• Journal of the Korean Society of Radiology
• /
• v.18 no.3
• /
• pp.249-256
• /
• 2024

The study aimed to evaluate the efficacy of treatment plans using full Arc and Partial Arc Coplanar volumetric modulated arc therapy and Non-Coplanar volumetric modulated arc therapy to minimize radiation treatment side effects, such as pneumonia, and protect normal organs in esophageal cancer radiotherapy. 30 patients who underwent Concurrent Chemoradiotherapy for esophageal cancer were included. Compared planning target volume, lung, heart, spinal cord and total monitor units among three treatment plans: fVMAT(2 Full Arc), pVMAT(4 Partial Arc), and ncVMAT(2 Partial Arc + 2 Non-Coplanar Arc). All plans met the PTV criteria, showing uniform distribution. The average dose to the heart was 5.8 Gy for fVMAT, 6.97 Gy for pVMAT, and 7.6 Gy for ncVMAT, with the lowest value in fVMAT, which was statistically significant. However, the average lung dose was 9.01 Gy for fVMAT, 7.71 Gy for pVMAT, and 7.12 Gy for ncVMAT, with V_5Gy(%) values of 52.22%, 38.61%, 36.35% and V_10Gy(%) values of 37.8%, 27.33%, 24.15% respectively. ncVMAT showed the lowest values, while fVMAT had the highest, with statistical significance. In conclusion, ncVMAT effectively reduces lung radiation exposure in esophageal cancer radiotherapy, potentially reducing the incidence of side effects such as pneumonia. However, considering factors like setup accuracy and treatment time, applying an appropriate treatment plan may lead to better outcomes.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.39 no.4
• /
• pp.276-284
• /
• 2023

After tooth extraction, alveolar bone is resorbed over time. Loss of alveolar bone and reduction of upper soft tissue poses difficulties in future implant placement and long-term survival of the implant. This case report focuses on increasing the soft and hard tissues at the implant placement site by using alveolar ridge augmentation and a xenogeneic collagen matrix as a soft tissue substitute in an extraction socket affected by periodontal disease. In each case, the width of the alveolar bone increased to 6 mm, 8 mm, and 4 mm, and regeneration of the interdental papilla around the implant was shown, as well as buccal keratinized gingiva of 4 mm, 6 mm, and 4 mm, respectively. Enlarged alveolar bone facilitates implant surgery, and interdental papillae and keratinized gingiva enable aesthetic prosthesis. This study performed alveolar ridge augmentation on patients with extraction sockets affected by periodontal disease and additionally used soft tissue substitutes to provide a better environment for implant placement and have positive effects for aesthetic and predictive implant surgery.

• Pediatric Infection and Vaccine
• /
• v.30 no.3
• /
• pp.139-144
• /
• 2023

Purpose: Children with incomplete Kawasaki disease (KD) and pyuria may be misdiagnosed with urinary tract infection (UTI) during the early phase of the prodrome. We investigated the percentage of UTI diagnoses preceding a KD diagnosis. Methods: Using the National Health Insurance data of South Korea, we assessed differences in UTI diagnoses made during the week preceding a KD diagnosis, according to demographic and geographic factors from November 2007-October 2019. Results: A total of 53,822 KD cases were identified, including 304 patients (0.56%) diagnosed with a UTI during the week preceding a KD diagnosis. The younger age group (0-11 months) showed the highest percentage of preceding UTI diagnoses (0.95%), with higher odds than 4-year-old children (3.12; 95% confidence interval, 2.05-4.77). Conclusions: These findings suggest a potentially misleading presentation of incomplete KD, a clinical conundrum requiring further investigation and validation, particularly in infants.

• Journal of Korean Neurosurgical Society
• /
• v.67 no.1
• /
• pp.60-72
• /
• 2024

Objective : Recently, robotic-assisted spine surgery (RASS) has been considered a minimally invasive and relatively accurate method. In total, 495 robotic-assisted pedicle screw fixation (RAPSF) procedures were attempted on 100 patients during a 14-month period. The current study aimed to analyze the accuracy, potential risk factors, and learning curve of RAPSF. Methods : This retrospective study evaluated the position of RAPSF using the Gertzbein and Robbins scale (GRS). The accuracy was analyzed using the ratio of the clinically acceptable group (GRS grades A and B), the dissatisfying group (GRS grades C, D, and E), and the Surgical Evaluation Assistant program. The RAPSF was divided into the no-breached group (GRS grade A) and breached group (GRS grades B, C, D, and E), and the potential risk factors of RAPSF were evaluated. The learning curve was analyzed by changes in robot-used time per screw and the occurrence tendency of breached and failed screws according to case accumulation. Results : The clinically acceptable group in RAPSF was 98.12%. In the analysis using the Surgical Evaluation Assistant program, the tip offset was 2.37±1.89 mm, the tail offset was 3.09±1.90 mm, and the angular offset was 3.72°±2.72°. In the analysis of potential risk factors, the difference in screw fixation level (p=0.009) and segmental distance between the tracker and the instrumented level (p=0.001) between the no-breached and breached group were statistically significant, but not for the other factors. The mean difference between the no-breach and breach groups was statistically significant in terms of pedicle width (p<0.001) and tail offset (p=0.042). In the learning curve analysis, the occurrence of breached and failed screws and the robot-used time per screw screws showed a significant decreasing trend. Conclusion : In the current study, RAPSF was highly accurate and the specific potential risk factors were not identified. However, pedicle width was presumed to be related to breached screw. Meanwhile, the robot-used time per screw and the incidence of breached and failed screws decreased with the learning curve.

• The Journal of Internal Korean Medicine
• /
• v.44 no.6
• /
• pp.1294-1317
• /
• 2023

Background: Post-COVID-19 pulmonary fibrosis (PCPF) is a common complication in severe COVID-19 cases, often associated with acute respiratory distress syndrome or mechanical ventilation. Patients with PCPF frequently experience a decline in their quality of life due to persistent COVID-19 sequelae, including cough and chest pain. However, there is currently no established standard treatment, and the efficacy of existing medications remains uncertain. Case Report: A 65-year-old female patient presenting with cough, dyspnea, chest pain, and fatigue due to PCPF received Korean medicine treatment for 25 days. Symptom evaluation utilized the modified Medical Research Council scale, the Leicester Cough Questionnaire, and the Numeral Rating Scale. Quality of life and functional status were assessed using the Post-COVID-19 Functional Status and the EuroQol 5-Dimensional 5-Level. The extent of pulmonary fibrosis was assessed by comparing chest computed tomography (chest CT) scans before and after hospitalization. Following treatment, the patient demonstrated clinically meaningful improvement in clinical symptoms, enhanced quality of life, and decreased fibrotic lesions on CT scans. Conclusion: This case report suggests that Korean medicine treatment may be effective in improving clinical symptoms, such as cough and dyspnea caused by PCPF, while also enhancing post-COVID-19 quality of life and ameliorating pulmonary fibrotic lesions.

• The Journal of the Convergence on Culture Technology
• /
• v.10 no.2
• /
• pp.27-33
• /
• 2024

In this article, this study examines the issue of "Physician-assisted Suicide" and how Ramon Sampedro asserts his right to a dignified death through litigation. Ramon, the protagonist of the movie <The Sea Inside> is a patient, severely paralyzed man who has spent more than 26 years in bed. The only thing he can do is verbally ask his family for help. Ramon can no longer support this worthless existence, so he pursues death with dignity. Ramon files a lawsuit to authorize death with dignity within a legal framework, but is denied on the grounds that life is a duty. Ramon eventually fulfills his desire for death with dignity with the help of his friends. Ramon sets up a camera to document the process of his death and introduces the cyanide, which is used in assisted dying, by inhaling cyanide in front of the camera and dying quietly. Although Ramon is not a terminally ill patient, who can blame him for practicing death with dignity as he chooses to do so. We will need to work to build social consensus and legislate for death with dignity for seriously ill patients like Ramon.

• Molecules and Cells
• /
• v.47 no.3
• /
• pp.100033.1-100033.13
• /
• 2024

Considering the recent increase in the number of colorectal cancer (CRC) cases in South Korea, we aimed to clarify the molecular characteristics of CRC unique to the Korean population. To gain insights into the complexities of CRC and promote the exchange of critical data, RNA-sequencing analysis was performed to reveal the molecular mechanisms that drive the development and progression of CRC; this analysis is critical for developing effective treatment strategies. We performed RNA-sequencing analysis of CRC and adjacent normal tissue samples from 214 Korean participants (comprising a total of 381 including 169 normal and 212 tumor samples) to investigate differential gene expression between the groups. We identified 19,575 genes expressed in CRC and normal tissues, with 3,830 differentially expressed genes (DEGs) between the groups. Functional annotation analysis revealed that the upregulated DEGs were significantly enriched in pathways related to the cell cycle, DNA replication, and IL-17, whereas the downregulated DEGs were enriched in metabolic pathways. We also analyzed the relationship between clinical information and subtypes using the Consensus Molecular Subtype (CMS) classification. Furthermore, we compared groups clustered within our dataset to CMS groups and performed additional analysis of the methylation data between DEGs and CMS groups to provide comprehensive biological insights from various perspectives. Our study provides valuable insights into the molecular mechanisms underlying CRC in Korean patients and serves as a platform for identifying potential target genes for this disease. The raw data and processed results have been deposited in a public repository for further analysis and exploration.

• Phonetics and Speech Sciences
• /
• v.16 no.1
• /
• pp.41-48
• /
• 2024

The significance of self-reported voice assessments concerning patients' chief complaints and quality of life has increased. Therefore, readability assessments of questionnaire items are essential. In this study, readability analyses were performed based on text grade and complexity, vocabulary frequency and grade, and lexical diversity of the 11 Korean versions of self-reported voice disorder questionnaires (KVHI, KAVI, KVQOL, K-SVHI, K-VAPP, K-VPPC, TVSQ, K-VDCQ, K-VFI, K-VTDS, and K-VoiSS). Additionally, a comparative readability assessment was conducted on the original versions of these questionnaires to discern the differences between their Korean counterparts and the questionnaires for children. Consequently, it was determined that voice disorder questionnaires could be used without difficulty for populations with lower literacy levels. Evaluators should consider subjects' reading levels when conducting assessments, and future developments and revisions should consider their reading difficulties.

• Journal of the Korean Applied Science and Technology
• /
• v.40 no.6
• /
• pp.1567-1579
• /
• 2023

Sucralose is used as a sucrose alternative in the food sector and is a globally approved pyrogenic, high-intensity artificial sweetener. However, due to the lack of studies on the effects of sweeteners on the brain, this study confirmed whether short-term consumption of sucralose has cognitive and memory protective effects in scopolamine-induced memory-injured animal models. After oral administration of sucralose 2, 5, and 10 mg/kg, scopolamine (1 mg/kg) was administered to the control group and the drug group 30 minutes later, and saline was administered intraperitoneally to the normal group, followed by behavioral experiments As a result of the experiment, Y-Maze, passive avoidance, and Morris WaterMaze recovered more than 10% of cognitive function compared to the control group. In addition, as a result of measuring proinflammatory cytokines, sucralose was found to inhibit IL-6 and TNF-α by more than 30%, and we observed that the expression level of ERK-CREB with intracellular signaling mechanisms increased in a concentration-dependent manner. Therefore, it suggests that sucralose is associated with functional foods for the prevention of functional food patients.

• Korean Journal of Radiology
• /
• v.21 no.7
• /
• pp.869-879
• /
• 2020

Objective: To evaluate the performance of a convolutional neural network (CNN) model that can automatically detect and classify rib fractures, and output structured reports from computed tomography (CT) images. Materials and Methods: This study included 1079 patients (median age, 55 years; men, 718) from three hospitals, between January 2011 and January 2019, who were divided into a monocentric training set (n = 876; median age, 55 years; men, 582), five multicenter/multiparameter validation sets (n = 173; median age, 59 years; men, 118) with different slice thicknesses and image pixels, and a normal control set (n = 30; median age, 53 years; men, 18). Three classifications (fresh, healing, and old fracture) combined with fracture location (corresponding CT layers) were detected automatically and delivered in a structured report. Precision, recall, and F1-score were selected as metrics to measure the optimum CNN model. Detection/diagnosis time, precision, and sensitivity were employed to compare the diagnostic efficiency of the structured report and that of experienced radiologists. Results: A total of 25054 annotations (fresh fracture, 10089; healing fracture, 10922; old fracture, 4043) were labelled for training (18584) and validation (6470). The detection efficiency was higher for fresh fractures and healing fractures than for old fractures (F1-scores, 0.849, 0.856, 0.770, respectively, p = 0.023 for each), and the robustness of the model was good in the five multicenter/multiparameter validation sets (all mean F1-scores > 0.8 except validation set 5 [512 x 512 pixels; F1-score = 0.757]). The precision of the five radiologists improved from 80.3% to 91.1%, and the sensitivity increased from 62.4% to 86.3% with artificial intelligence-assisted diagnosis. On average, the diagnosis time of the radiologists was reduced by 73.9 seconds. Conclusion: Our CNN model for automatic rib fracture detection could assist radiologists in improving diagnostic efficiency, reducing diagnosis time and radiologists' workload.