• Journal of Korean Neurosurgical Society
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• 제61권6호
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• pp.723-730
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• 2018

Objective : The aim of the present study was to identify whether the deformity angular ratio (DAR) influences the occurrence of complications after posterior vertebral column resection (PVCR) and to establish the DAR cut-off value. Methods : Thirty-six consecutive patients undergoing PVCR from December 2010 to October 2016 were reviewed. The relationships between the total, sagittal, and coronal DAR and complications were assessed using receiver operator characteristics curves. The patients were divided into two groups according to a reference value based on the cut-off value of DAR. Demographic, surgical, radiological, and clinical outcomes were compared between the groups. Results : There were no significant differences in the patient demographic and surgical data between the groups. The cut-off values for the total DAR (T-DAR) and the sagittal DAR (S-DAR) were 20.2 and 16.4, respectively (p=0.018 and 0.010). Both values were significantly associated with complications (p=0.016 and 0.005). In the higher T-DAR group, total complications (12 vs. 21, p=0.042) and late-onset complications (3 vs. 9, p=0.036) were significantly correlated with the T-DAR. The number of patients experiencing complications (9 vs. 11, p=0.029) and the total number of complications (13 vs. 20, p=0.015) were significantly correlated with the S-DAR. Worsening intraoperative neurophysiologic monitoring was more frequent in the higher T-DAR group (2 vs. 4) than in the higher S-DAR group (3 vs. 3). There was no difference in neurological deterioration between the groups after surgery. Conclusion : Both the T-DAR and the S-DAR are risk factors for complications after PVCR. Those who had a T-DAR >20.2 or S-DAR >16.4 experienced a higher rate of complications after PVCR.

• Gut and Liver
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• 제12권6호
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• pp.714-721
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• 2018

Background/Aims: Recently reported prognostic models for primary biliary cholangitis (PBC) have been shown to be effective in Western populations but have not been well-validated in Asian patients. This study aimed to compare the performance of prognostic models in Korean patients and to investigate whether inflammation-based scores can further help in prognosis prediction. Methods: This study included 271 consecutive patients diagnosed with PBC in Korea. The following prognostic models were evaluated: the Barcelona model, the Paris-I/II model, the Rotterdam criteria, the GLOBE score and the UK-PBC score. The neutrophil-to-lymphocyte ratio (NLR) was analyzed with reference to its association with prognosis. Results: For predicting liver transplant or death at the 5-year and 10-year follow-up examinations, the UK-PBC score (areas under the receiver operating characteristic curve [AUCs], 0.88 and 0.82) and GLOBE score (AUCs, 0.85 and 0.83) were significantly more accurate in predicting prognosis than the other scoring systems (all p<0.05). There was no significant difference between the performance of the UK-PBC and GLOBE scores. In addition to the prognostic models, a high NLR (>2.46) at baseline was an independent predictor of reduced transplant-free survival in the multivariate analysis (adjusted hazard ratio, 3.74; p<0.01). When the NLR was applied to the prognostic models, it significantly differentiated the prognosis of patients. Conclusions: The UK-PBC and GLOBE scores showed good prognostic performance in Korean patients with PBC. In addition, a high NLR was associated with a poorer prognosis. Including the NLR in prognostic models may further help to stratify patients with PBC.

• 정보보호학회논문지
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• 제10권4호
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• pp.81-93
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• 2000

본 논문에서는 RSA 암호 시스템의 핵심 연산인 모듈로 멱승의 처리속도를 향상시키기 위한 방법으로 하이래딕스 (High-Radix) 연산 방식과 CRT(Chinese Remainder Theorem)를 적용한 새로운 하드웨어 구조를 제안한다. 모듈로 멱승의 기본 연산인 모듈로 곱셈은 16진 연산 방법을 사용하여 PE(Processing Element)의 개수를 1/4고 줄임으로써, 기존의 이 진 연산 방식에 비해 클럭 수차 파이프라이닝 플립플롭의 지연시간을 1/4로 줄였다. 복호화시에는 합성수인 계수 N 의 인수, p, q를 알고 있는 점을 이용하여 속도를 향상시키는 일반적인 방법인 CRT 알고리즘을 적용하였다. 즉, s비트 의 키에 대해, s/2비트 모듈로 곱셈기 두 개를 병렬로 동시 수행함으로써 처리 속도를 CRT를 사용하지 않을 때보다 4 배정도 향상시켰다. 암호화의 경우는 두 개의 s/2비트 모듈로 곱셈기를 직렬로 연결하여 s/비트에 대한 연산이 가능하도록 하였으며 공개키는 E는 17비트까지의 지수를 허용하여 빠른 속도를 유지하였다. 모듈로 곱셈은 몽고메리 알고리즘을 변형하여 사용하였으며, 그 내부 계산 구조를 보여주는 데이터 종속 그래프(Dependence Graph)를 수평으로 매핑하여 1차원 선형 어레이 구조로 구성하였다. 그 결과 삼성 0.5um CMOS 스탠다드 셀 라이브러리를 근거로 산출한 때, 1024 비트 RSA 연산에 대해서 160Mhz의 클럭 주파수로 암호화 시에 15Mbps, 복호화 시에 1.22Mbs의 성능을 가질 것으로 예측되며, 이러한 성능은 지금가지 발표된 국내의의 어느 논문보다도 빠른 RSA 처리 시간이다.

• 방송공학회논문지
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• 제28권3호
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• pp.314-328
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• 2023

본 논문에서는 동적 메쉬 부/복호화 시 스케일러빌리티 기능을 지원하기 위해 SHVC의 계층적 부호화 방식을 기반으로 텍스처 맵을 압축하는 방법을 제안한다. 제안하는 방법은 고해상도 텍스처 맵을 다운샘플링하여 다해상도의 텍스처 맵을 생성하고 이를 SHVC로 부호화함으로써 효과적으로 다해상도 텍스처 맵들의 중복성을 제거한다. 동적 메쉬 복호화기에서는 수신기 성능, 네트워크 환경 등에 따라 적합한 해상도의 텍스처 맵을 복호화하여 메쉬 데이터의 스케일러빌리티를 지원할 수 있도록 한다. 제안하는 방법의 성능을 검증하기 위해 V-DMC (Video-based Dynamic Mesh Coding) 참조 소프트웨어인 TMMv1.0에 제안하는 방법을 적용하고 본 논문에서 제안하는 스케일러블 부/복호화기와 TMMv1.0 기반의 시뮬캐스트 방식의 성능을 비교하였다. 제안하는 방법은 시뮬캐스트 방법 대비 AI, LD 환경에서 Luma BD-rate (Luma PSNR)가 각각 평균 -7.7%, -5.7%의 향상된 결과를 얻어 제안하는 방법을 통해 효과적으로 동적 메쉬 데이터의 텍스처 맵 스케일러빌리티 지원이 가능함을 확인하였다.

• Korean Journal of Radiology
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• 제21권4호
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• pp.431-441
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• 2020

Objective: To compare the diagnostic performance and interobserver variability of strain ratio obtained from one or two regions of interest (ROI) on breast elastography. Materials and Methods: From April to May 2016, 140 breast masses in 140 patients who underwent conventional ultrasonography (US) with strain elastography followed by US-guided biopsy were evaluated. Three experienced breast radiologists reviewed recorded US and elastography images, measured strain ratios, and categorized them according to the American College of Radiology breast imaging reporting and data system lexicon. Strain ratio was obtained using the 1-ROI method (one ROI drawn on the target mass), and the 2-ROI method (one ROI in the target mass and another in reference fat tissue). The diagnostic performance of the three radiologists among datasets and optimal cut-off values for strain ratios were evaluated. Interobserver variability of strain ratio for each ROI method was assessed using intraclass correlation coefficient values, Bland-Altman plots, and coefficients of variation. Results: Compared to US alone, US combined with the strain ratio measured using either ROI method significantly improved specificity, positive predictive value, accuracy, and area under the receiver operating characteristic curve (AUC) (all p values < 0.05). Strain ratio obtained using the 1-ROI method showed higher interobserver agreement between the three radiologists without a significant difference in AUC for differentiating breast cancer when the optimal strain ratio cut-off value was used, compared with the 2-ROI method (AUC: 0.788 vs. 0.783, 0.693 vs. 0.715, and 0.691 vs. 0.686, respectively, all p values > 0.05). Conclusion: Strain ratios obtained using the 1-ROI method showed higher interobserver agreement without a significant difference in AUC, compared to those obtained using the 2-ROI method. Considering that the 1-ROI method can reduce performers' efforts, it could have an important role in improving the diagnostic performance of breast US by enabling consistent management of breast lesions.

• Korean Journal of Radiology
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• 제23권2호
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• pp.180-188
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• 2022

Objective: To validate the performance of 3T spin-echo echo-planar imaging (SE-EPI) magnetic resonance elastography (MRE) for staging hepatic fibrosis in a large population, using surgical specimens as the reference standard. Materials and Methods: This retrospective study initially included 310 adults (155 undergoing hepatic resection and 155 undergoing donor hepatectomy) with histopathologic results from surgical liver specimens. They underwent 3T SE-EPI MRE ≤ 3 months prior to surgery. Demographic findings, underlying liver disease, and hepatic fibrosis pathologic stage according to METAVIR were recorded. Liver stiffness (LS) was measured by two radiologists, and inter-reader reproducibility was evaluated using the intraclass correlation coefficient (ICC). The mean LS of each fibrosis stage (F0-F4) was calculated in total and for each etiologic subgroup. Comparisons among subgroups were performed using the Kruskal-Wallis test and Conover post-hoc test. The cutoff values for fibrosis staging were estimated using receiver operating characteristic (ROC) curve analysis. Results: Inter-reader reproducibility was excellent (ICC, 0.98; 95% confidence interval, 0.97-0.99). The mean LS values were 1.91, 2.41, 3.24, and 5.41 kPa in F0-F1 (n = 171), F2 (n = 26), F3 (n = 38), and F4 (n = 72), respectively. The discriminating cutoff values for diagnosing ≥ F2, ≥ F3, and F4 were 2.18, 2.71, and 3.15 kPa, respectively, with the ROC curve areas of 0.97-0.98 (sensitivity 91.2%-95.9%, specificity 90.7%-99.0%). The mean LS was significantly higher in patients with cirrhosis (F4) of nonviral causes, such as primary biliary cirrhosis (9.56 kPa) and alcoholic liver disease (7.17 kPa) than in those with hepatitis B or C cirrhosis (4.28 and 4.92 kPa, respectively). There were no statistically significant differences in LS among the different etiologic subgroups in the F0-F3 stages. Conclusion: The 3T SE-EPI MRE demonstrated high interobserver reproducibility, and our criteria for staging hepatic fibrosis showed high diagnostic performance. LS was significantly higher in patients with non-viral cirrhosis than in those with viral cirrhosis.

• Korean Journal of Radiology
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• 제24권10호
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• pp.983-995
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• 2023

Objective: To compare the diagnostic performance and interobserver agreement between contrast-enhanced computed tomography (CECT) and contrast-enhanced magnetic resonance imaging (CE-MRI) with magnetic resonance cholangiopancreatography (MRCP) for evaluating the resectability in patients with extrahepatic cholangiocarcinoma (eCCA). Materials and Methods: This retrospective study included treatment-naïve patients with pathologically confirmed eCCA, who underwent both CECT and CE-MRI with MRCP using extracellular contrast media between January 2015 and December 2020. Among the 214 patients (146 males; mean age ± standard deviation, 68 ± 9 years) included, 121 (56.5%) had perihilar cholangiocarcinoma. R0 resection was achieved in 108 of the 153 (70.6%) patients who underwent curative-intent surgery. Four fellowship-trained radiologists independently reviewed the findings of both CECT and CE-MRI with MRCP to assess the local tumor extent and distant metastasis for determining resectability. The pooled area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of CECT and CE-MRI with MRCP were compared using clinical, surgical, and pathological findings as reference standards. The interobserver agreement of resectability was evaluated using Fleiss kappa (κ). Results: No significant differences were observed between CECT and CE-MRI with MRCP in the pooled AUC (0.753 vs. 0.767), sensitivity (84.7% [366/432] vs. 90.3% [390/432]), and specificity (52.6% [223/424] vs. 51.4% [218/424]) (P > 0.05 for all). The AUC for determining resectability was higher when CECT and CE-MRI with MRCP were reviewed together than when CECT was reviewed alone in patients with discrepancies between the imaging modalities or with indeterminate resectability (0.798 [0.754-0.841] vs. 0.753 [0.697-0.808], P = 0.014). The interobserver agreement for overall resectability was fair for both CECT (κ = 0.323) and CE-MRI with MRCP (κ = 0.320), without a significant difference (P = 0.884). Conclusion: CECT and CE-MRI with MRCP showed no significant differences in the diagnostic performance and interobserver agreement in determining the resectability in patients with eCCA.

• Korean Journal of Radiology
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• 제23권3호
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• pp.343-354
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• 2022

Objective: To develop and evaluate a deep learning-based artificial intelligence (AI) model for detecting skull fractures on plain radiographs in children. Materials and Methods: This retrospective multi-center study consisted of a development dataset acquired from two hospitals (n = 149 and 264) and an external test set (n = 95) from a third hospital. Datasets included children with head trauma who underwent both skull radiography and cranial computed tomography (CT). The development dataset was split into training, tuning, and internal test sets in a ratio of 7:1:2. The reference standard for skull fracture was cranial CT. Two radiology residents, a pediatric radiologist, and two emergency physicians participated in a two-session observer study on an external test set with and without AI assistance. We obtained the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity along with their 95% confidence intervals (CIs). Results: The AI model showed an AUROC of 0.922 (95% CI, 0.842-0.969) in the internal test set and 0.870 (95% CI, 0.785-0.930) in the external test set. The model had a sensitivity of 81.1% (95% CI, 64.8%-92.0%) and specificity of 91.3% (95% CI, 79.2%-97.6%) for the internal test set and 78.9% (95% CI, 54.4%-93.9%) and 88.2% (95% CI, 78.7%-94.4%), respectively, for the external test set. With the model's assistance, significant AUROC improvement was observed in radiology residents (pooled results) and emergency physicians (pooled results) with the difference from reading without AI assistance of 0.094 (95% CI, 0.020-0.168; p = 0.012) and 0.069 (95% CI, 0.002-0.136; p = 0.043), respectively, but not in the pediatric radiologist with the difference of 0.008 (95% CI, -0.074-0.090; p = 0.850). Conclusion: A deep learning-based AI model improved the performance of inexperienced radiologists and emergency physicians in diagnosing pediatric skull fractures on plain radiographs.

• Korean Journal of Radiology
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• 제24권11호
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• pp.1142-1150
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• 2023

Objective: To evaluate ^99mtechnetium-three polyethylene glycol spacers-arginine-glycine-aspartic acid (^99mTc-3PRGD₂) single-photon emission computed tomography (SPECT)/computed tomography (CT) imaging for diagnosing lymph node metastasis of primary malignant lung neoplasms. Materials and Methods: We prospectively enrolled 26 patients with primary malignant lung tumors who underwent ^99mTc-3PRGD₂ SPECT/CT and ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/CT imaging. Both imaging methods were analyzed in qualitative (visual dichotomous and 5-point grades for lymph nodes and lung tumors, respectively) and semiquantitative (maximum tissue-to-background radioactive count) manners for the lymph nodes and lung tumors. The performance of the differentiation of lymph nodes with and without metastasis was determined at the per-lymph node station and per-patient levels using histopathological results as the reference standard. Results: Total 42 stations had metastatic lymph nodes and 136 stations had benign lymph nodes. The differences between metastatic and benign lymph nodes in the visual qualitative and semiquantitative analyses of ^99mTc-3PRGD₂ SPECT/CT and ¹⁸F-FDG PET/CT were statistically significant (all P < 0.001). The area under the receiver operating characteristic curve (AUC) in the semi-quantitative analysis of ^99mTc-3PRGD₂ SPECT/CT was 0.908 (95% confidence interval [CI], 0.851-0.966), and the sensitivity, specificity, positive predictive value, and negative predictive value were 0.86 (36/42), 0.88 (120/136), 0.69 (36/52), and 0.95 (120/126), respectively. Among the 26 patients (including two patients each with two lung tumors), 15 had pathologically confirmed lymph node metastasis. The difference between primary lung lesions in patients with and without lymph node metastasis was statistically significant only in the semi-quantitative analysis of ^99mTc-3PRGD₂ SPECT/CT (P = 0.007), with an AUC of 0.807 (95% CI, 0.641-0.974). Conclusion: ^99mTc-3PRGD₂ SPECT/CT imaging may notably perform in the direct diagnosis of lymph node metastasis of primary malignant lung tumors and indirectly predict the presence of lymph node metastasis through uptake in the primary lesions.

• 한국전자파학회논문지
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• 제20권9호
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• pp.868-882
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• 2009

본 논문에서는 현재 주목을 받고 있는 테라헤르츠 대역의 주파수에서 근거리 무선 통신 응용을 위한 채널 모델과 무선 링크의 성능 분석에 대하여 서술한다. 10 Gbps 이상의 전송 속도를 실현하기 위해서는 주파수 대역폭이 기존의 밀리미터파에서 사용하는 주파수 대역폭보다 더 넓은 대역폭이 필요하며, 이 대역폭을 얻기 위해서는 테라헤르츠 주파수 대역으로 자연적으로 옮겨가지 않을 수 없다. ITU-R P.676-7 모델을 이용하여 테라헤르츠 대역의 대기 전파 감쇠 특성 분석 결과, 중심 주파수 220, 300, 350 GHz에서 약 68, 48, 45 GHz의 주파수 대역폭이 가용하며, 스펙트럼 효율이 1 이하인 변조 방식으로도 10 Gbps 이상의 데이터 속도를 얻을 수 있음을 시뮬레이션을 통하여 확인하였다. 간략화 PDP 모델을 이용하여 실내 공간의 건물 재질에 따른 지연 특성을 분석하였다. 실내 공간의 크기 $6\;m(L){\times}5\;m(W){\times}2.5\;m(H)$에서 콘크리트 벽의 경우 TE 편파에서 RMS 지연 확산은 9.23 ns였다. 이 결과는 참고문헌의 Ray-Tracing 시뮬레이션에서 얻은 10 ns 이내에 근접한다. 옥내 무선 링크 성능 분석 결과, 수신기의 감도는 BPSK 변조 방식을 사용하는 경우 대역폭 $5{\sim}50\;GHz$에 대하여 $-56{\sim}-46\;dBm$이고, 안테나 이득은 10 m 링크에서 $26.6{\sim}31.6\;dBi$였다. AWGN 채널과 LOS 환경을 가정할 때 송신기 출력 -15dBm에서 캐리어 주파수 220, 300, 350 GHz일 때 최대 달성 가능한 데이터 속도는 각각 30, 16, 12 Gbps였다. 이 결과는 BPSK 변조 방식을 사용하여 1 m 링크에서 얻은 결과이다. BER은 $10^{-12}$으로 가정하였고, 송신기 출력을 증가시키면 더욱 높은 데이터 속도를 얻을 수 있다.