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Postoperative Imaging Findings of Biliary Atresia (담도폐쇄증의 수술 후 영상 소견)

  • Jisun Hwang;Hee Mang Yoon;Pyeong Hwa Kim;Jung-Man Namgoong;Seak Hee Oh;Ah Young Jung;Jin Seong Lee;Young Ah Cho
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.1014-1031
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    • 2022
  • The Kasai portoenterostomy is the first-line treatment for the restoration of the flow of bile to the small intestine in patients with biliary atresia. Various complications can occur after Kasai portoenterostomy, including ascending cholangitis, biliary cirrhosis, and portal hypertension. Of these potential complications, ascending cholangitis in the most common. In cases of patients having uncontrolled complications due to progressive liver cirrhosis, portal hypertension, or progressive hyperbilirubinemia, liver transplantation is the indicated as treatment plan. Lifelong follow-up, particularly involving imaging studies, is important for the identification of various complications arising from biliary atresia after Kasai portoenterostomy. Additionally, imaging studies play a crucial role in the evaluation of potential liver donors and recipients. US is a key imaging modality utilized in the management of patients who undergo Kasai portoenterostomy, while CT and MRI are imperative to obtaining an accurate diagnosis.

Bone Age Assessment Using Artificial Intelligence in Korean Pediatric Population: A Comparison of Deep-Learning Models Trained With Healthy Chronological and Greulich-Pyle Ages as Labels

  • Pyeong Hwa Kim;Hee Mang Yoon;Jeong Rye Kim;Jae-Yeon Hwang;Jin-Ho Choi;Jisun Hwang;Jaewon Lee;Jinkyeong Sung;Kyu-Hwan Jung;Byeonguk Bae;Ah Young Jung;Young Ah Cho;Woo Hyun Shim;Boram Bak;Jin Seong Lee
    • Korean Journal of Radiology
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    • v.24 no.11
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    • pp.1151-1163
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    • 2023
  • Objective: To develop a deep-learning-based bone age prediction model optimized for Korean children and adolescents and evaluate its feasibility by comparing it with a Greulich-Pyle-based deep-learning model. Materials and Methods: A convolutional neural network was trained to predict age according to the bone development shown on a hand radiograph (bone age) using 21036 hand radiographs of Korean children and adolescents without known bone development-affecting diseases/conditions obtained between 1998 and 2019 (median age [interquartile range {IQR}], 9 [7-12] years; male:female, 11794:9242) and their chronological ages as labels (Korean model). We constructed 2 separate external datasets consisting of Korean children and adolescents with healthy bone development (Institution 1: n = 343; median age [IQR], 10 [4-15] years; male: female, 183:160; Institution 2: n = 321; median age [IQR], 9 [5-14] years; male: female, 164:157) to test the model performance. The mean absolute error (MAE), root mean square error (RMSE), and proportions of bone age predictions within 6, 12, 18, and 24 months of the reference age (chronological age) were compared between the Korean model and a commercial model (VUNO Med-BoneAge version 1.1; VUNO) trained with Greulich-Pyle-based age as the label (GP-based model). Results: Compared with the GP-based model, the Korean model showed a lower RMSE (11.2 vs. 13.8 months; P = 0.004) and MAE (8.2 vs. 10.5 months; P = 0.002), a higher proportion of bone age predictions within 18 months of chronological age (88.3% vs. 82.2%; P = 0.031) for Institution 1, and a lower MAE (9.5 vs. 11.0 months; P = 0.022) and higher proportion of bone age predictions within 6 months (44.5% vs. 36.4%; P = 0.044) for Institution 2. Conclusion: The Korean model trained using the chronological ages of Korean children and adolescents without known bone development-affecting diseases/conditions as labels performed better in bone age assessment than the GP-based model in the Korean pediatric population. Further validation is required to confirm its accuracy.

Establishment of Local Diagnostic Reference Levels of Pediatric Abdominopelvic and Chest CT Examinations Based on the Body Weight and Size in Korea

  • Jae-Yeon Hwang;Young Hun Choi;Hee Mang Yoon;Young Jin Ryu;Hyun Joo Shin;Hyun Gi Kim;So Mi Lee;Sun Kyung You;Ji Eun Park
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1172-1184
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    • 2021
  • Objective: The purposes of this study were to analyze the radiation doses for pediatric abdominopelvic and chest CT examinations from university hospitals in Korea and to establish the local diagnostic reference levels (DRLs) based on the body weight and size. Materials and Methods: At seven university hospitals in Korea, 2494 CT examinations of patients aged 15 years or younger (1625 abdominopelvic and 869 chest CT examinations) between January and December 2017 were analyzed in this study. CT scans were transferred to commercial automated dose management software for the analysis after being de-identified. DRLs were calculated after grouping the patients according to the body weight and effective diameter. DRLs were set at the 75th percentile of the distribution of each institution's typical values. Results: For body weights of 5, 15, 30, 50, and 80 kg, DRLs (volume CT dose index [CTDIvol]) were 1.4, 2.2, 2.7, 4.0, and 4.7 mGy, respectively, for abdominopelvic CT and 1.2, 1.5, 2.3, 3.7, and 5.8 mGy, respectively, for chest CT. For effective diameters of < 13 cm, 14-16 cm, 17-20 cm, 21-24 cm, and > 24 cm, DRLs (size-specific dose estimates [SSDE]) were 4.1, 5.0, 5.7, 7.1, and 7.2 mGy, respectively, for abdominopelvic CT and 2.8, 4.6, 4.3, 5.3, and 7.5 mGy, respectively, for chest CT. SSDE was greater than CTDIvol in all age groups. Overall, the local DRL was lower than DRLs in previously conducted dose surveys and other countries. Conclusion: Our study set local DRLs in pediatric abdominopelvic and chest CT examinations for the body weight and size. Further research involving more facilities and CT examinations is required to develop national DRLs and update the current DRLs.

A STUDY ON SOFT TISSUE FACIAL PROFILE CHANCES IN ORTHODONTIC TREATMENT WITH FOUR PREMOLAR EXTRACTIONS (4개 소구치 발치를 통한 교정치료시 나타나는 안모 연조직 변화에 관한 연구)

  • Jin, Hee-Kwan;Moon, Yoon-Shik
    • The korean journal of orthodontics
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    • v.28 no.5 s.70
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    • pp.825-838
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    • 1998
  • The purpose of this study was to evaluate the differences of soft tissue profile changes between the growing patients and the adult who had passed the growth peak, in orthodontic treatment with four premolar extractions. The results which was taken by correlating the soft tissue changes with hard tissue changes, lip thickness, molar relationship and arch length discrepancy in both groups was like the followings. 1. Significant hard tissue changes were decrease of VIs, VIi, UlPP, LlMP, HIi and increase of HPog'in adults and decrease of VIs, VIi and increase of VA, VPog'and all the vertical measurements in adolescents. 2. Significant soft tissue changes were decrease of VLs, VLi, and VILS in adults and increase of VSn, VSLS, VLs, VPog' and almost all vertical measurements in adolescents, and ${\Delta}LsE,\;{\Denta}LiE$ in adults and ${\Delta}LsE,\;{\Denta}LiE,\;{\Delta}LiSP\;and\;{\Delta}Mang$ was also significant 3. Correlation coefficient between ${\Delta}VIs\;and\;{\Delta}VLs$ was the greatest in adults and the next was ${\Delta}Ii/{\Delta}Li,\;{\Delta}Ii/{\Delta}ILS,\;{\Delta}ID/{\Delta}Li\;and\;{\Delta}ID/{\Delta}ILS$. In contrast all the vertical and horizontal measurements of hard and soft tissue in adolescents showed statistically significant corerrlation. 4. There were differences in correlation between soft tissue changes and incisor inclination and retraction at both groups, but the lower lip, nasolabial angle and mentolabial angle were commonly less influenced by the hard tissue changes in both groups. 5. The thinner the upper lip was, the more the ${\Delta}LsSP$ was in both groups, and the thinner the lower lip was, the more the ${\Delta}LiE\;and\;{\Denta}LiSP$ was in adolescents. 6. Molar relationship didn't influence the soft tissue profile changes. 7. Arch length discrepancy didn't influence the soft tissue profile changes.

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A Study about modification of Gejitang that showed on sympton and prescription about Soumin (소음인(少陰人) 병증(病證) 및 처방(處方)에 나타난 계기장(桂技場)의 변용(變用)에 대한 고찰(考察))

  • Kim, Jeong-hee;Song, Jeong-mo
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.1
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    • pp.201-220
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    • 1999
  • We got these results after studying about modification of Gejitang(桂枝湯) that showed on sympton and prescription about Soumin(少陰人). 1. There are totally eleven prescriptions related to Gejitang appeared on Dongyi-Soose-Bowon(東醫壽世保元). Among them, one is prescription of Danguisayoktang(當歸四逆湯) in prescription of Discussion of Cold Induced Disorder(傷寒論) and another is Gejibujatang(桂枝附子湯) in Won-Myung dynasty period(元明時代). There are nine prescriptions in LeeJae-Ma(李濟馬)'s pre-scription and we can see there are many prescriptions used prescriptions related to Gejitang for Mang Yang(亡陽). 2. Pre-scriptions related to Gejitang has seven prescriptions in Extra-disease(表病證), and two prescriptions in Intra-disease(裏病證) which are analyzed as modified prescription from Gejitang. 3. Although 藿香正氣散, 香蘇散, 芎歸香蘇散, 八物君子湯 etc. are not modified prescriptions of Gejitang, We can see that its are brought up to be on the same with alternative remedy of Gejitang in each step of symptoms. 4. Symptoms are exactly classified in Soumin, the prescription which is used in different symptoms of diseases is similar in raw materials. It's because the remedy of Acending and Descending(升降) is used under the same purpose that maintain Yangnan Qi(陽暖之氣). 5. We could realize that Panax gienseng(人蔘), Cinnamomum Cassia(肉桂) and Aconitum Carrnichali(附子) are commonly important to reinforce Yangnan Qi because the more disease got worse, the more patient lost Yangnan Qi on both Extra-disease and Intra-disease in the Soumin's disease.

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Posterior Cruciate Ligament Augmentation Using an Autogenous Hamstring Tendon Graft and the Posterior-Posterior Triangulation Technique (만성 단독 후방십자인대 파열에서 자가 슬괵건과 후-후 삼각술기를 이용한 만성 후방십자인대 보강술)

  • Kim, Yeung Jin;Chae, Soo Uk;Choi, Byong San;Kim, Jong Yun;Lee, Hwang Yong;Han, Chang Wan;Han, Su Hyoun
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.24-30
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    • 2013
  • Purpose: To evaluate the outcome of arthroscopic posterior cruciate ligament (PCL) augmentation using an autogenous hamstring tendon graft and the posterior-posterior triangulation technique with preservation of ligament remnant or elongated ligament. Materials and Methods: From January 2002 to December 2009, we performed PCL augmentation using an autogenous hamstring tendon graft and the posterior-posterior triangulation technique in 32 patients. The mean age was 35.2 years. Twenty two cases were male and 10 cases were female. Average follow-up period was 5 years and 5 months (range: 2-7.9). Subjective and objective parameters were utilized in analyses, such as the mean range of motion, post. drawer test, Lysholm knee score, Tegner activity score, International Knee Documentation Cominittee (IKDC) grade, and second look arthroscopic examination. Results: At last follow up posterior displacement by the Telos stress test decreased from $10.8{\pm}5.1\;mm$ to $2.8{\pm}3.7\;mm$ (p<0.05). The final Lysholm knee score improved from $60.4{\pm}5.8$ to $84.6{\pm}4.8$. Tegner activity score improved from 3.2 to 4.8. The final IKDC grade was A in 18, B in 11, C in 3. Postoperative Lysholm knee score, IKDC grades, Tegner activity scale, and posterior displacement demonstrated statistically significant improvement compared to the preoperative state (p<0.05). Conclusion: Arthroscopic PCL reconstruction using an autogenous hamstring tendon with preservation of ligament remnant showed a good clinical results and posterior stability.

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Problems with ERP Education at College and How to Solve the Problems (대학에서의 ERP교육의 문제점 및 개선방안)

  • Kim, Mang-Hee;Ra, Ki-La;Park, Sang-Bong
    • Management & Information Systems Review
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    • v.31 no.2
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    • pp.41-59
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    • 2012
  • ERP is a new technique of process innovation. It indicates enterprise resource planning whose purpose is an integrated total management of enterprise resources. ERP can be also seen as one of the latest management systems that organically connects by using computers all business processes including marketing, production and delivery and control those processes on a real-time basis. Currently, however, it's not easy for local enterprises to have operators who will be in charge of ERP programs, even if they want to introduce the resource management system. This suggests that it's urgently needed to train such operators through ERP education at school. But in the field of education, actually, the lack of professional ERP instructors and less effective learning programs for industrial applications of ERP are obstacles to bringing up ERP workers who are competent as much as required by enterprises. In ERP, accounting is more important than any others. Accountants are assuming more and more roles in ERP. Thus, there's a rapidly increasing demand for experts in ERP accounting. This study examined previous researches and literature concerning ERP education, identified problems with current ERP education at college and proposed how to solve the problems. This study proposed the ways of improving ERP education at college as follows. First, a prerequisite learning of ERP, that is, educating the principle of accounting should be intensified to make students get a basic theoretical knowledge of ERP enough. Second, lots of different scenarios designed to try ERP programs in business should be created. In association, students should be educated to get a better understanding of incidents or events taken place in those scenarios and apply it to trying ERP for themselves. Third, as mentioned earlier, ERP is a system that integrates all enterprise resources such as marketing, procurement, personnel management, remuneration and production under the framework of accounting. It should be noted that under ERP, business activities are organically connected with accounting modules. More importantly, those modules should be recognized not individually, but as parts comprising a whole flow of accounting. This study has a limitation because it is a literature research that heavily relied on previous studies, publications and reports. This suggests the need to compare the efficiency of ERP education between before and after applying what this study proposed to improve that education. Also, it's needed to determine students' and professors' perceived effectiveness of current ERP education and compare and analyze the difference in that perception between the two groups.

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Field Manager's Opinion of the Dental Hygiene Student's Competency: In-Depth Interview Study (치위생학과 학생에게 바라는 역량에 대한 특성화 선택과정 실습기관 실무자의 의견: 심층면접)

  • Kim, So-Mang;Kim, Ji-Yeop;Park, Eun-Bi;Choi, Jeong-Eum;Choi, Hye-In;Park, Go-Eun;Kim, Nam-Hee
    • Journal of dental hygiene science
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    • v.14 no.1
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    • pp.81-86
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    • 2014
  • The aim of this study was to take the field manager's opinion about the dental hygiene student's competency. Study design was cross sectional contents analysis with the in-depth interviews. Twelve subjects were randomly selected in half an hour interview. They were signed there's own autograph on the informed consents. The contents of the qualitative interviews were divided into two parts: students' competency required for the field practice and the system of the field practice. The first part consisted of the attitude of the field's practice, how well has accomplished the job, and demanded requirements for the better performance. And the other part was made up of duration of practice, the number of students per institution and other opinion. The results showed that most of them have positive conception about student's competency. They mentioned that many students have 'enthusiastic behavior and attitude in task performance' and 'progressive attitude and mind in duty'. While 'lack of interest in practice and sociality', 'the arrogant demeanor in the fields', and 'passive behavior and attitude in the interpersonal relationship' should be avoided for excellent competency. It is required for dental hygiene students to write daily practice record and clarify their reasons to choose the institution for better performance. In addition, it should be considered to make concrete evaluation items and students and field managers should have mutual responsibility.

Changes of Nutritive Values and Qualities in Various Regions of Sorghum × Sorghum Hybrid Silage by Manufacture Method of Silage (수수 × 수수 교잡종의 사일리지 제조방법에 따른 부위별 사료가치 및 품질 변화)

  • Choi, Ki Choon;Jung, Min-Woong;Park, Hyung Su;Kim, Da Hye;Kim, Jong Geun;Lee, Sang Lak;Kim, Myeong Hwa;Han, Young Jun;Kim, Mang Jung;Kim, Won Ho;Choi, Gi Jun
    • Journal of Animal Environmental Science
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    • v.18 no.3
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    • pp.247-256
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    • 2012
  • This study was carried out to investigate the effects of various regions of sorghum-sorghum hybrid (SSH) silage on nutritive values and qualities of SSH silage. SSH "SS405" was harvested at ripen stage and ensiled. Samples of SSH silage used in this study were collected in three regions (outside, middle and inside). The contents of crude protein (CP), neutral detergent fiber (NDF), acid detergent fiber (ADF), total digestible nutrients (TDN) and in vitro dry matter digestibility (IVDMD) in SSH silage were not influenced by SSH silage manufacture methods and lactic acid bacteria. The contents of CP in inside region of SSH silage were lower than those of outside and middle regions (p<0.05). However, the contents of NDF, ADF and TDN, and IVDMD were not different between the regions of SSH silage. The content of lactic acid in SSH round bale silage was significantly decreased (p<0.05), as compared to SSH square bale silage (SB), gunny bag silage (GB) and trench silage (TS). The contents of acetic acid and butyric acid in SSH silage were not influenced by SSH silage manufacture methods and lactic acid bacteria. The contents of lactic acid in inside region of SSH silage were lower than those of outside and middle regions (p<0.05). In addition, the contents of lactic acid, acetic acid and butyric acid were not different between the regions of SSH silage. Therefore we suggest that nutritive values and quality of SSH silage were not influenced by regions of sampling collected from these silages.

Desalination of Boiled Oyster Extract by Electrodialysis (전기투석에 의한 굴자숙액의 탈염 특성)

  • 박표잠;이상훈;김세권
    • KSBB Journal
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    • v.15 no.2
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    • pp.167-173
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    • 2000
  • For selective elimination of salt from boiled oyster extract (BOE), electrodialyzer was used and the desalination conditions of B BOE were investigated. The ion-exchange membrane with a molecular weight cut off 100 Da was used for desalting of B BOE. The desalination efficiency at pH 4.0 was 13% higher than that at pH 9.0 when BOE was desalted for 90min. The e electrodialysis pro$\infty$ss could remove above 90% of the initial salt content when 5% BOE was desalted at pH 5.62 for 1 100min. The initial volume and concentration of permeation solution did not have significant effects on desalination time and r ratio. The important factors for the desalination of BOE were found to be pH and concentration of BOE. The results obtained prove that electrodialysis is a practical solution to the problem of selective elimination of salt from BOE.

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