• Progress in Medical Physics
• /
• v.29 no.4
• /
• pp.150-156
• /
• 2018

This study aims to develop an improved Feldkamp-Davis-Kress (FDK) reconstruction algorithm using anisotropic total variation (ATV) minimization to enhance the image quality of low-dose cone-beam computed tomography (CBCT). The algorithm first applies a filter that integrates the Shepp-Logan filter into a cosine window function on all projections for impulse noise removal. A total variation objective function with anisotropic penalty is then minimized to enhance the difference between the real structure and noise using the steepest gradient descent optimization with adaptive step sizes. The preserving parameter to adjust the separation between the noise-free and noisy areas is determined by calculating the cumulative distribution function of the gradient magnitude of the filtered image obtained by the application of the filtering operation on each projection. With these minimized ATV projections, voxel-driven backprojection is finally performed to generate the reconstructed images. The performance of the proposed algorithm was evaluated with the catphan503 phantom dataset acquired with the use of a low-dose protocol. Qualitative and quantitative analyses showed that the proposed ATV minimization provides enhanced CBCT reconstruction images compared with those generated by the conventional FDK algorithm, with a higher contrast-to-noise ratio (CNR), lower root-mean-square-error, and higher correlation. The proposed algorithm not only leads to a potential imaging dose reduction in repeated CBCT scans via lower mA levels, but also elicits high CNR values by removing noisy corrupted areas and by avoiding the heavy penalization of striking features.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.19 no.4
• /
• pp.217-226
• /
• 2019

Background: We aimed to assess the dose needed to achieve the propofol effect-site concentration using target-controlled infusion in intellectually disabled patients and to detail the most effective method for achieving a safe level of consciousness without hemodynamic changes as well as detail any resulting adverse effects. Methods: We performed a retrospective review of sedation service records of 138 intellectually disabled patients (51, mental retardation; 36, autism; 30, brain lesion, 12 genetic diseases, 9 dementia) aged over 15 years and weighing over 30 kg. These patients had received propofol via target-controlled infusion in the special care dental clinic of Seoul National University Dental Hospital from May 2008 to September 2018 for restorative treatment (112), minor surgery (13), prosthodontics (7), periodontics treatment (5), and implant (1). Results: For all groups, the duration of dental treatments was $43{\pm}18$ minutes, total sedation time was $73{\pm}23$ minutes, and total BIS values was $57{\pm}12$. The propofol maintenance dosage values for each group were: mental retardation, $3{\pm}0.5(2-4){\mu}g/ml$; autism, $3.1{\pm}0.7(2-5){\mu}g/ml;$; brain lesion, $2.8{\pm}0.7(1.5-5){\mu}g/ml;$; genetic disease, $2.9{\pm}0.9(1-4){\mu}g/ml;$ and dementia $2.3{\pm}0.7(1-3.4){\mu}g/ml;$. Conclusions: The dementia group needed a lower dosage to reach a safe, effective propofol effect-site concentration than the other groups. Since there were no complications, deep sedation is a great alternative to general anesthesia for dental treatment of intellectually disabled patients.

• Progress in Medical Physics
• /
• v.30 no.1
• /
• pp.22-31
• /
• 2019

Purpose: To develop a new diffusion-based functional MRI (fMRI) sequence to generate apparent diffusion coefficient (ADC) maps in single excitation and evaluate the contribution of b0 signal on neuronal changes. Materials and Methods: A diffusion-based fMRI sequence was designed with single measurement that can acquire images of three directions at a time, obtaining $b=0s/mm^2$ during the first baseline condition (b0_b), followed by 107 diffusion-weighted imaging (DWI) with $b=600s/mm^2$ during the baseline and visual stimulation conditions, and another $b=0s/mm^2$ during the last activation condition (b0_a). ADC was mapped in three different ways: 1) using b0_b (ADC_b) for all time points, 2) using b0_a (ADC_a) for all time points, and 3) using b0_b and b0_a (ADC_ba) for baseline and stimulation scans, respectively. The fMRI studies were conducted on the brains of 16 young healthy volunteers using visual stimulations in a 3T MRI system. In addition, the blood oxygen level dependent (BOLD) fMRI was also acquired to compare it with diffusion-based fMRI. A sample t-test was used to investigate the voxel-wise average between the subjects. Results: The BOLD data consisted of only activated voxels. However, ADC_ba data was observed in both deactivated and activated voxels. There were no statistically significant activated or deactivated voxels for DWI, ADC_b, and ADC_a. Conclusions: With the new sequence, neuronal activations can be mapped with visual stimulation as compared to the baseline condition in several areas in the brain. We showed that ADC should be mapped using both DWI and b0 images acquired with the same conditions.

• Journal of Periodontal and Implant Science
• /
• v.48 no.6
• /
• pp.337-346
• /
• 2018

Purpose: Peripheral artery disease (PAD) is a form of arteriosclerosis that occurs in the extremities and involves ischemia. Previous studies have reported that patients with periodontitis are at high risk for PAD. However, the relationship between these 2 diseases has not yet been fully elucidated. In this cross-sectional study, we investigated this relationship by comparing patients with PAD to those with arrhythmia (ARR) as a control group. Methods: A large-scale survey was conducted of patients with cardiovascular disease who visited Tokyo Medical and Dental University Hospital. We investigated their oral condition and dental clinical measurements, including probing pocket depth, bleeding on probing, clinical attachment level, and number of missing teeth; we also collected salivary and subgingival plaque samples and peripheral blood samples. All patients with PAD were extracted from the whole population (n=25), and a matching number of patients with ARR were extracted (n=25). Simultaneously, ARR patients were matched to PAD patients in terms of age, gender, prevalence of diabetes, hypertension, dyslipidemia, obesity, and the smoking rate (n=25 in both groups). Real-time polymerase chain reaction was performed to measure the bacterial counts, while the enzyme-linked immunosorbent assay method was used to measure anti-bacterial antibody titers and proinflammatory cytokine levels in serum. Results: PAD patients had more missing teeth ($18.4{\pm}2.0$) and higher serum levels of C-reactive protein ($1.57{\pm}0.85mg/dL$) and tumor necrosis factor-alpha ($70.3{\pm}5.7pg/mL$) than ARR patients ($12.0{\pm}1.7$, $0.38{\pm}0.21mg/dL$, and $39.3{\pm}4.5pg/mL$, respectively). Meanwhile, no statistically significant differences were found in other dental clinical measurements, bacterial antibody titers, or bacterial counts between the 2 groups. Conclusions: Our findings suggested that PAD patients had poorer oral and periodontal state with enhanced systemic inflammation.

• Journal of Microbiology and Biotechnology
• /
• v.29 no.3
• /
• pp.410-418
• /
• 2019

To investigate a novel ${\beta}$-glucosidase from Bifidobacterium breve ATCC 15700 (BbBgl) to produce compound K (CK) via ginsenoside $F_2$ by highly selective and efficient hydrolysis of the C-3 glycoside from ginsenoside Rd, the BbBgl gene was cloned and expressed in E. coli BL21. The recombinant BbBgl was purified by Ni-NTA magnetic beads to obtain an enzyme with specific activity of 37 U/mg protein using pNP-Glc as substrate. The enzyme activity was optimized at pH 5.0, $35^{\circ}C$, 2 or 6 U/ml, and its activity was enhanced by $Mn^{2+}$ significantly. Under the optimal conditions, the half-life of the BbBgl is 180 h, much longer than the characterized ${\beta}$-glycosidases, and the $K_m$ and $V_{max}$ values are 2.7 mM and $39.8{\mu}mol/mg/min$ for ginsenoside Rd. Moreover, the enzyme exhibits strong tolerance against high substrate concentration (up to 40 g/l ginsenoside Rd) with a molar biotransformation rate of 96% within 12 h. The good enzymatic properties and gram-scale conversion capacity of BbBgl provide an attractive method for large-scale production of rare ginsenoside CK using a single enzyme or a combination of enzymes.

• Child Health Nursing Research
• /
• v.25 no.2
• /
• pp.184-195
• /
• 2019

Purpose: This study aimed to characterize the relationship between parental stress and nurses' communication as perceived by parents of high-risk newborns in a neonatal intensive care unit (NICU). Methods: The participants were 54 parents of high-risk newborns in a NICU. Data were collected from January to March 2018. Parental stress and parents' perceptions of nurses' communication ability and styles were measured using a questionnaire. Results: The average scores for parental stress and nurses' communication ability were 3.39 and 4.38 respectively, on a 5-point scale. Parents most commonly reported that nurses showed a friendly communication style, followed by informative and authoritative styles. Mothers and fathers reported significantly different levels of parental stress. Parental stress showed a negative correlation with nurses' perceived verbal communication ability. Higher scores for nurses' verbal communication ability and for friendly and informative communication styles were associated with lower parental stress induced by the environment, the baby's appearance and behaviors, and treatments in the NICU. Conclusion: The findings of this study suggest that nurses need to offer proper information for parents and to support parents by encouraging them to express their emotions of stress and by providing parents with therapeutic communication and opportunities to participate in care.

• Journal of Periodontal and Implant Science
• /
• v.48 no.6
• /
• pp.395-404
• /
• 2018

Purpose: The purpose of this study was to propose a technique for periodontal biotype modification through thickening of the entire facial aspect using a volume-stable collagen matrix and autogenous subepithelial connective tissue graft (CTG) for the treatment of gingival recession. Methods: Four systemically healthy patients showing Miller class I or class II gingival recession in the mandibular incisor area were included in this study. Full-mouth scaling and root planing procedures were performed at least 4 weeks prior to periodontal plastic surgery. A split-thickness flap with a horizontal intrasulcular incision and 2 vertical incisions was used in cases 1-3, and the modified tunnel technique was used in case 4 for coronal advancement of the mucogingival complex. After the exposed root surfaces were debrided thoroughly, double-layered volume-stable collagen matrix was placed on the apical part of the recession and a subepithelial CTG harvested from the palatal area was placed on the coronal part. The amount of root coverage at 3 months postoperatively was evaluated in cases 1-3, and facio-lingual volumetric changes were analyzed in cases 1 and 2. Results: Healing was uneventful in all 4 cases and complete root coverage was shown in cases 1-3. In case 4, reduction of gingival recession was observed at 3 months after surgery. In cases 1 and 2, a comparison of stereolithographic files from the preoperative and postoperative time points demonstrated that the entire facio-lingual volume had increased. Conclusions: The surgical technique suggested herein, using a volume-stable collagen matrix and autogenous subepithelial CTG, may be an effective method for periodontal biotype modification through thickening of the entire facial aspect for the treatment of gingival recession.

• Food Science of Animal Resources
• /
• v.39 no.2
• /
• pp.222-228
• /
• 2019

This research was motivated by our encounter with the situation where an optimization was done based on statistically non-significant models having poor fits. Such a situation took place in a research to optimize manufacturing conditions for improving storage stability of coffee-supplemented milk beverage by using response surface methodology, where two responses are $Y_1$=particle size and $Y_2$=zeta-potential, two factors are $F_1$=speed of primary homogenization (rpm) and $F_2$=concentration of emulsifier (%), and the optimization objective is to simultaneously minimize $Y_1$ and maximize $Y_2$. For response surface analysis, practically, the second-order polynomial model is almost solely used. But, there exists the cases in which the second-order model fails to provide a good fit, to which remedies are seldom known to researchers. Thus, as an alternative to a failed second-order model, we present the heterogeneous third-order model, which can be used when the experimental plan is a two-factor central composite design having -1, 0, and 1 as the coded levels of factors. And, for multi-response optimization, we suggest a modified desirability function technique. Using these two methods, we have obtained statistical models with improved fits and multi-response optimization results with the predictions better than those in the previous research. Our predicted optimum combination of conditions is ($F_1$, $F_2$)=(5,000, 0.295), which is different from the previous combination. This research is expected to help improve the quality of response surface analysis in experimental sciences including food science of animal resources.

• Journal of Periodontal and Implant Science
• /
• v.49 no.2
• /
• pp.90-104
• /
• 2019

Purpose: The aim of this study was to evaluate clinical and radiographic changes and the survival rate after periodontal surgery using deproteinized bovine bone mineral (DBBM) with 10% collagen or DBBM with a collagen membrane in endo-periodontal lesions. Methods: A total of 52 cases (41 patients) with at least 5 years of follow-up were included in this study. After scaling and root planing with or without endodontic treatment, periodontal regenerative procedures with DBBM with 10% collagen alone or DBBM with a collagen membrane were performed, yielding the DBBM + 10% collagen and DBBM + collagen membrane groups, respectively. Changes in clinical parameters including the plaque index, bleeding on probing, probing pocket depth, gingival recession, relative clinical attachment level, mobility, and radiographic bone gains were evaluated immediately before periodontal surgical procedures and at a 12-month follow-up. Results: At the 12-month follow-up after regenerative procedures, improvements in clinical parameters and radiographic bone gains were observed in both treatment groups. The DBBM + 10% collagen group showed greater probing pocket depth reduction ($4.52{\pm}1.06mm$) than the DBBM + collagen membrane group ($4.04{\pm}0.82mm$). However, there were no significant differences between the groups. Additionally, the radiographic bone gain in the DBBM + 10% collagen group ($5.15{\pm}1.54mm$) was comparable to that of the DBBM + collagen membrane group ($5.35{\pm}1.84mm$). The 5-year survival rate of the teeth with endo-periodontal lesions after periodontal regenerative procedures was 92.31%. Conclusions: This study showed that regenerative procedures using DBBM with 10% collagen alone improved the clinical attachment level and radiographic bone level in endo-periodontal lesions. Successful maintenance of the results after regenerative procedures in endo-periodontal lesions can be obtained by repeated oral hygiene education within strict supportive periodontal treatment.

• Physical Therapy Rehabilitation Science
• /
• v.10 no.2
• /
• pp.167-174
• /
• 2021

Objective: Single leg bridge exercise (SLBE) improves trunk muscle activation and provides muscle stability by aligning joints related to posture. This preliminary study aimed to investigate the effects of SLBE on abdominal muscle activation in subacute stroke patients. Design: Cross-sectional study. Methods: Fifteen subacute stroke patients (9 males, 6 females) voluntarily participated in this study. SLBE was performed on the affected side. Each individual patient performed an SLBE ten times in three sets and was asked to hold their position for 5 s. Muscles activity was recorded using a surface electromyography (EMG) system before and after the SLBE. A surface EMG system was used to analyze the muscle activity during general bridge exercise, including the rectus abdominis (RA), internal oblique (IO), and external oblique (EO) abdominal muscles. Results: Muscle activity of both EO and IO on the affected side significantly increased (p<0.05), whereas the muscle activity of the RA and the three muscles on the unaffected side did not show a significant difference. In addition, improvement in muscle asymmetry of the EO and IO showed a significant change after SLBE (p<0.05). Conclusions: SLBE is effective in activating the abdominal muscles of stroke patients on the affected side and is a helpful exercise intervention that activates the muscles to transform asymmetric abdominal muscles into symmetric patterns.