• Progress in Medical Physics
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• v.23 no.3
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• pp.145-153
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• 2012

In this study, we quantify the residual motion artifact in 4D-CT scan using the dynamic lung phantom which could simulate respiratory target motion and suggest a simple one-dimension theoretical model to explain and characterize the source of motion artifacts in 4DCT scanning. We set-up regular 1D sine motion and adjusted three level of amplitude (10, 20, 30 mm) with fixed period (4s). The 4DCT scans are acquired in helical mode and phase information provided by the belt type respiratory monitoring system. The images were sorted into ten phase bins ranging from 0% to 90%. The reconstructed images were subsequently imported into the Treatment Planning System (CorePLAN, SC&J) for target delineation using a fixed contour window and dimensions of the three targets are measured along the direction of motion. Target dimension of each phase image have same changing trend. The error is minimum at 50% phase in all case (10, 20, 30 mm) and we found that ${\Delta}S$ (target dimension change) of 10, 20 and 30 mm amplitude were 0 (0%), 0.1 (5%), 0.1 (5%) cm respectively compare to the static image of target diameter (2 cm). while the error is maximum at 30% and 80% phase ${\Delta}S$ of 10, 20 and 30 mm amplitude were 0.2 (10%), 0.7 (35%), 0.9 (45%) cm respectively. Based on these result, we try to analysis the residual motion artifact in 4D-CT scan using a simple one-dimension theoretical model and also we developed a simulation program. Our results explain the effect of residual motion on each phase target displacement and also shown that residual motion artifact was affected that the target velocity at each phase. In this study, we focus on provides a more intuitive understanding about the residual motion artifact and try to explain the relationship motion parameters of the scanner, treatment couch and tumor. In conclusion, our results could help to decide the appropriate reconstruction phase and CT parameters which reduce the residual motion artifact in 4DCT.

• Clinical and Experimental Pediatrics
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• v.49 no.11
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• pp.1211-1215
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• 2006

Purpose : In this study, we analyzed the short term changes of thyroid function, incidence and risk factors of thyroid dysfunction soon after allogeneic hematopoietic stem cell transplantation (HSCT) in children. Methods : We enrolled 80 pediatric patients following allogeneic HSCT, at the Catholic HSCT center between January, 2004 and February, 2006. Serum TSH (thyroid stimulating hormone), total serum thyroxine and total serum triiodothyronine levels were systematically measured in 80 patients before the HSCT, and at 1 month, 6 months and 12 months after HSCT. Results : Thyroid function statistically decreased at 1 month after HSCT(P<0.001). Thyroid dysfunction at 1 month was observed in 43 (54 percent) of 80 patients, 31 (39 percent) of whom presented with euthyroid sick syndrome (ETS). Thyroid dysfunction was normalized within 1 year after HSCT. In univariate analysis, malignant disease and the presence of acute graft-versus-host disease (grade ${\geq}II$) were risk factors for ETS (P=0.04, 0.01 respectively). In multivariate analysis, we could not detect an independent risk factor for ETS (P=0.19, 0.06 respectively). Conclusion : The present study suggests that the incidence of thyroid dysfunction is high after allogeneic HSCT. Therefore, regular monitoring of thyroid hormone levels after HSCT is required.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1172-1182
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• 1998

Background: Primary goal of anticoagulation treatment in patients with mechanical heart valve is the effective prevention of thromboembolism and safe avoidance of bleeding as well. Material and Method: Two-hundred and nine patients with the St. Jude Medical prosthesis operated on between 1984 and 1995, for mitral(MVR 122), aortic(AVR 39) and double mitral and aortic valve replacement(DVR 48) respectively, were studied on the practically achieved levels of anticoagulation and the clinical outcomes. Patients were on Coumadin and followed up by monthly visit to outpatient clinic for examination and prothrombin time measurement to adjust the International Normalized Ratios(INRs) within the low-intensity target range between 1.5 and 2.5. Result: A total anticoagulation follow-up period was 1082.0 patient- years(mean 62.1 months) and INRs of 10,205 measurements were available for evaluation. The accomplished INRs among the replacement groups were not significantly different and only 65% of INRs were within the target range. And, in individual patients, only 37% of patients had INRs included within the target range in more than 70% of tests during follow-up period. The levels of INRs in patients with atrial fibrillation, which was found in 57% of patients, were definitely higher than the ones measured in patients with regular rhythm(p<0.001). Thromboembolisms were experienced by 15 patients with the incidence of 1.265%/patient- year(MVR 1.412%, AVR 0.462% and DVR 1.531%/patient-year) and major bleeding by 4 patients with the incidence of 0.337%/patient-year(MVR 0.424%, AVR none and DVR 0.383%/patient-year). Frequent as well as prolonged missing of prothrombin time tests was the main risk factor strongly associated with the thromboembolic complications(odds ratio 1.99). The proportion of INRs within target range of less than 60% in individual patient was the highly significant risk factor of both thromboembolic and overall embolic and bleeding complications(p<0.004 and p<0.002 respectively). Conclusion: In conclusion, the low-intensity therapeutic target range of INRs was adequate in patients with AVR and in sinus rhythm. However, the patients with replacement of the mitral valve were more likely to require higher target range of INRs, especially in the presence of atrial fibrillation, to achieve the practical levels of anticoagulation enough to prevent thromboembolic complications effectively. For the higher therapeutic target range of INRs between 2.0∼3.0, further accumulation of clinical evidences are required. It is highly desirable to improve the patients' compliance under continuous instructions in visiting outpatient clinic and in taking daily Coumadin without omission and to keep INRs consistently within optimal range with tight control for minimization of chances and of periods of exposure to the risk of complications. And, particularly, patients with high risk of complications and with wide fluctuation of INRs should be better managed with frequent monitoring anticoagulation levels.

• Tuberculosis and Respiratory Diseases
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• v.43 no.1
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• pp.14-21
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• 1996

Objectives: Although outbreak of MDR Tb has been a recent problem in western countries, it has been a longstanding problem in Korea. The poor outcome of MDR Tb is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. Thus, to improve the outcome of MDR Tb, it is crucial to make individualized adequate prescription based on the knowledge of the patterns of resistance to each drugs in the community as well as the natural history. The purpose of present study is to evaluate the clinical features of Korean MDR Tb patients including patterns of drug resistance and success rate of treatment which was prescribed according to the sensitivity tests. Methods: Retroscpective analysis of 71 Korean patients with MDR Tb was made. All strains isolated from patients showed resistence to at least two first line drugs. Patients profile, previous treatment history, patterns of drug resistance, outcome of treatment was analysed. Initial treatment regimen was selected according to the previous treatment history and was modified according to the sensitivity reports. The regimen was composed to include at least 4 sensitive drugs when possible. Results: The patients showed resistance to 4.1 drugs on average. 90% of them were resistant to INH and RFP. Among 71 patients, 35 patients(49%) had cavitary lesions in CXR. Treatment outcome was analysed in 55 patients. 35 patients(67%) were improved after treatment and 18 patients(33%) showed treatment failure. 5 patients showed primary resistance. Treatment outcome could be evaluated in 4 of them and all showed improvement after treatment. 14 patients(20%) had to change their regimens due to drug side effects. The most frequent side effect was elevation of liver enzymes(6 patients). Others included dizziness, hyperuricemia, tinnitus, skin rash, GI troubles. More than 50% of side effects developed within 3 months. In repeated drug sensitivity test, the concordance rate of resistance to INH was 100% and RFP 98%. EMB, PZA showed 80% concordance rate. But in the other drugs, the concordances were less than 50%. Operation was done in 5 patient - 1 patients as a adjunctive means of chemotherapy -. In that case, negative conversion of sputum AFB was done. Conclusion: 2/3 patients of multidrug-resistant tuberculosis were improved by appropriate prescription and regular medication suggesting that more aggressive management and monitoring is indicated in multidrug-resistant tuberculosis.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.17 no.3
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• pp.92-95
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• 2017

Fabry disease (FD) is an X-linked lysosomal storage disorder caused by an ${\alpha}$-galactosidase A (GLA, MIM 300644) enzyme deficiency due to pathogenic variants in the ${\alpha}$-galactosidase A gene (GLA). The disease leads to accumulation of globotriaosylceramide (Gb3) and related glycophospholipids affecting nearly all major organ systems, with the primary sites damaged by Gb3 including renal glomeruli, myocardium, neurons of the dorsal ganglion and autonomic nervous system, and vascular endothelial and smooth muscle. Progressive deposition in these organ systems present with various clinical manifestations including acroparesthesia, renal failure and heart failure. Here, we report a Chinese male diagnosed with Fabry disease in his late $4^{th}$ decades showing improvement of acroparesthesia during enzyme replacement therapy (ERT). A 48-year-old Chinese man who presented with chronic recurrent severe burning pain in his fingers and toes since the age of 10, with worse involvement of the former visited to our clinic for further evaluation. His medical history included a transient ischemic attack aged 40 and diagnosed with stage 4-5 chronic kidney disease aged 47. In the family history, the patient's brother was found to be have Fabry disease 1 month before his visit. Except for his brother, all other members of the family are healthy. Based on his medical history and family history, he was strongly suspicious for Fabry disease. He was found to have a galactose-alpha-1,3-galactose level 4.96 (Reference range, 42.5-67.9) suggestive of Fabry disease. The followed sequencing of GLA coding region in our patient revealed hemizyosity for the mutation c.988C>T (Q330X) in Exon 7. Since ERT start, he showed significant improvement in his symptoms of burning sensation of fingers and toes. On the contrary, due to deteriorating kidney function even with ERT, he is considered for kidney transplantation. Despite of diagnostic delay until late 4th decades, ERT showed a potential improvement of acroparesthesia in our patient. However, late start of ERT can lead to poor outcome in multiorgan function. Therefore, early diagnosis with high index of suspicion followed by continuous ERT with regular monitoring have an impact on quality of life in Fabry disease.

• Korean Journal of Ecology and Environment
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• v.46 no.4
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• pp.561-569
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• 2013

This study examines locational environment factors that may affect the vegetation structure in the forests of Naejang National Park. To that end, we selected LAI (Leaf Area Index), diameter at breast height, and tree height as structural variables as well as altitude above sea level, gradient, slope direction, soil moisture, topographic location, and amount of solar radiation as locational environment factors, using the method of canonical correlation analysis in order to find out correlation between them. As to the simple correlation between the locational environment factors and structural variables, the correlation coefficient was relatively low (0.6). The values of LAI, measured along the ridge with higher altitudes, decreased as the soil moisture and solar radiation increased. However, LAI increased as the gradient increased and the slope direction faced the north (farther from the east). In respect of the diameter at breast height, the diameter decreased as the altitude and gradient increased. But the diameter increased as the moisture and solar radiation increased. The tree height decreased as the moisture increased and the site was closer to the ridge. These various correlations show a variety of locational environment factors in the national park, implying that the structural variables are affected by complex locational environment factors. This study conducted a canonical correlation analysis on locational environment factors which may affect the vegetation structure, and the result showed that LAI increased and tree height & diameter at breast height decreased as the solar radiation & moisture decreased and altitude increased. Although more factors that may affect vegetation structure (e.g. climate) should be taken into account, this study is significant in that the vegetation structure, which can adapt to more unfavorable conditions in terms of solar radiation, moisture, and higher altitudes, could be inferred in a statistical way. The results of this study, especially the locational environment factors based on DEM, can be used for assessing diversity of vegetation structure in a forest and for monitoring the structure in a national park on a regular basis so as to establish more effective maintenance plans of a park.

• Weed & Turfgrass Science
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• v.3 no.2
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• pp.86-94
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• 2014

Survey was carried out in paddy fields to investigate the dominance of weed species and weed occurrence on 200 fields of southern Gyeonggi region in Korea during the year 2013. We observed 3 species of grass, 5 species of sedge, and 11 species of broadleaf and other weeds. The most dominant weed species was Eleocharis kuroguwai, followed by Echinochloa crus-galli, Sagittaria trifolia, Monochoria vaginalis, Scirpus juncoides and Bidens tripartita. The dominance value of E. kuroguwai and B. tripartita decreased compared to the survey results performed in 2005 but that of M. vaginalis, S. juncoides, S. trifolia and E. crus-galli increased. Weed occurrence increased from 2.83 g in 2005 to 3.51 g in 2013 based on weed dry weight per $m^2$. Occurrence ratio of annual weeds to perennial weeds changed from 45.2% : 54.8% in 2005 to 45.8% : 54.2% in 2013. If we analyze dominance of weed species based on the rice transplanting timing, E. kuroguwai and E. crus-galli were the most dominant weed species at mid-May transplanting, and M. vaginalis and S. juncoides were the most dominant weed species at late- May transplanting, and M. vaginalis and E. kuroguwai were the most dominant weed species at early-June transplanting. Since paddy weeds resistant to sulfonylurea herbicides are expected to be continuously increased, the regular monitoring of their occurrence and efficient control methods should be considered in future.

• Korean Journal of Ecology and Environment
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• v.44 no.2
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• pp.239-251
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• 2011

To compare the different water environments in the Jigsaw stream (st. 1, 2) and Jujin stream (st. 3, 4) crossing over the Byeonsan-Bando and Seonunsan parklands, the physico-chemical factors and the species compositions of epilithic diatoms were analyzed from March 2009 to February 2010. The mean values of conductivity (681.1 ${\mu}S\;cm^{-1}$), suspended solids (27.83 mg $L^{-1}$), biological oxygen demand (3.15 mg $L^{-1}$), total nitrogen (3.24 mg $L^{-1}$), total phosphorus (0.24 mg $L^{-1}$) and chlorophyll-${\alpha}$ (12.99 mg $m^{-3}$ ) in Jujin stream were significantly higher than each element in Jigsaw stream. Eighty taxa were classified into 73 species and seven varieties belonging to 24 genera, eight families, three suborders and two orders in Jigsaw stream. Eighty eight taxa were classified into 81 species and seven varieties belonging to 22 genera, seven families, three suborders and two orders in Jujin stream. Biological water quality assessments revealed that Jigsaw stream was ${\beta}$~${\alpha}$-oligosaprobic and Jujin stream was ${\beta}$-mesosaprobic. Dominant and diversity indices were indicated from 0.25~0.81 and from 1.73~4.14 in Jigsaw stream, respectively, and from 0.29~0.64 and from 2.72~4.02 in Jujin stream, respectively. Jujin stream was more eutrophic than those of Jigsaw stream. The different water environments between the two streams could be due to the different ecosystems of the neighboring basins of each stream crossing over in the mountain. Further studies should investigate the water environments of two streams by continuous and regular monitoring to analyze the different ecosystem mechanisms.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.38 no.1
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• pp.142-151
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• 2020

This study is designed to deduce an implication for an effective implementation of the Special Act for Conservation, Management and Utilization of World Heritage in Korea which was legislated in February, 2020. To draw an implication, which is regarded as highly valuable for preparing for the implementation of the act, several case studies were performed focusing on four World Natural Heritage sites in Japan, and the result is as follows. First, it is enormously crucial for the central administration agencies and the local government to have a system through which they communicate one another regularly. All the target areas in Japan consist of three national parks and a prefectural park with natural monuments, and the national forest covers a tremendously large proportion of the areas. The Japanese central agencies including Ministry of the Environment, Forestry Agency and Agency for Cultural Affairs have communication with the local government through a system named Regional Liaison Committee in order to manage the sites effectively. Also, in the case of Japan, de facto administrating agencies involving non-profit organizations and the tourism association also participate in the regular conferences to communicate. Second, a specific committee consisting of academic advisers is strongly needed. In the case of Japan, Scientific Committee provides academic grounds for the management plan established by the members of Regional Liaison Committee, and an active system which allows the members to organize consultative committees and subcommittees has been established. Scientific Committee plays an important role in preventing the local government, which tends to manage the world natural heritage in more economically profitable ways, from damaging the environment of the site. The establishment of this type of committee is thought to be extremely desirable because the World Natural Heritage requires comprehensive and sustainable management plans on the ecosystem. Third, establishment of comprehensive management plan based on continuous monitoring on the environment and detailed action plan is exceedingly needed. To sum up, it is vital to establish a management plan considering environmental aspect, and detailed guidelines, which help execute the plan both properly and effectively, are required for systematic and sustainable management.

• Proceedings of the Korea Water Resources Association Conference
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• 2015.05a
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• pp.237-237
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• 2015

The district of Marlborough has had more than its share of river management projects over the past 150 years, each one uniquely affecting the geomorphology and flood hazard of the Wairau Plains. A major early project was to block the Opawa distributary channel at Conders Bend. The Opawa distributary channel took a third and more of Wairau River floodwaters and was a major increasing threat to Blenheim. The blocking of the Opawa required the Wairau and Lower Wairau rivers to carry greater flood flows more often. Consequently the Lower Wairau River was breaking out of its stopbanks approximately every seven years. The idea of diverting flood waters at Tuamarina by providing a direct diversion to the sea through the beach ridges was conceptualised back around the 1920s however, limits on resources and machinery meant the mission of excavating this diversion didn't become feasible until the 1960s. In 1964 a 10 m wide pilot channel was cut from the sea to Tuamarina with an initial capacity of $700m^3/s$. It was expected that floods would eventually scour this 'Wairau Diversion' to its design channel width of 150 m. This did take many more years than initially thought but after approximately 50 years with a little mechanical assistance the Wairau Diversion reached an adequate capacity. Using the power of the river to erode the channel out to its design width and depth was a brilliant idea that saved many thousands of dollars in construction costs and it is somewhat ironic that it is that very same concept that is now being used to deal with the aggradation problem that the Wairau Diversion has caused. The introduction of the Wairau Diversion did provide some flood relief to the lower reaches of the river but unfortunately as the Diversion channel was eroding and enlarging the Lower Wairau River was aggrading and reducing in capacity due to its inability to pass its sediment load with reduced flood flows. It is estimated that approximately $2,000,000m^3$ of sediment was deposited on the bed of the Lower Wairau River in the time between the Diversion's introduction in 1964 and 2010, raising the Lower Wairau's bed upwards of 1.5m in some locations. A numerical morphological model (MIKE-11 ST) was used to assess a number of options which led to the decision and resource consent to construct an erodible (fuse plug) bank at the head of the Wairau Diversion to divert more frequent scouring-flows ($+400m^3/s$)down the Lower Wairau River. Full control gates were ruled out on the grounds of expense. The initial construction of the erodible bank followed in late 2009 with the bank's level at the fuse location set to overtop and begin washing out at a combined Wairau flow of $1,400m^3/s$ which avoids berm flooding in the Lower Wairau. In the three years since the erodible bank was first constructed the Wairau River has sustained 14 events with recorded flows at Tuamarina above $1,000m^3/s$ and three of events in excess of $2,500m^3/s$. These freshes and floods have resulted in washout and rebuild of the erodible bank eight times with a combined rebuild expenditure of $80,000. Marlborough District Council's Rivers & Drainage Department maintains a regular monitoring program for the bed of the Lower Wairau River, which consists of recurrently surveying a series of standard cross sections and estimating the mean bed level (MBL) at each section as well as an overall MBL change over time. A survey was carried out just prior to the installation of the erodible bank and another survey was carried out earlier this year. The results from this latest survey show for the first time since construction of the Wairau Diversion the Lower Wairau River is enlarging. It is estimated that the entire bed of the Lower Wairau has eroded down by an overall average of 60 mm since the introduction of the erodible bank which equates to a total volume of $260,000m^3$. At a cost of $$0.30/m^3$ this represents excellent value compared to mechanical dredging which would likely be in excess of $$10/m^3$. This confirms that the idea of using the river to enlarge the channel is again working for the Wairau River system and that in time nature's "excavator" will provide a channel capacity that will continue to meet design requirements.