• Journal of Korean Neurosurgical Society
• /
• v.41 no.6
• /
• pp.371-376
• /
• 2007

Objective : The aim of this study was to investigate the usefulness of diffusion-weighted imaging [DWI] and apparent diffusion coefficiency [ADC] in distinguishing brain abscesses from cystic or necrotic brain tumors, which are difficult to be differentiated by conventional magnetic resonance imaging techniques. Methods : Seven patients with brain abscesses and ten patients with cystic brain tumors were studied from September 2003 to October 2005. Abscess, subdural empyema and ventriculitis were categorized to the abscess group and cystic or necrotic brain gliomas or metastatic brain tumors into the tumor group. Preoperative magnetic resonance images were performed in all patients and diffusion-weighted images and apparent diffusion coefficiency values of lesions were calculated directly from software of 1.5 tesla MRI [General Electrics, USA]. The ratio of the ADC of the lesion to contralateral regional ADC was also measured [relative ADC, rADC]. Results : The average ADC value of pyogenic abscesses group was $0.82+/-0.14{\times}10^{-3}\;[mean+/-S.D.]\;mm^2/s$ and mean rADC was 0.75. Cystic or necrotic areas had high ADC values [$2.49+/-0.79{\times}10^{-3}\;mm^2/s$, mean rADC=2.14]. ADC and rADC values of abscesses group showed about three times lower values than those of cystic or necrotic tumor group. Conclusion : This study results based on numerical comparison of signal intensities and quantitative analysis to distinguish between brain abscess and cystic or necrotic tumor, DWI and ADC mapping are thought to be very useful diagnostic tools.

• Anxiety and mood
• /
• v.14 no.2
• /
• pp.80-87
• /
• 2018

Objective : The purpose of this study was to investigate prevalence and clinical characteristics of Post-traumatic Stress Disorder (PTSD) in North Korean defectors (NKD). Methods : The study population consisted of 300 NKDs registered in the multi-regional adaptation center (Hana Center), within three years of settling in South Korea. We conducted in-person interviews and a survey with each subject, based on the North Korean version of the WHO-Composite International Diagnostic Interview (NK-CIDI) and various clinical scales. Results : Lifetime prevalence of PTSD in NKDs was 15.3%, approximately nine times higher than South Koreans (1.7%). Although experiencing broader type of traumas with higher rate than South Koreans, NKDs revealed lower odds of PTSD in most type of trauma (p<0.05). Conclusion : NKDs are at higher risk of experiencing different types of trauma than the general population in South Korea, and it is further validated that prevalence of PTSD is also higher. Careful evaluation for comorbid psychiatric symptoms and type of traumas prior to PTSD treatment for NKDs is necessary to facilitate more appropriate intervention for each subject, according to personal experience.

• Biomedical Science Letters
• /
• v.25 no.1
• /
• pp.99-106
• /
• 2019

Amyloid positron emission tomography (PET) allows early and accurate diagnosis in suspected cases of Alzheimer's disease (AD) and contributes to future treatment plans. In the present study, a method of implementing a diagnostic system to distinguish ${\beta}$-Amyloid ($A{\beta}$) positive from $A{\beta}$ negative with objectiveness and accuracy was proposed using a machine learning approach, such as the Principal Component Analysis (PCA) and Support Vector Machine (SVM). $^{18}F$-Florbetaben (FBB) brain PET images were arranged in control and patients (total n = 176) with mild cognitive impairment and AD. An SVM was used to classify the slices of registered PET image using PET template, and a system was created to diagnose patients comprehensively from the output of the trained model. To compare the per-slice classification, the PCA-SVM model observing the whole brain (WB) region showed the highest performance (accuracy 92.38, specificity 92.87, sensitivity 92.87), followed by SVM with gray matter masking (GMM) (accuracy 92.22, specificity 92.13, sensitivity 92.28) for $A{\beta}$ positivity. To compare according to per-subject classification, the PCA-SVM with WB also showed the highest performance (accuracy 89.21, specificity 71.67, sensitivity 98.28), followed by PCA-SVM with GMM (accuracy 85.80, specificity 61.67, sensitivity 98.28) for $A{\beta}$ positivity. When comparing the area under curve (AUC), PCA-SVM with WB was the highest for per-slice classifiers (0.992), and the models except for SVM with WM were highest for the per-subject classifier (1.000). We can classify $^{18}F$-Florbetaben amyloid brain PET image for $A{\beta}$ positivity using PCA-SVM model, with no additional effects on GMM.

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.27 no.2
• /
• pp.39-48
• /
• 2021

Purpose: The study aims to demonstrate regional diagnosis methods and results combined with geographical information to expand the physical infrastructure related to community care services. To this end, the physical infrastructure for the core elements of community care was analyzed in terms of the fulfilment and access of facilities to derive the underserved elements and regions. Methods: Utilizes GIS network analysis techniques that can derive physical infrastructure service areas. Underserved elements are derived by comparing and analyzing the service area for each core element. Next, the underserved regions for each core element are derived through the overlapping of the set service area and the diagnosis population. Results: Among the physical infrastructure by core elements for community care, the housing support element was considerably weak, and the nursing care facility compared to health care was also analyzed to be weak. In addition, underserved regions by dong in Mapo-gu were deduced and presented for each diagnosed population. Implications: The discovery of underserved elements and underserved regions is meaningful as a diagnostic process that can derive the physical infrastructure that needs to be expanded urgently for the realization of community care and determine the priority projects and targets of the projects.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.24 no.4
• /
• pp.325-336
• /
• 2021

The occurrence of functional gastrointestinal disorders (FGIDs) is a formidable challenge for infants, parents, and healthcare professionals. Although data from the Middle East are scarce, experts consider FGIDs a prevalent condition in everyday clinical practice. The new Rome IV criteria revisited the definitions from a clinical perspective to provide a practical and consistent diagnostic protocol for FGIDs. However, the treatment practices for functional disorders vary considerably among Middle Eastern countries, often resulting in mismanagement with unnecessary investigations and treatments. In addition, the role of various treatment modalities, including probiotics such as Lactobacillus reuteri DSM 17938, in FGIDs requires further discussion and evaluation. During a consensus meeting, a locally relevant approach for treating common FGIDs such as infant regurgitation, infant colic, and functional constipation was discussed and approved by regional experts. The participants suggested a simplified treatment plan and protocol for general pediatricians and other primary care physicians managing FGIDs. This easy-to-follow standardized protocol will help streamline the initial management of this complex disorder in the Middle East region and even globally.

• Korean Journal of Radiology
• /
• v.24 no.11
• /
• pp.1131-1141
• /
• 2023

Objective: Cortical iron deposition has recently been shown to occur in Alzheimer's disease (AD). In this study, we aimed to evaluate how cortical gray matter iron, measured using quantitative susceptibility mapping (QSM), differs in the clinical cognitive impairment spectrum. Materials and Methods: This retrospective study evaluated 73 participants (mean age ± standard deviation, 66.7 ± 7.6 years; 52 females and 21 males) with normal cognition (NC), 158 patients with mild cognitive impairment (MCI), and 48 patients with AD dementia. The participants underwent brain magnetic resonance imaging using a three-dimensional multi-dynamic multi-echo sequence on a 3-T scanner. We employed a deep neural network (QSMnet+) and used automatic segmentation software based on FreeSurfer v6.0 to extract anatomical labels and volumes of interest in the cortex. We used analysis of covariance to investigate the differences in susceptibility among the clinical diagnostic groups in each brain region. Multivariable linear regression analysis was performed to study the association between susceptibility values and cognitive scores including the Mini-Mental State Examination (MMSE). Results: Among the three groups, the frontal (P < 0.001), temporal (P = 0.004), parietal (P = 0.001), occipital (P < 0.001), and cingulate cortices (P < 0.001) showed a higher mean susceptibility in patients with MCI and AD than in NC subjects. In the combined MCI and AD group, the mean susceptibility in the cingulate cortex (β = -216.21, P = 0.019) and insular cortex (β = -276.65, P = 0.001) were significant independent predictors of MMSE scores after correcting for age, sex, education, regional volume, and APOE4 carrier status. Conclusion: Iron deposition in the cortex, as measured by QSMnet+, was higher in patients with AD and MCI than in NC participants. Iron deposition in the cingulate and insular cortices may be an early imaging marker of cognitive impairment related neurodegeneration.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.21 no.2
• /
• pp.143-150
• /
• 2023

Purpose: This study aimed to compare the clinical features of methanol and ethylene glycol poisoning. Methods: This single-center retrospective observational study included patients with toxic alcohol poisoning who visited a regional emergency medical center. Patients with methanol and ethylene glycol poisoning from January 2004 to June 2023 were selected for the study using diagnostic codes. Results: Twenty-two patients with toxic alcohol poisoning visited during the study period, with 11 patients for each category. Compared to methanol poisoning, ethylene glycol poisoning patients were more likely to have consumed alcohol for suicidal purposes (n=4 [36.36%] vs. n=8 [72.73%]) and were more likely to be drowsy (n=0 vs. n=6 [54.55%], p=0.016). The anion gap (25.43±8.35 mmol/L vs. 13.22±6.23 mmol/L, p=0.001) and lactic acid levels (1.785 [1.3-2.785] mmol/L vs. 9.90 [4.20-11.81] mmol/L, p=0.007) were higher in ethylene glycol poisoning patients than in methanol poisoning patients. Among alcohol dehydrogenase blockers, oral ethanol was administered to 10 patients (45.45%) (n=4 [36.36%] vs. n=6 [54.55%]), and intravenous ethanol was administered to six patients (n=4 [36.36%] vs. n=2 [18.18%]). Fomepizole was administered to two patients (9.09%) each, and renal replacement therapy was non-significantly more common in patients with ethylene glycol poisoning (n=8 [72.73%] vs. n=3 [27.27%], p=0.128). Three patients had delays in diagnosis and treatment, and while there were no fatalities, one patient was left with permanent vision damage. Conclusion: Because these are uncommon types of poisoning and the clinical presentation is difficult to recognize early, healthcare providers should be familiar with toxic alcohol types and screen for them to ensure proper diagnosis and treatment.

• Nuclear Medicine and Molecular Imaging
• /
• v.40 no.6
• /
• pp.309-315
• /
• 2006

Purpose: Accurate evaluation of cervical lymph node (LN) metastasis of head and neck squamous cell canter (SCC) is important to treatment planning. We evaluated the diagnostic accuracy of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the detection of cervical LN metastasis of head and neck SCC and performed a retrospective comparison with CT/MRI findings. Materials & Methods: Seventeen patients with pathologically proven head and neck SCC underwent F-18 FDG PET/CT and CT/MRI within 4 week before surgery. We recorded lymph node metastases according to the neck level system of imaging-based nodal classification. F-18 FDG PET/CT images were analyzed visually for assessment of regional tracer uptake in LN. We analyzed the differences in sensitivity and specificity between F-18 FDG PET/CT and CT/MRI using the Chi-square test. Results: Among the 17 patients, a total of 123 LN levels were dissected, 29 of which showed metastatic involvement. The sensitivity and specificity of F-18 FDG PET/CT for detecting cervical LN metastasis on a level-by-level basis were 69% (20/29) and 99% (93/94). The sensitivity and specificity of CT/MRI were 62% (18/29) and 96% (90/94). There was no significant difference in diagnostic accuracy between F-18 FDG PET/CT and CT/MRI. Interestingly, F-18 FDG PET/CT detected double primary tumor (hepatocellular carcinoma) and rib metastasis, respectively. Conclusion: There was not statistically significant difference of diagnostic accuracy between F-18 FDG PET/CT and CT/MRI for the detection of cervical LN metastasis of head and neck SCC. The low sensitivity of F-18 FDG PET/CT was due to limited resolution for small metastatic deposits.

• The Korean Journal of Nuclear Medicine
• /
• v.38 no.3
• /
• pp.241-252
• /
• 2004

Purpose: Population based structural and functional maps of the brain provide effective tools for the analysis and interpretation of complex and individually variable brain data. Brain MRI and PET standard templates and statistical probabilistic maps based on image data of Korean normal volunteers have been developed and probabilistic maps based on cytoarchitectonic data have been introduced. A quantification method using these data was developed for the objective assessment of regional intensity in the brain images. Materials and Methods: Age, gender and ethnic specific anatomical and functional brain templates based on MR and PET images of Korean normal volunteers were developed. Korean structural probabilistic maps for 89 brain regions and cytoarchitectonic probabilistic maps for 13 Brodmann areas were transformed onto the standard templates. Brain FDG PET and SPGR MR images of normal volunteers were spatially normalized onto the template of each modality and gender. Regional uptake of radiotracers in PET and gray matter concentration in MR images were then quantified by averaging (or summing) regional intensities weighted using the probabilistic maps of brain regions. Regionally specific effects of aging on glucose metabolism in cingulate cortex were also examined. Results: Quantification program could generate quantification results for single spatially normalized images per 20 seconds. Glucose metabolism change in cingulate gyrus was regionally specific: ratios of glucose metabolism in the rostral anterior cingulate vs. posterior cingulate and the caudal anterior cingulate vs. posterior cingulate were significantly decreased as the age increased. 'Rostral anterior'/'posterior' was decreased by 3.1% per decade of age ($P<10^{-11}$, r=0.81) and 'caudal anterior'/'posterior' was decreased by 1.7% ($P<10^{-8}$, r=0.72). Conclusion: Ethnic specific standard templates and probabilistic maps and quantification program developed in this study will be useful for the analysis of brain image of Korean people since the difference in shape of the hemispheres and the sulcal pattern of brain relative to age, gender, races, and diseases cannot be fully overcome by the nonlinear spatial normalization techniques.

• The Korean Journal of Emergency Medical Services
• /
• v.3 no.1
• /
• pp.65-76
• /
• 1999

Objectives: This study sought to examine the impact of alcohol use and misuse on mortality in korea during the 1991-l997. Methods: Alcohol-Related Disease Impact estimation software and Korea vital statistics data were used to calculate alcohol related-mortality, mortality rates, and YPLL(years of potential life lost). The major findings are as follows : An estimated 23,528 Korean died during 1997 from causes related to alcohol. Such deaths accounted for 17,052(12.60%) of all deaths for men and 6,206(5.88%) for women. Motor vehicle accidents were major contributors to the total estimated number of alcohol related deaths and years of potential life lost before age 65. Alcohol related mortality rates were significantly higher for men. For men, major causes of the deaths were motor vehicle accidents(4,147 deaths, 17.90 per 100,000 population), cancer of the stomach(1,467 deaths, 16.60 per 100,000 population) and chronic liver diseases and cirrhosis(1,233 deaths, 13.10). For women, the largest contributors to alcohol related mortality were motor vehicle accidents(1,509 deaths, 6.61), cerebrovascular diseases(1,114 deaths, 11.3) and cancer of the stomach(810 deaths, 8.24). Kleinman's method was used for obtaining on regional(Dongs, ups and Myons) differential of the alcohol related mortality in 1995. In general, The alcohol-related death rate for men was significantly higher than that for women, and the rate for ups and myons was significantly higher than that for dongs During 1997, approximately 356,667(male: 282, 510, female: 74, 157)YPLL to age 65 and 572,708(male:424,338, female:148,370)YPLL to life expectancy were attributable to alcohol related causes. Men accounted for 79% of the total YPLL to age 65 and 74% of the total YPLL to life expectancy The major contributors to these alcohol related years lost were the diagnostic categories of unintentional injuries. Particullary, In male, Motor vehicle accidents and accidental drowning-YPLL are considerably higher for other causes. Male-female YPLL differentials were greatest for mental disorder. Male-female mean-YPLL to age 65, accidental drowning(male;36.47, female;37.67) is higher for other causes. In both sexes, The YPLL and M-YPLL to life expectancy was significantly higher than the YPLL and M-YPLL to life expectancy.