• Journal of the Korean Orthopaedic Association
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• v.54 no.6
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• pp.509-518
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• 2019

Purpose: Lymph node metastasis is a very important prognostic factor for all skin cancers and some sarcomas. A sentinel lymph node (SLN) biopsy is the most useful technique for identifying SLNs. Recently, a new generation of diagnostic tools, such as single photon emission computed tomography/computed tomography (SPECT/CT) and positron emission tomography/CT (PET/CT) enabled the detection of SLNs. This study compared the efficacy of PET/CT for detecting lymph node metastases with a SLN biopsy in a single medical center. Materials and Methods: From 2008 to 2018, 72 skin cancers of sarcoma patients diagnosed with some lymph node involvement in a whole body PET/CT reading were assessed. Patients suspected of lymph node metastasis were sent to biopsy and those suspected to be reactive lesions were observed. The analysis was performed retrospectively using the medical records, clinical information, PET/CT readings, and pathology results. Results: The age of patients ranged from 14 to 88 years and the mean follow-up period was 2.4 years. Twenty-two patients were suspected of a lymph node metastasis and confirmed. The sensitivity, specificity, positive predictive value and negative predictive value of PET/CT images in sarcoma and non-sarcoma tumors were increased significantly when the expert's findings were considered together. Conclusion: PET/CT is effective in detecting lymph node metastases.

• Journal of Digestive Cancer Research
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• v.6 no.2
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• pp.69-72
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• 2018

Mucinous adenocarcinoma occurs in 1.6-25.4% of patients with colorectal cancer. We report a case of a 27-year-old man with negative findings on initial colonoscopic biopsy, but finally diagnosed with mucinous adenocarcinoma of the colon. After undergoing an abdominal CT due to persistent abdominal pain, he was transferred to our hospital. The abdominal CT showed a diffuse and irregular wall thickening in the distal transverse colon. Due to the edema and stenosis of colonic wall, it was difficult to insert the colonoscope into the proximal region; a biopsy revealed chronic colitis with lymphofollicular hyperplasia. Transverse colectomy and lymph node dissection were performed. The diagnosis was mucinous adenocarcinoma of approximately 20×4.5 cm. Compared to adenocarcinoma, mucinous adenocarcinoma is found in a younger population with an advanced stage and is less responsive to palliative chemotherapy. Therefore, recalcitrant abdominal pain even in young people warrants early detection through appropriate examinations such as abdominal CT and colonoscopy.

• Journal of Digestive Cancer Research
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• v.2 no.2
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• pp.64-67
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• 2014

Esophageal cancer has a poor prognosis, because the progression rate is faster compared to that of other cancers, Up to 30-40% of cases are inoperable at diagnosis, and most cases occur in the elderly. By this time, surgery has been regarded as the treatment of choice in patients suffering esophageal cancer and recent improvements in surgical techniques and perioperative management have significantly increased the resection rate and reduced the operative mortality. And Although the combination of chemotherapy and radiation therapy has been reported to be an effective treatment for esophageal cancer, most cases show only partial remission. Moreover, radiation therapy alone or chemotherapy alone has limited efficacy. We report a rare case of an 80-year-old man who presented with a chief complaint of dysphasia and was diagnosed with advanced esophageal cancer, with a review of the literature. Considering his advanced age, generally poor performance status, and the risk of fistula development after radiation therapy due to indentation of esophageal cancer into the main bronchus, palliative, rather than therapeutic, chemotherapy was performed, and complete remission was obtained.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.43-49
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• 2023

In Korea, the dependence on living donations is high due to the shortage of organs available for donation compared to the number of people waiting for transplants and the number of living organ donations continues to increase. In particular, the number of living-donor transplantations is high worldwide, highlighting the importance of pre-transplant psychosocial evaluation of living kidney donors. According to previous studies, when evaluating living organ donors before transplantation, it is crucial to determine whether the donor can give informed consent and be aware of the risks after surgery. Pre-transplant evaluation tests such as ELPAT living organ donor Psychological Assessment Tool (EPAT), Live Donor Assessment Tool (LDAT), Living Donation Expectancies Questionnaire (LDEQ), Minnesota Multiphasic Personality Inventory-2 questionnaire (MMPI-2) and Temperament and Character Inventory (TCI) are conducted for donors. After reviewing the literature on these pre-transplant psychosocial assessment tools, we will also look at legal considerations for living kidney donors in Korea and suggest an effective and essential pre-transplant screening evaluation method for living kidney transplant donors.

• Journal of the Korean Society of Radiology
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• v.81 no.2
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• pp.272-289
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• 2020

Current advances in CT techniques allow thorough evaluation of the beating heart. The strengths of cardiac CT relative to echocardiography and magnetic resonance imaging are its high availability in most institutions, rapid production of high-quality images, and outstanding delineation of the anatomy. For many normal variants and pathologic conditions, such as thrombi, masses, and congenital abnormalities of the left atrium, CT findings are sufficient to make a presumptive diagnosis. Assessments of the left atrium and left atrial appendage are particularly important for the management of atrial fibrillation, as various catheter-based procedures are aimed at the mechanical and electrical isolation of these structures. CT offers information crucial to a successful catheter-based procedure or surgery. Therefore, a comprehensive review of the geometry (shape, size, and relative position), along with various CT imaging features of pathologic states, should be provided in radiology reports to be of clinical value.

• The Korean Society of Law and Medicine
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• v.24 no.4
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• pp.37-63
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• 2023

In medical litigation, there are various cases where a doctor's 'explanation' of a patient becomes problematic. Medical explanations and guidance are required from the doctor, starting from the beginning of diagnosis, through treatment processes such as surgery, when hospitalization is necessary for treatment, during hospitalization, upon discharge, and after discharge. Furthermore, notification from the doctor or medical institution may be requested regarding the economic costs that will be incurred due to medical treatment. South Korea's judiciary has been developing legal principles regarding such doctor's explanations by distinguishing between explanations for obtaining consent for medical treatment and medical explanations related to guidance on patient treatment methods, taking into account related laws such as the stage of treatment and the Medical Service Act. Additionally, the Constitutional Court recently ruled on the non-benefit cost notification system linked to the explanation of economic costs. However, holding a doctor accountable solely because the doctor's explanation was insufficient has aspects that do not correspond to the actual situation in clinical reality, and may have a reflexive disadvantage that results in a decline in legal rights. Therefore, the doctor's explanation needs to be examined from both perspectives: guaranteeing the patient's right to self-determination and protecting his or her right to decision.

• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.4
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• pp.267-275
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• 2023

To obtain better esthetic results when immediately placing a dental implant, the soft tissue surrounding the implant must be conditioned during healing of the extraction socket. To this end, the emergence profile can be customized through immediate restoration of the provisional prosthesis, and good clinical results can be obtained at the time of definitive restoration in the future, resulting in high patient satisfaction. In this case, horizontal root fracture occurred after trauma to both maxillary central incisors. Immediate implant placement and loading was planned considering aesthetics and alveolar bone condition. By taking an impression using a digital intraoral scanner, a digital diagnostic wax-up was performed to make a more aesthetic prosthesis without applying external force to the traumatized teeth. Based on this, the ideal placement location was determined and immediate implant placement was performed using a 3D printed surgical guide. The provisional prosthesis was restored 5 days after placement, and the definitive zirconia crown was restored through soft tissue conditioning and customization using the shape of the provisional prosthesis for 3 months.

• Journal of the Korean Society of Radiology
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• v.84 no.6
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• pp.1367-1372
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• 2023

Primary angiitis of the central nervous system (PACNS) is a rare vasculitis in the central nervous system. Herein, we report a case of diagnosis and treatment of necrotic pattern PACNS, which was difficult to differentiate from a brain abscess. A 19-year-old male presented with blurred vision and a headache. Brain MRI revealed irregular rim-enhancing necrotic masses with central diffusion-high signal intensity in the corpus callosum and peripheral diffusion-high signal intensity in the left parietotemporal periventricular area. Susceptibility-weighted imaging revealed multiple punctate hemorrhages in the lesions. The patient was diagnosed with unusual abscess or tumefactive PACNS. Therefore, we initially treated the patient with antibiotics to rule out brain abscess. However, the brain lesions did not improve on follow-up MRI after the antibiotic treatment. Surgical biopsy was performed, and the histopathological diagnosis was PACNS with a necrotic pattern. The necrotic lesions became smaller on follow-up MRI after high-dose corticosteroid treatment.

• The Transactions of the Korea Information Processing Society
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• v.13 no.7
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• pp.326-334
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• 2024

Extra-oral imaging techniques such as Panoramic X-rays (PXs) and Cone Beam Computed Tomography (CBCT) are the most preferred imaging modalities in dental clinics owing to its patient convenience during imaging as well as their ability to visualize entire teeth information. PXs are preferred for routine clinical treatments and CBCTs for complex surgeries and implant treatments. However, PXs are limited by the lack of third dimensional spatial information whereas CBCTs inflict high radiation exposure to patient. When a PX is already available, it is beneficial to reconstruct the 3D oral structure from the PX to avoid further expenses and radiation dose. In this paper, we propose 3DentAI - an U-Net based deep learning framework for 3D reconstruction of oral structure from a PX image. Our framework consists of three module - a reconstruction module based on attention U-Net for estimating depth from a PX image, a realignment module for aligning the predicted flattened volume to the shape of jaw using a predefined focal trough and ray data, and lastly a refinement module based on 3D U-Net for interpolating the missing information to obtain a smooth representation of oral cavity. Synthetic PXs obtained from CBCT by ray tracing and rendering were used to train the networks without the need of paired PX and CBCT datasets. Our method, trained and tested on a diverse datasets of 600 patients, achieved superior performance to GAN-based models even with low computational complexity.

• Restorative Dentistry and Endodontics
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• v.24 no.1
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• pp.166-179
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• 1999

Apical sealing is essential for the success of surgical endodontic treatment. Root-end cavity is apt to be contaminated with moisture or blood, and is not always easy to be dried completely. The purpose of this study was to evaluate the influence of dry methods of retrocavity on the apical seal in endodontic surgery. Apical seal was investigated through the evaluation of apical leakage and adaptation of filling material over the cavity wall. To investigate the influence of various dry methods on the apical leakage, 125 palatal roots of extracted human maxillary molar teeth were used. The clinical crown of each tooth was removed at 10 mm from the root apex using a slow-speed diamond saw and water spray. Root canals of the all the specimens were prepared with step-back technique and filled with gutta-percha by lateral condensation method. After removing of the coronal 2 mm of filling material, the access cavities were closed with Cavit$^{(R)}$. Two coats of nail polish were applied to the external surface of each root. Apical three millimeters of each root was resected perpendicular to the long axis of the root with a diamond saw. Class I retrograde cavities were prepared with ultrasonic instruments. Retrocavities were washed with physiologic saline solution and dried with various methods or contaminated with human blood. Retrocavities were filled either with IRM, Super EBA or composite resin. All the specimens were immersed in 2% methylene blue solution for 7 days in an incubator at $37^{\circ}C$. The teeth were dissolved in 14 ml of 35% nitric acid solution and the dye present within the root canal system was returned to solution. The leakage of dye was quantitatively measured via spectrophotometric method. The obtained data were analysed statistically using one-way ANOVA and Duncan's Multiple Range Test. To evaluate the influence of various dry methods on the adaptation of filling material over the cavity wall, 12 palatal roots of extracted human maxillary molar teeth were used. After all the roots were prepared and filled, and retrograde cavities were made and filled as above, roots were sectioned longitudinally. Filling-dentin interface of cut surfaces were examined by scanning electron microscope. The results were as follows: 1. Cavities dried with paper point or compressed air showed less leakage than those dried with cotton pellet in Super EBA filled cavity (p<0.05). However, there was no difference between paper point- and compressed air-dried cavities. 2. When cavities were dried with compressed air, dentin-bonded composite resin-filled cavities showed less apical leakage than IRM- or Super EBA-filled ones (p<0.05). 3. Regardless of the filling material, cavities contaminated with human blood showed significantly more apical leakage than those dried with compressed air after saline irrigation (p<0.05). 4. Outer half of the cavity showed larger dentin-filling interface gap than inner half did when cavities were filled with IRM or Super EBA. 5. In all the filling material groups, cavities contaminated with blood or dried with cotton pellets only showed larger defects at the base of the cavity than ones dried with paper points or compressed air.