• Korean Journal of Radiology
• /
• 제22권6호
• /
• pp.959-969
• /
• 2021

Objective: This study aimed to evaluate the role of preoperative two-dimensional (2D) shear wave elastography (SWE) in assessing the stages of liver fibrosis in patients with suspected biliary atresia (BA) and compared its diagnostic performance with those of serum fibrosis biomarkers. Materials and Methods: This study was approved by the ethical committee, and written informed parental consent was obtained. Two hundred and sixteen patients were prospectively enrolled between January 2012 and October 2018. The 2D SWE measurements of 69 patients have been previously reported. 2D SWE measurements, serum fibrosis biomarkers, including fibrotic markers and biochemical test results, and liver histology parameters were obtained. 2D SWE values, serum biomarkers including, aspartate aminotransferase to platelet ratio index (APRi), and other serum fibrotic markers were correlated with the stages of liver fibrosis by METAVIR. Receiver operating characteristic (ROC) curves and area under the ROC (AUROC) curve analyses were used. Results: The correlation coefficient of 2D SWE value in correlation with the stages of liver fibrosis was 0.789 (p < 0.001). The cut-off values of 2D SWE were calculated as 9.1 kPa for F1, 11.6 kPa for F2, 13.0 kPa for F3, and 15.7 kPa for F4. The AUROCs of 2D SWE in the determination of the stages of liver fibrosis ranged from 0.869 to 0.941. The sensitivity and negative predictive value of 2D SWE in the diagnosis of ≥ F3 was 93.4% and 96.0%, respectively. The diagnostic performance of 2D SWE was superior to that of APRi and other serum fibrotic markers in predicting severe fibrosis and cirrhosis (all p < 0.005) and other serum biomarkers. Multivariate analysis showed that the 2D SWE value was the only statistically significant parameter for predicting liver fibrosis. Conclusion: 2D SWE is a more effective non-invasive tool for predicting the stage of liver fibrosis in patients with suspected BA, compared with serum fibrosis biomarkers.

• Korean Journal of Radiology
• /
• 제22권2호
• /
• pp.253-262
• /
• 2021

Objective: To determine whether the values of hepatic apparent diffusion coefficient (ADC) can differentiate biliary atresia (BA) from non-BA or be correlated with the grade of hepatic fibrosis in infants with cholestasis. Materials and Methods: This retrospective cohort study included infants who received liver MRI examinations to evaluate cholestasis from July 2009 to October 2017. Liver ADC, ADC ratio of liver/spleen, aspartate aminotransferase to platelet ratio index (APRI), and spleen size were compared between the BA and non-BA groups. The diagnostic performances of all parameters for significant fibrosis (F3-4) were obtained by receiver-operating characteristics (ROCs) curve analysis. Results: Altogether, 227 infants (98 males and 129 females, mean age = 57.2 ± 36.3 days) including 125 BA patients were analyzed. The absolute ADC difference between two reviewers was 0.10 mm²/s for both liver and spleen. Liver ADC value was specific (80.4%) and ADC ratio was sensitive (88.0%) for the diagnosis of BA with comparable performance. There were 33 patients with F0, 15 with F1, 71 with F2, 35 with F3, and 11 with F4. All four parameters of APRI (τ = 0.296), spleen size (τ = 0.312), liver ADC (τ = -0.206), and ADC ratio (τ = -0.288) showed significant correlation with fibrosis grade (all, p < 0.001). The cutoff values for significant fibrosis (F3-4) were 0.783 for APRI (area under the ROC curve [AUC], 0.721), 5.9 cm for spleen size (AUC, 0.719), 1.044 x 10^-3 mm²/s for liver ADC (AUC, 0.673), and 1.22 for ADC ratio (AUC, 0.651). Conclusion: Liver ADC values and ADC ratio of liver/spleen showed limited additional diagnostic performance for differentiating BA from non-BA and predicting significant hepatic fibrosis in infants with cholestasis.

• 한국환경과학회지
• /
• 제33권4호
• /
• pp.257-268
• /
• 2024

This study investigated the growth characteristics of Euonymus japonicus, Hedera helix, and Peperomia puteolata treated with different calcium chloride (CaCl₂) concentrations to evaluate salt tolerance limits in hydroculture cultivation. Six concentrations of CaCl₂ (0, 1, 2, 5, 10, and 15 g·L^-1 referred to as Cont., C1, C2, C5, C10, and C15) were applied to solution - grown plant species. The survival rate, growth index, plant height, plant width, leaf width, leaf length, number of leaves, and relative chlorophyll contents were measured at monthly intervals. Euonymus japonicus, Hedera helix, and Peperomia puteolata survived up to C2, C5, and C10 at each CaCl₂ concentration. The Euonymus japonicus was higher in the C1 treatment than in the Cont. for most growth characteristics. Hedera helix had the highest leaf width, leaf length, and number of leaves in the Cont., a significant difference was observed compared with the C1 treatment. The chlorophyll content did not differ significantly between the C5 and Cont. treatments. The leaf width and length of Peperomia puteolata were greater in the C2 and C1 treatments than in the Cont., whereas the number of leaves and chlorophyll content were the highest in C5. Dry weight analysis revealed that Euonymus japonicus, Hedera helix, and Peperomia puteolata were the lowest in the Cont. treatments. Euonymus japonicus was 74% in C15, and Hedera helix, and Peperomia puteolata were analyzed at approximately 37%- 50% and 9%-14%, respectively, regardless of the concentration in the CaCl₂ treatment groups. In indoor hydroponic cultivation, the salt tolerance limit concentrations of Euonymus japonicus, Hedera helix, and Peperomia puteolata are 2, 5, and 10 g·L^-1, respectively, indicating that hydroculture management techniques should be applied at higher concentrations.

• 대한소아치과학회지
• /
• 제50권4호
• /
• pp.409-420
• /
• 2023

이 연구의 목적은 건강보험심사평가원의 자료를 이용하여 만 14세 이하 소아청소년들의 치아 우식 유병률의 경향성과 치료의 현황을 파악하는 것이다. 이 연구는 2011년부터 2020년까지 연도별로 전체 소아청소년이 포함된 모집단에서 약 100만명을 무작위 표본 추출한 집단의 진료내역을 이용하여 분석을 시행하였다. 이 연구에서 K02 치아우식 주상병명을 진단받는 아이들은 연도별로 증가하였고, 전반적으로 모든 연령군에서 치아 우식 치료를 받는 아이들도 증가하는 경향성을 보였다. 반면 중증의 치아 우식으로 인해 치수 치료 또는 발치를 경험한 10 - 14세 어린이들은 감소하는 경향을 보였다. 2021 - 2022년 아동 구강 건강 실태조사에서도 5세와 12세의 우식경험지수는 정체되거나 소폭 증가하는 경향을 보였으나 우식 유병자율은 감소하였다. 치료적 관점에서 개인적, 지역적 환경은 과거에 비해 전반적으로 개선된 것으로 나타났으나 예방적 관점에서 치아 우식 유병 상태와 예방 진료가 지난 10년간 개선되지 않고 정체 상태로 머물러 있던 것으로 해석된다. 따라서 대한민국에서 소아청소년을 대상으로 구강건강 증진 및 예방을 위해 시행되고 있는 구강 보건 사업에 대한 홍보와 효용성에 대한 평가가 필요하다.

• 한국음향학회지
• /
• 제28권6호
• /
• pp.542-547
• /
• 2009

본 in vivo 연구에서는 36명의 골다공증 여성을 대상으로 요추골 및 대퇴골 부위의 골밀도와 종골 음속 사이의 상관관계를 조사하였다 2-4번 요추골 및 우측 대퇴골 경부의 단위면적당 골밀도는 이중에너지 X-선 흡수계측법을 이용하여 측정되었다. 우측 종골의 음속은 초음파 골밀도 측정기를 이용하여 측정되었다. 각 측정값 사이의 상관관계를 분석하기 위하여 Pearson 상관계수 (r) 및 유의수준 (p)이 이용되었다. 요추골 골밀도와 대퇴골 골밀도 사이에는 매우 높은 양의 상관관계가 나타났다 (r=0.81). 요추골 및 대퇴골 골밀도는 연령과 음의 상관관계를 보였다 (r=-0.52 및 r=-0.55). 종골 음속과 연령 사이에도 음의 상관관계가 나타나는 것을 알 수 있었다 (r=-0.45). 종골 음속은 요추골 및 대퇴골 골밀도와 비교적 높은양의 상관관계를 보였으며, 요추골 골밀도보다 대퇴골 골밀도와 더 높은 상관관계를 나타냈다 (r=0.54 및 r=0.62). 그러나 이는 종골 음속이 종골 골밀도와 갖는 상관관계에 비하여 낮으므로 종골 음속은 골절률이 가장 높은 요추골 및 대퇴골부위의 골밀도를 평가하기에 최적의 지표가 아님을 알 수 있었다. 그러므로 요추골 및 대퇴골 부위의 골밀도를 보다 정확히 평가하기 위하여 이 부위의 음향특성을 직접 측정할 수 있는 정량적 초음파 기술을 개발할 필요가 있다.

• 동의신경정신과학회지
• /
• 제35권2호
• /
• pp.205-216
• /
• 2024

Objectives: To evaluate the effectiveness of Mindfulness & Loving Beingness (M&L) psychotherapy combined with traditional Korean medicine in treating acute sleep disorders in patients hospitalized following traffic accidents. Methods: We applied traditional Korean medicine treatments in conjunction with various mindfulness meditation techniques from M&L therapy, including Resource Mindfulness and Nourishment Brief Therapy. This study was conducted on three patients who reported acute sleep disorder symptoms on the first day of hospitalization following a traffic accident. The effectiveness of these interventions was assessed using the PTSD Checklist for DSM-5 (PCL-5-K), Insomnia Severity Index (ISI), EuroQol 5-Dimension (EQ-5D), Numerical Rating Scale (NRS), and Patient Global Impression of Change (PGIC). Results: ISI and PCL-5-K scores showed significant improvements after treatment, indicating reduced sleep disturbances and stress symptoms. Additionally, EQ-5D and PGIC scores were enhanced, reflecting an overall improvement in quality of life. Conclusions: This study suggests that integrating M&L therapy with traditional Korean medicine could significantly improve symptoms in patients with acute sleep disorders following traffic accidents.

• 대한영상의학회지
• /
• 제83권2호
• /
• pp.360-371
• /
• 2022

목적 이 연구의 목적은 관상동맥 석회화 CT에서 측정한 대동맥 폭으로 정의한 대동맥 전개(aortic unfolding)에 영향을 미치는 요인을 평가하고 대동맥 전개의 정상 범위를 알아보는 것이다. 대상과 방법 이 후향적 연구에서 우리는 2015년 6월부터 2018년 6월까지 건강검진을 목적으로 관상동맥 석회화 CT를 시행 받은 924명의 무증상 성인에서 대동맥 전개를 측정했다. 다변량 회귀 분석을 사용하여 대동맥 전개에 영향을 미치는 요인들을 평가했다. 그 후 대동맥 전개와 관련된 위험 요소가 있는 성인을 제외되고 283명의 성인이 대동맥 전개의 정상값 분석에 포함되었다. 대동맥 전개의 평균, 표준 편차 및 상한값이 계산되었다. 결과 성별, 나이, 관상동맥 석회화 점수, 체질량지수, 체 표면적, 고혈압, 좌심실 비대, 혈장 크레아티닌, 흡연은 대동맥 전개와 유의한 관계가 있었다. 평균 대동맥 전개값은 남성의 경우 102.2 ± 12.8 mm, 여성의 경우 93.1 ± 10.7 mm였다. 대동맥 전개값은 연령이 증가할 수록(10년당 9.6 mm)으로 증가했다. 결론 관상동맥 석회화 CT에서 측정된 대동맥 전개는 심혈관 위험 인자들과 관련이 있었다. 또한 본 연구에서 저위험군에서 대동맥 전개의 정상 범위를 나이, 성별 및 체표표면적당으로 정의하였다.

• Korean Journal of Radiology
• /
• 제25권4호
• /
• pp.384-394
• /
• 2024

Objective: To evaluate the image quality of novel dark-blood computed tomography angiography (CTA) imaging combined with deep learning reconstruction (DLR) compared to delayed-phase CTA images with hybrid iterative reconstruction (HIR), to visualize the cervical artery wall in patients with Takayasu arteritis (TAK). Materials and Methods: This prospective study continuously recruited 53 patients with TAK (mean age: 33.8 ± 10.2 years; 49 females) between January and July 2022 who underwent head-neck CTA scans. The arterial- and delayed-phase images were reconstructed using HIR and DLR. Subtracted images of the arterial-phase from the delayed-phase were then added to the original delayed-phase using a denoising filter to generate the final-dark-blood images. Qualitative image quality scores and quantitative parameters were obtained and compared among the three groups of images: Delayed-HIR, Dark-blood-HIR, and Dark-blood-DLR. Results: Compared to Delayed-HIR, Dark-blood-HIR images demonstrated higher qualitative scores in terms of vascular wall visualization and diagnostic confidence index (all P < 0.001). These qualitative scores further improved after applying DLR (Dark-blood-DLR compared to Dark-blood-HIR, all P < 0.001). Dark-blood DLR also showed higher scores for overall image noise than Dark-blood-HIR (P < 0.001). In the quantitative analysis, the contrast-to-noise ratio (CNR) values between the vessel wall and lumen for the bilateral common carotid arteries and brachiocephalic trunk were significantly higher on Dark-blood-HIR images than on Delayed-HIR images (all P < 0.05). The CNR values were significantly higher for Dark-blood-DLR than for Dark-blood-HIR in all cervical arteries (all P < 0.001). Conclusion: Compared with Delayed-HIR CTA, the dark-blood method combined with DLR improved CTA image quality and enhanced visualization of the cervical artery wall in patients with TAK.

• Korean Journal of Radiology
• /
• 제25권1호
• /
• pp.43-54
• /
• 2024

Objective: To evaluate the added value of diffusion-weighted imaging (DWI)-based quantitative parameters to distinguish uterine sarcomas from atypical leiomyomas on preoperative magnetic resonance imaging (MRI). Materials and Methods: A total of 138 patients (age, 43.7 ± 10.3 years) with uterine sarcoma (n = 44) and atypical leiomyoma (n = 94) were retrospectively collected from four institutions. The cohort was randomly divided into training (84/138, 60.0%) and validation (54/138, 40.0%) sets. Two independent readers evaluated six qualitative MRI features and two DWI-based quantitative parameters for each index tumor. Multivariable logistic regression was used to identify the relevant qualitative MRI features. Diagnostic classifiers based on qualitative MRI features alone and in combination with DWI-based quantitative parameters were developed using a logistic regression algorithm. The diagnostic performance of the classifiers was evaluated using a cross-table analysis and calculation of the area under the receiver operating characteristic curve (AUC). Results: Mean apparent diffusion coefficient value of uterine sarcoma was lower than that of atypical leiomyoma (mean ± standard deviation, 0.94 ± 0.30 10^-3 mm²/s vs. 1.23 ± 0.25 10^-3 mm²/s; P < 0.001), and the relative contrast ratio was higher in the uterine sarcoma (8.16 ± 2.94 vs. 4.19 ± 2.66; P < 0.001). Selected qualitative MRI features included ill-defined margin (adjusted odds ratio [aOR], 17.9; 95% confidence interval [CI], 1.41-503, P = 0.040), intratumoral hemorrhage (aOR, 27.3; 95% CI, 3.74-596, P = 0.006), and absence of T2 dark area (aOR, 83.5; 95% CI, 12.4-1916, P < 0.001). The classifier that combined qualitative MRI features and DWI-based quantitative parameters showed significantly better performance than without DWI-based parameters in the validation set (AUC, 0.92 vs. 0.78; P < 0.001). Conclusion: The addition of DWI-based quantitative parameters to qualitative MRI features improved the diagnostic performance of the logistic regression classifier in differentiating uterine sarcomas from atypical leiomyomas on preoperative MRI.

• Korean Journal of Radiology
• /
• 제23권11호
• /
• pp.1055-1066
• /
• 2022

Objective: The clinical relevance of myosteatosis has not been well evaluated in patients with pancreatic ductal adenocarcinoma (PDAC), although sarcopenia has been extensively researched. Therefore, we evaluated the prognostic value of muscle quality, including myosteatosis, in patients with resectable PDAC treated surgically. Materials and Methods: We retrospectively evaluated 347 patients with resectable PDAC who underwent curative surgery (mean age ± standard deviation, 63.6 ± 9.6 years; 202 male). Automatic muscle segmentation was performed on preoperative computed tomography (CT) images using an artificial intelligence program. A single axial image of the portal phase at the inferior endplate level of the L3 vertebra was used for analysis in each patient. Sarcopenia was evaluated using the skeletal muscle index, calculated as the skeletal muscle area (SMA) divided by the height squared. The mean SMA attenuation was used to evaluate myosteatosis. Diagnostic cutoff values for sarcopenia and myosteatosis were devised using the Contal and O'Quigley methods, and patients were classified according to normal (nMT), sarcopenic (sMT), myosteatotic (mMT), or combined (cMT) muscle quality types. Multivariable Cox regression analyses were conducted to assess the effects of muscle type on the overall survival (OS) and recurrence-free survival (RFS) after surgery. Results: Eighty-four (24.2%), 73 (21.0%), 75 (21.6%), and 115 (33.1%) patients were classified as having nMT, sMT, mMT, and cMT, respectively. Compared to nMT, mMT and cMT were significantly associated with poorer OS, with hazard ratios (HRs) of 1.49 (95% confidence interval, 1.00-2.22) and 1.68 (1.16-2.43), respectively, while sMT was not (HR of 1.40 [0.94-2.10]). Only mMT was significantly associated with poorer RFS, with an HR of 1.59 (1.07-2.35), while sMT and cMT were not. Conclusion: Myosteatosis was associated with poor OS and RFS in patients with resectable PDAC who underwent curative surgery.