• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.676-687
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• 2020

Purpose To analyze the altered brain regions and intrinsic brain activity patterns in trauma-exposed firefighters without posttraumatic stress disorder (PTSD). Materials and Methods Resting-state functional MRI (rsfMRI) was performed for all subjects. Thirty-one firefighters over 40 years of age without PTSD (31 men; mean age, 49.8 ± 4.7 years) were included. Twenty-six non-traumatized healthy controls (HCs) (26 men; mean age, 65.3 ± 7.84 years) were also included. Voxel-based morphometry was performed to investigate focal differences in the brain anatomy. Seed-based functional connectivity analysis was performed to investigate differences in spontaneous brain characteristics. Results The mean z-scores of the Seoul Verbal Learning Test for immediate and delayed recall, Controlled Oral Word Association Test (COWAT) score for animals, and COWAT phonemic fluency were significantly lower in the firefighter group than in the HCs, indicating decreased neurocognitive function. Compared to HCs, firefighters showed reduced gray matter volume in the left superior parietal gyrus and left inferior temporal gyrus. Further, in contrast to HCs, firefighters showed alterations in rsfMRI values in multiple regions, including the fusiform gyrus and cerebellum. Conclusion Structural and resting-state functional abnormalities in the brain may be useful imaging biomarkers for identifying alterations in trauma-exposed firefighters without PTSD.

• 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.81 no.6
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• pp.1436-1447
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• 2020

Purpose To investigate the clinical and CT features at admission to predict the progression to necrotizing pancreatitis (NP) in patients initially diagnosed with interstitial edematous pancreatitis (IEP). Materials and Methods Patients with IEP who underwent contrast-enhanced CT at admission and follow-up CT (< 14 days) were included (n = 178). Two radiologists performed a consensus review of follow-up CT scans and diagnosed the type of acute pancreatitis as IEP or NP. Laboratory findings at admission were recorded. Clinical, CT, and laboratory findings were compared between the IEP-IEP group and IEP-NP group using the chi-square test and the t-test. Multivariate analysis was also performed. Results There were 112 and 66 patients in the IEP-IEP and the IEP-NP groups, respectively. The proportion of patients with alcohol etiology was significantly larger in the IEP-NP group. Among the CT findings, the presence of peripancreatic fluid and heterogeneous parenchymal enhancement were more frequently observed in the IEP-NP group. Among the laboratory variables, serum C-reactive protein levels and white blood cell counts were significantly higher in the IEP-NP group. Multivariate analysis revealed that the presence of peripancreatic fluid and heterogeneous parenchymal enhancement were significant findings distinguishing the two groups. Conclusion CT findings, such as the presence of peripancreatic fluid and heterogeneous pancreatic parenchymal enhancement, may be helpful in predicting the progression to NP in patients initially diagnosed with IEP.

• 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.

• Journal of the Daesoon Academy of Sciences
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• v.48
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• pp.375-406
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• 2024

This study aims to define the meaning of 'Sangsaeng (mutual beneficence)' within the context of 'Sangsaeng ecological theory,' a form of discourse of that has emerged from Daesoon Jinrihoe's perspective on ecology. Sangsaeng ecological theory applies the concept of interdependence to ecology in order to explain how Sangsaeng, which is commonly used as an ethical system for humans, can be applied to the realm of ecology such that it extends its scope of application to include non-human beings. Interdependence, when applied to ecology, is formed via relationships between individuals. Such relationships can be positive, negative, or neutral, and the type of interdependence that emerges can be competitive, predatory, parasitc, and symbiotic. Even if the relationship between individuals ends negatively, it can still exert a positive effect on the ecosystem. Consequently, all of these produce a type of 'dependence'. However, relationships that end negatively can generate grievances, and from the perspective of Sangsaeng ethics, this type of interdependence is to be avoided. Therefore, by way of contrast, ecological Sangsaeng may include both relationships of positive interdependence and relationships of predation, parasitism, and competition in so far as there no grievances. Ecological theory requires a perspective that enables an understand of the relationship between nature and humans in an integrated way that does not separate them. One view of universe, known as Cheonji-saengin-yongin (Heaven and Earth give produce humans make use of them) provides insights into the relationship between the universe and humans and nature and humans from an interdependent perspective. Heaven and Earth take humans as the basis of their existence, and only after humans discover the law of nature and the sacredness behind it can a deep interdependence between Heaven and Earth and humans and nature and humans be established. However, as modern humans emerge, the interdependence between Heaven and Earth and humans collapses as they destroy nature and lower the authority of Shindo (divine order). Haewon Sangsaeng (the resolution of grievances for mutual beneficence) and Boeun Sangsaeng (the reciprocation of favors for mutual beneficence) is the solution to reestablish the interdependence that has been disconnected between Heaven and Earth and humans and nature and humans. The practice of Haewon Sangsaeng through Gongbu rituals is the way to restore interdependence between nature and humans. The process of humans achieving Dotong (mastery of the Dao) through religious practices is the practice of Boeun Sangsaeng, and humans will be reborn into Injon (Human Nobility or 'divine humans') with ecological nature and enjoy an eternal interdependent relationship with nature. In summary, Sangsaeng in the context of Sangsaeng ecological theory is the idea and practice of allowing nature and humans to restore their interdependence and live on eternally.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.29 no.2
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• pp.77-100
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• 2024

Circulation, tides, currents, harmful algal blooms, water quality, and hypoxic conditions in Jinhae-Masan Bay have been extensively studied. However, these previous studies primarily focused on short-term variations, and there was limited detailed investigation into the physical mechanisms responsible for ocean circulation in the bays. Oceanic processes in the bays, such as pollutant dispersal, changes on a seasonal time scale. Therefore, this study aimed to understand how the circulation in Jinhae-Masan Bay varies seasonally and to examine the effects of tides, winds, and river discharges on regional ocean circulation. To achieve this, a three-dimensional ocean circulation model was used to simulate circulation patterns from 2016 to 2018, and sensitivity experiments were conducted. This study reveals that convective estuarine circulation develops in Jinhae and Masan Bays, characterized by the inflow of deep oceanic water from the Korea Strait through Gadeoksudo, while surface water flows outward. This deep water intrusion divides into northward and westward branches. In this study, the volume transport was calculated along the direction of bottom channels in each region. The meridional water exchange in the eastern region of Jinhae Bay is 2.3 times greater in winter and 1.4 times greater in summer compared to that of zonal exchange in the western region. In the western region of Jinhae Bay, the circulation pattern varies significantly by season due to changes in the balance of forces. During winter, surface currents flow southward and bottom currents flow northward, strengthening the north-south convective circulation due to the combined effects of northwesterly winds and the slope of the sea surface. In contrast, during summer, southwesterly winds cause surface seawater to flow eastward, and the elevated sea surface in the southeastern part enhances northward barotropic pressure gradient intensifying the eastward surface flow. The density gradient and southward baroclinic pressure gradient increase in the lower layer, causing a strong westward inflow of seawater from Gadeoksudo, enhancing the zonal convective circulation by 26% compared to winter. The convective circulation in the western Jinhae Bay is significantly influenced by both tidal current and wind during both winter and summer. In the eastern Jinhae Bay and Masan Bay, surface water flows outward to the open sea in all seasons, while bottom water flows inward, demonstrating a typical convective estuarine circulation. In winter, the contributions of wind and freshwater influx are significant, while in summer, the influence of mixing by tidal currents plays a major role in the north-south convective circulation. In the eastern Jinhae Bay, tidally driven residual circulation patterns, influenced by the local topography, are distinct. The study results are expected to enhance our understanding of pollutant dispersion, summer hypoxic events, and the abundance of red tide organisms in these bays.

• Journal of the Korean Society of Radiology
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• v.85 no.3
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• pp.581-595
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• 2024

Purpose The present study aimed to investigate the frequency and extent of compensatory common bile duct (CBD) dilatation after cholecystectomy, assess the time between cholecystectomy and CBD dilatation, and identify potentially useful CT findings suggestive of obstructive CBD dilatation. Materials and Methods This retrospective study included 121 patients without biliary obstruction who underwent multiple CT scans before and after cholecystectomy at a single center between 2009 and 2011. The maximum short-axis diameters of the CBD and intrahepatic duct (IHD) were measured on each CT scan. In addition, the clinical and CT findings of 11 patients who were initially excluded from the study because of CBD stones or periampullary tumors were examined to identify distinguishing features between obstructive and non-obstructive CBD dilatation after cholecystectomy. Results The mean (standard deviation) short-axis maximum CBD diameter of 121 patients was 5.6 (± 1.9) mm in the axial plane before cholecystectomy but increased to 7.9 (± 2.6) mm after cholecystectomy (p < 0.001). Of the 106 patients with a pre-cholecystectomy axial CBD diameter of < 8 mm, 39 (36.8%) showed CBD dilatation of ≥ 8 mm after cholecystectomy. Six of the 17 patients with long-term (> 2 years) serial follow-up CT scans (35.3%) eventually showed a significant (> 1.5-fold) increase in the axial CBD diameter, all within two years after cholecystectomy. Of the 121 patients without obstruction or related symptoms, only one patient (0.1%) showed IHD dilatation > 3 mm after cholecystectomy. In contrast, all 11 patients with CBD obstruction had abdominal pain and abnormal laboratory indices, and 81.8% (9/11) had significant dilatation of the IHD and CBD. Conclusion Compensatory non-obstructive CBD dilatation commonly occurs after cholecystectomy to a similar extent as obstructive dilatation. However, the presence of relevant symptoms, significant IHD dilatation, or further CBD dilatation 2-3 years after cholecystectomy should raise suspicion of CBD obstruction.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.112-126
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• 2022

Purpose To determine the value of 3 Tesla (T) MRI texture analysis for predicting tumor margin infiltration in soft tissue sarcomas. Materials and Methods Thirty-one patients who underwent 3T MRI and had a pathologically confirmed diagnosis of soft tissue sarcoma were included in this study. Margin infiltration on pathology was used as the gold standard. Texture analysis of soft tissue sarcomas was performed on axial T1-weighted images (WI) and T2WI, fat-suppressed contrast-enhanced (CE) T1WI, diffusion-weighted images (DWI) with b-value of 800 s/mm², and apparent diffusion coefficient (ADC) was mapped. Quantitative parameters were compared between sarcomas with infiltrative margins and those with circumscribed margins. Results Among the 31 patients with soft tissue sarcomas, 23 showed tumor margin infiltration on pathology. There were significant differences in kurtosis with the spatial scaling factor (SSF) of 0 and 6 on T1WI, kurtosis (SSF, 0) on CE-T1WI, skewness (SSF, 0) on DWI, and skewness (SSF, 2, 4) on ADC between sarcomas with infiltrative margins and those with circumscribed margins (p ≤ 0.046). The area under the receiver operating characteristic curve based on MR texture features for identification of infiltrative tumor margins was 0.951 (p < 0.001). Conclusion MR texture analysis is reliable and accurate for the prediction of infiltrative margins of soft tissue sarcomas.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.149-161
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• 2022

Purpose To investigate the correlation between computer-aided diagnosis (CAD) parameters in 3-tesla (T) MRI and pathologic immunohistochemical (IHC) markers in invasive carcinoma of no special type (NST). Materials and Methods A total of 94 female who were diagnosed with NST carcinoma and underwent 3T MRI using CAD, from January 2018 to April 2019, were included. The relationship between angiovolume, curve peak, and early and late profiles of dynamic enhancement from CAD with pathologic IHC markers and molecular subtypes were retrospectively investigated using Dwass, Steel, Critchlow-Fligner multiple comparison analysis, and univariate binary logistic regression analysis. Results In NST carcinoma, a higher angiovolume was observed in tumors of higher nuclear and histologic grades and in lymph node (LN) (+), estrogen receptor (ER) (-), progesterone receptor (PR) (-), human epidermal growth factor 2 (HER2) (+), and Ki-67 (+) tumors. A high rate of delayed washout and a low rate of delayed persistence were observed in Ki-67 (+) tumors. In the binary logistic regression analysis of NST carcinoma, a high angiovolume was significantly associated with a high nuclear and histologic grade, LN (+), ER (-), PR (-), HER2 (+) status, and non-luminal subtypes. A high rate of washout and a low rate of persistence were also significantly correlated with the Ki-67 (+) status. Conclusion Angiovolume and delayed washout/persistent rate from CAD parameters in contrast enhanced breast MRI correlated with predictive IHC markers. These results suggest that CAD parameters could be used as clinical prognostic, predictive factors.

• Journal of Food Hygiene and Safety
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• v.39 no.1
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• pp.35-43
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• 2024

Numerous methods have been applied to assess the antibacterial effectiveness of hand hygiene products. However, the different results obtained through various evaluation methods have complicated our understanding of the real efficacy of the products. Few studies have compared test methods for assessing the efficacy of hand hygiene products. In particular, reports on ex vivo pig skin testing are limited. This study aimed to compare and characterize the methodologies applied for evaluating hand hygiene products, involving in vitro, ex vivo, and in vivo approaches, applicable to both leave-on sanitizers and wash-off products. Our further aim was to enhance the reliability of ex vivo test protocols by identifying influential factors. We performed an in vitro method (EN1276) and an in vivo test (EN1499 and ASTM2755) with at least 20 participants, against Serratia marcescens or Escherichia coli and Staphylococcus aureus. For the ex vivo experiment, we used pig skin squares prepared in the same way as those used in the in vivo test method and determined the optimal treated sample volumes for sanitizers and the amount of water required to wash off the product. The hand sanitizers showed at least a 5-log reduction in bacterial load in the in vitro test, while they showed little antibacterial activity in the in vivo and ex vivo tests, particularly those with a low alcohol content. For the hand wash products, the in vitro test was limited because of bubble formation or the high viscosity of the products and it showed low antibacterial activity of less than a 1-log reduction against E. coli. In contrast, significantly higher log reductions were observed in ex vivo and in vivo tests, consistently demonstrating these results across the two methods. Our findings revealed that the ex vivo and in vivo tests reflect the two different antibacterial mechanisms of leave-on and wash-off products. Our proposed optimized ex vivo test was more rapid and more precise than the in vitro test to evaluate antibacterial results.