• Korean Journal of Radiology
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• v.22 no.12
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• pp.1964-1973
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• 2021

Objective: To investigate the diagnostic performance of CT fractional flow reserve (CT-FFR) for myocardial bridging-related ischemia using dynamic CT myocardial perfusion imaging (CT-MPI) as a reference standard. Materials and Methods: Dynamic CT-MPI and coronary CT angiography (CCTA) data obtained from 498 symptomatic patients were retrospectively reviewed. Seventy-five patients (mean age ± standard deviation, 62.7 ± 13.2 years; 48 males) who showed myocardial bridging in the left anterior descending artery without concomitant obstructive stenosis on the imaging were included. The change in CT-FFR across myocardial bridging (ΔCT-FFR, defined as the difference in CT-FFR values between the proximal and distal ends of the myocardial bridging) in different cardiac phases, as well as other anatomical parameters, were measured to evaluate their performance for diagnosing myocardial bridging-related myocardial ischemia using dynamic CT-MPI as the reference standard (myocardial blood flow < 100 mL/100 mL/min or myocardial blood flow ratio ≤ 0.8). Results: ΔCT-FFR_systolic (ΔCT-FFR calculated in the best systolic phase) was higher in patients with vs. without myocardial bridging-related myocardial ischemia (median [interquartile range], 0.12 [0.08-0.17] vs. 0.04 [0.01-0.07], p < 0.001), while CT-FFR_systolic (CT-FFR distal to the myocardial bridging calculated in the best systolic phase) was lower (0.85 [0.81-0.89] vs. 0.91 [0.88-0.96], p = 0.043). In contrast, ΔCT-FFR_diastolic (ΔCT-FFR calculated in the best diastolic phase) and CT-FFR_diastolic (CT-FFR distal to the myocardial bridging calculated in the best diastolic phase) did not differ significantly. Receiver operating characteristic curve analysis showed that ΔCT-FFR_systolic had largest area under the curve (0.822; 95% confidence interval, 0.717-0.901) for identifying myocardial bridging-related ischemia. ΔCT-FFR_systolic had the highest sensitivity (91.7%) and negative predictive value (NPV) (97.8%). ΔCT-FFR_diastolic had the highest specificity (85.7%) for diagnosing myocardial bridging-related ischemia. The positive predictive values of all CT-related parameters were low. Conclusion: ΔCT-FFR_systolic reliably excluded myocardial bridging-related ischemia with high sensitivity and NPV. Myocardial bridging showing positive CT-FFR results requires further evaluation.

• Korean Journal of Radiology
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• v.22 no.6
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• pp.959-969
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• 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
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• v.22 no.6
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• pp.983-993
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• 2021

Objective: To investigate the image quality of ultralow-dose CT (ULDCT) of the chest reconstructed using a cycle-consistent generative adversarial network (CycleGAN)-based deep learning method in the evaluation of pulmonary tuberculosis. Materials and Methods: Between June 2019 and November 2019, 103 patients (mean age, 40.8 ± 13.6 years; 61 men and 42 women) with pulmonary tuberculosis were prospectively enrolled to undergo standard-dose CT (120 kVp with automated exposure control), followed immediately by ULDCT (80 kVp and 10 mAs). The images of the two successive scans were used to train the CycleGAN framework for image-to-image translation. The denoising efficacy of the CycleGAN algorithm was compared with that of hybrid and model-based iterative reconstruction. Repeated-measures analysis of variance and Wilcoxon signed-rank test were performed to compare the objective measurements and the subjective image quality scores, respectively. Results: With the optimized CycleGAN denoising model, using the ULDCT images as input, the peak signal-to-noise ratio and structural similarity index improved by 2.0 dB and 0.21, respectively. The CycleGAN-generated denoised ULDCT images typically provided satisfactory image quality for optimal visibility of anatomic structures and pathological findings, with a lower level of image noise (mean ± standard deviation [SD], 19.5 ± 3.0 Hounsfield unit [HU]) than that of the hybrid (66.3 ± 10.5 HU, p < 0.001) and a similar noise level to model-based iterative reconstruction (19.6 ± 2.6 HU, p > 0.908). The CycleGAN-generated images showed the highest contrast-to-noise ratios for the pulmonary lesions, followed by the model-based and hybrid iterative reconstruction. The mean effective radiation dose of ULDCT was 0.12 mSv with a mean 93.9% reduction compared to standard-dose CT. Conclusion: The optimized CycleGAN technique may allow the synthesis of diagnostically acceptable images from ULDCT of the chest for the evaluation of pulmonary tuberculosis.

• Korean Journal of Radiology
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• v.22 no.3
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• pp.324-333
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• 2021

Objective: The clinical course of an individual patient with heart failure is unpredictable with left ventricle ejection fraction (LVEF) only. We aimed to evaluate the prognostic value of cardiac magnetic resonance (CMR)-derived myocardial fibrosis extent and to determine the cutoff value for event-free survival in patients with non-ischemic cardiomyopathy (NICM) who had severely reduced LVEF. Materials and Methods: Our prospective cohort study included 78 NICM patients with significantly reduced LV systolic function (LVEF < 35%). CMR images were analyzed for the presence and extent of late gadolinium enhancement (LGE). The primary outcome was major adverse cardiac events (MACEs), defined as a composite of cardiac death, heart transplantation, implantable cardioverter-defibrillator discharge for major arrhythmia, and hospitalization for congestive heart failure within 5 years after enrollment. Results: A total of 80.8% (n = 63) of enrolled patients had LGE, with the median LVEF of 25.4% (19.8-32.4%). The extent of myocardial scarring was significantly higher in patients who experienced MACE than in those without any cardiac events (22.0 [5.5-46.1] %LV vs. 6.7 [0-17.1] %LV, respectively, p = 0.008). During follow-up, 51.4% of patients with LGE ≥ 12.0 %LV experienced MACE, along with 20.9% of those with LGE ≤ 12.0 %LV (log-rank p = 0.001). According to multivariate analysis, LGE extent more than 12.0 %LV was independently associated with MACE (adjusted hazard ratio, 6.71; 95% confidence interval, 2.54-17.74; p < 0.001). Conclusion: In NICM patients with significantly reduced LV systolic function, the extent of LGE is a strong predictor for long-term adverse cardiac outcomes. Event-free survival was well discriminated with an LGE cutoff value of 12.0 %LV in these patients.

• Korean Journal of Radiology
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• v.22 no.5
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• pp.725-734
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• 2021

Objective: To intraindividually compare hepatocellular carcinoma (HCC) washout between MRIs using hepatobiliary agent (HBA) and extracellular agent (ECA). Materials and Methods: This study included 114 prospectively enrolled patients with chronic liver disease (mean age, 55 ± 9 years; 94 men) who underwent both HBA-MRI and ECA-MRI before surgical resection for HCC between November 2016 and May 2019. For 114 HCCs, the lesion-to-liver visual signal intensity ratio (SIR) using a 5-point scale (-2 to +2) was evaluated in each phase. Washout was defined as negative visual SIR with temporal reduction of visual SIR from the arterial phase. Illusional washout (IW) was defined as a visual SIR of 0 with an enhancing capsule. The frequency of washout and MRI sensitivity for HCC using LR-5 or its modifications were compared between HBA-MRI and ECA-MRI. Subgroup analysis was performed according to lesion size (< 20 mm or ≥ 20 mm). Results: The frequency of portal venous phase (PP) washout with HBA-MRI was comparable to that of delayed phase (DP) washout with ECA-MRI (77.2% [88/114] vs. 68.4% [78/114]; p = 0.134). The frequencies were also comparable when IW was allowed (79.8% [91/114] for HBA-MRI vs. 81.6% [93/114] for ECA-MRI; p = 0.845). The sensitivities for HCC of LR-5 (using PP or DP washout) were comparable between HBA-MRI and ECA-MRI (78.1% [89/114] vs. 73.7% [84/114]; p = 0.458). In HCCs < 20 mm, the sensitivity of LR-5 was higher on HBA-MRI than on ECA-MRI (70.8% [34/48] vs. 50.0% [24/48]; p = 0.034). The sensitivity was similar to each other if IW was added to LR-5 (72.9% [35/48] for HBA-MRI vs. 70.8% [34/48] for ECA-MRI; p > 0.999). Conclusion: Extracellular phase washout for HCC diagnosis was comparable between MRIs with both contrast agents, except for tumors < 20 mm. Adding IW could improve the sensitivity for HCC on ECA-MRI in tumors < 20 mm.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.23 no.2
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• pp.32-49
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• 2024

In this paper, we analyzed the impacts of road traffic conditions and speed limit changes on traffic flow and safety. Travel speed and moving speed were set as traffic flow indicators and'moving speed-travel speed',speed deviation, large speed deviation ratio, and number of conflicts were set as safety indicators, and the impacts of changes in road traffic conditions and speed limits on these were analyzed. According to the analysis results, the speed limit had a significant impacts on the traffic indicators, but did not significantly affect the safety indicators. As a result of the statistical validity test, it was proven that the traffic flow index increases as the speed limit increases. However, although safety indicators often increase, their validity has not been proven statistically. Therefore, if the speed limit is set and operated by properly considering the traffic flow status according to various road conditions and changes in traffic volume, it can be said to match the speed at which drivers drive and improve traffic flow and safety. Therefore, it is expected that calculating the speed limit considering the traffic flow indicators and safety indicators presented in this paper and operating the speed limit according to changes in traffic volume will contribute to stabilizing the traffic flow on the road.

• Journal of the korean academy of Pediatric Dentistry
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• v.51 no.2
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• pp.149-164
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• 2024

This study compared the solubility, water absorption, dimensional stability, release of various ions (hydroxyl, calcium, sulfur, strontium, and silicon), and cytotoxicity of light-cured resin-modified pulp-capping materials. Resin-modified calcium hydroxide (Ultra-blend^TM plus, UBP), light-cured resin-modified calcium silicate (TheraCal LC^TM, TLC), and dual-cure resin-modified calcium silicate (TheraCal PT^TM, TPT) were used. Each material was polymerized; solubility, 24-hour water absorption, and 30- day dimensional stability experiments were conducted to test its physical properties. Solubility was assessed according to the ISO 6876 standard, and 24 hours of water absorption, 30 days of dimensional stability were assessed by referring to the previous protocol respectively. Eluates at 3 and 24 hours and on 7, 14, and 28 days were analyzed according to the ISO 10993-12 standard. And the pH, Ion-releasing ability, cell proliferation rate, and cell viability were assessed using the eluates to evaluate biochemical characteristics. pH was measured with a pH meter and Ion-releasing ability was assessed using inductively coupled plasma atomic emission spectrometry (ICP-AES). Cell proliferation rate and cell viability were assessed using human dental pulp cells (hDPCs). The former was assessed by an absorbance assay using the CCK-8 solution, and the latter was assessed by Live and Dead staining. TPT exhibited lower solubility and water absorption than TLC. UBP and TPT demonstrated higher stability than TLC. The release of sulfur, strontium, calcium, and hydroxyl ions was higher for TLC and TPT than for UBP. The 28-day release of hydroxyl and silicon ions was similar for TLC and TPT. TLC alone exhibited a lower cell proliferation rate compared to the control group at a dilution ratio of 1 : 2 in cell proliferation and dead cells from Live and Dead assay evaluation. Thus, when using light-cure resin-modified pulp-capping materials, calcium silicate-based materials can be considered alternatives to calcium hydroxide-based materials. Moreover, when comparing physical and biochemical properties, TPT could be prioritized over TLC as the first choice.

• Journal of Korean Tunnelling and Underground Space Association
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• v.25 no.6
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• pp.541-554
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• 2023

The utilization of underground spaces in relation to tunnels and energy/waste storage is on the rise. To ensure the stability of underground spaces, it is crucial to reinforce rock fractures and discontinuities. Discontinuities, such as joints, can weaken the strength of the rock and lead to groundwater inflow into underground spaces. In order to enhance the strength and stability of the area around these discontinuities, rock grouting techniques are employed. However, during rock grouting, it is impossible to visually confirm whether the grouting material is being smoothly injected as intended. Without proper injection, the expected increases in strength, durability, and degree of consolidation may not be achieved. Therefore, it is necessary to predict in advance whether the grouting material is being injected as designed. In this study, we aimed to assess the injection performance based on injection variables such as the water/cement mixture ratio, injection pressure, and injection flow using UDEC (Universal Distinct Element Code) numerical program. Additionally, numerical results were validated by the lab experiment. The results of this study are expected to help optimize variables such as injection material properties, injection time, and pump pressure in the grouting design in the field.

• Journal of Physiology & Pathology in Korean Medicine
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• v.37 no.6
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• pp.172-177
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• 2023

In order to deduce the pathogenic factor(PF) diagnosis logic of underlying in pattern identification of Korean medicine, 2,072 cases of DSOM(Diagnosis System of Oriental Medicine) data from May 2005 to April 2022 were collected and analyzed by means of decision tree model(DTM). The entire data were divided into training data and validation data at a ratio of 7:3. The CHAID algorithm was used for analysis of DTM, and then validity was tested by applying the validation data. The decision rules of items and pathways determined from the diagnosis data of Qi Deficiency, Blood Deficiency, Yin Deficiency and Yang Deficiency Pathogenic Factor of DSOM were as follows. Qi Deficiency PF had 7 decision rules and used 5 questions: Q124, Q116a, Q119, Q119a, Q55. The primary indicators(PI) were 'lack of energy' and 'weary of talking'. Blood deficiency PF had 7 decision rules and used 6 questions: Q113, Q84, Q85, Q114, Q129, Q130. The PI were 'numbness in the limbs', 'dizziness when standing up', and 'frequent cramps'. Yin deficiency PF had 3 decision rules and used 2 questions: Q144 and Q56. The PI were 'subjective heat sensation from the afternoon to night' and 'heat sensation in the limbs'. Yang deficiency PF had 3 decision rules and used 3 questions: Q55, Q10, and Q102. The PI were 'sweating even with small movements' and 'lack of energy'. Conclusively, these rules and symptom information to decide the Qi·Blood·Yin·Yang Deficiency PF would be helpful for Korean medicine diagnostics.

• Information Systems Review
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• v.25 no.1
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• pp.213-231
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• 2023

With the rapid development of live streaming commerce, online host as an information source plays a critical role in affecting live streaming performance. However, the impact of different product types on the relationship between online hosts and live streaming has been less studied. Based on the elaboration likelihood model (ELM) and information source theory, this study aims to empirically investigate what factors influence the sales of live streaming commerce and how product type moderates the relationship between them. The analysis of 11,422 live streaming commerce data collected for four months from October 10, 2021 to February 10, 2022 shows that, among the factors related to source credibility and attractiveness, multi-channel networks (MCN) and the number of followers positively affect the sales volume of live streaming commerce, whereas the reputation score harms the sales. Moreover, the moderating effect of the product type (i.e., ratio of involvement products) on the relationships is confirmed. The findings enrich the literature on live streaming commerce performance. The limitations and future research directions are also discussed.