• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.50 no.2
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• pp.86-93
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• 2024

Objectives: Orthognathic surgery is a surgical procedure performed by intraoral approach with established and safe techniques; however, excessive blood loss has been reported in rare cases. In response, investigative efforts to identify methods to reduce the amount of blood loss have been made. Among such methods, the administration of tranexamic acid was reported to reduce the amount of intraoperative blood loss. However, few studies to date have reported the effect of tranexamic acid in orthognathic surgery under hypotensive anesthesia. The present study aimed to investigate the effect of the administration of tranexamic acid on intraoperative blood loss in patients undergoing bimaxillary (maxillary and mandibular) orthognathic surgery under hypotensive anesthesia. Patients and Methods: A total of 156 patients (mean age, 27.0±10.8 years) who underwent bimaxillary orthognathic surgery under hypotensive anesthesia performed by the same surgeon between June 2013 and February 2022 were included in this study. The following data were collected from the medical records of each patient: background factors (age, sex, and body mass index), use of tranexamic acid, surgical procedures, previous medical history, duration of surgery, American Society of Anesthesiology physical status findings before surgery, intraoperative blood loss as a primary outcome, in-out balance, and blood test results. Descriptive statistics were calculated for statistical analysis, and a t-test and the chi-squared test were used for between-group comparisons. Group comparisons were performed after 1:1 propensity score matching to adjust for confounding factors. Statistical significance was set at P<0.05. Results: Comparison between the groups based on the use of tranexamic acid revealed a significant difference in operation time. Propensity score matching analysis revealed that intraoperative blood loss was significantly lower in the tranexamic acid group. Conclusion: The administration of tranexamic acid was effective in reducing intraoperative blood loss in patients undergoing bimaxillary orthognathic surgery under hypotensive anesthesia.

• Journal of Acupuncture Research
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• v.41
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• pp.149-159
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• 2024

Background: Police officers are an occupational group with a high risk of developing musculoskeletal, cardiovascular, and mental diseases because of the nature of their work. This study aimed to gain an understanding of job-related health risks by comparing overall health awareness, presence of physical and mental disabilities and their causes, medical use patterns, and quality of life of the general public through a survey. Methods: In this comparative study, police officer data were collected through a survey conducted from October 1, 2022, to November 15, 2022, and general public data from the 8th National Health and Nutrition Examination Survey of Korea were used for comparison. Results: Police officers' health perception of physical or mental disabilities was significantly more negative than that of the general public because of their work characteristics, patterns, and functions. In addition, police officers with disabilities had severe work and daily living limitations, and their awareness of their overall quality of life was low enough to warrant alarm. Despite their high rates of seeking treatment in medical institutions, continuous medical use was limited. Conclusion: More research on major diseases to which police officers are at risk of exposure is necessary to analyze risk factors and accumulate related data to systematize health management. In addition, Korean medicine treatment techniques with excellent disease prevention are recommended for the health management of police officers.

• Investigative Magnetic Resonance Imaging
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• v.13 no.2
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• pp.161-170
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• 2009

Purpose : A parallel imaging method provides us to improve temporal resolution to obtain three-dimensional (3D) MR images. The objective of this study was to optimize three 3D MRI techniques by adjusting 2D SESNE factors of the parallel imaging method in phantom and human brain. Materials and Methods : With a 3 Tesla MRI system and an 8-channel phase-array sensitivity-encoding (SENSE) coil, three 3D MRI techniques of 3D T1-weighted imaging (3D T1WI), 3D T2-weighted imaging (3D T2WI) and 3D fluid attenuated inversion recovery (3D FLAIR) imaging were optimized with adjusting SESNE factors in a water phantom and three human brains. The 2D SENSE factor was applied on the phase-encoding and the slice-encoding directions. Signal-to-noise ratio(SNR), percent signal reduction rate(%R), and contrast-to-noise ratio(CNR) were calculated by using signal intensities obtained in specific regions-of-interest (ROI). Results : In the phantom study, SENSE factor = 3 was provided in 0.2% reduction of signals against without using SENSE with imaging within 5 minutes for 3D T1WI. SENSE factor = 2 was provided in 0.98% signal reduction against without using SENSE with imaging within 5 minutes for 3D T2WI. SENSE factor = 4 was provided in 0.2% signal reduction against without using SENSE with imaging around 6 minutes for 3D FLAIR. In the human brain study, SNR and CNR were higher with SENSE factors = 3 than 4 for all three imaging techniques. Conclusion : This study was performed to optimize 2D SENSE factors in the three 3D MRI techniques that can be scanned in clinical time limitations with minimizing SNR reductions. Without compromising SNR and CNR, the optimum 2D SENSE factors were 3 and 4, yielding the scan time of about 5 to 6 minutes. Further studies are necessary to optimize 3D MRI techniques in other areas in human body.

• Investigative Magnetic Resonance Imaging
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• v.6 no.1
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• pp.41-46
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• 2002

The Fourier transform arteriography (FTA) exploits the periodic variation of arterial flow velociety of arterial flow velocity in stnchronized with cardiac cycles. This technique is intrinsically unique compared to other modern techniques. This technique separates the arteries from the veins using the pulsatile arterial flow without using the presaturation RF pulses. Therefore, it has less RF deposition and is free from the dark band artifacts that can arise from retrograde flow and curved arteries. Furthermore, it is free from the artifacts induced by eddy currents. However, there are some drawbacks such as a single projection view and the saturation of arteries at the end of an imaging slab. These drawbacks are circumvented by applying recently developed techniques. The fast gradient switching capability of modern MRI systems enabled us to incorporate dual projection views into the conventional FTA sequence without increasing the repetition time. In addition, signals from the distal arteries were enhanced by use of a ramped RF pulse and therefore the distal arteries were less saturated. By use of the FTA sequence with dual projection views and the ramped RF pulse, we acquired the sagittal and coronal projection views of femoral arteriograms simultaneously with more enhanced signals of distal arteries than the conventional FTA.

• Investigative Magnetic Resonance Imaging
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• v.7 no.1
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• pp.12-21
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• 2003

Purpose : In order to overcome limitations in the existing conventional spectrometer, a new spectrometer with advanced functionalities is designed and implemented. Materials and Methods : We designed a spectrometer using the TMS320C6701 DSP capable of 1 giga floating point operations per second (GFLOPS). The spectrometer can generate continuously varying complicate gradient waveforms by real-time calculation, and select image plane interactively. The designed spectrometer is composed of two parts: one is DSP-based digital control part, and the other is analog part generating gradient and RF waveforms, and performing demodulation of the received RF signal. Each recover board can measure 4 channel FID signals simultaneously for parallel imaging, and provides fast reconstruction using the high speed DSP. Results : The developed spectrometer was installed on a 1.5 Tesla whole body MRI system, and performance was tested by various methods. The accurate phase control required in digital modulation and demodulation was tested, and multi-channel acquisition was examined with phase-array coil imaging. Superior image quality is obtained by the developed spectrometer compared to existing commercial spectrometer especially in the fast spin echo images. Conclusion : Interactive control of the selection planes and real-time generation of gradient waveforms are important functions required for advanced imaging such as spiral scan cardiac imaging. Multi-channel acquisition is also highly demanding for parallel imaging. In this paper a spectrometer having such functionalities is designed and developed using the TMS320C6701 DSP having 1 GFLOPS computational power. Accurate phase control was achieved by the digital modulation and demodulation techniques. Superior image qualities are obtained by the developed spectrometer for various imaging techniques including FSE, GE, and angiography compared to those obtained by the existing commercial spectrometer.

• Investigative Magnetic Resonance Imaging
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• v.13 no.1
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• pp.22-30
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• 2009

Purpose : Patient motion during magnetic resonance (MR) imaging is one of the major problems due to its long scan time. Entropy based post-processing motion correction techniques have been shown to correct motion artifact effectively. One of main limitations of these techniques however is its long processing time. In this study, we propose several methods to reduce this long processing time effectively. Materials and Methods : To reduce the long processing time, we used the separability property of two dimensional Fourier transform (2-D FT). Also, a computationally light metric (sum of all image pixel intensity) was used instead of the entropy criterion. Finally, partial Fourier reconstruction, in particular the projection onto convex set (POCS) method, was combined thereby reducing the size of the data which should be processed and corrected. Results : Time savings of each proposed method are presented with different data size of brain images. In vivo data were processed using the proposed method and showed similar image quality. The total processing time was reduced to 15% in two dimensional images and 30% in the three dimensional images. Conclusion : The proposed methods can be useful in reducing image motion artifacts when only post-processing motion correction algorithms are available. The proposed methods can also be combined with parallel imaging technique to further reduce the processing times.

• Investigative Magnetic Resonance Imaging
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• v.22 no.2
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• pp.102-109
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• 2018

Purpose: The purpose of this study is to compare the performance of the T1 3D subtraction technique and the conventional 2D dynamic contrast enhancement (DCE) technique in diagnosing Cushing's disease. Materials and Methods: Twelve patients with clinically and biochemically proven Cushing's disease were included in the study. In addition, 23 patients with a Rathke's cleft cyst (RCC) diagnosed on an MRI with normal pituitary hormone levels were included as a control, to prevent non-blinded positive results. Postcontrast T1 3D fast spin echo (FSE) images were acquired after DCE images in 3T MRI and image subtraction of pre- and postcontrast T1 3D FSE images were performed. Inter-observer agreement, interpretation time, multiobserver receiver operating characteristic (ROC), and net benefit analyses were performed to compare 2D DCE and T1 3D subtraction techniques. Results: Inter-observer agreement for a visual scale of contrast enhancement was poor in DCE (${\kappa}=0.57$) and good in T1 3D subtraction images (${\kappa}=0.75$). The time taken for determining contrast-enhancement in pituitary lesions was significantly shorter in the T1 3D subtraction images compared to the DCE sequence (P < 0.05). ROC values demonstrated increased reader confidence range with T1 3D subtraction images (95% confidence interval [CI]: 0.94-1.00) compared with DCE (95% CI: 0.70-0.92) (P < 0.01). The net benefit effect of T1 3D subtraction images over DCE was 0.34 (95% CI: 0.12-0.56). For Cushing's disease, both reviewers misclassified one case as a nonenhancing lesion on the DCE images, while no cases were misclassified on T1 3D subtraction images. Conclusion: The T1 3D subtraction technique shows superior performance for determining the presence of enhancement on pituitary lesions compared with conventional DCE techniques, which may aid in diagnosing Cushing's disease.

• Investigative Magnetic Resonance Imaging
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• v.1 no.1
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• pp.109-113
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• 1997

Purpose: To evaluate the differences of functional imaging patterns between conventional spoiled gradient echo (SPGR) and echo planar imaging (EPI) methods in cerebral motor cortex activation. Materials and Methods: Functional MR imaging of cerebral motor cortex activation was examined on a 1.5T MR unit with SPGR (TRfrE/flip angle=50ms/4Oms/$30^{\circ}$, FOV=300mm, matrix $size=256{\times}256$, slice thickness=5mm) and an interleaved single shot gradient echo EPI (TRfrE/flip angle = 3000ms/40ms/$90^{\circ}$, FOV=300mm, matrix $size=128{\times}128$, slice thickness=5mm) techniques in five male healthy volunteers. A total of 160 images in one slice and 960 images in 6 slices were obtained with SPGR and EPI, respectively. A right finger movement was accomplished with a paradigm of an 8 activation/ 8 rest periods. The cross-correlation was used for a statistical mapping algorithm. We evaluated any differences of the time series and the signal intensity changes between the rest and activation periods obtained with two techniques. Also, the locations and areas of the activation sites were compared between two techniques. Results: The activation sites in the motor cortex were accurately localized with both methods. In the signal intensity changes between the rest and activation periods at the activation regions, no significant differences were found between EPI and SPGR. Signal to noise ratio (SNR) of the time series data was higher in EPI than in SPGR by two folds. Also, larger pixels were distributed over small p-values at the activation sites in EPI. Conclusions: Good quality functional MR imaging of the cerebral motor cortex activation could be obtained with both SPGR and EPI. However, EPI is preferable because it provides more precise information on hemodynamics related to neural activities than SPGR due to high sensitivity.

• Journal of forensic and investigative science
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• v.1 no.2
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• pp.5-19
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• 2006

Data mining is an information extraction activity to discover hidden facts contained in databases. Using a combination of machine learning, statistical analysis, modeling techniques and database technology, data mining finds patterns and subtle relationships in data and infers rules that allow the prediction of future results. Typical applications include market segmentation, customer profiling, fraud detection, evaluation of retail promotions, and credit risk analysis. Law enforcement agencies deal with mass data to investigate the crime and its amount is increasing due to the development of processing the data by using computer. Now new challenge to discover knowledge in that data is confronted to us. It can be applied in criminal investigation to find offenders by analysis of complex and relational data structures and free texts using their criminal records or statement texts. This study was aimed to evaluate possibile application of data mining and its limitation in practical criminal investigation. Clustering of the criminal cases will be possible in habitual crimes such as fraud and burglary when using data mining to identify the crime pattern. Neural network modelling, one of tools in data mining, can be applied to differentiating suspect's photograph or handwriting with that of convict or criminal profiling. A case study of in practical insurance fraud showed that data mining was useful in organized crimes such as gang, terrorism and money laundering. But the products of data mining in criminal investigation should be cautious for evaluating because data mining just offer a clue instead of conclusion. The legal regulation is needed to control the abuse of law enforcement agencies and to protect personal privacy or human rights.

• Journal of forensic and investigative science
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• v.2 no.1
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• pp.32-51
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• 2007

Serial violent crimes have occurred more frequently. Additional attention is paid to relevant areas in which discussions has also increased. This study analyzed Young-cheol Yoo, serial killer case. Two of Yoo's crimes were studied for modus operandi. The cases selected were the premeditated break-in homicide of upper-class elderly people and the impulsive homicide of the Hwanghak-Dong street vendor. Crime motives, targets, times, places, means and methods were analyzed. Profiling techniques in Young-cheol Yoo cases were evaluated and the problems discovered during investigation were discussed. The followings are the findings of the analysis of the serial killer Yoo cases. Yoo exhibited a hatred toward the rich, the elderly, and women as well as a fear of diseases and death. Yoo's crime targets were the elderly residing in wealthy houses, street vendors and prostitutes. The numbers of victims were: 3 men and 5 women victims in 4 homicide cases involving the elderly residents in wealthy houses; one man in 1 street vendor homicide case 11 women in 11 prostitute homicide cases, so total 20 persons were murdered in 16 cases. The time of the crimes were between 10 am and noon in the homicide cases of the elderly and very late at night or early in the morning in the prostitute homicide cases. Means and methods facilitated include the use of a knife as a threat and a hammer made by Yoo to strike the head and face of victims. In the homicide cases involving the elderly, he attempted to disguise the crime scene as a burglary or committed arson to destroy the evidence; in the prostitute homicide cases, bodies were mutilated and buried in secret. 1) Generally each serial killer case has different characteristics, motives, and purposes; while some serial killer cases involve similar methods, others use different methods. Unlike other crimes, serial killers' characteristics and tastes are very different, so it is difficult to explain serial killings based on a specific model. It is important to accurately capture modus operandi of each serial killing and for detectives to familiarize themselves with them. The process of tracing and use of imagination which follows a serial killer's psychology and thought must be used to find out what kind of thoughts pushed the killer to commit the crime. In order to investigate and research difficult subjects such as serial killing, various methods, skills, and relevant knowledge should be studied, and institutional endeavors should go hand in hand with individual efforts.