• Korean Journal of Radiology
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• 제22권6호
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• pp.959-969
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• 2021

Objective: This study aimed to evaluate the role of preoperative two-dimensional (2D) shear wave elastography (SWE) in assessing the stages of liver fibrosis in patients with suspected biliary atresia (BA) and compared its diagnostic performance with those of serum fibrosis biomarkers. Materials and Methods: This study was approved by the ethical committee, and written informed parental consent was obtained. Two hundred and sixteen patients were prospectively enrolled between January 2012 and October 2018. The 2D SWE measurements of 69 patients have been previously reported. 2D SWE measurements, serum fibrosis biomarkers, including fibrotic markers and biochemical test results, and liver histology parameters were obtained. 2D SWE values, serum biomarkers including, aspartate aminotransferase to platelet ratio index (APRi), and other serum fibrotic markers were correlated with the stages of liver fibrosis by METAVIR. Receiver operating characteristic (ROC) curves and area under the ROC (AUROC) curve analyses were used. Results: The correlation coefficient of 2D SWE value in correlation with the stages of liver fibrosis was 0.789 (p < 0.001). The cut-off values of 2D SWE were calculated as 9.1 kPa for F1, 11.6 kPa for F2, 13.0 kPa for F3, and 15.7 kPa for F4. The AUROCs of 2D SWE in the determination of the stages of liver fibrosis ranged from 0.869 to 0.941. The sensitivity and negative predictive value of 2D SWE in the diagnosis of ≥ F3 was 93.4% and 96.0%, respectively. The diagnostic performance of 2D SWE was superior to that of APRi and other serum fibrotic markers in predicting severe fibrosis and cirrhosis (all p < 0.005) and other serum biomarkers. Multivariate analysis showed that the 2D SWE value was the only statistically significant parameter for predicting liver fibrosis. Conclusion: 2D SWE is a more effective non-invasive tool for predicting the stage of liver fibrosis in patients with suspected BA, compared with serum fibrosis biomarkers.

• Bulletin of the Korean Chemical Society
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• 제34권9호
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• pp.2725-2730
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• 2013

Single C-reactive protein (CRP) molecules, which are non-specific acute phase markers and products of the innate immune system, were quantitatively detected on a gold-nanopatterned biochip using evanescent field-enhanced fluorescence imaging. The $4{\times}5$ gold-nanopatterned biochip (spot diameter of 500 nm) was fabricated by electron beam nanolithography. Unlabeled CRP molecules in human serum were identified with single-molecule sandwich immunoassay by detecting secondary fluorescence generated by total internal reflection fluorescence (TIRF) microscopy. With decreased standard CRP concentrations, relative fluorescence intensities reduced in the range of 33.3 zM-800 pM. To enhance fluorescence intensities in TIRF images, the distance between biochip surface and CRP molecules was optimally adjusted by considering the quenching effect of gold and the evanescent field intensity. As a result, TIRF only detected one single-CRP molecule on the biochip the first time.

• Clinical and Experimental Pediatrics
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• 제58권2호
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• pp.73-76
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• 2015

Isolated sphenoid sinusitis is a rare disease in children, and its symptoms are often nonspecific and confusing. Rarely, severe headache can be the first or only symptom of isolated sphenoid sinusitis. New daily persistent headache (NDPH) is a form of chronic daily headache that may have features of both migraines and tension-type headaches. NDPH is difficult to diagnose and requires a multifaceted approach. Here, we report on a 10-year-old boy and an 11-year-old girl who both presented with typical NDPH symptoms. These patients had no nasal symptoms or signs of infection. Neither nonsteroidal anti-inflammatory drugs nor topiramate had any effect on the headaches. Their neurological and ophthalmological examinations were normal. The results of routine blood work, including thyroid function tests, inflammatory markers, complete blood count, tests for viral infection, and a metabolic panel, were normal. A brain magnetic resonance imaging scan showed isolated sphenoid sinusitis. Both patients' symptoms resolved completely after approximately 1 month of oral antibiotics for sinusitis.

• 대한한방내과학회지
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• 제33권3호
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• pp.338-346
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• 2012

Objectives : To observe the therapeutic effects of Oriental herbal prescriptions on an advanced metastatic gallbladder cancer patient. Methods : Hang-Am-Plus (HAP), Gun-Chil-Gye-Bok-Jung (GGJ) and Se-Gan-San (SGS) were prescribed three times a day. To observe the therapeutic effects of oriental medical prescriptions, computed tomography (CT) and magnetic resonance imaging (MRI) images, tumor markers and laboratory tests were carried out regularly. Results : The levels of AST, ALT, ALP, ${\gamma}$-GTP, TB, DB, CA19-9, and CEA decreased significantly from November 29th 2011 to March 14th 2012. There was no interval change on CT images taken between November 15th 2011 and January 3rd 2012. Conclusions : In this case, it could be concluded that Oriental medicinal treatment might be considered as a palliative alternative therapy for the advanced metastatic gallbladder patient.

• Advances in biomechanics and applications
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• 제1권4호
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• pp.269-277
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• 2014

In skin-marker based motion analysis, knee translation measurement is highly dependent on a pre-selected reference point (functional center) on each segment determined by the location of anatomical landmarks. However, the placement of skin markers on palpable anatomical landmarks (i.e., femoral epicondyles) has limited reproducibility. Thus, it produces large variances in knee translation measurement among different subjects, as well as across studies. In order improve the repeatability of knee translation measurement, in this study an optimization method was introduced, by which the femoral functional center was numerically determined. At that point the knee anteroposterior translation during the stance phase of walking was minimized. This new method was tested on 30 healthy subjects during walking in gait lab with motion capture system. Using this new method, the impact of skin marker position (at anatomical landmarks) on the knee translation measurement has been minimized. In addition, the ranges of anteroposterior knee translations during stance phase were significantly (p<0.001) smaller than those measured by conventional method which relies on a pre-selected functional center ($11.1{\pm}3.5mm$ vs. $19.9{\pm}5.5mm$). The results of anteroposterior translation using this new method were very close to a previously reported knee translation (12.4 mm) from dual fluoroscopic imaging technique. Moreover, this new method increased the reproducibility of knee translation measurement by 50%.

• Clinical and Experimental Pediatrics
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• 제62권2호
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• pp.68-74
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• 2019

Purpose: To investigate the prevalence of occult spinal dysraphism (OSD) and subsequent neurosurgery in pediatric patients with isolated or combined dorsal midline cutaneous stigmata with or without other congenital malformations. Methods: We carried out a retrospective review of patients who underwent sonography or magnetic resonance imaging (MRI) for OSD because of suspicion of dorsal midline cutaneous stigmata (presumed to be a marker for OSD) between January 2012 and June 2017. Information about patient characteristics, physical examination findings, spinal ultrasound and MRI results, neurosurgical notes, and accompanying congenital anomalies was collected. Results: Totally 250 patients (249 ultrasound and one MRI screening) were enrolled for analysis. Eleven patients underwent secondary MRI examinations. The prevalence of OSD confirmed by an MRI was 2.4% (6 patients including one MRI screening). Five patients (2%) had tethered cord and underwent prophylactic neurosurgery, 3 of whom had a sacrococcygeal dimple and a fibrofatty mass. Prevalence of tethered cord increased as markers associated with a sacrococcygeal dimple increased (0.5% of the isolated marker group, 8.1% of the 2-marker group, and 50% of the 3-marker group). Incidence of OSD with surgical detethering in 17 other congenital anomaly patients was 11.8%, which was higher than the 1.3% in 233 patients without other congenital anomalies. Conclusion: Our results suggest that the presence of dorsal midline cutaneous stigmata, particularly fibrofatty masses, along with a sacrococcygeal dimple is associated with OSD or cord tethering requiring surgery. OSD should be suspected in patients with concurrent occurrence of other congenital anomalies.

• Journal of Korean Neurosurgical Society
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• 제65권3호
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• pp.370-379
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• 2022

Abusive head trauma (AHT) is the most severe form of physical abuse in children. Such injury involves traumatic damage to the head and/or spine of infants and young children. The term AHT was introduced to include a wider range of injury mechanisms, such as intentional direct blow, throw, and even penetrating trauma by perpetuator(s). Currently, it is recommended to replace the former term, shaken baby syndrome, which implicates shaking as the only mechanism, with AHT to include diverse clinical and radiological manifestations. The consequences of AHT cause devastating medical, social and financial burdens on families, communities, and victims. The potential harm of AHT to the developing brain and spinal cord of the victims is tremendous. Many studies have reported that the adverse effects of AHT are various and serious, such as blindness, mental retardation, physical limitation of daily activities and even psychological problems. Therefore, appropriate vigilance for the early recognition and diagnosis of AHT is highly recommended to stop and prevent further injuries. The aim of this review is to summarize the relevant evidence concerning the early recognition and diagnosis of AHT. To recognize this severe type of child abuse early, all health care providers maintain a high index of suspicion and vigilance. Such suspicion can be initiated with careful and thorough history taking and physical examinations. Previously developed clinical prediction rules can be helpful for decision-making regarding starting an investigation when considering meaningful findings. Even the combination of biochemical markers may be useful to predict AHT. For a more confirmative evaluation, neuroradiological imaging is required to find AHT-specific findings. Moreover, timely consultation with ophthalmologists is needed to find a very specific finding, retinal hemorrhage.

• 대한한방내과학회지
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• 제44권4호
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• pp.765-773
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• 2023

Objective: This long-term case report details a case of pancreatic cancer with lung metastasis suppressed by integrative cancer medicine (IMT). Methods: A 64-year-old woman diagnosed with pancreatic cancer visited a Korean medicine hospital complaining about the side effects of chemotherapy for lung metastasis. She received IMT involving Korean traditional medicine and Western immunotherapy from May 2017 to June 2023. Tumor dimensions were assessed through computed tomography (CT) and positron-emission tomography/CT scans, while tumor markers and safety were monitored by laboratory tests. Results: IMT suppressed the progression of cancer, as observed by imaging and laboratory tests. The patient achieved 5-year survival, even after discontinuing chemotherapy. Conclusion: This case presents a potential therapeutic alternative for patients who are ineligible for chemotherapy or surgical interventions.

• Journal of Korean Neurosurgical Society
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• 제57권4호
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• pp.235-241
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• 2015

Objective : Magnetic resonance imaging (MRI) of chronic subdural hematoma (CSDH) detects various patterns, which can be attributed to many factors. The purpose of this study was to measure the level of interleukin-6 (IL-6), interleukin-8 (IL-8), and highly specific protein [beta-trace protein (${\beta}TP$)] for cerebrospinal fluid (CSF) in CSDHs, and correlate the levels of these markers with the MRI findings. Methods : Thirty one patients, treated surgically for CSDH, were divided on the basis of MRI findings into hyperintense and non-hyperintense groups. The concentrations of IL-6, IL-8, and ${\beta}TP$ in the subdural fluid and serum were measured. The ${\beta}TP$ was considered to indicate an admixture of CSF to the subdural fluid if ${\beta}TP$ in the subdural fluid $({\beta}TP_{SF})/{\beta}TP$ in the serum $({\beta}TP_{SER})>2$. Results : The mean concentrations of IL-6 and IL-8 of the hyperintense group (n=17) of T1-WI MRI were $3975.1{\pm}1040.8pg/mL$ and $6873.2{\pm}6365.4pg/mL$, whereas them of the non-hyperintense group (n=14) were $2173.5{\pm}1042.1pg/mL$ and $2851.2{\pm}6267.5pg/mL$ (p<0.001 and p=0.004). The mean concentrations of ${\beta}TP_{SF}$ and the ratio of ${\beta}TP_{SF}/{\beta}TP_{SER}$ of the hyperintense group (n=13) of T2-WI MRI were $7.3{\pm}2.9mg/L$ and $12.6{\pm}5.4$, whereas them of the non-hyperintense group (n=18) were $4.3{\pm}2.3mg/L$ and $7.5{\pm}3.9$ (p=0.011 and p=0.011). Conclusion : The hyperintense group on T1-WI MRI of CSDHs exhibited higher concentrations of IL-6 and IL-8 than non-hyperintense group. And, the hyperintese group on T2-WI MRI exhibited higher concentrations of ${\beta}TP_{SF}$ and the ratio of ${\beta}TP_{SF}/{\beta}TP_{SER}$ than non-hyperintense group. These findings appear to be associated with rebleeding and CSF admixture in the CSDHs.

• Nuclear Medicine and Molecular Imaging
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• 제42권3호
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• pp.209-217
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• 2008

목적: 현재까지 난소암의 재발을 평가하는데 해부학적 영상 검사와 tumor marker들이 주를 이루고 있다. 저자들은 재발 난소암의 진단에서 CT, 그리고 tumor marker CA 125와 비교하여 $^{18}F$-FDG PET/CT의 유용성을 알아보고자 하였다. 대상 및 방법: 조직학적으로 확진 된 난소암 환자 중 재발 평가를 위하여 PET/CT를 시행하고 한달 이내로 pelvis CT 검사를 시행한 환자 73명을 대상으로 하였다. Tumor marker CA 125은 모두에서 측정하였다. PET/CT 영상에서 의심되는 부위의 maximum SUV를 기록하였다. 26명은 수술 또는 생검을 통해 확진되었고, 나머지 47명은 임상 소견과 추적 영상 검사를 통하여 진단하였다. 결과: 난소암의 재발을 진단하는데 PET/CT의 예민도는 93%였고, 특이도는 88%였다. Enhanced CT의 예민도는 83%, 특이도는 88%였다. Tumor marker CA 125의 예민도와 특이도는 각각 50%와 95%였다. 결론: 재발 난소암의 진단에서 FDG PET/CT의 예민도가 CT보다 좋았으나 통계학적으로 의미 있는 차이는 아니였고, 특이도는 PET/CT 와 CT가 비슷하였다. Tumor marker CA 125보다는 PET/CT의 예민도가 월등히 높았다. 하지만 재발 환자에서 위의 세 검사의 일치도는 43%로 낮은 편으로, 난소암 환자의 경과 관찰 중, 특히 PET/CT 영상에서, 양성 소견이 보이면 재발의 가능성이 높다.