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Myelin Content in Mild Traumatic Brain Injury Patients with Post-Concussion Syndrome: Quantitative Assessment with a Multidynamic Multiecho Sequence

  • Roh-Eul Yoo;Seung Hong Choi;Sung-Won Youn;Moonjung Hwang;Eunkyung Kim;Byung-Mo Oh;Ji Ye Lee;Inpyeong Hwang;Koung Mi Kang;Tae Jin Yun;Ji-hoon Kim;Chul-Ho Sohn
    • Korean Journal of Radiology
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    • v.23 no.2
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    • pp.226-236
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    • 2022
  • Objective: This study aimed to explore the myelin volume change in patients with mild traumatic brain injury (mTBI) with post-concussion syndrome (PCS) using a multidynamic multiecho (MDME) sequence and automatic whole-brain segmentation. Materials and Methods: Forty-one consecutive mTBI patients with PCS and 29 controls, who had undergone MRI including the MDME sequence between October 2016 and April 2018, were included. Myelin volume fraction (MVF) maps were derived from the MDME sequence. After three dimensional T1-based brain segmentation, the average MVF was analyzed at the bilateral cerebral white matter (WM), bilateral cerebral gray matter (GM), corpus callosum, and brainstem. The Mann-Whitney U-test was performed to compare MVF and myelin volume between patients with mTBI and controls. Myelin volume was correlated with neuropsychological test scores using the Spearman rank correlation test. Results: The average MVF at the bilateral cerebral WM was lower in mTBI patients with PCS (median [interquartile range], 25.2% [22.6%-26.4%]) than that in controls (26.8% [25.6%-27.8%]) (p = 0.004). The region-of-interest myelin volume was lower in mTBI patients with PCS than that in controls at the corpus callosum (1.87 cm3 [1.70-2.05 cm3] vs. 2.21 cm3 [1.86-3.46 cm3]; p = 0.003) and brainstem (9.98 cm3 [9.45-11.00 cm3] vs. 11.05 cm3 [10.10-11.53 cm3]; p = 0.015). The total myelin volume was lower in mTBI patients with PCS than that in controls at the corpus callosum (0.45 cm3 [0.39-0.48 cm3] vs. 0.48 cm3 [0.45-0.54 cm3]; p = 0.004) and brainstem (1.45 cm3 [1.28-1.59 cm3] vs. 1.54 cm3 [1.42-1.67 cm3]; p = 0.042). No significant correlation was observed between myelin volume parameters and neuropsychological test scores, except for the total myelin volume at the bilateral cerebral WM and verbal learning test (delayed recall) (r = 0.425; p = 0.048). Conclusion: MVF quantified from the MDME sequence was decreased at the bilateral cerebral WM in mTBI patients with PCS. The total myelin volumes at the corpus callosum and brainstem were decreased in mTBI patients with PCS due to atrophic changes.

Semi-Quantitative Scoring of Late Gadolinium Enhancement of the Left Ventricle in Patients with Ischemic Cardiomyopathy: Improving Interobserver Reliability and Agreement Using Consensus Guidance from the Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT) 2020

  • Cherry Kim;Chul Hwan Park;Do Yeon Kim;Jaehyung Cha;Bae Young Lee;Chan Ho Park;Eun-Ju Kang;Hyun Jung Koo;Kakuya Kitagawa;Min Jae Cha;Rungroj Krittayaphong;Sang Il Choi;Sanjaya Viswamitra;Sung Min Ko;Sung Mok Kim;Sung Ho Hwang;Nguyen Ngoc Trang;Whal Lee;Young Jin Kim;Jongmin Lee;Dong Hyun Yang
    • Korean Journal of Radiology
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    • v.23 no.3
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    • pp.298-307
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    • 2022
  • Objective: This study aimed to evaluate the effect of implementing the consensus statement from the Asian Society of Cardiovascular Imaging-Practical Tutorial 2020 (ASCI-PT 2020) on the reliability of cardiac MR with late gadolinium enhancement (CMR-LGE) myocardial viability scoring between observers in the context of ischemic cardiomyopathy. Materials and Methods: A total of 17 cardiovascular imaging experts from five different countries evaluated CMR obtained in 26 patients (male:female, 23:3; median age [interquartile range], 55.5 years [50-61.8]) with ischemic cardiomyopathy. For LGE scoring, based on the 17 segments, the extent of LGE in each segment was graded using a five-point scoring system ranging from 0 to 4 before and after exposure according to the consensus statement. All scoring was performed via web-based review. Scores for slices, vascular territories, and total scores were obtained as the sum of the relevant segmental scores. Interobserver reliability for segment scores was assessed using Fleiss' kappa, while the intraclass correlation coefficient (ICC) was used for slice score, vascular territory score, and total score. Inter-observer agreement was assessed using the limits of agreement from the mean (LoA). Results: Interobserver reliability (Fleiss' kappa) in each segment ranged 0.242-0.662 before the consensus and increased to 0.301-0.774 after the consensus. The interobserver reliability (ICC) for each slice, each vascular territory, and total score increased after the consensus (slice, 0.728-0.805 and 0.849-0.884; vascular territory, 0.756-0.902 and 0.852-0.941; total score, 0.847 and 0.913, before and after implementing the consensus statement, respectively. Interobserver agreement in scoring also improved with the implementation of the consensus for all slices, vascular territories, and total score. The LoA for the total score narrowed from ± 10.36 points to ± 7.12 points. Conclusion: The interobserver reliability and agreement for CMR-LGE scoring for ischemic cardiomyopathy improved when following guidance from the ASCI-PT 2020 consensus statement.

Development of a Tool to Measure Knowledge of Clinical Dental Hygienists on Precautions for Dental Treatment of Dementia Patients (임상 치과위생사의 치매 환자 치과 진료 시 주의 사항에 관한 지식측정 도구 개발)

  • Nahyun Kim;So-Jung Mun;Hie-Jin Noh;Sun-Young Han
    • Journal of Korean Dental Hygiene Science
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    • v.6 no.2
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    • pp.79-89
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    • 2023
  • Background and Objectives: The prevalence of dementia is steadily increasing each year, and preceding studies continue to explore the association between dementia and oral health. Dental hygienists require specialized competencies to provide appropriate dental healthcare services, necessitating the development of a tool for the objective measurement of their knowledge levels. This study aimed to develop a knowledge assessment tool for dental hygienists concerning considerations for dental care for patients with dementia. Methods: The study constructed preliminary items based on a literature review and then conducted expert validation, a pilot survey, and the main survey. The main survey was conducted among 220 dental hygienists. Validity and reliability analyses were conducted with the collected data to select the final items, and the correctness rates for each selected item were verified. Results: As a result of the analysis of the collected data, 18 items were eliminated out of a total of 40 preliminary items, leaving a total of 6 factors and 22 items. The Cronbach's α value for the selected items was 0.791. The six factors are as follows: 'Considerations during dental treatment for dementia patients' (5 items), 'medication side effects in dementia patients' (4 items), 'oral care methods for dementia patients' (4 items), 'communication with dementia patients' (4 items), 'psychological reactions of dementia patients' (3 items), and 'guidance for dementia patients' (2 items). The item with the highest correctness rate was item 2 of the 'guidance for dementia patients' category at 98.6%, while the item with the lowest correctness rate was item 2 of the 'psychological reactions of dementia patients' category at 5.9%. Conclusion: This study validated the reliability and validity of the knowledge assessment tool, which lays the foundation for future research on dental hygienists and dementia. It contributes essential data for ongoing education, development of educational programs, and establishing operational guidelines in healthcare institutions.

Administration of chromium picolinate and meloxicam alleviates regrouping stress in dairy heifers

  • Da Jin Sol Jung;Jaesung Lee;Do Hyun Kim;Seok-Hyeon Beak;Soo Jong Hong;In Hyuk Jeong;Seon Pil Yoo;Jin Oh Lee;In Gu Cho;Dilla Mareistia Fassah;Hyun Jin Kim;Mohammad Malekkhahi;Myunggi Baik
    • Animal Bioscience
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    • v.37 no.8
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    • pp.1495-1502
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    • 2024
  • Objective: This research investigated the effect of administering chromium (Cr) and meloxicam (MEL) on growth performance, cortisol and blood metabolite, and behaviors in young, regrouped heifers. Methods: Fifty Holstein dairy heifers (body weight [BW] 198±32.7 kg and 6.5±0.82 months of age) were randomly assigned to non-regrouped group or four regrouped groups. Non-regrouped animals were held in the same pen throughout the entire experimental period (NL: non-regrouping and administration of lactose monohydrate [LM; placebo]). For regrouping groups, two or three heifers maintained in four different pens for 2 weeks were regrouped into a new pen and assigned to one of four groups: regrouping and LM administration (RL); regrouping and Cr administration (RC); regrouping and MEL administration (RM), and regrouping and Cr and MEL administration (RCM). LM (1 mg/kg BW), Cr (0.5 mg Cr picolinate/kg dry matter intake), and MEL (1 mg/kg BW) were orally administered immediately before regrouping. Blood was collected before regrouping (0 h) and at 3, 9, and 24 h and 7 and 14 d thereafter. Behaviors were recorded for 7 consecutive days after regrouping. Results: Average daily gain was lower (p<0.05) in RL than NL heifers, but was higher (p<0.05) in RM, RC, and RCM than RL heifers. RL heifers had higher (p<0.05) cortisol than NL heifers on d 1 after regrouping. The cortisol concentrations in RC, RM, and RCM groups were lower (p<0.05) than in RL treatment 1 d after regrouping. Displacement behavior was greater (p<0.05) in RL group than all other groups at 2, 3, and 6 d after regrouping. Conclusion: Regrouping caused temporal stress, reduced growth performance, and increased displacement behavior in heifers. Administering Cr and MEL recovered the retarded growth rate and reduced displacement behavior, thereby alleviating regrouping stress.

Effects of Various Biodegradable Mulching Films on Growth, Yield, and Soil Environment in Soybean Cultivation (콩 재배지에서 다양한 생분해성 멀칭필름 종류별 작물 생육, 수량 및 토양환경에 미치는 영향)

  • Ye-Guon Kim;Yeon-Hu Woo;Hyun-Hwa Park;Do-Jin Lee;Yong-In Kuk
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.69 no.1
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    • pp.34-48
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    • 2024
  • The objective of this study was to evaluate the safety of biodegradable mulching films in soybean (Glycine max) cultivation by measuring their effects on crop growth and yield, film decomposition and soil chemical and physical properties. In 2022 and 2023, plant height, branch number, chlorophyll contents, yield components, and yield of soybean did not vary significantly in areas using PE films and biodegradable mulching films. The light transmission rate of the biodegradable mulching films ranged from 6.4 to 15.8% when measured 112 days after soybean transplanting, and was higher, on average, in 2023 than in 2022. In both years, degradation of the biodegradable mulching films began 20 days after soybean transplantation and increased over time. In addition, remains of biodegradable mulching films were present in fields at soybean harvest and remained until 50 days after harvest. Decomposition rates of the biodegradable mulching films at 112 days after soybean transplanting ranged from 9.8 to 26.7% in 2022 and 13 to 36% in 2023. Although soil pH and EC varied based on the year and timing of measurements, there was no significant difference between areas that used biodegradable mulching films and PE films. Soil organic matter, nitrate and exchangeable cation contents such as Ca, Mg, and K were not significantly different in areas that used both PE films and biodegradable films. However, significantly higher levels of available phosphoric acid content were measured in areas that used biodegradable mulch films E, S, and T. Regardless of which films were used, there were no significant differences in the soil's physical properties. In 2022 and 2023, there was no difference between areas that used biodegradable mulch films and PE films. However, soil temperature in mulched areas was 2℃ higher and soil moisture was 5-15% higher than in non-mulched areas. Barley growth was not affected by being planted in soil that had been used for soybean cultivation with biodegradable films. Therefore, the biodegradable mulch films used in this study can be used without negatively affecting the growth, yield, and soil environment of soybeans.

Quantitative Vertebral Bone Density Seen on Chest CT in Chronic Obstructive Pulmonary Disease Patients: Association with Mortality in the Korean Obstructive Lung Disease Cohort

  • Hye Jeon Hwang;Sang Min Lee;Joon Beom Seo;Ji-Eun Kim;Hye Young Choi;Namkug Kim;Jae Seung Lee;Sei Won Lee;Yeon-Mok Oh
    • Korean Journal of Radiology
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    • v.21 no.7
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    • pp.880-890
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    • 2020
  • Objective: Patients with chronic obstructive pulmonary disease (COPD) are known to be at risk of osteoporosis. The purpose of this study was to evaluate the association between thoracic vertebral bone density measured on chest CT (DThorax) and clinical variables, including survival, in patients with COPD. Materials and Methods: A total of 322 patients with COPD were selected from the Korean Obstructive Lung Disease (KOLD) cohort. DThorax was measured by averaging the CT values of three consecutive vertebral bodies at the level of the left main coronary artery with a round region of interest as large as possible within the anterior column of each vertebral body using an in-house software. Associations between DThorax and clinical variables, including survival, pulmonary function test (PFT) results, and CT densitometry, were evaluated. Results: The median follow-up time was 7.3 years (range: 0.1-12.4 years). Fifty-six patients (17.4%) died. DThorax differed significantly between the different Global Initiative for Chronic Obstructive Lung Disease stages. DThorax correlated positively with body mass index (BMI), some PFT results, and the six-minute walk distance, and correlated negatively with the emphysema index (EI) (all p < 0.05). In the univariate Cox analysis, older age (hazard ratio [HR], 3.617; 95% confidence interval [CI], 2.119-6.173, p < 0.001), lower BMI (HR, 3.589; 95% CI, 2.122-6.071, p < 0.001), lower forced expiratory volume in one second (FEV1) (HR, 2.975; 95% CI, 1.682-5.262, p < 0.001), lower diffusing capacity of the lung for carbon monoxide corrected with hemoglobin (DLCO) (HR, 4.595; 95% CI, 2.665-7.924, p < 0.001), higher EI (HR, 3.722; 95% CI, 2.192-6.319, p < 0.001), presence of vertebral fractures (HR, 2.062; 95% CI, 1.154-3.683, p = 0.015), and lower DThorax (HR, 2.773; 95% CI, 1.620-4.746, p < 0.001) were significantly associated with all-cause mortality and lung-related mortality. In the multivariate Cox analysis, lower DThorax (HR, 1.957; 95% CI, 1.075-3.563, p = 0.028) along with older age, lower BMI, lower FEV1, and lower DLCO were independent predictors of all-cause mortality. Conclusion: The thoracic vertebral bone density measured on chest CT demonstrated significant associations with the patients' mortality and clinical variables of disease severity in the COPD patients included in KOLD cohort.

Contrast Media in Abdominal Computed Tomography: Optimization of Delivery Methods

  • Joon Koo Han;Byung Ihn Choi;Ah Young Kim;Soo Jung Kim
    • Korean Journal of Radiology
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    • v.2 no.1
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    • pp.28-36
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    • 2001
  • Objective: To provide a systematic overview of the effects of various parameters on contrast enhancement within the same population, an animal experiment as well as a computer-aided simulation study was performed. Materials and Methods: In an animal experiment, single-level dynamic CT through the liver was performed at 5-second intervals just after the injection of contrast medium for 3 minutes. Combinations of three different amounts (1, 2, 3 mL/kg), concentrations (150, 200, 300 mgI/mL), and injection rates (0.5, 1, 2 mL/sec) were used. The CT number of the aorta (A), portal vein (P) and liver (L) was measured in each image, and time-attenuation curves for A, P and L were thus obtained. The degree of maximum enhancement (Imax) and time to reach peak enhancement (Tmax) of A, P and L were determined, and times to equilibrium (Teq) were analyzed. In the computed-aided simulation model, a program based on the amount, flow, and diffusion coefficient of body fluid in various compartments of the human body was designed. The input variables were the concentrations, volumes and injection rates of the contrast media used. The program generated the time-attenuation curves of A, P and L, as well as liver-to-hepatocellular carcinoma (HCC) contrast curves. On each curve, we calculated and plotted the optimal temporal window (time period above the lower threshold, which in this experiment was 10 Hounsfield units), the total area under the curve above the lower threshold, and the area within the optimal range. Results: A. Animal Experiment: At a given concentration and injection rate, an increased volume of contrast medium led to increases in Imax A, P and L. In addition, Tmax A, P, L and Teq were prolonged in parallel with increases in injection time The time-attenuation curve shifted upward and to the right. For a given volume and injection rate, an increased concentration of contrast medium increased the degree of aortic, portal and hepatic enhancement, though Tmax A, P and L remained the same. The time-attenuation curve shifted upward. For a given volume and concentration of contrast medium, changes in the injection rate had a prominent effect on aortic enhancement, and that of the portal vein and hepatic parenchyma also showed some increase, though the effect was less prominent. A increased in the rate of contrast injection led to shifting of the time enhancement curve to the left and upward. B. Computer Simulation: At a faster injection rate, there was minimal change in the degree of hepatic attenuation, though the duration of the optimal temporal window decreased. The area between 10 and 30 HU was greatest when contrast media was delivered at a rate of 2 3 mL/sec. Although the total area under the curve increased in proportion to the injection rate, most of this increase was above the upper threshould and thus the temporal window was narrow and the optimal area decreased. Conclusion: Increases in volume, concentration and injection rate all resulted in improved arterial enhancement. If cost was disregarded, increasing the injection volume was the most reliable way of obtaining good quality enhancement. The optimal way of delivering a given amount of contrast medium can be calculated using a computer-based mathematical model.

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Effect of organic fertilizer application on soil carbon accumulation (유기질비료의 사용이 작물의 생육, 토양화학성 및 토양탄소 축적량에 미치는 영향)

  • Yu Na Lee;Dong Won Lee;Jin Ju Yun;Jae Hong Shim;Sang Ho Jeon;Yun Hae Lee;Soon Ik Kwon;Seong Heon Kim
    • Journal of the Korea Organic Resources Recycling Association
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    • v.32 no.1
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    • pp.5-11
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    • 2024
  • Objective of this study was to evaluate the effect of organic fertilizer application on yield, soil chemical properties and soil organic carbon (SOC) in Korean cabbage cultural field. The experimental treatments consisted of none fertilizer (NF), NPK (inorganic fertilizer, N-P2O5-K2O : 320-78-198 kg ha-1), Organic fertilizer (OF 50, 100, 150% on application rate of standard 110 kg ha-1 as N, topdressing: 210 kg ha-1 as inorganic fertilizer). In experimental results, the growth characteristics and yields were not significantly different among the treatments. There was no significant difference in soil pH, available phosphate, ammonium nitrogen and exchangeable potassium, while organic matter, electrical conductivity and nitrate nitrogen were increased when organic fertilizer application. Also, SOC was increased with the application of organic fertilizers. These results showed that pre-application of organic fertilizer might be effective in a carbon storage in the field soil cultivating Korean cabbage.

Effect of the Ayres Sensory Integration Intervention on the Motor Skills and Occupation Participation of Preschool Children with Attention-Deficit/Hyperactivity Disorder (Ayres의 감각통합중재가 학령전기 주의력결핍 과잉행동장애(ADHD) 성향 아동의 운동기능 및 작업참여에 미치는 영향)

  • Jung, Yun-Jin;Kang, Je-wook;Chang, Moon-young;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.22 no.1
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    • pp.1-14
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    • 2024
  • Objective : This study aimed to investigate the impact of Ayres' sensory integration (ASI) intervention on motor skills and occupational participation of preschool children with attention-deficit/hyperactivity disorder (ADHD). Method : Children with ADHD aged between 4 and 6 years who met the inclusion and exclusion criteria were randomly recruited through screening tests. The subjects were divided into an experimental group (10 subjects) and a control group (8 subjects). The instruments used were the Bruininks-Oseretsky test of motor proficiency-2 (BOT-2), Pediatric Evaluation of Disability Inventory (PEDI), and Goal Attainment Scale (GAS) to evaluate occupational participation. The subjects in the experimental group underwent individual sensory integration therapy according to the ASI principles for 40 minutes twice a week in a total of 16 sessions over eight weeks. The control group did not receive the ASI intervention. Data analysis was performed using the Mann-Whitney U test, chi-squared test, Wilcoxon signed-rank test, and Cohen's d test in SPSS 20.0. Results : The ASI experimental group had significantly higher scores in total motor composite, manual coordination, body coordination, strength, and agility in motor function than the control group (p<.05). The two groups did not differ significantly in terms of occupational participation (PEDI), but GAS scores for individual target activities were significantly higher in the experimental group than in the control group (p<.05). Conclusion : This study shows that the ASI intervention has positive effects on motor skills and occupation participation among preschool children with ADHD.

The historical study on the Ukrainian territorial conflicts: Focusing on the Crimean War and the German-Soviet War (우크라이나 영토분쟁에 관한 사(史)적 연구: 크림전쟁과 독소전쟁의 사례를 중심으로)

  • Eunchae Lee;Ikhyun Jang
    • Analyses & Alternatives
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    • v.8 no.2
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    • pp.65-86
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    • 2024
  • This study delves into the geopolitical tensions surrounding Ukraine throughout modern European history, aiming to shed light on its significance in geopolitical discourse. Since the 19th century, European powers, particularly the Anglo-Saxons and Germans, have formulated distinct geopolitical strategies concerning the Eurasian continent, with Ukraine at its focal point. The Crimean War and the German-Soviet War serve as key events to analyze these powers' geopolitical ambitions and interests. The British Empire, driven by its doctrine of thwarting land powers with sea power, intervened in the Crimean War against Russia. Its objective was to disrupt Russian dominance over Ukraine, thereby hindering Russian expansion into the Black Sea and Central Europe. On the other hand, the Third Reich of Germany, fixated on creating a European sphere exclusive from Anglo-Saxon sea powers and the Russian land power, initiated the German-Soviet War. This move aimed to secure a vast territory, including Ukraine, to facilitate expansion into the Caucasus and establish a buffer zone against the Soviet Union. Three key insights emerge from this analysis. Firstly, the absence of a dominant power rooted in Ukraine since the fall of the Principality of Kiev made geopolitical clashes inevitable. Secondly, these clashes ultimately result in a hollow victory for all involved parties, signifying the high costs and minimal gains of such confrontations. Lastly, the root cause of these clashes lies in the discord between exclusive geopolitical visions that fail to accommodate sustainable coexistence among diverse geopolitical spheres. In essence, the study underscores Ukraine's pivotal role in shaping European geopolitics and highlights the recurring clashes driven by competing visions of dominance and control over its territory. From the Crimean War to the German-Soviet War, the struggle for influence over Ukraine reflects broader geopolitical dynamics and the pursuit of strategic advantage by major powers. Ultimately, the study emphasizes the enduring significance of Ukraine in European geopolitics and the complexities inherent in managing its geopolitical tensions.