• Korean Journal of Radiology
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• 제22권3호
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• pp.395-404
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• 2021

Objective: To compare the utility of computed tomography perfusion (CTP) and three different 4-point scoring systems in computed tomography angiography (CTA) in confirming brain death (BD) in patients with and without skull defects. Materials and Methods: Ninety-two patients clinically diagnosed as BD using CTA and/or CTP for confirmation were retrospectively reviewed. For the final analysis, 86 patients were included in this study. Images were re-evaluated by three radiologists according to the 4-point scoring systems that consider the vessel opacification on 1) the venous phase for both M4 segments of the middle cerebral arteries (MCAs-M4) and internal cerebral veins (ICVs) (A60-V60), 2) the arterial phase for the MCA-M4 and venous phase for the ICVs (A20-V60), 3) the venous phase for the ICVs and superior petrosal veins (ICV-SPV). The CTP images were independently reviewed. The presence of an open skull defect and stasis filling was noted. Results: Sensitivities of the ICV-SPV, A20-V60, A60-V60 scoring systems, and CTP in the diagnosis of BD were 89.5%, 82.6%, 67.4%, and 93.3%, respectively. The sensitivity of A20-V60 scoring was higher than that of A60-V60 in BD patients (p < 0.001). CTP was found to be the most sensitive method (86.5%) in patients with open skull defect (p = 0.019). Interobserver agreement was excellent in the diagnosis of BD, in assessing A20-V60, A60-V60, ICV-SPV, CTP, and good in stasis filling (κ: 0.84, 0.83, 0.83, 0.83, and 0.67, respectively). Conclusion: The sensitivity of CTA confirming brain death differs between various proposed 4-point scoring systems. Although the ICV-SPV is the most sensitive, evaluation of the SPV is challenging. Adding CTP to the routine BD CTA protocol, especially in cases with open skull defect, could increase sensitivity as a useful adjunct.

• 한국연초학회지
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• 제23권1호
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• pp.31-39
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• 2001

This study was carried out to investigate the changes of physical and chemical properties and the usability of long-term stored leaf tobacco. The physical chemical properties of the flue-cured and burley leaves produced in 1993, processed in 1994 were analysed from Nov. 1996 to Nov. 1999. The pH and moisture content in leaf decreased slowly until 4 years’storage after processing, while those of leaf changed little thereafter. However, total sugar content continuously decreased until 5 years after processing. The filling capacity increased and shatter resistance index decreased in long-term stored leaf. The sensory test, cilia stasis and the chemical components of cigarette smoke had no significant differences between short and long-term stored leaves. When the processed leaves were stored till 5 years after processing, there were no deteriorative effects on quality and usability of leaf tobacco. Therefore, it is considered that the processed leaf may be stored for 5 years or more under the inevitable situation.