• Korean Journal of Radiology
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• v.25 no.3
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• pp.243-256
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• 2024

Objective: We aimed to investigate whether 2-[¹⁸F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (2-[¹⁸F]FDG PET/CT) can aid in evaluating the risk of malignancy in ampullary tumors detected by endoscopy. Materials and Methods: This single-center retrospective cohort study analyzed 155 patients (79 male, 76 female; mean age, 65.7 ± 12.7 years) receiving 2-[¹⁸F]FDG PET/CT for endoscopy-detected ampullary tumors 5-87 days (median, 7 days) after the diagnostic endoscopy between June 2007 and December 2020. The final diagnosis was made based on histopathological findings. The PET imaging parameters were compared with clinical data and endoscopic features. A model to predict the risk of malignancy, based on PET, endoscopy, and clinical findings, was generated and validated using multivariable logistic regression analysis and an additional bootstrapping method. The final model was compared with standard endoscopy for the diagnosis of ampullary cancer using the DeLong test. Results: The mean tumor size was 17.1 ± 7.7 mm. Sixty-four (41.3%) tumors were benign, and 91 (58.7%) were malignant. Univariable analysis found that ampullary neoplasms with a blood-pool corrected peak standardized uptake value in earlyphase scan (SUVe) ≥ 1.7 were more likely to be malignant (odds ratio [OR], 16.06; 95% confidence interval [CI], 7.13-36.18; P < 0.001). Multivariable analysis identified the presence of jaundice (adjusted OR [aOR], 4.89; 95% CI, 1.80-13.33; P = 0.002), malignant traits in endoscopy (aOR, 6.80; 95% CI, 2.41-19.20; P < 0.001), SUVe ≥ 1.7 in PET (aOR, 5.43; 95% CI, 2.00-14.72; P < 0.001), and PET-detected nodal disease (aOR, 5.03; 95% CI, 1.16-21.86; P = 0.041) as independent predictors of malignancy. The model combining these four factors predicted ampullary cancers better than endoscopic diagnosis alone (area under the curve [AUC] and 95% CI: 0.925 [0.874-0.956] vs. 0.815 [0.732-0.873], P < 0.001). The model demonstrated an AUC of 0.921 (95% CI, 0.816-0.967) in candidates for endoscopic papillectomy. Conclusion: Adding 2-[¹⁸F]FDG PET/CT to endoscopy can improve the diagnosis of ampullary cancer and may help refine therapeutic decision-making, particularly when contemplating endoscopic papillectomy.

• Korean Journal of Radiology
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• v.25 no.5
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• pp.414-425
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• 2024

Objective: This study aims to explore the opinions on the insurance coverage of artificial intelligence (AI), as categorized based on the distinct value elements offered by AI, with a specific focus on patient-centered outcomes (PCOs). PCOs are distinguished from traditional clinical outcomes and focus on patient-reported experiences and values such as quality of life, functionality, well-being, physical or emotional status, and convenience. Materials and Methods: We classified the value elements provided by AI into four dimensions: clinical outcomes, economic aspects, organizational aspects, and non-clinical PCOs. The survey comprised three sections: 1) experiences with PCOs in evaluating AI, 2) opinions on the coverage of AI by the National Health Insurance of the Republic of Korea when AI demonstrated benefits across the four value elements, and 3) respondent characteristics. The opinions regarding AI insurance coverage were assessed dichotomously and semi-quantitatively: non-approval (0) vs. approval (on a 1-10 weight scale, with 10 indicating the strongest approval). The survey was conducted from July 4 to 26, 2023, using a web-based method. Responses to PCOs and other value elements were compared. Results: Among 200 respondents, 44 (22%) were patients/patient representatives, 64 (32%) were industry/developers, 60 (30%) were medical practitioners/doctors, and 32 (16%) were government health personnel. The level of experience with PCOs regarding AI was low, with only 7% (14/200) having direct experience and 10% (20/200) having any experience (either direct or indirect). The approval rate for insurance coverage for PCOs was 74% (148/200), significantly lower than the corresponding rates for other value elements (82.5%-93.5%; P ≤ 0.034). The approval strength was significantly lower for PCOs, with a mean weight ± standard deviation of 5.1 ± 3.5, compared to other value elements (P ≤ 0.036). Conclusion: There is currently limited demand for insurance coverage for AI that demonstrates benefits in terms of non-clinical PCOs.

• Korean Journal of Radiology
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• v.23 no.5
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• pp.548-554
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• 2022

Objective: To evaluate the safety and feasibility of prostatic artery embolization (PAE) via transradial access (TRA) compared with transfemoral access (TFA). Materials and Methods: This retrospective study included 53 consecutive men with lower urinary tract symptoms (LUTS) who underwent PAE between September 2018 and September 2021. Thirty-one patients (mean age ± standard deviation: 70.6 ± 8.4 years) were treated with TFA, including 14 patients treated before adopting TRA. Since December 2019, TRA has also been attempted with the procedure's selection criteria of patent carpal circulation and a height ≤ 172 cm, with 22 patients treated via TRA (69.1 ± 9.6 years). Parameters of technical success (defined as successful bilateral embolization), clinical success (defined as LUTS improvement), procedural time, radiation dose, and adverse events were compared between the two groups using the Fisher's exact test, independent sample t test, Wilcoxon signed-rank test, or Mann-Whitney test. Results: All patients received at least one-side PAE. Technical success of PAE was achieved in most patients (TRA, 21/22; TFA, 30/31; p > 0.999). No technical problem-related conversion from TRA to TFA occurred. The clinical success rate was 85% (11/13) in patients with TRA, and 89% (16/18) in patients with TFA for follow-up > 2 weeks post-PAE (median, 3 months) (p > 0.999). The median procedure time was similar in both groups (TRA, 81 minutes vs. TFA, 94 minutes; p = 0.570). No significant dose differences were found between the TRA and TFA groups in the dose-area product (median Gycm², 95 [range, 44-255] for TRA and 84 [34-255] for TFA; p = 0.678) or cumulative air kerma (median mGy, 609 [236-1584] for TRA and 634 [217-1594] for TFA; p = 0.551). No major adverse events occurred in either of the groups. Conclusion: PAE via TRA is a safe and feasible method comparable to conventional TFA. It can be safely implemented by selecting patients with patent carpal circulation and adequate height.

• Journal of Chest Surgery
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• v.57 no.3
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• pp.242-251
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• 2024

Background: This study compared the outcomes of surgical aortic valve replacement (AVR) in patients aged 50 to 70 years based on the type of prosthetic valve used. Methods: We compared patients who underwent mechanical AVR to those who underwent bioprosthetic AVR at our institution between January 2000 and March 2019. Competing risk analysis and the inverse probability of treatment weighting (IPTW) method based on propensity score were employed for comparisons. Results: A total of 1,580 patients (984 patients with mechanical AVR; 596 patients with bioprosthetic AVR) were enrolled. There was no significant difference in early mortality between the mechanical AVR and bioprosthetic AVR groups (0.9% vs. 1.7%, p=0.177). After IPTW adjustment, the risk of all-cause mortality was significantly higher in the bioprosthetic AVR group than in the mechanical AVR group (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.07-1.80; p=0.014). Competing risk analysis revealed lower risks of stroke (sub-distributional hazard ratio [sHR], 0.44; 95% CI, 0.28-0.67; p<0.001) and anticoagulation-related bleeding (sHR, 0.35; 95% CI, 0.23-0.53; p<0.001) in the bioprosthetic AVR group. Conversely, the risk of aortic valve (AV) reintervention was higher in the bioprosthetic AVR group (sHR, 6.14; 95% CI, 3.17-11.93; p<0.001). Conclusion: Among patients aged 50 to 70 years who underwent surgical AVR, those receiving mechanical valves showed better survival than those with bioprosthetic valves. The mechanical AVR group exhibited a higher risk of stroke and anticoagulation-related bleeding, while the bioprosthetic AVR group showed a higher risk of AV reintervention.

• Korean Journal of Agricultural Science
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• v.49 no.4
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• pp.1015-1023
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• 2022

Production of high-quality horses is important to make the horse industry grow. Grazing during the growing period can be an important factor affecting the production of high-quality horses. The objective of this study was to determine the effects of grazing on growing horses by analyzing their blood components and intestinal microbiota. Twelve growing horses for evaluating blood components and ten growing horses for evaluating intestinal microbiota were raised for about seven months and separated by two treatments: grazing vs. stable. Complete blood count, blood chemistry, and creatine kinase levels were analyzed as blood components and a 16s rRNA gene sequence analysis was performed to analyze intestinal microbiota. Calcium ions tended to be lower in the group with grazing treatment. Alkaline phosphatase and creatine kinase tended to be higher in the group with grazing treatment. These results indicate that grazing can provide horses with more exercise than staying in stables. At the phylum level, Firmicutes/Bacteroidetes ratios in grazing and stable groups were 4.2 and 6.5, respectively. Because various studies have reported that a. high Firmicutes/Bacteroidetes ratio indicates obesity, the method of raising horses might affect their physical ability. At the species level, rates of Clostridium butyricum in grazing and stable groups were 3.2% and 13.1%, respectively. Some strains of C. butyricum can cause several diseases such as botulism. These results indicate that grazing can positively affect growing horses in terms of blood components and intestinal microbiota. Moreover, grazing can be helpful to make growing horses healthy through proper exercise.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.3-7
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• 2012

Purpose : In myocardial perfusion SPECT, the type of orbit (circular vs. body contouring) that affect the image quality is still on the debate. Presently in the nuclear medicine field, the body contouring orbit acquisition is widely used to improve the image quality on the myocardial perfusion SPECT. But in case of body contouring acquisition using the vertical method with dual detect machine, there is a tendency of increasing the radius. In this research, we compared body contouring orbit acquisition with circular orbit acquisition, so we suggest ideal method that reduces the radius for improving image quality. Materials and Methods : Phantom and clinical studies were performed. The anthropomorphic torso phantom was made on equally with counts from patient's body. The study was performed under six different conditions. To compare image quality according to the radius, we increased radius sequentially per step during circular orbit acquisition. On the other hand, sensors that protect a collision and reduce the radius automatically were used to acquire image during body contouring orbit acquisition. So we compared FWHM value of apex. In clinical studies, we analyzed the 40 patients who were examined by Tl-201 gated myocardial perfusion SPECT in department of nuclear medicine at Asan Medical Center in August 2011. To acknowledge the differences according to the radius, we acquired the results two times using circular orbit acquisition and body contouring orbit acquisition. Results : In phantom study, we analyzed that increase of radius resulted in changes of FWHM value. It was 5.41, 6.24, 6.33, 6.42, 6.93 mm. On the other hand, using the body contouring orbit acquisition, FWHM value was 6.23 mm. In clinical study, difference of average radius between two methods was 2.5 cm (circular orbit acquisition was more close to patients). Conclusion : Through the experiments using Anthropomorphic torso phantom and patients data, we found that FWHM value of circular orbit acquisition was lower than body contouring orbit acquisition. As a result, if the difference of average radius exists approximately 3 cm, circular orbit type acquisition is better than body contouring type acquisition. But clinical investigation is only aimed to average radius, so it needs more investigation in comparison of patient's image.

• Applied Biological Chemistry
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• v.48 no.3
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• pp.267-272
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• 2005

trans-Cinnamaldehyde, a major component of Cinnamomum cassia, was quantitatively analyzed using the $^1H-NMR$ spectrometry. Applicability of this method was confirmed through observing the variation of chemical shift in the $^1H-NMR$ spectrum of t-cinnamaldehyde and the integration value according to various sample concentrations or running temperatures. When the $^1H-NMR$ spectrometry was run for t-cinnamaldehyde (7.1429 mg/ml) at 19, 25, 30, 40 and $50^{\circ}C$, the chemical shifts of the doublet methine signal due to an aldehyde group were observed at 9.7202, 9.7184, 9.7169, 9.7142 and 9.7124 ppm, respectively, to imply that the running temperature had no significant variation in the chemical shift of the signal. The integration values of the signal were $1.37\;(19^{\circ}C),\;1.37\;(25^{\circ}C),\;1.37\;(30^{\circ}C),\;1.37(40^{\circ}C)$ and $1.37(50^{\circ}C)$, respectively, to also indicate running temperature gave no effect on the integration value. When the sample solutions with various concentrations such as 0.4464, 0.8929, 1.7857, 3.5714, 7.1429 and 14.286 mg/ml were respectively measured for the $^1H-NMR$ at $25^{\circ}C$, the chemical shifts of the aldehyde group were observed at 9.7206, 9.7201, 9.7196, 9.7192, 9.7185 and 9.7174 ppm. Even though the signal was slightly shifted to the high field in proportion to the increase of sample concentration, the alteration was not significant enough to applicate this method. The calibration curve for integration values of the doublet methine signal due to the aldehyde group vs the sample concentration was linear and showed very high regression rate ($r^2=1.0000$). Meantime, the $^1H-NMR$ spectra (7.1429 mg/ml $CDCl_3,\;25^{\circ}C$) of t-cinnamaldehyde and t-2-methoxycinnamaldehyde, another constituent of Cinnamomum cassia, showed the chemical shifts of the aldehyde group as ${\delta}_H$ 9.7174 (9.7078, 9.7270) for the former compound and ${\delta}_H$ 9.6936 (9.6839, 9.7032) for the latter one. The difference of the chemical shift between two compounds was big enough to be distinguished using the NMR spectrometer with 0.45 Hz of resolution. The contents of cinnamaldehyde in Cinnamomum cassia, which were respectively extracted with n-hexane, $CHCl_3$, and EtOAc, were determiend as 94.2 \;mg/g (0.94%), 137.6 mg/g (1.38%) and 140.1 mg/g(1.40%) t-cinnamaldehyde in each extract, respectively, by using the above method.

• Korean Journal of Cognitive Science
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• v.28 no.3
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• pp.149-171
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• 2017

In this research, based on the fact that spatial ability is important for the achievement in the STEM fields, and technological innovation, Purdue Spatial Visualization Test-Rotation has been used to investigate engineering freshmen's spatial ability and gender differences. Students who have taken advanced mathematics courses in high school(those who have taken type B math test in Korean SAT test) and students with general math courses(those who have taken type A in Korean SAT-Math test) are included in this study to find out the relationship between mathematics achievement and spatial ability. Finding out the strategies taken by students was another aim of this study. This strategic differences between high achievers and lower achievers, male and female students were analyzed from students' self report. Spatial ability test score was highest in the SAT-Math type B male students, decreased in the order of type A male students, type B female students, and lastly type A female students. There was no substantial difference between second and third groups. In each group, male students' average score was 8~10% higher than female students, which affirms 2015's results. The correlation between spatial ability and mathematics achievement was negligible in each group, but male students' math score and spatial ability score were higher than that of female students. This can be interpreted that there is some correlation between these two. Strategic choices can vary in the continuous spectrum with analytic method and holistic method at both ends. From students' self report, using Mann-Witney test, it turned out that there exists strategic differences between male and female students. Male students have a tendency to use holistic strategy more often than female students. I also found that the strategy choice did not vary greatly among all score groups. For the perfect score groups, both female and male students used holistic strategy most frequently. For low achieving groups, there is an evidence that these students overuse one method compared to average or high achieving groups, which turned out to be less effective. Based on these, I suggest that low achieving students need to have more chances to adopt efficient strategies and to practice challenging problems to improve their spatial abilities.

• Ocean and Polar Research
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• v.36 no.1
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• pp.13-24
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• 2014

We established the first complete ice core processing method and analytical procedures for fundamental proxies, using a 40.2 m long ice core drilled on the Mt. Tsambagarav glacier in the Mongolian Altai mountains in July 2008. The whole core was first divided into two sub ice core sections and the measurements of the visual stratigraphy and electrical conductivity were performed on the surface of these sub core sections. A continuous sequence of samples was then prepared for chemical analyses (stable isotope ratios of oxygen ($^{18}O/^{16}O$) and hydrogen ($^2H/^1H$), soluble ions and trace elements). A total of 29 insoluble dust layers were identified from the measurement of visual stratigraphy. The electrical conductivity measurement (ECM) shows 11 peaks with the current more than 0.8 ${\mu}A$ Comparing the profiles of $SO_4{^{2-}}$ and $Cl^-$ concentrations to correlate with known volcanic eruptions, the first two ECM peaks appear to be linked to the eruptions (January and June 2007) of Kliuchevskoi volcano on the Kamchatka Peninsula of Russia, which supports the reliability of our ECM data. Finally, the composition of stable isotopes (${\delta}^{18}O$ and ${\delta}D$) shows a well-defined seasonal variation, suggesting that various chemical proxies may have been well preserved in the successive ice layers of Tsambagarav ice core. Our ice core processing method and analytical procedures for fundamental proxies are expected to be used for paleoclimate and paleoenvironmental studies from polar and alpine ice cores.

• Journal of Chest Surgery
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• v.41 no.4
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• pp.469-475
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• 2008

Background: Video-assisted thoracic sympathicotomy is a definitive minimally invasive treatment for axillary hyperhidrosis. Different techniques exist for controlling axillary hyperhidrosis, but they are temporary and expensive. We compared the results after using two different levels of sympathicotomy for treating axillary hyperhidrosis: T3-T4 and T4. Material and Method: Between June 2002 and May 2007, 30 patients with isolated axillary hyperhidrosis underwent either T3-T4 or T4 thoracoscopic sympathicotomy in the Department of Thoracic & Cardiovascular Surgery at Wonkwang University Hospital. The patients were divided into two groups. Group I (n=15) was composed of patients who underwent T3-T4 sympathicotomy (thermal ablation), and Group II (n=15) was composed of patients who underwent T4 sympathicotomy (thermal ablation). The procedures were bilateral and simultaneous, involving the use of two 2-mm trocars and a 0-degree 2-mm thoracoscope under general anesthesia with single endotracheal intubation. Outcome parameters included satisfaction rate of treatment, degree of compensatory sweating, and postoperative complications. Patients were interviewed by telephone regarding satisfaction and compensatory hyperhidrosis. Result: There were no differences in age between group I and group II. The mean follow-up for the T3-T4 group was $38.7{\pm}2.3$ months, and the mean follow-up for the T4 group was $18.7{\pm}3.6$ months. The immediate therapeutic success rate (within 2 weeks postoperative) was 100% in both groups, and there were no recurrences in either group during the long-term follow-up period. The satisfaction rate was higher (93.3%) in the T4 group than in the T3-T4 group (53.3%), and the incidence of compensatory hyperhidrosis was lower in the T4 group (6.7%) than in the T3-T4 group (46.7%). Postoperative complications included one mild pneumothorax and two instances of intercostal neuralgia. Digital infrared thermographic imaging (DITI) correlated well with postoperative satisfaction. Conclusion: Both techniques proved effective for controlling isolated axillary hyperhidrosis. The T4 group had a higher satisfaction rate and lower severity of compensatory hyperhidrosis. Hence, thermal ablation of the lower interganglionic fibers of the third thoracic sympathetic ganglion on the fourth rib is a more practical and minimally invasive treatment than is the T3-T4 surgical method, according to the degree of compensatory sweating in isolated axillary hyperhidrosis.