided into 86 non-suicide patients and 48 suicide attempters. The serum lipid levels and sub-scores of the Korean Symptom Checklist-95 (KSCL95) were compared. We also investigated the relationship between serum lipids and sub-scores of KSCL95 and investigated whether serum lipids were risk factors for suicide attempts. Results : There was no difference in serum lipids between the two groups. Among the sub-items of KSCL95, obsession was higher in non-suicide group. Triglyceride showed positive correlations with anxiety, phobic anxiety, agoraphobia, schizophrenia, and self-regulation problem. High triglyceride was a risk factor for suicide attempts. Conclusions : Triglyceride is associated with depression, anxiety, and self - regulation, and high serum triglyceride levels may be a risk factor for suicide attempts.

• Journal of the Korean Society of Radiology
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• v.81 no.1
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• pp.176-189
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• 2020

Purpose To evaluate the clinical efficacy of real-time sonoelastography (RTS) for the follow-up of congenital muscular torticollis, based on measurements of muscle elasticity. Materials and Methods Thirty-four infants (23 male, 11 female) with congenital sternocleidomastoid (SCM) muscle torticollis underwent ultrasonography and elastography between November 2012 and December 2014. We evaluated the thickness, morphology (mass-like, fusiform, or overall thickened shape), and echogenicity of the SCM muscle on grayscale images and color patterns (homogeneous blue, mixed green < 50% and ≥ 50%, and green to red) on elastography. Strain ratios were measured using Q-lab software. A clinician classified the degree of neck rotation and side flexion deficits using a 5-point grade system based on angles of neck rotation and side flexion. Correlations between the ultrasonography and clinical findings were evaluated by statistical analysis. Results Twenty-two infants had right and 12 had left SCM torticollis, respectively. Linear regression analysis showed that involved/contralateral SCM thickness differences, morphology, elasticity color scores, and strain ratios of the affected SCM muscles were significantly correlated with neck rotation and side flexion deficit scores (p < 0.05). The elasticity color score of the affected SCM muscle was the most significant factor. Conclusion RTS might provide a reliable means for evaluating and monitoring congenital muscular torticollis.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.638-653
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• 2021

Purpose To compare the recurrence pattern, disease-free survival (DFS), and overall survival (OS) after curative surgery for pancreatic ductal adenocarcinoma (PDAC) in patients who underwent preoperative evaluation with CT alone or in combination with MRI, and to compare the prognosis according to the first recurrence site. Materials and Methods We retrospectively evaluated 152 patients who underwent R0 resection of PDAC. Preoperative CT or combined CT and MRI were performed for 103 and 49 patients, respectively. Two radiologists recorded the location and date of the first recurrence in consensus. The recurrence pattern, DFS, and OS were compared between the two groups. OS was analyzed according to the first recurrence site. Results In both groups, liver metastasis was the most common recurrence pattern. DFS (p = 0.247) or OS (p = 0.067) showed no significant difference between the two groups. OS according to the first recurrence site was the lowest for liver metastasis, followed by locoregional recurrence (p < 0.001). Conclusion There were no significant differences in the recurrence pattern, DFS, or OS between patients evaluated with preoperative CT alone or with CT and MRI after curative resection of PDAC. Liver metastasis was the most common tumor recurrence pattern with the lowest OS.

• Journal of the Korean Society of Radiology
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• v.82 no.5
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• pp.1218-1230
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• 2021

Purpose To compare the per-patient diagnostic performance of simulated abbreviated MRI (AMRI) to that of conventional MRI (CMRI) with full-sequence dynamic gadoxetic acid (GA) enhancement for early-stage hepatocellular carcinoma (HCC) screening in high-risk patients. Materials and Methods A total of 201 consecutive patients at high-risk for HCC, who underwent 3T liver MRI, were included in this retrospective study. The AMRI protocol comprised T2-weighted imaging, hepatobiliary phase imaging after GA injection, and diffusion-weighted imaging. For each patient, two AMRI and CMRI image sets were independently reviewed by two radiologists. Inter-reader agreement was assessed using Cohen's kappa value. A composite reference standard was used to determine the diagnostic performance of each image set for each reader. Results A total of 93 HCCs were detected in 79 patients. The inter-reader agreement was almost perfect for both image sets (κ = 0.839, 0.948). In AMRI, the per-patient sensitivity and negative predictive values (NPV) were 94.9% and 96.4%, respectively. In CMRI, the per-patient sensitivity and NPV were 96.2% and 97.5%, respectively. Conclusion AMRI, using only three sequences, had a comparable diagnostic performance to CMRI in screening early-stage HCC. AMRI could be an alternative HCC screening tool for high-risk HCC patients.

• Journal of Korean Medicine Rehabilitation
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• v.33 no.2
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• pp.33-48
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• 2023

Objectives The purpose of this study is to investigate the latest research trends regarding the traditional Chinese medicine treatment of plantar fasciitis and suggest the direction for future research. Methods We investigated recent clinical studies about traditional Chines medicine treatment for Plantar fasciitis through searching the electronic database of China National Knowledge Infrastructure. We analyzed the characteristics of selected studies according to study design, criteria for diagnosis and evaluation, periods, treatment methods. Results Twenty-six clinical studies published from 2018 to 2022 were analyzed. Acupuncture, herbal medication, herbal fumigation and washing, herbal integration, herbal external application, and manual therapy were performed for the treatment of plantar fasciitis in China. In particular, studies on acupuncture, herbal fumigation and washing, and manual therapy were actively conducted and all of these treatment methods were effective. Conclusions Various Chinese medical interventions are being studied in China for the treatment of plantar fasciitis. However, in order to reinforce evidence for effectiveness of treatment, additional high-level clinical studies are required. It is considered that additional research related to the Korean medicine treatment for plantar fasciitis is needed in the future in Korea.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.85-93
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• 2020

Purpose: The annual statistics for poisoning are reported based on the data from poison control centers in many advanced countries. In 2016 a study was conducted to analyze the 2016 Korea Poisoning status. This study was conducted to make a better annual report for poisoning statistics in Korea from a 2017-2018 national representative database. Methods: This study was a retrospective analysis of poisoning patients based on the data from an emergency department (ED) based injury in-depth surveillance project by the Korea Centers for Disease Control and Prevention in 2017-2018. Bite or sting injuries were not included. Results: A total of 17714 patients presented to 23 EDs because of poisoning. Adults above 20 years old age accounted for 84.6% of the population, while the proportion of intentional poisoning was 60.8%. The poisoning substance presented in the ED were therapeutic drugs (51.2%), gas (20.3%), pesticides (16.4%), and artificial substances (11.4%). Overall, 35% of patients were admitted for further treatment. The mortality was 2.4% (422 cases), and the most common fatal substances in order were carbon monoxide, other herbicides, and paraquat. Conclusion: This study showed the 2017-2018 status of poisoning in Korea. The prognosis is different from the cause of poisoning and the initial mental state of the patient. Therefore, appropriate methods for preventing poisoning and therapeutic plans in specific situations are needed.

• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1397-1411
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• 2020

Purpose To survey the perception, knowledge, wishes, and expectations of Korean radiology residents regarding artificial intelligence (AI) in radiology. Materials and Methods From June 4th to 7th, 2019, questionnaires comprising 19 questions related to AI were distributed to 113 radiology residents. Results were analyzed based on factors such as the year of residency and location and number of beds of the hospital. Results A total of 101 (89.4%) residents filled out the questionnaire. Fifty (49.5%) respondents had studied AI harder than the average while 68 (67.3%) had a similar or higher understanding of AI than the average. In addition, the self-evaluation and knowledge level of AI were significantly higher for radiology residents at hospitals located in Seoul and Gyeonggi-do compared to radiology residents at hospitals located in other regions. Furthermore, the self-evaluation and knowledge level of AI were significantly lower in junior residents than in residents in the 4th year of training. Of the 101 respondents, only 16 (15.8%) had experiences in AI-related study while 91 (90%) were willing to participate in AI-related study in the future. Conclusion Organizational efforts through a radiology society would be needed to meet the need of radiology trainees for AI education and to promote the role of radiologists more adequately in the era of medical AI.

• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.2
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• pp.93-99
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• 2021

Purpose: Nutritional status and support in critically ill patients are important factors in determining patient recovery and prognosis. The aim of this study was to analyze the early nutritional status and the methods of nutritional support in critically ill patients with acute poisoning and to evaluate the effect of nutritional status on prognosis. Methods: A retrospective study was conducted in tertiary care teaching hospital from January 2018 to December 2020. in an emergency department of university hospital, 220 patients who were stayed more than 2 days of poisoning in intensive care unit were enrolled. Results: 155 (70.5%) of patients with acute poisoning had low-risk in nutritional risk screening (NRS). Patients with malignancy had higher NRS (low risk 5.2%, moderate risk 18.5%, high risk 13.2%, p=0.024). Patients of 91.4% supplied nutrition via oral route or enteral route. Parenteral route for starting method of nutritional support were higher in patients with acute poisoning of herbicide or pesticide (medicine 3.2%, herbicide 13.8%, pesticide 22.2%, p=0.000). In multivariate logistic regression analysis, herbicide or pesticide intoxication, higher risk in NRS and sequential organ failure assessment over 4.5 were affecting factor on poor recovery at discharge. Conclusion: NRS in patients intoxicated with herbicide or pesticide were higher than that in patients intoxicated with medicine intoxication. Enteral nutrition in patients intoxicated with herbicide or pesticide was less common. Initial NRS was correlated with recovery at discharge in patient with intoxication. It is expected to be helpful in finding patients with high-risk nutritional status in acute poisoning patients and establishing a treatment plan that can actively implement nutritional support.