• Korean Journal of Radiology
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• v.22 no.2
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• pp.253-262
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• 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.

• Korean Journal of Radiology
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• v.24 no.11
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• pp.1093-1101
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• 2023

Objective: Cine magnetic resonance imaging (MRI) has emerged as a noninvasive method to quantitatively assess bowel motility. However, its accuracy in measuring various degrees of small bowel motility has not been extensively evaluated. We aimed to draw a quantitative small bowel motility score from cine MRI and evaluate its performance in a population with varying degrees of small bowel motility. Materials and Methods: A total of 174 participants (28.5 ± 7.6 years; 135 males) underwent a 22-second-long cine MRI sequence (2-dimensional balanced turbo-field echo; 0.5 seconds per image) approximately 5 minutes after being intravenously administered 10 mg of scopolamine-N-butyl bromide to deliberately create diverse degrees of small bowel motility. In a manually segmented area of the small bowel, motility was automatically quantified using a nonrigid registration and calculated as a quantitative motility score. The mean value (MV) of motility grades visually assessed by two radiologists was used as a reference standard. The quantitative motility score's correlation (Spearman's ρ) with the reference standard and performance (area under the receiver operating characteristics curve [AUROC], sensitivity, and specificity) for diagnosing adynamic small bowel (MV of 1) were evaluated. Results: For the MV of the quantitative motility scores at grades 1, 1.5, 2, 2.5, and 3, the mean ± standard deviation values were 0.019 ± 0.003, 0.027 ± 0.010, 0.033 ± 0.008, 0.032 ± 0.009, and 0.043 ± 0.013, respectively. There was a significant positive correlation between the quantitative motility score and the MV (ρ = 0.531, P < 0.001). The AUROC value for diagnosing a MV of 1 (i.e., adynamic small bowel) was 0.953 (95% confidence interval, 0.923-0.984). Moreover, the optimal cutoff for the quantitative motility score was 0.024, with a sensitivity of 100% (15/15) and specificity of 89.9% (143/159). Conclusion: The quantitative motility score calculated from a cine MRI enables diagnosis of an adynamic small bowel, and potentially discerns various degrees of bowel motility.

• Journal of Gastric Cancer
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• v.24 no.3
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• pp.327-340
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• 2024

Purpose: Results of initial endoscopic biopsy of gastric lesions often differ from those of the final pathological diagnosis. We evaluated whether an artificial intelligence-based gastric lesion detection and diagnostic system, ENdoscopy as AI-powered Device Computer Aided Diagnosis for Gastroscopy (ENAD CAD-G), could reduce this discrepancy. Materials and Methods: We retrospectively collected 24,948 endoscopic images of early gastric cancers (EGCs), dysplasia, and benign lesions from 9,892 patients who underwent esophagogastroduodenoscopy between 2011 and 2021. The diagnostic performance of ENAD CAD-G was evaluated using the following real-world datasets: patients referred from community clinics with initial biopsy results of atypia (n=154), participants who underwent endoscopic resection for neoplasms (Internal video set, n=140), and participants who underwent endoscopy for screening or suspicion of gastric neoplasm referred from community clinics (External video set, n=296). Results: ENAD CAD-G classified the referred gastric lesions of atypia into EGC (accuracy, 82.47%; 95% confidence interval [CI], 76.46%-88.47%), dysplasia (88.31%; 83.24%-93.39%), and benign lesions (83.12%; 77.20%-89.03%). In the Internal video set, ENAD CAD-G identified dysplasia and EGC with diagnostic accuracies of 88.57% (95% CI, 83.30%-93.84%) and 91.43% (86.79%-96.07%), respectively, compared with an accuracy of 60.71% (52.62%-68.80%) for the initial biopsy results (P<0.001). In the External video set, ENAD CAD-G classified EGC, dysplasia, and benign lesions with diagnostic accuracies of 87.50% (83.73%-91.27%), 90.54% (87.21%-93.87%), and 88.85% (85.27%-92.44%), respectively. Conclusions: ENAD CAD-G is superior to initial biopsy for the detection and diagnosis of gastric lesions that require endoscopic resection. ENAD CAD-G can assist community endoscopists in identifying gastric lesions that require endoscopic resection.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.17 no.1
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• pp.53-62
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• 2007

목적: 1990년대 초반부터 시작된 우리나라의 산업 보건에 대한 사회적 관심의 증대와 시장의 요구에 따라 산업위생기관의 양적인 팽창이 이루어지긴 하였으나 실험실 관련 안전보건규정이 미비한 상태에서 추진되어 산업위생 실험실에서 다양한 유해 위험성 인자를 취급함에도 불구하고 사용되는 량이 소규모로 인해 안전보건과 관련된 사항은 대부분 간과하고 있으며, 산업위생 실험실의 안전보건관리 실태는 선진외국에 비해 상당히 낙후되어 있는 실정이다. 따라서 본 연구는 우리나라 산업위생 실험실과 관련한 안전보건관리 실태를 평가함으로써 향후 실험실의 안전보건관리 수준을 향상 시키는데 효과적인 자료로 활용하는데 기여하고자 한다. 방법: 산업위생실험실의 안전보건 실태를 파악하기 위해 설문조사를 수행하였으며, 설문은 실험실의 전반적인 안전보건, 화학물질 저장 및 용기, 가연성 및 인화성 화학물질, 가스 실린더, 의사전달, 응급처치 및 비상사태 장비, 정리정돈, 소방안전, 전기안전, 개인보호구, 흄후드 및 환기, 및 이황화탄소 취급 사례로서 12개 영역으로 구성되었다. 연구대상은 2001년 한국산업안전공단 정도관리프로그램에 참여한 기관으로서 총 대상은 119개 기관이었다. 연구기간은 2002년 7월 01일부터 8월 30일까지 약 60일 이었다. 설문은 반송봉투에 넣어 설문완성 후 연구자에게 보낼 수 있도록 배려하였으며, 1차 설문을 보낸 후 2주 후에 설문 참여를 독려하기 위해 엽서를 발송하였고, 다시 2주 후에 각 산업위생기관에 개별 전화 연락을 취하였다. 그 결과 63% (75개 기관)의 완성된 설문을 얻을 수 있었다. 설문의 총 조사항목은 79문항으로 구성되어 있으며, 산업위생실험실의 안전보건 수준을 정량적으로 평가하기 위해 안전보건 매뉴얼, 교육훈련프로그램 및 한국산업안전공단 실험실 지침서를 보유한 기관과 그렇지 않은 기관간의 차이는 선별된 67문항에 대해 각 문항에 합당하거나 적절할 경우 1점을 부여하는 방식으로 점수화하였다. 이들의 관련성을 파악하기 위하여 Microsoft-Excel 2000 프로그램을 이용하여 two-tailed t-test 분석을 실시하였다. 결과 1. 산업위생실험실 운영과 관련한 67개 항목(항목별로 각 1점 부여)에 대한 안전보건 성과지수화 (100점으로 점수 환산) 결과 안전보건 매뉴얼을 보유한 기관은 $42.98{\pm}13.36$(p<0.001)점, 교육훈련프로그램을 보유한 기관은 $50.75{\pm}14.12$(p<0.01)점, 한국산업안전공단 실험실 지침서를 보유한 기관은 $43.58{\pm}11.92$(p<0.01)점으로 그렇지 않은 기관에 비해 통계적으로 유의하게 높은 점수분포를 보였다. 2. 화학물질 보관 캐비닛이 있는 기관 중 64.8%의 기관은 화학물질을 알파벳 순으로, 27.8%는 분류 기준에 따라, 그리고 7.4%는 무작위로 보관하고 있었다. 3. 단지 8.0% (6개)의 기관만이 실험실내에 눈세정 분수(2 개), 샤워기(3개) 및 눈세정물병(3개, 2개 중복 응답 기관)과 같은 응급처치 장치 및 물품을 갖추고 있었다. 4. 89.0%의 기관이 흄후드내에 화학물질을 보관하고 있었다. 5. 물질안전보건자료, 흄후드 기록지, 비상사태 절차서 및 한국산업안전공단 실험실 지침서와 같은 문서관리는 부적절하게 관리 및 기록되고 있었다. 6. 대부분의 산업위생 실험실은 응급처치 장비, 화학물질 또는 가스용기 보관실과 같은 실험실 안전설비가 부족할 뿐만 아니라 정리정돈, 화학물질 저장 캐비닛, 안전보호구 및 흄후드와 같은 관리가 미비하였다. 결론: 이상의 결과에 근거하여 기관장은 실험실의 안전보건관리를 위하여 문서관리체계를 제공하고, 모든 실험실 종사자가 적절한 개인보호구를 착용할 수 있도록 하며, 비상 장비를 설치하고, 실험실과 관련한 적절한 규정을 제정하며, 교육훈련 프로그램을 제공하여야 한다. 또한 실험실 종사자는 실험 중 적절한 개인보호구의 착용하고, 비상장비 이용에 대한 교육훈련에 참여하며, 적절한 실험실 운영관리에 대한 책임감을 가져야 한다. 위의 권고사항 이행을 위해서 KOSHA는 KQCP 프로그램에 실험실 안전보건관리 항목을 삽입하여 주기적인 평가를 수행할 필요가 있다. 우리나라 실험실의 특성을 고려할 때 본 연구결과는 일반 실험실에도 적용될 수 있을 것으로 생각된다.

• Journal of The Korean Society of Grassland and Forage Science
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• v.29 no.1
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• pp.43-50
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• 2009

Two experiments were conducted to evaluate the effects of nitrogen (N) application level and regrowth period on the fatty acid (FA) concentration and forage production of tall fescue (Festuca arundinacea Schr.) and bermudagrass (Cynodon dactylon (L.) Pers.). N was applied at 0, 50 and 100 kg/ha, and swards were cut after regrowth periods (15d, 30d and 45d). Concentrations of Individual FA were determined by gas chromatography. FA composition of tall fescue contains a high proportion ($87{\sim}88%$) of total FA contents as palmitic (C16:0), linoleic (C18:2) and linolenic acid (C18:3). The FA composition was not affected by N application, but a longer regrowth period significantly (p<0.05) decreased the composition of linolenic acid (C18:3) and increased those of linoleic acid (C18:2). The FA composition of bermudagrass was not affected by N application, but a longer regrowth period significantly (p<0.001) decreased the composition of linoleic (C18:2) and linolenic acid (C18:3). Linoleic and linolenic acfd of tall fescue were higher than those of bermudagrass. Dry matter (DM) yield of bermudagrass was significantly (P<0.05) affected by N application level and regrowth period. DM yield was higher at high N application and was higher at longer regrowth period. The crude protein concentration was higher at high N application and was low at longer regrowth period. Application of nitrogen fertilizer Increases dry matter (DM) yield and crude protein (CP) content of bermudagrass. These studies demonstrate opportunities to affect the FA concentration and composition of FA in forage through management strategies, which could affect milk FA composition.

• The Korean Journal of Food And Nutrition
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• v.30 no.3
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• pp.539-551
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• 2017

This study investigated the current status and needs for nutrition education to help reduce children's sugars intake at the Center for Children's Foodservice Management (CCFM, n=115), and Child Care Facilities (CCF, n=646) through an online survey conducted from October $5^{th}$ to $30^{th}$ 2015. A total of 14.8% of CCFM respondents and 31.9% of CCF respondents provided nutrition education on sugars intake to young children as a main topic (p<0.001). A higher percentage (CCFM 47.8%: CCF 42.4%) delivered nutrition education on sugars intake to young children as a sub-component (p<0.001). Over 90% of the CCFM and CCF participants agreed on the necessity of providing nutrition education on sugars intake to children. The most common reasons given for delivering nutrition education on children's sugar intake were "there are many more urgent nutrition education topics" for CCFM, and "insufficient nutrition education information and materials" for CCF. The percentage of nutrition education on children's sugar intake provided to the children's parents was low showing about 20% in the both groups. The percentage of CCFM participants providing nutrition, education on children's sugar intake to the teachers in CCF was also low, showing about 14.8%; however, 68.0% of the CCF participants wanted to received teacher's education on guiding children's sugar intake. Regarding ideas about a nutrition education program on children's sugar intake for young children, most respondents in both groups answered "sugar intake and dental cavities or obesity" for appropriate education contents, "story telling or puppet show" for appropriate education methods, and "dietitian from CCFM and class teacher together" for appropriate educator. For appropriate education time, there was a significantl difference between the CCFM responses (average 2.7 times) and the CCF responses (average 4 times). Based on the above results, we found that implementing nutrition education on children's sugar intake at the CCFM and CCF, was low; however, awareness of the need for nutrition education on children's sugar intake and the program development and supply was very high. Also, the opinions of CCFM and CCF participants about a nutrition education program on children's sugar intake for young children can provide foundation data to develop and implement the CCFM-based nutrition education program.

• Journal of Chest Surgery
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• v.29 no.10
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• pp.1095-1101
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• 1996

From July 1983 to June 1995, 95 consecutive patients with mitral stenosis were treated surgically in the Department of Thoracic and Cardiovascular Surgery, Chonbuk national University Hospital, mitral valve replacement(MVR) in 62 patients and open mitral commissurotomy(OMC) in 33 patients. Mitral stenosis combined with coronary artery disease, with aortic valve disease, or wish mitral valvular Insufficiency, were excluded from this study. Surgical procedures for mitral stenosis were evaluated, according to complication, reoperation, mor- tality, nd functional change at mid- and long-term postoperative period. Cardiothoracic ratio in the MVR group was greater than the OMC group(0.59 $\pm$0.07 in MVR, 0.53 $\pm$0. 07 in OMC, p<0.05), but other variables(age, sex, MYHA functional classification, EKG finding, echocardiographic finding) did not show significant difference between two groups in the preoperative periods. Even though pathologic valvular lesion(Sellor's pathologic type m: 35 in MVR, 13 in OMC) and valvular calcification(35 in MVR, 11 in OMC) were severe in the MVR group(p=0.001) at intraoperative observation, OMC was possible in 11 patients(23.9%) among 46 patients with valvular calcification and in 13 patients(27.1 %) among 61 patients with Sellor's pathologic type IH . There was no significant difference in early and late mortality, actuarial survival(75% in MVR, 87.6% in OMC at 12 year), but early and late hemorrhagic, thromboembolic complications in the MVR group were greater than in the OMC. Functional changes in NYHA functional classification, EKG lEnding, cardiothoraclc ratio, and echocardiographic finding(EF, LVIDS, LWDd, LAD) did not differ between two groups in mid- and long-term postoperative periods. We conclude that our efforts for preservation of the native valve would be continued, because hemorrhagic and thromboembolic complications in the MVR were greater than in the OMC, and OMC was possible even in patients with severely stenotic and calcified mitral valve, although there was no sis-nificant difference in the functional change, mortality, and survival between the M VR and OMC.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.592-597
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• 2010

Hyperimmunoglobulin E syndrome (HIES) is a rare immunodeficiency disease which is characterized by high serum IgE levels, eczema, and recurrent infections. Herein we present the case of a patient with HIES associated with STAT3 gene ($stat3$) mutation. A 16 year-old girl was admitted to our hospital due to hemoptysis caused by pneumonia with bronchiectasis. She had a history of recurrent skin and respiratory tract infections, such as pneumonia caused by MRSA (methicillin-resistant $Staphylococcus$ $aureus$) and $Pseudomonas$ $aeruginosa$. On physical examination, a broad round shaped nose, oral thrush, and chronic eczematous skin rash over her whole body were found. Laboratory data showed an elevated eosinophil count ($750/{\mu}L$) and total IgE level (5,001 U/mL). The patient's National Institutes of Health (NIH) score for HIES was 44. Direct sequencing of the STAT3 gene revealed that the patient was heterozygous for a missense mutation in the DNA binding domain of the STAT3 protein (c.1144C>T, p. Arg382Trp). HIES should be suspected in patients with recurrent infections and can be confirmed by clinical scoring and genetic analysis.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.152-157
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• 1997

From August 1986 until June 1995, single aortic valve replacement was performed in 65 patients at the Chonnam National University Hospital. worthy-eight were male and 17 were female patients, ranging from 19 to 68 years of age(median : 43 years). The causes of the valve lesions were rheumatic in 29 patients (44.6%), bicuspid aortic valve in 6 patients (6.2%), endocarditis in 6 patients(6.2%), unknown in others. Concomitant surgical procedures were performed in 10 patients : repair of congenital defect in 5, pericardiectomy in 1, coronary artery bypass grafting in 1, noncoronary sinus plication in 1, Valsalva sinus aneurysmectomy in 1, subaortic membrane resection in 1 Used valves were 51. Jude-Medical valve in 42, Duromedics valve in 22, Bjork-Shiley valve in 2, Carpentier-Edward valve in 1. There were 3 hospital deaths (4.6%), and 2 late deaths (3.2%). Follow-up was 95.2% complete. The 10-year acturlal survival rate was 85.3%. Postoperative complications were low cardiac utput in 8, arrythmia in 5, valve related hemolysis in 1, cerebral infarction in 1, and gastrointestinal bleeding in 2. Reoperation was performed in 4 for surgical bleeding, in 3 for paravalvular leak. The mean improvement in New York Heart Association functional class is from 2.79 $\pm$ 0.66 preoperatively to 1.25 $\pm$ 0.49 postoperatively(p < 0.001) The change of cardiothoracic ratio from preoperative to postoperative is 0.57 $\pm$ 0.06 to 0.54 $\pm$ 0.05 (p < 0.05). The left ventricular ejection fraction change is not significant perioperatively. There are no mechanical failures. This early and intermediate-term follow-up suggests that in adults in whom valve repair is not possible, the mechanical valve is a reliable and durable prosthesis with good hemodynamic function and a low rate of thromboembolic event.

• Tuberculosis and Respiratory Diseases
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• v.61 no.6
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• pp.554-561
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• 2006

Background: In AIDS patients, the respiratory tract is one of the most frequently involved site of by an opportunistic infection, and an even common, casual pulmonary infection manifests in a peculiar ways in AIDS patients. In Korea, because of the low prevalence of AIDS, there is insufficient data compared with other Southeast Asian counties. However, considering the sexual behavior of the younger generation, it is expected that it will not be long before AIDS becomes a major public health issue in Korea. This study examined the clinical manifestation of HIV positive people and AIDS patients. The pulmonary manifestion of HIV-positive was evaluated. This study focused on the differences in the clinical manifestation between AIDS patients with pulmonary disease and simple HIV positive people. The characteristics of common pulmonary infections in AIDS patients were also analyzed. Method: The medical records of 28 HIV positive patients who visited the hospital of ChungAng University Hospital from January, 2001 to February, 2006 were analyzed retrospectively. Result: Twenty-seven patients out of 28 HIV positive patients were male and the average age was 40.6(23-65). Patients in their thirties were most commonly affected. Elven patients had pulmonary diseases. Pulmonary tuberculosis (4 cases) and pneumocystis pneumonia (4 cases) were the most common respiratory infection. One patient showed a peculiar type of systemic cryptococcus. which was accompanied by lung and pleural dissemination. The CD4+lymphocyte count of patients with a pulmonary infection was significantly lower in patients with a pulmonary manifestation than those with only a HIV infection ($79.5/mm^3$ vs $400/mm^3$, respectively)(p<.05). Patients with pulmonary disease were in a more severe immunosuppressive state. There were 4 patients with pulmonary tuberculosis, 4 with pneumocystis pneumonia, 4 with secondary syphilis, 2 with primary syphilis, and 2 with HZV infection. The average CD4 lymphocyte counts was $56/mm^3$ in those with pulmonary tuberculosis, $42/mm^3$ in those with pneumocystis pneumonia, and $455/mm^3$ in those with secondary syphilis. Conclusion: This study examined the clinical manifestation of HIV positive patients, particularly AIDS patients with pulmonary disease, A more severe immunosuppressive status was observed in HIV-related pulmonary compared with those with HIV-related extrapulmonary disease, and the frequency of pulmonary tuberculosis in pulmonary disease was higher than expected. Respiratory infection in AIDS manifest in uncommon ways e.g. disseminated cryptococcosis involving the lung and pleura. Evidently, AIDS patients with a respiratory infection have a more severe form of immunosuppression than those with a simple HIV infection. As expected, patients with a pulmonary infection were in a more severe immunosuppressed state than those with a simple HIV infection. Opportunistic infections can show peculiar clinical presentations in AIDS patients.