• Journal of Korean Neurosurgical Society
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• v.66 no.6
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• pp.681-689
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• 2023

Objective : Subarachnoid hemorrhage (SAH) is a condition characterized by bleeding in the subarachnoid space, often resulting from the rupture of a cerebral aneurysm. Delayed cerebral ischemia caused by vasospasm is a significant cause of mortality and morbidity in SAH patients, and inflammatory markers such as systemic inflammatory response index (SIRI), systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), and derived NLR (dNLR) have shown potential in predicting clinical vasospasm and outcomes in SAH patients. This article aims to investigate the relationship between inflammatory markers and cerebral vasospasm after aneurysmatic SAH (aSAH) and evaluate the predictive value of various indices, including SIRI, SII, NLR, and dNLR, in predicting clinical vasospasm. Methods : A retrospective analysis was performed on a cohort of 96 patients who met the inclusion criteria out of a total of 139 patients admitted Trakya University Hospital with a confirmed diagnosis of aSAH between January 2013 and December 2021. Diagnostic procedures, neurological examinations, and laboratory tests were performed to assess the patients' condition. The Student's t-test compared age variables, while the chi-square test compared categorical variables between the non-vasospasm (NVS) and vasospasm (VS) groups. Receiver operating characteristic (ROC) curve analyses were used to evaluate the diagnostic accuracy of laboratory parameters, calculating the area under the ROC curve, cut-off values, sensitivity, and specificity. A significance level of p<0.05 was considered statistically significant. Results : The study included 96 patients divided into two groups : NVS and VS. Various laboratory parameters, such as NLR, SII, and dNLR, were measured daily for 15 days, and statistically significant differences were found in NLR on 7 days, with specific cut-off values identified for each day. SII showed a significant difference on day 9, while dNLR had significant differences on days 2, 4, and 9. Graphs depicting the values of these markers for each day are provided. Conclusion : Neuroinflammatory biomarkers, when used alongside radiology and scoring scales, can aid in predicting prognosis, determining severity and treatment decisions for aSAH, and further studies with larger patient groups are needed to gain more insights.

• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.116-127
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• 2021

Purpose To evaluate the feasibility of texture analysis of gray-scale ultrasound (US) images for staging of hepatic fibrosis. Materials and Methods Altogether, 167 patients who had undergone routine US and laboratory tests for a fibrosis-4 (FIB-4) index were included. Texture parameters were measured using a dedicated in-house software. Regions of interest were placed in five different segments (3, 5, 6, 7, 8) for each patient. The FIB-4 index was used as the reference standard for hepatic fibrosis grade. Comparisons of the texture parameters between different fibrosis groups were performed with the Student's t-test or Mann-Whitney U-test. Diagnostic performance was evaluated by receiver operating curve analysis. Results The study population comprised of patients with no fibrosis (FIB-4 < 1.45, n = 50), mild fibrosis (1.45 ≤ FIB-4 ≤ 2.35, n = 37), moderate fibrosis (2.35 < FIB-4 ≤ 3.25, n = 27), and severe fibrosis (FIB-4 > 3.25, n = 53). Skewness in hepatic segment 5 showed a difference between patients with no fibrosis and mild fibrosis (0.2392 ± 0.3361, 0.4134 ± 0.3004, respectively, p = 0.0109). The area under the curve of skewness for discriminating patients with no fibrosis from those with mild fibrosis was 0.660 (95% confidence interval, 0.551-0.758), with an estimated accuracy, sensitivity, specificity of 64%, 87%, 48%, respectively. Conclusion A significant difference was observed regarding skewness in segment 5 between patients with no fibrosis and patients with mild fibrosis.

• Korean Journal of Radiology
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• v.23 no.6
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• pp.664-673
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• 2022

Objective: To evaluate the performance of baseline clinical characteristics and pretherapeutic histogram parameters derived from T2 mapping of the extraocular muscles (EOMs) in the prediction of treatment response to intravenous glucocorticoid (IVGC) therapy for active and moderate-to-severe thyroid-associated ophthalmopathy (TAO) and to investigate the effect of fat-suppression (FS) in T2 mapping in this prediction. Materials and Methods: A total of 79 patients clinically diagnosed with active, moderate-to-severe TAO (47 female, 32 male; mean age ± standard deviation, 46.1 ± 10 years), including 43 patients with a total of 86 orbits in the responsive group and 36 patients with a total of 72 orbits in the unresponsive group, were enrolled. Baseline clinical characteristics and pretherapeutic histogram parameters derived from T2 mapping with FS (i.e., FS T2 mapping) or without FS (i.e., conventional T2 mapping) of EOMs were compared between the two groups. Independent predictors of treatment response to IVGC were identified using multivariable analysis. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of the prediction models. Differences between the models were examined using the DeLong test. Results: Compared to the unresponsive group, the responsive group had a shorter disease duration, lower kurtosis (FS-kurtosis), lower standard deviation, larger 75th, 90th, and 95th (FS-95th) T2 relaxation times in FS mapping and lower kurtosis in conventional T2 mapping. Multivariable analysis revealed that disease duration, FS-95th percentile, and FS-kurtosis were independent predictors of treatment response. The combined model, integrating all identified predictors, had an optimized area under the ROC curve of 0.797, 88.4% sensitivity, and 62.5% specificity, which were significantly superior to those of the imaging model (p = 0.013). Conclusion: An integrated combination of disease duration, FS-95th percentile, and FS-kurtosis was a potential predictor of treatment response to IVGC in patients with active and moderate-to-severe TAO. FS T2 mapping was superior to conventional T2 mapping in terms of prediction.

• Korean Journal of Radiology
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• v.20 no.5
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• pp.709-718
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• 2019

Objective: To investigate the association of myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) with troponin level and left ventricle (LV) function in patients with ST-segment elevated myocardial infarction (STEMI). Materials and Methods: Thirty-five STEMI patients who successfully had undergone reperfusion treatment within 1 week of their infarction were consecutively enrolled. All patients were referred for dynamic CT-MPI. Serial high-sensitivity troponin T (hs-TnT) levels and left ventricular ejection fraction (LVEF) measured by echocardiography were recorded. Twenty-six patients with 427 segments were included for analysis. Various quantitative parameters derived from dynamic CT-MPI were analyzed to determine if there was a correlation between hs-TnT levels and LVEF on admission and again at the 6-month mark. Results: The mean radiation dose for dynamic CT-MPI was 3.2 ± 1.1 mSv. Infarcted territories had significantly lower MBF (30.5 ± 7.4 mL/min/100 mL versus 73.4 ± 8.1 mL/min/100 mL, p < 0.001) and myocardial blood volume (MBV) (2.8 ± 0.9 mL/100 mL versus 4.2 ± 1.1 mL/100 mL, p = 0.044) compared with those of reference territories. MBF showed the best correlation with the level of peak hs-TnT (r = -0.682, p < 0.001), and MBV showed a moderate correlation with the level of peak hs-TnT (r = -0.437, p = 0.026); however, the other parameters did not show any significant correlation with hs-TnT levels. As for the association with LV function, only MBF was significantly correlated with LVEF at the time of admission (r = 0.469, p = 0.016) and at 6 months (r = 0.585, p = 0.001). Conclusion: MBF quantified by dynamic CT-MPI is significantly inversely correlated with the level of peak hs-TnT. In addition, patients with lower MBF tended to have impaired LV function at the time of their admission and at 6 months.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.34 no.4
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• pp.443-448
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• 2010

In this paper, the changes in performance parameters, e.g., the combustor pressure, turbine power, engine mixture ratio, temperature of gas generator, and product gas, of a liquid rocket engine employing gas generator cycle with the variations in propellant-supply pressure have been described. Engine performance is numerically calculated using the 13 major system-level variables of the rocket engine. The combustor pressure and turbine power increase with an increase in the oxidizer-supply pressure and decrease with an increase in fuel-supply pressure. The lower mixture ratio of gas generator for increased fuel mass flow rate decreases the gas generator gas temperature and deteriorates the gas material properties as the turbine working fluid. The turbine power decreases with an increase in fuel-supply pressure; this results in a decrease in the main-combustor pressure, which is directly proportional to engine thrust.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.26 no.5
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• pp.914-923
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• 2002

Recently, there has been considerable interest in micro gyroscopes made of silicon chips. It can be applied to many micro-electro-mechanical systems (MEMS): devices for stabilization, general rate control, directional pointing, autopilot systems, and missile control. This paper shows how the mechanical design of the gyroscope can be done using axiomatic design, followed by the application of the Taguchi robust design method to determine the dimensions of the parts so as to accommodate the dimensional variations introduced during manufacturing. Functional requirements are defined twofold. One is that the natural frequencies should have fixed values, and the other is that the system should be robust to large tolerances. According to the Independence Axiom, design parameters are classified into a few groups. Then, the detailed design process is performed fellowing the sequence indicated by the design matrix. The dimensions of the structure are determined to have constant values fur the difference of frequencies without consideration of the tolerances. It is noted that the Taguchi concept is utilized as a unit process of the entire axiomatic approach.

• Earthquakes and Structures
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• v.3 no.2
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• pp.141-168
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• 2012

The Retrofit Yield Spectrum (RYS) is a new spectrum-based device that relates seismic demand of a retrofitted structure with the fundamental design parameters of the retrofit. This is obtained from superposition of Yield Point Spectra with design charts that summarize in pertinent spectrum-compatible coordinates the attributes of a number of alternative retrofit scenarios. Therefore, once the requirements for upgrading a given structure have been determined, the RYS enable direct insight of the sensitivity of the seismic response of the upgraded structure to the preliminary design decisions made while establishing the retrofit plan. By virtue of their spectrum-based origin, RYS are derived with reference to a single mode of structural vibration; a primary objective is to control the contribution of this mode in the retrofit design so as to produce a desirable distribution of damage at the ultimate limit state by removing soft storey formations and engaging the maximum number of structural members in deformation, in response to the input motion. Calculations are performed with reference to the yield-point, where secant stiffness is proportional to the flexural strength of reinforced concrete members. Derivation and use of the Retrofit Yield Spectra (RYS) refers to the seismic demand expressed either in terms of spectral acceleration, spectral displacement or interstory drift, at yield of the first storey. A reinforced concrete building that has been tested in full scale to a sequence of simulated earthquake excitations is used in the paper as a demonstration case study to examine the effectiveness of the proposed methodology.

• Wind and Structures
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• v.16 no.1
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• pp.93-115
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• 2013

This paper describes a study of the influence of a dynamically flexible building structure on pressures inside and net pressures on the roof of low-rise buildings with a dominant opening. It is shown that dynamic interaction between the flexible roof and the internal pressure results in a coupled system that is similar to a two-degree-of-freedom mechanical system consisting of two mass-spring-damper systems with excitation forces acting on both the masses. Two resonant modes are present, the natural frequencies of which can readily be obtained from the model. As observed with quasi-static building flexibility, the effect of increased dynamic flexibility is to reduce the first natural frequency as well as the corresponding peak value of the admittance, the latter being the result of increased damping effects. Consequently, it is found that the internal and net roof pressure fluctuations (RMS coefficients) are also reduced with dynamic flexibility. This model has been validated from experiments conducted using a cylindrical model with a leeward end flexible diaphragm, whereby good match between predicted and measured natural frequencies, and trends in peak admittances and RMS responses with flexibility, were obtained. Furthermore, since significant differences exist between internal and net roof pressure responses obtained from the dynamic flexibility model and those obtained from the quasi-static flexibility model, it is concluded that the quasi-static flexibility assumption may not be applicable to dynamically flexible buildings. Additionally, since sensitivity analyses reveal that the responses are sensitive to both the opening loss coefficient and the roof damping ratio, careful estimates should therefore be made to these parameters first, if predictions from such models are to have significance to real buildings.

• Journal of Environmental Impact Assessment
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• v.20 no.6
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• pp.891-905
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• 2011

Climate vulnerability index is usually defined as a function of the climate exposure, sensitivity, and adaptive capacity, which requires adequate selection of proxy variables of each variable. We selected and used 9 proxy variables related to climate exposure in the literature, and diagnosed the adequacy of them for application in Korean peninsula. The selected proxy variables are: four variables from temperature, three from precipitation, one from wind speed, and one from relative humidity. We collected climate data over both previous year (1981~2010) and future climate scenario (A1B scenario of IPCC SERES) for 2020, 2050, and 2100. We introduced the spatial and temporal diagnostic statistical parameters, and evaluated both spatial and time variabilities in the relative scale. Of 9 proxy variables, effective humidity indicated the most sensitive to climate change temporally with the biggest spatial variability, implying a good proxy variable in diagnostics of climate change vulnerability in Korea. The second most sensitive variable is the frequency of strong wind speed with a decreasing trend, suggesting that it should be used carefully or may not be of broad utility as a proxy variable in Korea. The A1B scenario of future climate in 2020, 2050 and 2100 matches well with the extension of linear trend of observed variables during 1981~2010, indicating that, except for strong wind speed, the selected proxy variables can be effectively used in calculating the vulnerability index for both past and future climate over Korea. Other local variabilities for the past and future climate in association with climate exposure variables are also discussed here.

• Structural Engineering and Mechanics
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• v.16 no.6
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• pp.749-769
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• 2003

The structural deterioration of concrete structures due to reinforcement corrosion is a major worldwide problem. Service life of the age-degraded concrete structures is governed by the protective action provided by the cover concrete against the susceptibility of the reinforcement to the corrosive environment. The corrosion of steel would result in the various corrosion products, which depending on the level of the oxidation may have much greater volume than the original iron that gets consumed by the process of corrosion. This volume expansion would be responsible for exerting the expansive radial pressure at the steel-concrete interface resulting in the development of hoop tensile stresses in the surrounding cover concrete. Once the maximum hoop tensile stress exceeds the tensile strength of the concrete, cracking of cover concrete would take place. The cracking begins at the steel-concrete interface and propagates outwards and eventually resulting in the through cracking of the cover concrete. The cover cracking would indicate the loss of the service life for the corrosion-affected structures. In the present paper, analytical models have been developed considering the residual strength of the cracked concrete and the stiffness provided by the combination of the reinforcement and expansive corrosion products. The problem is modeled as a boundary value problem and the governing equations are expressed in terms of the radial displacement. The analytical solutions are presented considering a simple 2-zone model for the cover concrete viz. cracked or uncracked. A sensitivity analysis has also been carried out to show the influence of the various parameters of the proposed models. The time to cover cracking is found to be function of initial material properties of the cover concrete and reinforcement plus corrosion products combine, type of rust products, rate of corrosion and the residual strength of the cover concrete. The calculated cracking times are correlated against the published experimental and analytical reference data.