• Korean Journal of Radiology
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• v.22 no.6
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• pp.994-1004
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• 2021

Objective: To extract pulmonary and cardiovascular metrics from chest CTs of patients with coronavirus disease 2019 (COVID-19) using a fully automated deep learning-based approach and assess their potential to predict patient management. Materials and Methods: All initial chest CTs of patients who tested positive for severe acute respiratory syndrome coronavirus 2 at our emergency department between March 25 and April 25, 2020, were identified (n = 120). Three patient management groups were defined: group 1 (outpatient), group 2 (general ward), and group 3 (intensive care unit [ICU]). Multiple pulmonary and cardiovascular metrics were extracted from the chest CT images using deep learning. Additionally, six laboratory findings indicating inflammation and cellular damage were considered. Differences in CT metrics, laboratory findings, and demographics between the patient management groups were assessed. The potential of these parameters to predict patients' needs for intensive care (yes/no) was analyzed using logistic regression and receiver operating characteristic curves. Internal and external validity were assessed using 109 independent chest CT scans. Results: While demographic parameters alone (sex and age) were not sufficient to predict ICU management status, both CT metrics alone (including both pulmonary and cardiovascular metrics; area under the curve [AUC] = 0.88; 95% confidence interval [CI] = 0.79-0.97) and laboratory findings alone (C-reactive protein, lactate dehydrogenase, white blood cell count, and albumin; AUC = 0.86; 95% CI = 0.77-0.94) were good classifiers. Excellent performance was achieved by a combination of demographic parameters, CT metrics, and laboratory findings (AUC = 0.91; 95% CI = 0.85-0.98). Application of a model that combined both pulmonary CT metrics and demographic parameters on a dataset from another hospital indicated its external validity (AUC = 0.77; 95% CI = 0.66-0.88). Conclusion: Chest CT of patients with COVID-19 contains valuable information that can be accessed using automated image analysis. These metrics are useful for the prediction of patient management.

• The Korean Society of Law and Medicine
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• v.24 no.4
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• pp.131-160
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• 2023

An amendment to Medical Law allowing permanent face-to-face treatment has been proposed in the 21st National Assembly, with five different bills introduced. However, each proposed amendment focuses on different aspects, and the issue is currently in a state of 'ongoing review' due to factors such as opposition from the medical profession and political considerations. However, from the perspective that the introduction of non-face-to-face treatment should be institutionalized and legislated prioritizing patient safety, certain directions are proposed. These include focusing on returning patients as the primary target, chronic diseases as the focal conditions, outpatient medical institutions as the implementing agencies, restricting non-face-to-face means primarily to video systems, and legally exempting healthcare professionals from responsibility for incidents beyond their control. The proposed directions also emphasize establishing the right to demand face-to-face treatment. It is suggested to legislate initial standards that ensure a minimum level of safety and gradually expand the scope of non-face-to-face treatment through future research, evaluation, and similar step-by-step approaches.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.329-334
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• 2008

Background: Percutaneous cardiopulmonary support. (PCPS) has the potential to rescue patients in cardiogenic shock who might otherwise die. PCPS has been a therapeutic option in a variety of the clinical settings such as for patients with myocardial Infarction, high-risk coronary intervention and postcardiotomy cardiogenic shock, and the PCPS device is easy to install. We report our early experience with PCPS as a life saving procedure in cardiogenic shock patients due to acute myocardial infarction. Material and Method: From January 2005 to December 2006, eight patients in cardiogenic shock with acute myocardial infarction underwent PCPS using the CAPIOX emergency bypass system($EBS^{(R)}$, Terumo, Tokyo, Japan). Uptake cannulae were inserted deep into the femoral vein up to the right atrium and return cannulae were inserted into the femoral artery with Seldinger techniques using 20 and 16-French cannulae, respectively. Simultaneously, autopriming was performed at the $EBS^{(R)}$ circuit. The $EBS^{(R)}$ flow rate was maintained between $2.5{\sim}3.0L/min/m^2$ and anticoagulation was performed using intravenous heparin with an ACT level above 200 seconds. Result: The mean age of patients was $61.1{\pm}14.2$ years (range, 39 to 77 years). Three patients were under control of the $EBS^{(R)}$ before percutaneous coronary intervention (PCI), three patients were under control of the $EBS^{(R)}$ during PCI, one patient was under control of the $EBS^{(R)}$ after PCI, and one patient was under control of the $EBS^{(R)}$ after coronary bypass surgery. The mean support time was $47.5{\pm}27.9$ hours (range, 8 to 76 hours). Five patients (62.5%) could be weaned from the $EBS^{(R)}$ after $53.6{\pm}27.2$ hours. (range, 12 to 68 hours) of support. All of the patients who could successfully be weaned from support were discharged from the hospital. There were three complications: one case of gastrointestinal bleeding and two cases of acute renal failure. Two of the three mortality cases were under cardiac arrest before $EBS^{(R)}$ support, and one patient had an intractable ventricular arrhythmia during the support. All of the discharged patients are still surviving at $16.8{\pm}3.1$ months (range, 12 to 20 months) of follow-up. Conclusion: The use of $EBS^{(R)}$ for cardiogenic shock caused by an acute myocardial infarction could rescue patients who might otherwise have died. Successfully recovered patients after $EBS^{(R)}$ treatment have survived without severe complications. More experience and additional clinical investigations are necessary to elucidate the proper installation timing and management protocol of the $EBS^{(R)}$ in the future.

• Radiation Oncology Journal
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• v.26 no.4
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• pp.237-246
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• 2008

Purpose: Three-dimensional conformal radiation therapy (3DCRT) and intensity-modulated radiation therapy (IMRT) were found to reduce the incidence of acute and late rectal toxicity compared with conventional radiation therapy (RT), although acute and late urinary toxicities were not reduced significantly. Acute urinary toxicity, even at a low-grade, not only has an impact on a patient's quality of life, but also can be used as a predictor for chronic urinary toxicity. With bladder filling, part of the bladder moves away from the radiation field, resulting in a small irradiated bladder volume; hence, urinary toxicity can be decreased. The purpose of this study is to evaluate the impact of bladder volume on acute urinary toxicity during RT in patients with prostate cancer. Materials and Methods: Forty two patients diagnosed with prostate cancer were treated by 3DCRT and of these, 21 patients made up a control group treated without any instruction to control the bladder volume. The remaining 21 patients in the experimental group were treated with a full bladder after drinking 450 mL of water an hour before treatment. We measured the bladder volume by CT and ultrasound at simulation to validate the accuracy of ultrasound. During the treatment period, we measured bladder volume weekly by ultrasound, for the experimental group, to evaluate the variation of the bladder volume. Results: A significant correlation between the bladder volume measured by CT and ultrasound was observed. The bladder volume in the experimental group varied with each patient despite drinking the same amount of water. Although weekly variations of the bladder volume were very high, larger initial CT volumes were associated with larger mean weekly bladder volumes. The mean bladder volume was $299{\pm}155\;mL$ in the experimental group, as opposed to $187{\pm}155\;mL$ in the control group. Patients in experimental group experienced less acute urinary toxicities than in control group, but the difference was not statistically significant. A trend of reduced toxicity was observed with the increase of CT bladder volume. In patients with bladder volumes greater than 150 mL at simulation, toxicity rates of all grades were significantly lower than in patients with bladder volume less than 150 mL. Also, patients with a mean bladder volume larger than 100 mL during treatment showed a slightly reduced Grade 1 urinary toxicity rate compared to patients with a mean bladder volume smaller than 100 mL. Conclusion: Despite the large variability in bladder volume during the treatment period, treating patients with a full bladder reduced acute urinary toxicities in patients with prostate cancer. We recommend that patients with prostate cancer undergo treatment with a full bladder.

• Korean Journal of Agricultural Science
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• v.2 no.1
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• pp.9-47
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• 1975

These experiments were caried out to study the effects of caponization and various hormone treatments upon meat production and improvement of meat quality of growing chicken. Sixtyseven days old 160 New Hampshire cockerels were treated and growth rate, carcass yield, change of weight of individual organs, meat composition and change of amino acid were measured and analysed. Otherwise change of testis and thyroid gland by hormone treatment were investigated histologically. The results obtained were as follows. 1. The effectst of caponization and hormone treatment upon meat production were; 1) Body weight of cockerels in D. E. S. group without caponization was increased. upon 96.86% than initial period and A. C. T. H. group was 104.22% but other groups and all carponization groups were lighter than those of control group. 2) Weekly body gain of D. E. S. group without caponization was best showing the significance (102.69 g) and the group with caponization were lower than those groups without caponization. 3) Carcass yield was best in Testo. group without caponization (831.2 g) and the group with caponization were lower than the group without caponization. 4) Carcass rate was highest in A. C. T. H. group with caponization and (67.22%) lowest in Testo. group without caponization (63.37%), but any significance was not recognized. 2. The effects of caponizatitn and hormone treatments upon the coposition of meat and amino acids were; 1) Any significance was not recognized between treated and untreated group about change of moisture, crude protein, crude ash and glycogen contents in meat. 2) Fat co tent in muscle in the all treated groups were higher than that of control group. 3) Extracts of group without caponization were higher than those of groups with caponization. 4) Lysin contents were highest in D. E. S. group with caponization (11. 12/ 16.0 g N) and generelly Testo. group was lower compared with D. E. S. group. 5) Histidine and Arginine contents were higher in the groups with caponization than without caponization. 6) Aspartic acid content were higher in D. E. S. group and A. C. T. H. group without depend on caponization. 7) Treonine content was higher in Testo. group without caponization and in the group with caponization and without hormone treatment compared with those of control group without caponization. 8) Serine content was decreased in the group with caponization and increased by D. E. S. and A. C. T. H treatment groups and glutamic acid was also decreased in Testo. group with out caponization. 9) Cystine content was decreased by Testo. treatment and was not appeared in Testo. group without caponization. 10) Valine content was lower in control group with caponization but significance was not recognized between other groups and control group without caponization. 11) Glycine, Alanine, Methionine. Isoleucine, Leucine, Thyrosine and Phenylalanine contents were not so difference between hormone treated groups and control group without caponization. 3. The effects of caponization and hormone treatment upon the change of organs were: 1) The weight of all organs were heaviest in D. E. S. group without caponization (18.5g) and lightest in A. C. T. H. group without caponization (155. 3g) but no significance was recognized between hormone treatment groups. 2) Heart weight was heaviest in D. E. S. group without caponization (7.46 g) and lightest in Testo. group without caponization (5.95 g). 3) Liver weight was heaviest in D. E. S. group without caponization(32.89g) and lightest in hormone untreated group with caponization(29.66g). Significance was not recognized. 4) Spleen weight was heaivest in Testo. group with caponization (3.22 g) and lightest in D. E. S. group without caponization(2.00g) in contrast with the other groups. High significance was recognized among the groups (P<0.01). 5) Cloacal thymus weight was lightest in D. E. S. group with or without caponization compared with control group without caponization. High significance was recognized among the groups. 6) Muscle fat content was not appeared in A. C. T. H. group with caponization, but it was highly increased in D. E. S. group with or without caponization. 7) Testis weight was lightest in D. E. S. group (0.38g) compared with control group (2.66g). Significance was recognized among the groups. 8) Large intestine, small intestine and cecum weight and length were heavier and longer in D. E. S. group without caponization and control group without caponization was lighter than those of hormone treated groups. 4. The effects of caponization and hormone treatment upon histological change of testis and thyroid gland: 1) The histological change of testis was significantly appeared in D. E. S. group that seminifirous tubles was slowly atrophied, the funtion of spernatogenesis was ceased, spermatocyte was changed as degeneration by pyknosis and karyorrhexis and interstitial cell was also atrophied, but in Testo. and A. C. T. H. group were similar as control group. 2) The histological change of thyroid gland in Testo. and A. C. T. H. groups without caponization were similar to that of control group without caponization, but in D. E. S. group without caponization, was changed squamously. Thyroid gland of the groups with caponization, epithelium of was atrophied and changed squamously as degeneration by pyknosis and karyorrhexis and the function of thyroid gland was slowly ceased in colloid and in hormone treated group with caponization.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.409-423
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• 1998

Purpose : This retrospective study was tried to evaluate the clinical characteristics of patients, patterns of failure, survival rates, prognostic factors affecting survival, and treatment related toxicities when non-small cell lung cancer patients was treated by definitive radiotherapy alone or combined with chemotherapy. Materials and Methods : We evaluated the treatment results of 70 patients who were treated by definitive radiation therapy for non-small cell lung cancer at the Department of Radiation Oncology, Ewha Womans University Hospital, between March 1982 and April 1996. The number of patients of each stage was 2 in stage I, 6 in stage II, 30 in stage III-A, 29 in stage III-B, 3 in stage IV. Radiation therapy was administered by 6 MV linear accelerator and daily dose was 1.8-2.0 Gy and total radiation dose was ranged from 50.4 Gy to 72.0 Gy with median dose 59.4 Gy. Thirty four patients was treated with combined therapy with neoadjuvant or concurrent chemotherapy and radiotherapy, and most of them were administered with the multi-drug combined chemotherapy including etoposide and cisplatin. The survival rate was calculated with the Kaplan-Meier methods. Results : The overall 1-year, 2-year, and 3-year survival rates were 63$\%$, 29$\%$, and 26$\%$, respectively. The median survival time of all patients was 17 months. The disease-free survival rate for 1-year and 2-year were 23$\%$ and 16$\%$, respectively. The overall 1-year survival rates according to the stage was 100$\%$ for stage I, 80$\%$ for stage II, 61$\%$ for stage III, and 50$\%$ for stage IV. The overall 1-year 2-year, and 3-year survival rates for stage III patients only were 61$\%$, 23$\%$, and 20$\%$, respectively. The median survival time of stage III patients only was 15 months. The complete response rates by radiation therapy was 10$\%$ and partial response rate was 50$\%$. Thirty patients (43$\%$) among 70 patients assessed local control at initial 3 months follow-up duration. Twenty four (80$\%$) of these 30 Patients was possible to evaluate the pattern of failure after achievement of local control. And then, treatment failure occured in 14 patients (58$\%$): local relapse in 6 patients (43$\%$), distant metastasis in 6 patients (43$\%$) and local relapse with distant metastasis in 2 patients (14$\%$). Therefore, 10 patients (23$\%$) were controlled of disease of primary site with or without distant metastases. Twenty three patients (46$\%$) among 50 patients who were possible to follow-up had distant metastasis. The overall 1-year survival rate according to the treatment modalities was 59$\%$ in radiotherapy alone and 66$\%$ in chemoirradiation group. The overall 1-year survival rates for stage III patients only was 51$\%$ in radiotherapy alone and 68$\%$ in chemoirradiation group which was significant different. The significant prognostic factors affecting survival rate were the stage and the achievement of local control for all patients at univariate- analysis. Use of neoadjuvant or concurrent chemotherapy, use of chemotherapy and the achievement of local control for stage III patients only were also prognostic factors. The stage, pretreatment performance status, use of neoadjuvant or concurrent chemotherapy, total radiation dose and the achievement of local control were significant at multivariate analysis. The treatment-related toxicities were esophagitis, radiation pneunonitis, hematologic toxicity and dermatitis, which were spontaneously improved, but 2 patients were died with radiation pneumonitis. Conclusion : The conventional radiation therapy was not sufficient therapy for achievement of long-term survival in locally advanced non-small cell lung cancer. Therefore, aggressive treatment including the addition of appropriate chemotherapeutic drug to decrease distant metastasis and preoperative radiotherapy combined with surgery, hyperfractionation radiotherapy or 3-D conformal radiation therapy for increase local control are needed.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.821-827
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• 2005

Background: Hemodilution after priming of the cardiopulmonary bypass is known to increase the possibility of bleeding and homologous transfusion in adult cardiac surgery. We investigated the effects of retrograde autologous priming (RAP) to see whether it would decrease postoperative bleeding and homologous transfusion. Material and Method: We retrospectively reviewed 34 patients wpho underwent RAP and 46 patients who did not. Retrograde autologous priming consisted of arterial lire drainage, venous reservoir and oxygenator drainage and venous line drainage. We compared the amount of priming solution and RAP volume, perioperative hematocrit, postoperative bleeding and transfusion requirements in the two groups. Resuit: Mean withdrawal volume in RAP group was 613.5$\pm$160.6 mL and initial priming volume was 1381.9$\pm$37.2 mL. Hemoatocrits ($\%$) in RAP and control groups were 25.0$\pm$3.7 vs 20.9$\pm$3.6 (5 minutes after CPB), 25.9$\pm$3.7 vs 22.5$\pm$3.6 (30 minutes after CPB), 25.9$\pm$3.4 vs 23.8$\pm$2.8 (60 minutes after CPB), 31.9$\pm$3.9 vs 31.5$\pm$4.5 (postoperative 1 hour), 32.4$\pm$4.4 vs 32.1$\pm$4.5 (postoperative 6 hours), 33.4$\pm$5.0 vs 31.7$\pm$5.1 (postoperative 1 day)[repeated measures ANOVA, p < 0.05]. Chest tube drainages (mL) in the two groups were 357.2$\pm$177.1 vs 411.7$\pm$279.5 (postoperative 6 hours), 599.4$\pm$145.6 vs 678.8$\pm$256.4 (postoperative 24 hours)[t-test, p < 0.05]. Homologous transfusion was performed in 7 out of 34 patients in RAP group (20.6$\%$), and 16 out of 46 (34.8$\%$) in control group (p < 0.05). Conclusion: This study suggests that the effects of reducing the priming volume during cardiopulmonary bypass may result in lesser bleeding and homologous transfusion. Retrograde autologous priming would be used to reduce postoperative bleeding and chance of transfusion after adult cardiac surgery.

• Journal of Animal Science and Technology
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• v.52 no.2
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• pp.103-110
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• 2010

This study was conducted to determine the effect of supplemental medicinal plants (Artemisia, Acanthopanx and Garlic) on productive parameters in pigs. In experiment 1, a total of 90 multiparous sows were used in a 21-d performance study. The diets included: 1) CON (basal diet; Control), 2) BM1 (CON + 0.1% medicinal plants) and 3) BM2 (CON + 0.2% medicinal plants). Backfat thickness from farrowing to weaning was higher (P<0.05) in CON compared with sows fed treatments diets. The piglets weight gain was higher in the medicinal plants treatments (P<0.05). ADFI, nutrient digestibility and survivability were not affected by the experimental treatments. In experiment 2, a total of 60 finishing pigs (Landrace ${\times}$ Yorkshire ${\times}$ Duroc, $65.21\;{\pm}\;0.04\;kg$ average initial body weight) were used in a 56-d performance assay to determine the effects of supplemental medicinal plants (Artemisia, Acanthopanx and Garlic) on growth performance and carcass characteristics in finishing pigs. The dietary treatments included: 1) CON (basal diet ; Control), 2) BM1 (CON + 0.1% medicinal plants) and 3) BM2 (CON + 0.2% medicinal plants). For 4~8 weeks and overall period, ADG was higher (P<0.05) in the pigs fed medicinal plants. CON treatment was higher 24 pH loin and cooking loss than BM1 treatment (P<0.05). Water holding capacity and drip loss after 1day were affected by the dietary treatments (P<0.05). No numerical differences were observed in sensory evaluation, meat color, TBARS and loin area among three treatments. In conclusion, the results obtained from this feeding trial suggest that the medicinal plants mixture supplementation in diets for finishing pigs can improve ADG, water holding capacity, cooking loss and it improved backfat loss in sow and, litter weight gain.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.1
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• pp.1-13
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• 2011

The aim of this study was to evaluate shear bond strength of pressed reinforced composite resin ($TESCERA^{TM}$ ATL) veneering to zirconia with various surface treatments. Forty sintered zirconia specimens and forty pockmarked zirconia specimens were fabricated. All the materials were categorized as Group 1 (Control : porcelain veneering on zirconia surface), Group 2 ( $TESCERA^{TM}$ ATL dentine veneering after bonding agent application on zirconia surface), Group 3 ($TESCERA^{TM}$ ATL dentine veneering on pockmarked zirconia surface), Group 4 ($TESCERA^{TM}$ ATL dentine veneering after bonding agent application on pockmarked zirconia surface), Group 5 (Thermocycling on Group 1), Group 6 (Thermocycling on Group 2), Group 7 (Thermocycling on Group 3), and Group 8 (Thermocycling on Group 4). SBS(Shear bond strength) of 8 groups was determined with an Instron Universal Testing Machine. Also fractured surface of specimens were observed with a scanning electron microscope. There were no significant differences in the initial SBS between Group 1(control group), Group 3, and Group 4. (p>0.05) Group 2 presented the lowest SBS values. There was a no significant difference between just as 24hour water storage and simulated aging on pockmarked zirconia groups. (p>0.05) A formation of pockmarked irregularities on zirconia surface as mechanically pitted surface was reliable method for establishing a stronger bond between $TESCERA^{TM}$ ATL and zirconia-based material.

• Journal of Life Science
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• v.25 no.8
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• pp.889-895
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• 2015

Endothelial dysfunction is an initial step in atherosclerosis. B vitamins (B6, B12, and folate) are important contributing factors to vascular homeostasis. Deficiencies in these B vitamins induce cardiovascular diseases by altering vascular homeostasis. Folate plays important roles in nitric oxide homeostasis in the endothelium. To determine the dose-dependent effect of dietary folate on atherosclerosis, we studied aortic relaxation and hepatic C-reactive protein (CRP) levels in C57BL/6 mice. In this study, a total of 54 male C57BL/6, 8-wk old mice were split into 2 dietary groups (control and Western style diet). Each diet group was divided into 3 subgroups according to dietary folate dosage (0.2, 2, and 8 mg/kg). After 18 months, the relaxation response seen in aortic rings from mice fed 0.2 or 2 mg folate/kg in both diet groups. However, the aortic relaxation response was not seen and no differences were observed in mice fed 8mg folate/kg in either diet group (p<0.05). Hepatic CRP levels at all folate dosages (0.2, 2, 8 mg folate/kg) were higher in the groups fed a Western style diet than in mice fed a control diet (p=0.035). CRP levels were lower in mice fed 0.2 mg folate/kg than in mice fed 2 or 8 mg folate/kg in both diet groups (p<0.05). These results indicate that in C57BL/6 mice 0.2 mg folate/kg may be enough to prevent atherosclerosis by inducing the relaxation responses of the aorta and by reducing levels of hepatic CRP, regardless of dietary style.