• Food Science and Preservation
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• v.31 no.2
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• pp.315-323
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• 2024

This study aims to confirm the anti-inflammatory activities of acemannan and aloesin, which have been studied for various efficacies at various mixed sample ratios. The mixed samples were mixed at a ratio of 1:1 (AA-1), 1:2 (AA-2), 1:3 (AA-3), 2:1 (AA-4), and 3:1 (AA-5). Seven samples were evaluated for their cytotoxic ability on macrophages, and the results showed that all cell viability was over 90% at a concentration of 100 ㎍/mL. First, due to the NO production inhibitory activity, a better inhibitory effect was achieved when using a mixed sample rather than a single material. Afterward, the activity of inhibiting the production of PGE₂, TNF-α, and IL-6 was confirmed using a mixed sample. It was confirmed that AA-2 had the best inhibitory activity on producing PGE2, TNF-α, and IL-6 rather than AA-1, AA-3, AA-4, and AA-5. For this reason, experiments were conducted using AA-2 to determine the protein expression levels of iNOS and COX-2, which are inflammation-related proteins. It was confirmed that AA-2 inhibited iNOS and COX-2 protein expression by 25.01% and 27.27%, respectively, compared to the LPS-alone treatment group. In conclusion, the mixed sample of acemannan and aloesin is judged to have anti-inflammatory activity and can potentially to be used as a functional material.

• Food Science and Preservation
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• v.31 no.2
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• pp.287-297
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• 2024

It was confirmed that complex fermentation (CF) was more efficient than single-strain fermentations in inducing changes in the contents of phenolic compounds of Maclura tricuspidate and Pyrus Montana Nakai. A mixture of Maclura tricuspidata, Pyrus montana Nakai, Platycodon grandiflorum and Codonopsis lanceolata were fermented in CF using Aspergillus shirousamii (koji), yeast, and lactic acid bacteria (LAB) for 24 days, and the pH, °Brix, total acidity, anti-oxidant activity, polyphenol content, nitric oxide (NO), and Western blotting of inducible nitric oxide synthase (iNOS), cyclo-oxygenase-2 (COX-2), and tumor necrosis factor-𝛼 (TNF-𝛼) of the sample were determined. There was no significant change in pH and total acidity. °Brix significantly decreased from day 6 onwards. HPLC confirmed that the concentrations of chlorogenic acid, 4-hydrobenzoic acid, vanillic acid, and caffeic acid significantly increased from day 18 during the fermentation. Additionally, DPPH, ABTS radical scavenging activity, total phenol, and total flavonoid were confirmed to be increased until 18 days. NO was significantly inhibited from day 6, along with significant inhibition of iNOS, COX-2, and TNF-a. In conclusion, this study confirmed that CF of low-use (or underutilized) wild vegetables enhances phenolic compounds. It effectively suppresses NO, iNOS, COX-2, and TNF-𝛼, markers of inflammation-related pathogenesis. Altogether, our results suggest that CF of the above plants has a potential anti-inflammatory effect.

• Journal of the Korean Society of Radiology
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• v.81 no.2
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• pp.365-378
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• 2020

Purpose This study was performed to determine whether the T1 relaxation time of gadoxetic acid-enhanced liver MR imaging is useful for detecting and staging liver fibrosis in patients with chronic liver disease. Materials and Methods One hundred and three patients with suspected focal liver lesion underwent MR imaging and Fibroscan. Fibroscan was chosen as the reference standard for classifying liver fibrosis. T1 relaxation times were acquired before (preT1), 20 minutes after (postT1) contrast administration, and reduction rate of T1 relaxation time (rrT1) on transverse 3D VIBE (volumetric interpolated breath-hold examination) sequence using 3T MR imaging. The optimal cut-off values for the fibrosis staging were determined with ROC analysis. Results PreT1 and postT1 increased and rrT1 decreased constantly with increasing severity of liver fibrosis according to the METAVIR score (F0-F4). There were statistically significant differences between F2 and F3 in preT1 (F2, 836.0 ± 74.7 ms; F3, 888.6 ± 77.5 ms, p < 0.05) and between F3 and F4 in postT1 (F3, 309.0 ± 80.2 ms; F4, 406.6 ± 147.7 ms, p < 0.05) and rrT1 (F3, 65.4 ± 7.7%; F4, 57.3 ± 11.4%, p < 0.05). ROC analysis revealed that combination test (preT1 + postT1) was the best test for predicting liver fibrosis. Conclusion PreT1 and postT1 increased constantly with increasing severity of liver fibrosis. T1 mapping in gadoxetic acid-enhanced liver MR imaging could be a helpful complementary sequence to determine the liver fibrosis stage.

• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1556-1564
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• 2021

Purpose This study aimed to apply MR elastography (MRE) to achieve in vivo evaluation of the elastic properties of thigh muscles and validate the feasibility of quantifying the elasticity of normal thigh muscles using MRE. Materials and Methods This prospective study included 10 volunteer subjects [mean age, 32.5 years, (range, 23-45 years)] who reported normal activities of daily living and underwent both T2-weighted axial images and MRE of thigh muscles on the same day. A sequence with a motion-encoding gradient was used in the MRE to map the propagating shear waves in the muscle. Elastic properties were quantified as the shear modulus of the following four thigh muscles at rest; the vastus medialis, vastus lateralis, adductor magnus, and biceps femoris. Results The mean shear modulus was 0.98 ± 0.32 kPa and 1.00 ± 0.33 kPa for the vastus medialis, 1.10 ± 0.46 kPa and 1.07 ± 0.43 kPa for the vastus lateralis, 0.91 ± 0.41 kPa and 0.93 ± 0.47 kPa for the adductor magnus, and 0.99 ± 0.37 kPa and 0.94 ± 0.32 kPa for the biceps femoris, with reader 1 and 2, respectively. No significant difference was observed in the shear modulus based on sex (p < 0.05). Aging consistently showed a statistically significant negative correlation (p < 0.05) with the shear modulus of the thigh muscles, except for the vastus medialis (p = 0.194 for reader 1 and p = 0.355 for reader 2). Conclusion MRE is a quantitative technique used to measure the elastic properties of individual muscles with excellent inter-observer agreement. Age was consistently significantly negatively correlated with the shear stiffness of muscles, except for the vastus medialis.

• Journal of the Korean Society of Radiology
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• v.82 no.5
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• pp.1196-1206
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• 2021

Purpose To construct a standard dataset of contrast-enhanced CT images of liver tumors to test the performance and safety of artificial intelligence (AI)-based algorithms for clinical decision support systems (CDSSs). Materials and Methods A consensus group of medical experts in gastrointestinal radiology from four national tertiary institutions discussed the conditions to be included in a standard dataset. Seventy-five cases of hepatocellular carcinoma, 75 cases of metastasis, and 30-50 cases of benign lesions were retrieved from each institution, and the final dataset consisted of 300 cases of hepatocellular carcinoma, 300 cases of metastasis, and 183 cases of benign lesions. Only pathologically confirmed cases of hepatocellular carcinomas and metastases were enrolled. The medical experts retrieved the medical records of the patients and manually labeled the CT images. The CT images were saved as Digital Imaging and Communications in Medicine (DICOM) files. Results The medical experts in gastrointestinal radiology constructed the standard dataset of contrast-enhanced CT images for 783 cases of liver tumors. The performance and safety of the AI algorithm can be evaluated by calculating the sensitivity and specificity for detecting and characterizing the lesions. Conclusion The constructed standard dataset can be utilized for evaluating the machine-learning-based AI algorithm for CDSS.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1151-1163
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• 2020

Purpose This study aimed to evaluate changes of subprosthetic pannus on cardiac CT and determine its relationship to echocardiographic findings in patients with mechanical aortic valve replacement (AVR). Materials and Methods Between April 2011 and November 2017, 17 AVR patients (56.8 ± 8.9 years, 12% male) who showed pannus formation on CT and had undergone both follow-up CT and echocardiography were included. The mean interval from AVR to the date of pannus detection was 10.5 ± 7.1 years. In the initial and follow-up CT and echocardiography, the pannus extent and echocardiographic parameters were compared using paired t-tests. The relationship between the opening angle of the prosthetic valve and the pannus extent was evaluated using Pearson correlation analysis. Results The pannus extent was significantly increased on CT (p < 0.05). The peak velocity (3.9 ± 0.8 m/s vs. 4.2 ± 0.8 m/s, p = 0.03) and mean pressure gradient (36.4 ± 15.5 mm Hg vs. 42.1 ± 15.8 mm Hg, p = 0.03) were significantly increased. The mean opening angles of the mechanical aortic leaflets were slightly decreased, but there was no statistical significance (73.1 ± 8.3° vs. 69.4 ± 12.1°, p = 0.12). The opening angle of the prosthetic leaflets was inversely correlated with the pannus extent (r = -0.57, p < 0.001). Conclusion The pannus extent increases over time, increasing transvalvular peak velocity and the pressure gradient. CT can be used to evaluate the pannus extent associated with hemodynamic changes that need to be managed by surgical intervention.

• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1493-1504
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• 2021

Purpose This study aimed to evaluate the utility of the 16-cm axial volume scan technique for calculating the coronary artery calcium score (CACS) using non-enhanced chest CT. Materials and Methods This study prospectively enrolled 20 participants who underwent both, non-enhanced chest CT (16-cm-coverage axial volume scan technique) and calcium-score CT, with the same parameters, differing only in slice thickness (in non-enhanced chest CT = 0.625, 1.25, 2.5 mm; in calcium score CT = 2.5 mm). The CACS was calculated using the conventional Agatston method. The difference between the CACS obtained from the two CT scans was compared, and the degree of agreement for the clinical significance of the CACS was confirmed through sectional analysis. Each calcified lesion was classified by location and size, and a one-to-one comparison of non-contrast-enhanced chest CT and calcium score CT was performed. Results The correlation coefficients of the CACS obtained from the two CT scans for slice thickness of 2.5, 1.25, and 0.625 mm were 0.9850, 0.9688, and 0.9834, respectively. The mean differences between the CACS were -21.4% at 0.625 mm, -39.4% at 1.25 mm, and -76.2% at 2.5 mm slice thicknesses. Sectional analysis revealed that 16 (80%), 16 (80%), and 13 (65%) patients showed agreement for the degree of coronary artery disease at each slice interval, respectively. Inter-reader agreement was high for each slice interval. The 0.625 mm CT showed the highest sensitivity for detecting calcified lesions. Conclusion The values in the non-contrast-enhanced chest CT, using the 16-cm axial volume scan technique, were similar to those obtained using the CACS in the calcium score CT, at 0.625 mm slice thickness without electrocardiogram gating. This can ultimately help predict cardiovascular risk without additional radiation exposure.

• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1412-1423
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• 2020

Purpose Some patients with neonatal seizures show diffuse, symmetric diffusion-restricted lesions in the cerebral white matter. The aim of this study was to describe clinical and imaging findings of patients with neonatal seizures who had diffuse, symmetric diffusion-restricted lesions without any structural or metabolic etiology. Materials and Methods A total of 56 neonates aged less than 1 week underwent brain magnetic resonance imaging (MRI) for evaluation of seizures from November 2008 to February 2017. After excluding 43 patients, 13 patients showed diffuse white matter abnormality on diffusion-weighted imaging. Initial and follow-up clinical and MRI findings were analyzed retrospectively. Results All 13 patients were born at full term. Among the ten patients who underwent a stool test for viruses, six were positive for rotavirus and one for astrovirus. MRI revealed diffuse, symmetric diffusion-restricted lesions distributed along the cerebral white matter, thalami, and midbrain variably. Conclusion Diffuse, symmetric diffusion-restricted lesions involving the cerebral white matter can be seen in patients with neonatal seizures without any structural or metabolic etiology. Rotavirus is commonly but not exclusively detected in these patients. Nevertheless, viral infection-associated encephalopathy should be considered for patients with characteristic clinical and MRI findings.

• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1424-1435
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• 2020

Purpose The purpose of this study was to evaluate the usefulness of multiphasic CT and ¹⁸F-fluorodeoxyglucose (FDG) PET/CT for the differentiation of combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CCA) from hepatocellular carcinoma (HCC). Materials and Methods From January 2007 to April 2016, 93 patients with pathologically confirmed HCC (n = 84) or cHCC-CCA (n = 9) underwent CT and PET/CT imaging. Contrast enhancement patterns were divided into three types based on the attenuation of the surrounding liver parenchyma: type I (early arterial enhancement with delayed washout), type II (early arterial enhancement without delayed washout), and type III (early hypovascular, infiltrative appearance, or peripheral rim enhancement). Results cHCC-CCAs (89%) had a higher PET/CT positive rate than did HCCs (61%), but the PET/CT positive rate did not differ significantly (p = 0.095). Among the 19 cases of the type II enhancement pattern, 3 (21%) of 14 HCCs and 4 (80%) of 5 cHCC-CCAs were PET/CT positive. cHCC-CCAs had a significantly higher PET/CT positive rate (p = 0.020) in the type II enhancement pattern. Conclusion The PET/CT positive rate of cHCC-CCA was significantly higher than that of HCC in lesions with a type II enhancement pattern. The ¹⁸F-FDG PET/CT can be useful for the differentiation of cHCC-CCA from HCC in lesions with a type II enhancement pattern on multiphasic CT.

• The Korean Society of Law and Medicine
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• v.24 no.3
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• pp.155-206
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• 2023

When a person with diminished mental capacity refuses necessary medical care, normative judgments about when paternalistic intervention can be justified come into question. A typical example is involuntary hospitalization for people with mental disabilities, traditionally governed by mental health law. However, Korean civil law reform in 2011 introduced a new form of involuntary hospitalization through guardianship legislation, leading to a dualized system to involuntary hospitalization. Consequently, a conflict has arisen between the 'best interest and surrogate decision-making' paradigm of civil law and the 'social defense and preventive detention' paradigm of mental health law. Many countries have criticized this dualized system as not only inefficient but also unfair. Moreover, the requirement for the presence of 'mental illness' for involuntary hospitalization under mental health law has faced criticism for unfairly discriminating against people with mental disabilities. In response, attempts have been made to integrate guardianship legislation and mental health law based on mental capacity. This study examines the legislative process and framework of the Mental Capacity Act (Northern Ireland) 2016, which reorganized the mental health care system by fusing guardianship legislation with mental health law based on mental capacity. By analyzing the case of Northern Ireland, which has grappled with conflicts between guardianship legislation and mental health law since the 1990s and recently proposed mental capacity as a single, non-discriminatory standard, we aimed to offer insights for the Korean guardianship and mental health systems.