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Association between High Diffusion-Weighted Imaging-Derived Functional Tumor Burden of Peritoneal Carcinomatosis and Overall Survival in Patients with Advanced Ovarian Carcinoma

  • He An;Jose AU Perucho;Keith WH Chiu;Edward S Hui;Mandy MY Chu;Siew Fei Ngu;Hextan YS Ngan;Elaine YP Lee
    • Korean Journal of Radiology
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    • v.23 no.5
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    • pp.539-547
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    • 2022
  • Objective: To investigate the association between functional tumor burden of peritoneal carcinomatosis (PC) derived from diffusion-weighted imaging (DWI) and overall survival in patients with advanced ovarian carcinoma (OC). Materials and Methods: This prospective study was approved by the local research ethics committee, and informed consent was obtained. Fifty patients (mean age ± standard deviation, 57 ± 12 years) with stage III-IV OC scheduled for primary or interval debulking surgery (IDS) were recruited between June 2016 and December 2021. DWI (b values: 0, 400, and 800 s/mm2) was acquired with a 16-channel phased-array torso coil. The functional PC burden on DWI was derived based on K-means clustering to discard fat, air, and normal tissue. A score similar to the surgical peritoneal cancer index was assigned to each abdominopelvic region, with additional scores assigned to the involvement of critical sites, denoted as the functional peritoneal cancer index (fPCI). The apparent diffusion coefficient (ADC) of the largest lesion was calculated. Patients were dichotomized by immediate surgical outcome into high- and low-risk groups (with and without residual disease, respectively) with subsequent survival analysis using the Kaplan-Meier curve and log-rank test. Multivariable Cox proportional hazards regression was used to evaluate the association between DWI-derived results and overall survival. Results: Fifteen (30.0%) patients underwent primary debulking surgery, and 35 (70.0%) patients received neoadjuvant chemotherapy followed by IDS. Complete tumor debulking was achieved in 32 patients. Patients with residual disease after debulking surgery had reduced overall survival (p = 0.043). The fPCI/ADC was negatively associated with overall survival when accounted for clinicopathological information with a hazard ratio of 1.254 for high fPCI/ADC (95% confidence interval, 1.007-1.560; p = 0.043). Conclusion: A high DWI-derived functional tumor burden was associated with decreased overall survival in patients with advanced OC.

Feasibility of Free-Breathing, Non-ECG-Gated, Black-Blood Cine Magnetic Resonance Images With Multitasking in Measuring Left Ventricular Function Indices

  • Pengfei Peng;Xun Yue;Lu Tang;Xi Wu;Qiao Deng;Tao Wu;Lei Cai;Qi Liu;Jian Xu;Xiaoqi Huang;Yucheng Chen;Kaiyue Diao;Jiayu Sun
    • Korean Journal of Radiology
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    • v.24 no.12
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    • pp.1221-1231
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    • 2023
  • Objective: To clinically validate the feasibility and accuracy of cine images acquired through the multitasking method, with no electrocardiogram gating and free-breathing, in measuring left ventricular (LV) function indices by comparing them with those acquired through the balanced steady-state free precession (bSSFP) method, with multiple breath-holds and electrocardiogram gating. Materials and Methods: Forty-three healthy volunteers (female:male, 30:13; mean age, 23.1 ± 2.3 years) and 36 patients requiring an assessment of LV function for various clinical indications (female:male, 22:14; 57.8 ± 11.3 years) were enrolled in this prospective study. Each participant underwent cardiac magnetic resonance imaging (MRI) using the multiple breath-hold bSSFP method and free-breathing multitasking method. LV function parameters were measured for both MRI methods. Image quality was assessed through subjective image quality scores (1 to 5) and calculation of the contrast-to-noise ratio (CNR) between the myocardium and blood pool. Differences between the two MRI methods were analyzed using the Bland-Altman plot, paired t-test, or Wilcoxon signed-rank test, as appropriate. Results: LV ejection fraction (LVEF) was not significantly different between the two MRI methods (P = 0.222 in healthy volunteers and P = 0.343 in patients). LV end-diastolic mass was slightly overestimated with multitasking in both healthy volunteers (multitasking vs. bSSFP, 60.5 ± 10.7 g vs. 58.0 ± 10.4 g, respectively; P < 0.001) and patients (69.4 ± 18.1 g vs. 66.8 ± 18.0 g, respectively; P = 0.003). Acceptable and comparable image quality was achieved for both MRI methods (multitasking vs. bSSFP, 4.5 ± 0.7 vs. 4.6 ± 0.6, respectively; P = 0.203). The CNR between the myocardium and blood pool showed no significant differences between the two MRI methods (18.89 ± 6.65 vs. 18.19 ± 5.83, respectively; P = 0.480). Conclusion: Multitasking-derived cine images obtained without electrocardiogram gating and breath-holding achieved similar image quality and accurate quantification of LVEF in healthy volunteers and patients.

Usability Evaluation Criteria Development and Application for Map-Based Data Visualization (지도 기반 데이터 시각화 플랫폼 사용성 평가 기준 개발 및 적용 연구)

  • Sungha Moon;Hyunsoo Yoon;Seungwon Yang;Sanghee Oh
    • Journal of the Korean Society for Library and Information Science
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    • v.58 no.2
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    • pp.225-249
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    • 2024
  • The purpose of this study is to develop an evaluation tool for map-based data visualization platforms and to conduct heuristic usability evaluations on existing platforms representing inter-regional information. We compared and analyzed the usability evaluation criteria of map-based platforms from the previous studies along with Nielsen's (1994) 10 usability evaluation principles. We proposed nine evaluation criteria, including (1) visibility, (2) representation of the real world, (3) consistency and standards, (4) user control and friendliness, (5) flexibility, (6) design, (7) compatibility, (8) error prevention and handling, and (9) help provision and documentation. Additionally, to confirm the effectiveness of the proposed criteria, four experts was invited to evaluate five domestic and international map-based data visualization platforms. As a result, the experts were able to rank the usability of the five platforms using the proposed map-based data visualization usability evaluation criteria, which included quantified scores and subjective opinions. The results of this study are expected to serve as foundational material for the future development and evaluation of map-based visualization platforms.

Surgical outcome and risk scoring to predict survival after hepatic resection for hepatocellular carcinoma with portal vein tumor thrombosis

  • Tae-Seok Kim;Kwangho Yang;Gi Hong Choi;Hye Yeon Yang;Dong-Sik Kim;Hye-Sung Jo;Gyu-Seong Choi;Kwan Woo Kim;Young Chul Yoon;Jaryung Han;Doo Jin Kim;Shin Hwang;Koo Jeong Kang
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.2
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    • pp.134-143
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    • 2024
  • Backgrounds/Aims: The hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is classified as the advanced stage (BCLC stage C) with extremely poor prognosis, and in current guidelines is recommended for systemic therapy. This study aimed to evaluate the surgical outcomes and long-term prognosis after hepatic resection (HR) for patients who have HCC combined with PVTT. Methods: We retrospectively analyzed 332 patients who underwent HR for HCC with PVTT at ten tertiary referral hospitals in South Korea. Results: The median overall and recurrence-free survival after HR were 32.4 and 8.6 months, while the 1-, 3-, and 5-year overall survival rates were 75%, 48%, and 39%, respectively. In multivariate analysis, tumor number, tumor size, AFP, PIVKA-II, neutrophil-to-lymphocyte ratio, and albumin-bilirubin (ALBI) grade were significant prognostic factors. The risk scoring was developed using these seven factors-tumor, inflammation and hepatic function (TIF), to predict patient prognosis. The prognosis of the patients was well stratified according to the scores (log-rank test, p < 0.001). Conclusions: HR for patients who have HCC combined with PVTT provided favorable survival outcomes. The risk scoring was useful in predicting prognosis, and determining the appropriate treatment strategy for those patients who have HCC with PVTT.

Optimization of the Flip Angle and Scan Timing in Hepatobiliary Phase Imaging Using T1-Weighted, CAIPIRINHA GRE Imaging

  • Kim, Jeongjae;Kim, Bong Soo;Lee, Jeong Sub;Woo, Seung Tae;Choi, Guk Myung;Kim, Seung Hyoung;Lee, Ho Kyu;Lee, Mu Sook;Lee, Kyung Ryeol;Park, Joon Hyuk
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.1
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    • pp.1-9
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    • 2018
  • Purpose: This study was designed to optimize the flip angle (FA) and scan timing of the hepatobiliary phase (HBP) using the 3D T1-weighted, gradient-echo (GRE) imaging with controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) technique on gadoxetic acid-enhanced 3T liver MR imaging. Materials and Methods: Sixty-two patients who underwent gadoxetic acid-enhanced 3T liver MR imaging were included in this study. Four 3D T1-weighted GRE imaging studies using the CAIPIRINHA technique and FAs of $9^{\circ}$ and $13^{\circ}$ were acquired during HBP at 15 and 20 min after intravenous injection of gadoxetic acid. Two abdominal radiologists, who were blinded to the FA and the timing of image acquisition, assessed the sharpness of liver edge, hepatic vessel clarity, lesion conspicuity, artifact severity, and overall image quality using a five-point scale. Quantitative analysis was performed by another radiologist to estimate the relative liver enhancement (RLE) and the signal-to-noise ratio (SNR). Statistical analyses were performed using the Wilcoxon signed rank test and one-way analysis of variance. Results: The scores of the HBP with an FA of $13^{\circ}$ during the same delayed time were significantly higher than those of the HBP with an FA of $9^{\circ}$ in all the assessment items (P < 0.01). In terms of the delay time, images at the same FA obtained with a 20-min-HBP showed better quality than those obtained with a 15-min-HBP. There was no significant difference in qualitative scores between the 20-min-HBP and the 15-min-HBP images in the non-liver cirrhosis (LC) group except for the hepatic vessel clarity score with $9^{\circ}$ FA. In the quantitative analysis, a statistically significant difference was found in the degree of RLE in the four HBP images (P = 0.012). However, in the subgroup analysis, no significant difference in RLE was found in the four HBP images in either the LC or the non-LC groups. The SNR did not differ significantly in the four HBP images. In the subgroup analysis, 20-min-HBP imaging with a $13^{\circ}$ FA showed the highest SNR value in the LC-group, whereas 15-min-HBP imaging with a $13^{\circ}$ FA showed the best value of SNR in the non-LC group. Conclusion: The use of a moderately high FA improves the image quality and lesion conspicuity on 3D, T1-weighted GRE imaging using the CAIPIRINHA technique on gadoxetic acid, 3T liver MR imaging. In patients with normal liver function, the 15-min-HBP with a $13^{\circ}$ FA represents a feasible option without a significant decrease in image quality.

Job Satisfaction and Its Related Factors among 119 Rescue Workers (119 구급대원의 직무만족도와 그의 관련요인)

  • Park, Ho-Jin;Yoon, Seok-Han;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.46-57
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    • 2017
  • This study examined the level of job satisfaction of rescue workers in accordance with the sociodemographic and health related characteristics, as well as job-related factors. Moreover, this study aimed to know the relationship between job satisfaction and violence experience, job stress, and burn-out. A total of 1,240 rescue workers, who works in 14 fire stations across the country, were surveyed. The survey was conducted by self-administered questionnaires during the period between March 1st and April 30, 2016. As a result, the score of job satisfaction according to the sociodemographic and health related characteristics were significantly lower in the younger-aged group, unmarried group, no-regular exercise group, and poor group of subjective sleep evaluation, unhealthy group of subjective health status than their respective counterparts. From the perspective of job-related characteristics, the job satisfaction scores were significantly lower in the groups of lower rank, lower job career, lower monthly income, hard group of physical burden of work, dissatisfaction group of sense of satisfaction in work, unfit group of the job, without group of consider quitting the job than their respective counterparts. The score of job satisfaction, in accordance with violence experience, job stress, and burn-out were significantly lower in groups with higher scores of violence experience, job stress, and burn-out. In a logistic regression analysis, the adjusted odds ratio of the low-risk job satisfaction were significantly increased in the very high group than in the low group of violence experience, in middle, high and very high group than in low group of job stress, in very high group than in low group of burn-out. The results suggest that the job satisfaction of rescue workers is significantly influenced by various factors, including socio-demographic characteristics, health-related behaviors, job-related characteristics, violence experience, job stress, and burn-out.

A Study on the Evaluation Criteria for Reconstruction Charge Allocation (재건축부담금 배분을 위한 지자체 평가기준 연구)

  • Kim, Joo-Jin;Song, Young-Hyun
    • Land and Housing Review
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    • v.2 no.1
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    • pp.35-46
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    • 2011
  • This paper aims at examining the indices and their weights for the evaluation of local government to allocate reconstruction charge and reviewing the availability of them simulating local governments' evaluation. There has been no specific evaluation criteria existed, while central government has to allocate the reconstruction charge to local governments by the provision 3 of Restitution of Housing Reconstruction Gains Act. The results as follows : According to a survey on evaluation indices weight and AHP analysis, the weight of 'the housing welfare improve effort' is the highest with 25.1% among 5 upper-classification indices. Following this, each weight of 'housing welfare conditions(22.7%)', 'housing SOC establishment(22.5%)', 'the achievement and planning on reconstruction charge use(15.8%)', and 'housing sector achievement such as Bogeumjari(13.9%)' are ranked. Meanwhile, Among 16 lower-classification indices, 'the rate of minimum housing standard households(11.5%)', 'public rental housing supply(8.9%)', 'reconstruction charge use achievement(8.3%)', 'reconstruction charge use planning submit(7.5%)', and 'rate of water and sewage(6.3%)' hold high rank. The analysis results show the weight of 'housing sector achievement such as Bogeumjari' on the existing provisions should be decreased(30%${\rightarrow}$13.9%) as others' weight has to be slightly increased. According to the result of the simulation, Jeonbuk, Gyeongbuk, Jeonnam, Jeju, Gyeonggi received higher scores in the comprehensive evaluation, while Daejeon, Seoul, Incheon, Daegu and Gwangju, where the housing conditions are relatively good, received lower scores. These results of the analysis correspond with the direction of reconstruction charges allocation and indicate that the evaluation criteria used in this simulation is acceptable.

Learning Material Bookmarking Service based on Collective Intelligence (집단지성 기반 학습자료 북마킹 서비스 시스템)

  • Jang, Jincheul;Jung, Sukhwan;Lee, Seulki;Jung, Chihoon;Yoon, Wan Chul;Yi, Mun Yong
    • Journal of Intelligence and Information Systems
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    • v.20 no.2
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    • pp.179-192
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    • 2014
  • Keeping in line with the recent changes in the information technology environment, the online learning environment that supports multiple users' participation such as MOOC (Massive Open Online Courses) has become important. One of the largest professional associations in Information Technology, IEEE Computer Society, announced that "Supporting New Learning Styles" is a crucial trend in 2014. Popular MOOC services, CourseRa and edX, have continued to build active learning environment with a large number of lectures accessible anywhere using smart devices, and have been used by an increasing number of users. In addition, collaborative web services (e.g., blogs and Wikipedia) also support the creation of various user-uploaded learning materials, resulting in a vast amount of new lectures and learning materials being created every day in the online space. However, it is difficult for an online educational system to keep a learner' motivation as learning occurs remotely, with limited capability to share knowledge among the learners. Thus, it is essential to understand which materials are needed for each learner and how to motivate learners to actively participate in online learning system. To overcome these issues, leveraging the constructivism theory and collective intelligence, we have developed a social bookmarking system called WeStudy, which supports learning material sharing among the users and provides personalized learning material recommendations. Constructivism theory argues that knowledge is being constructed while learners interact with the world. Collective intelligence can be separated into two types: (1) collaborative collective intelligence, which can be built on the basis of direct collaboration among the participants (e.g., Wikipedia), and (2) integrative collective intelligence, which produces new forms of knowledge by combining independent and distributed information through highly advanced technologies and algorithms (e.g., Google PageRank, Recommender systems). Recommender system, one of the examples of integrative collective intelligence, is to utilize online activities of the users and recommend what users may be interested in. Our system included both collaborative collective intelligence functions and integrative collective intelligence functions. We analyzed well-known Web services based on collective intelligence such as Wikipedia, Slideshare, and Videolectures to identify main design factors that support collective intelligence. Based on this analysis, in addition to sharing online resources through social bookmarking, we selected three essential functions for our system: 1) multimodal visualization of learning materials through two forms (e.g., list and graph), 2) personalized recommendation of learning materials, and 3) explicit designation of learners of their interest. After developing web-based WeStudy system, we conducted usability testing through the heuristic evaluation method that included seven heuristic indices: features and functionality, cognitive page, navigation, search and filtering, control and feedback, forms, context and text. We recruited 10 experts who majored in Human Computer Interaction and worked in the same field, and requested both quantitative and qualitative evaluation of the system. The evaluation results show that, relative to the other functions evaluated, the list/graph page produced higher scores on all indices except for contexts & text. In case of contexts & text, learning material page produced the best score, compared with the other functions. In general, the explicit designation of learners of their interests, one of the distinctive functions, received lower scores on all usability indices because of its unfamiliar functionality to the users. In summary, the evaluation results show that our system has achieved high usability with good performance with some minor issues, which need to be fully addressed before the public release of the system to large-scale users. The study findings provide practical guidelines for the design and development of various systems that utilize collective intelligence.

A Study on Perception of Good Instruction between In-service and Pre-service Teachers ('좋은 수업'에 대한 현직교사와 예비교사의 인식 연구 - 지양해야 할 수업 형태와 관련하여 -)

  • Eom, Miri;Kim, Myeong-Rang;Park, Innwoo;Jang, Seon-Yeong
    • (The)Korea Educational Review
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    • v.15 no.1
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    • pp.107-132
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    • 2009
  • What is good instruction? The term "instruction" means the essential activity of school education, a precondition for good school, and the starting point of reforming school education. The purpose of this study is to investigate the meaning of "good instruction" by examining the difference of perception between in-service teachers and pre-service teachers who encompass the viewpoint of both teacher and student using open-ended questionnaires asking the type of instruction that they have to avoid and the undesirable instruction. This study was carried out with 150 teachers who were working in the schools and 160 students who were in college of education to be teacher in the future. Collected data was analyzed using the QSR Nvivo qualitative program. The findings of this study indicates the followings: First, the most undesirable class cited by in-service teachers was the class that applies uniform instructional strategy, followed by class based on directions instruction, unsystematic class, class characterized by lack of teaching competency, class that emphasizes test scores and competition, class that are not interactive enough, class that does not consider the level of students, class in which students are not respected, class that have poor educational environment, and the class in which little support is provided. Second, the most undesirable class cited by pre-service teachers was the class that applies uniform instructional strategy, followed by unsystematic class, class characterized by lack of teaching competency, class based on directions instruction, class in which students are not respected, class that emphasizes test scores and competition, class that does not consider the level of students, class that are not interactive enough, class that have poor educational environment, and the class in which little support is provided. Third, this study examined the difference of perception between in-service teachers and pre-service teachers toward the undesirable class that they have to avoid. In terms of the integrated rank that is common among in-service teachers and pre-service teachers, the most undesirable class that they have to avoid was the class that applies uniform instructional strategy, unsystematic class, class based on directions instruction, and class characterized by lack of teaching competency. The findings of this study may be used as a basis for in-service teachers to reflect on their professionalism of instruction that they provide and examine the attitude of students toward instruction, while providing a practical guideline for pre-service teachers to design and ensure systematic instruction in the future.

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.