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Distribution of Aortic Root Calcium in Relation to Frame Expansion and Paravalvular Leakage After Transcatheter Aortic Valve Implantation (TAVI): An Observational Study Using a Patient-specific Contrast Attenuation Coefficient for Calcium Definition and Independent Core Lab Analysis of Paravalvular Leakage

  • Nahid El Faquir;Quinten Wolff;Rafi Sakhi;Ben Ren;Zouhair Rahhab;Sander van Weenen;Patrick Geeve;Ricardo P J Budde;Eric Boersma;Joost Daemen;Nicolas M van Mieghem;Peter P de Jaegere
    • Journal of Cardiovascular Imaging
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    • v.30 no.4
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    • pp.292-304
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    • 2022
  • BACKGROUND: Calcium is a determinant of paravalvular leakage (PVL) after transcatheter aortic valve implantation (TAVI). This is based on a fixed contrast attenuation value while X-ray attenuation is patient-dependent and without considering frame expansion and PVL location. We examined the role of calcium in (site-specific) PVL after TAVI using a patient-specific contrast attenuation coefficient combined with frame expansion. METHODS: 57 patients were included with baseline CT, post-TAVI transthoracic echocardiography and rotational angiography (R-angio). Calcium load was assessed using a patient-specific contrast attenuation coefficient. Baseline CT and post-TAVI R-angio were fused to assess frame expansion. PVL was assessed by a core lab. RESULTS: Overall, the highest calcium load was at the non-coronary-cusp-region (NCR, 436 mm3) vs. the right-coronary-cusp-region (RCR, 233 mm3) and the left-coronary-cusp-region (LCR, 244 mm3), p < 0.001. Calcium load was higher in patients with vs. without PVL (1,137 vs. 742 mm3, p = 0.012) and was an independent predictor of PVL (odds ratio, 4.83, p = 0.004). PVL was seen most often in the LCR (39% vs. 21% [RCR] and 19% [NCR]). The degree of frame expansion was 71% at the NCR, 70% at the RCR and 74% at the LCR without difference between patients with or without PVL. CONCLUSIONS: Calcium load was higher in patients with PVL and was an independent predictor of PVL. While calcium was predominantly seen at the NCR, PVL was most often at the LCR. These findings indicate that in addition to calcium, specific anatomic features play a role in PVL after TAVI.

A Development of a Mixed-Reality (MR) Education and Training System based on user Environment for Job Training for Radiation Workers in the Nondestructive Industry (비파괴산업 분야 방사선작업종사자 직장교육을 위한 사용자 환경 기반 혼합현실(MR) 교육훈련 시스템 개발)

  • Park, Hyong-Hu;Shim, Jae-Goo;Park, Jeong-kyu;Son, Jeong-Bong;Kwon, Soon-Mu
    • Journal of the Korean Society of Radiology
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    • v.15 no.1
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    • pp.45-54
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    • 2021
  • This study was written to create educational content in non-destructive fields based on Mixed Reality. Currently, in the field of radiation, there is almost no content for educational Mixed Reality-based educational content. And in the field of non-destructive inspection, the working environment is poor, the number of employees is often 10 or less for each manufacturer, and the educational infrastructure is not built. There is no practical training, only practical training and safety education to convey information. To solve this, it was decided to develop non-destructive worker education content based on Mixed Reality. This content was developed based on Microsoft's HoloLens 2 HMD device. It is manufactured based on the resolution of 1280 ⁎ 720, and the resolution is different for each device, and the Side is created by aligning the Left, Right, Bottom, and TOP positions of Anchor, and the large image affects the size of Atlas. The large volume like the wallpaper and the upper part was made by replacing it with UITexture. For UI Widget Wizard, I made Label, Buttom, ScrollView, and Sprite. In this study, it is possible to provide workers with realistic educational content, enable self-directed education, and educate with 3D stereoscopic images based on reality to provide interesting and immersive education. Through the images provided in Mixed Reality, the learner can directly operate things through the interaction between the real world and the Virtual Reality, and the learner's learning efficiency can be improved. In addition, mixed reality education can play a major role in non-face-to-face learning content in the corona era, where time and place are not disturbed.

A PATTERN OF THE FORMATION AND ERUPTION OF FIRST PERMANENT MOLARS (제1대구치의 석회화와 맹출 양상)

  • Jeong, Hae-Kyoung;Yang, Yeon-Mi;Kim, Jae-Gon;Baik, Byeong-Ju;Soh, Yu-Ryeo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.3
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    • pp.317-327
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    • 2010
  • Among the permanent teeth, the first permanent molars play the greatest role in occlusion and function. So, early diagnosis for congenital missing, abnormal eruption and abnormal formation is very important to the first permanent molars in the course of arch development. The aim of this study is to analyse the differences between right and left first permanent molar's formation and eruption and between upper and lower one. A total of 545 children were selected am ong children who had visited our clinic, investigate eruption and calcification stage of permanent first molar, based on Gleiser and Hunt criteria for this study. 1. Gingival emergence of mandibular first molar is faster than maxillary first molar by 0.75~0.8 years, gingival emergence of maxillary first molar in girls faster than boys by 0.45 years, and that of mandibular first molar in girls faster than boys by 0.5 years. 2. There is the significant difference between right and left first molar on the eruption score and the calcification stage ; 5 year old children show the significant difference on the eruption score. 7 year old children show the significant difference on both the eruption score and calcification stage. 3. It shows the most active eruption movement of crown on the maxilla while the root is rapidly widening its furcation and completing root formation to 2/3, on the other hand, the most active crown emerging on mandible is shown when the root formation completed to 1/4 to 1/2.

THE EFFECT OF RESIDUAL PERIODONTAL LIGAMENT ON ALVEOLAR BONE REMODELING OF EXTRACTION SOCKETS IN RATS (백서 치아 발거후 잔존 치주인대가 발치와의 치조골 재건에 미치는 영향)

  • Cho, Seong-Hoon;Herr, Yeek;Park, Joon-Bong;Lee, Man-Sup;Kwon, Young-Hyuk
    • Journal of Periodontal and Implant Science
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    • v.25 no.3
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    • pp.703-719
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    • 1995
  • The purpose of this study was to observe the effects of the periodontal ligament on the healing and the formation of alveolar bone in the extraction socket, when this ligament had artificially remained in the socket during the tooth removal. Twenty rats aged 4 weeks were used and devided into the control groups (10) and the experimental groups (10) in this study. The maxillary right and left first molars were extracted in both groups. In the experimental groups the periodontal ligament was remained in the extraction sockets using 0.4% ${\beta}-aminopropionitrile$, and in the control the periodontal ligament was completely removed by curettage. At 1, 3, 5, 7 and 14 days after the tooth extraction, rats in both groups were serially sacrificed. And the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows ; 1. On 1 day, the periodontal ligament was only found in the extraction socket walls of the experimental groups, and there was not the distinguishable difference between the control and the experimental groups. 2. On 3 days, there were more collagen fibers and the appearance of higher cellular density in the experimental groups than in the control. And the cells and collagen of the periodontal ligament were so actively proliferated and synthesized that invaded into the connective tissue of the extraction sockets in the experimental groups. 3. In the experimental groups, the trabecular bone was formed on the basal and lateral bone surface on 5 days. However, there was not the new bone forming appearance in the control groups at this time. 4. On 7 days, the trabecular bone was formed in the control groups. 5. On 14 days, the extraction sockets were almost entirely filled with the bony trabeculae in both groups. But, compared to the control group, the experimental groups showed the prominent differences in the amount & the density of the new bone formed. In conclusion, it was suggested that the residual periodontal ligament tissue in the extraction socket will play a major role as the important cell source in the healing and the new bone formation of the extraction socket.

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An occlusal contact analysis of lateral mandibular movement using T-Scan system (T-Scan system을 이용한 하악 측방운동 시 교합접촉 분석)

  • Song, Joo-Hun;Joo, Se-Jin;Lee, Ho-Sun;Kang, Dong-Wan;Lee, Gyeong-Je
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.2
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    • pp.128-137
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    • 2015
  • Purpose: Most of the former studies about the occlusal contact patterns during the mandibular movement focused on foreigner. The purpose of this study is analyzing the occlusal contacts of young Koreans by using T-Scan system. Materials and methods: The sample size was 87 and the occlusal contacts of each right and left lateral movements were measured from the maximum intercuspation to the 3mm excursive position for three times respectively. All of the occlusal contacts were double checked through the thin metal foil. The results were categorized as two; 1) considering occlusal contact patterns on working side only, 2) considering occlusal contact patterns on working and nonworking sides. Results: The results showed that the nonworking side occlusal contacts play major roles in the lateral mandibular movement. In both cases of considering with and without the nonworking side occlusal contacts, the group function was the most prevalent. In the working side, the contacts were the most frequent in canine and the frequency of contacts was decreased as the distance was increased from canine to molar. In the nonworking side, the contacts were the most frequent in second molar. And the gender factor was statistically significant (${\alpha}$=.05), as females have more nonworking side occlusal contacts in this study. Conclusion: Among the three factors of anterior guidance, the group function was the most dominant factor. The analysis of 87 samples showed that canine contact was the most frequent in the working side and second molar contact was the most common in the nonworking side.

Development of Neuropathic Pain Behavior and Expression of CCL2/CCR2 and CX3CL1/CX3CR1 after Spinal Cord Hemisection

  • Park, Hea-Woon;Son, Jo-Young;Cho, Yun-Woo;Hwang, Se-Jin;Kim, Su-Jeong;Ahn, Sang-Ho;Jang, Sung-Ho;Jung, Yong-Jae
    • The Journal of Korean Physical Therapy
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    • v.22 no.3
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    • pp.99-105
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    • 2010
  • Purpose: The purpose of this study was to evaluate the development of pain behavior and the expression of CCL2/CCR2 and CX3CL1/CX3CR1 at above and below the level of hemisection of the spinal cord in a rat model. Methods: Spinal cords of adult female Sprague-Dawley rats (n= 16, 200~250 g, 6~8 weeks old) were hemisected at T13 on the right side to develop the spinal hemisection injury model. We compared behavioral responses of the hemisection and of a sham surgery group. Behavioral tests for motor function (by the BBB locomotor scale), and for pain response for mechanical and cold allodynia were assessed postoperatively (PO) for 21 days. Expression of mRNA for chemokines and their receptors (CCL2/CCR2 and CX3CL1/CX3CR1) below and above the level of the spinal cord dissection were examined by RT-PCR. Results: We observed gradual motor improvement and the development of mechanical and cold allodynia on the ipsilateral hindpaw after spinal hemisection injury. We also found upregulation of mRNA expression of CCL2/CCR2 both above and below the level of spinal cord dissection but CX3CL1/CX3CR1 mRNA expression. Conclusion: Upregulation of CCL2/CCR2 is associated with neuropathic pain after spinal hemisection injury. CCL2/CCR2 may play an important role in the development of neuropathic pain after SCI as well as of peripheral neuropathic pain. These findings may improve understanding of the pathophysiological mechanism of neuropathic pain after SCI.

The Policies of Care Providers in the United Kingdom: Towards Emphasis On Carers Rights and Quality Employment (영국의 케어 제공자에 관한 정책 연구: 보호자 권리와 유급고용의 질 강조)

  • Rhee, Ka-Oak;Woo, Kug-Hee
    • Korean Journal of Social Welfare
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    • v.57 no.2
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    • pp.185-204
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    • 2005
  • In a period of rapid change, transition and re-definition of care concept, this study reviewed social policies on care providers in the UK. In the face of care crisis, the British government has made a radical reform of the care system and enacted new legislations. In the UK social policy, care providers are classified into carers and care workers. Carers mean informal caregivers and care workers are those who are paid for providing care as part of a contract of employment. Recently, the United Kingdom has given carers recognition and reward. To enhance the status and right of carers, the Carers (Recognition and Services) Act 1995, the strategy document Caring about Carers 1999, Carers and Disabled Children Act 2000, and Carers (Equal Opportunities) Act 2004 have been enacted. At the heart of the policy for carers is the idea of active citizenship, carers-friendly employment and work-life balance etc. In case of paid care worker, government's focus seems to be on quality of employment. The government has established a new national infrastructure for quality. The five national bodies founded on Care Standards Act 2000 has been established. The UK government has realized care work would play an important part in job creation strategy. In this article, we have presented several criticisms and issues of current care policy in UK.

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Correlation Between NT-proBNP and Pulmonary Arterial Pressure in COPD Patients (만성 폐쇄성 폐질환 환자에서 뇌나트륨이뇨펩티드와 폐동맥압과의 상관관계에 관한 연구)

  • Hwang, Yong Il;Park, Geun Min;Kwon, Sung Youn;Yoon, Ho Il;Lee, Choon-Taek;Han, Sung Koo;Shim, Young Soo;Lee, Jae Ho
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.346-352
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    • 2007
  • Background: Pulmonary hypertension is one of the cardiovascular complications of in COPD. However, a diagnosis of pulmonary hypertension requires an invasive test, such as right heart catheterization. NT-proBNP is a cardiac hormone that is elevated when a cardiac volume or pressure overload is present. It was hypothesized that NT-proBNP might play a role in detecting of pulmonary hypertension in COPD patients. Method: The 31 COPD patients, who underwent all of NT-proBNP, echocardiography, and spirometry in Seoul National University Bundang Hospital during the period from November 2003 to July 2005, were retrospectively analyzed. Result: Of the 31 COPD patients, 9 patients had pulmonary hypertension. A significant positive correlation was observed between the NT-proBNP and pulmonary arterial pressure (r=0.589, p=0.002). However, there was no significant correlation observed between the $FEV_1$ and NT-proBNP and $FEV_1$ and pulmonary arterial pressure. Conclusion: NT-proBNP might indicate the presence of pulmonary hypertension in COPD patients.

Radiation Effect on NO, NOS and TGF-$\beta$ Expressions In Rat Lung (쥐의 폐에서 방사선이 Nitric Oxide (NO), Nitric Oxide Synthase (NO) 및 TGF- $\beta$의 발현에 미치는 영향)

  • Oh Young-Taek;Park Kwang-Joo;Kil Hoon-Jong;Ha Mahn Joon;Chun Mison;Kang Seung-Hee;Park Seong-Eun;Chang Sei-Kyung
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.321-328
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    • 2000
  • Purpose :NOS2 induce NO Production and NO activate TGF-${\beta}$. The TGF-${\beta}$ is a inhibitor of NOS2. If this negative feedback mechanism operating in radiation pneumonitis model, NOS2 inhibitor may play a role in TGF-${\beta}$ suppression. We planned this study to evaluate the expression patterns of NO, NOS2 and TGF-${\beta}$ in vivo radiation pneumonitis model. Materials and Methods : Sixty sprague-Dawley rat were irradiated 5 Gy or 20 Gy. They were sacrificed 3, 7, 14, 28 and 56 days after irradiation. During sacrifice, we peformed broncho-alveolar lavage (BAL). The BAL fluids were centrifuged and supernatents were used for measure NO and TGF-${\beta}$, and the cells were used for RT-PCR. Results : After 5 Gy of radiation, NO in BAL fluid increased at 28 days in both lung and TGF-${\beta}$ in left lung at 56 days. NO increased in BAL fluid at 28 days in both lung after irradiation and TGF-${\beta}$ in right lung at 28-56 days after 20 Gy of radiation. After 5 Gy of radiation, NOS2 expression was increased in right lung at 14 days, in both lung at 28 days and in left lung at 56 days. TGF-${\beta}$ expression was reduced in both lung at 28 days and increased in left lung at 56 days. Conclusions :The Proposed feedback mechanism of NO, NOS2 and TGF-${\beta}$ was operated in vivo radiation pneumonitis model. At 56 days, however, NOS2 and TGF-${\beta}$ expressed concurrently in left lung after 5 Gy and in both lung after 20 Gy of radiation.

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A Study on Anjoon-gut Music in Daejeon - Focused on Sir Shin Seok-bong's Antaek-gut Music- (대전의 앉은굿 음악 연구 - 신석봉 법사의 안택굿을 중심으로 -)

  • Park, Hye-jeong
    • Korean Journal of Heritage: History & Science
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    • v.38
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    • pp.5-42
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    • 2005
  • Based on a field investigation of intangible cultural asset # 2, author Sir Shin Seok-bong of Daejeon Metropolitan Cityinvestigated the music of Antaek-gut, which is the base and core of Anjoon-gut, and found the following musical features: A Jang-gu(drum) and Kkoaengkwari(gong) were used to recitethe Sutra(kyungmoon) of Anjoon-gut. The Jang-gu, located on the right side, played an accompaniment role with regular beats when the Sutra was recited. The Kkoaengkwari, located on the left side, played the role of covering the caesura of the Sutra passages, so it is played with various rhythmic variations in accordance with Kojang(鼓杖). This is one way of playing Korean national classical music that has temporary caesuras, depending on the rector's bre! ath or the contents of a Sutra during the Sutra chanting, with the Jang-gu covering the pause with its variation. In other words, when being played in concert, the instruments that play the main melody are at rest while another instrument takes its turn to play the main melody as a form of prolonged sound. The rhythmic cycles of the sutras of Antaek-gut recited with this instrumental accompaniment consist of five types; a) Woemarch-jangdan (a single beat) of 4 meter by 3 bit, b) Dumarch-jangdan (two beats) of 8 meter by 3 bit, c) Saemarch-jangdan (three beats) of 4 meter by 3 bit with a fast tempo, d) Mak-gojang, uniform beats with a standardized rhythm, and e) incomplete beats deviated from the regular beats. Sir Shin Seok-bong chanted Chang (唱), a traditional native song which he called 'Cheong (淸)' with a cycle of 'Dumarch-jangdan' throughout the places of Antaek-gut. Only 'Toesonggyung' a chant for the gate that was the last location of the Antaek, was chanted with a cycle of 'Woemarch-jan! gdan'. In addition, 'Saemarch-jangdan' and 'Mak-gojang' that had comparatively faster tempos than the former two jangdans, were played without a chant when a female shaman was dancing and catching her spirit-invoking wand. The 'Saemarch-jangdan', particularly, was played while dancing began at a relatively slow tempo, then proceeded at a violent tempo and then back again to the slow tempo. This shows one of the representative tempos of our music with a slow-fast-slow tempo. The organizational tones were 'mi-la-do'-re'', and its key tones of 'mi-la-do'' were performed with perfect fourth and minor third, which was the same as those of Menari-tori. However, it did not show a typical Sigimse, an ornamental tone, of Menari-tory, whose first tone, 'mi', is vibrated and its Sigimse is gliding down from the tone 're' to 'do'. That is because the regional tone-tori of Chungcheong-do have a relatively weaker musical expression than that of Gyeongsang-do. In addition, the rhythmic types in accordance with the words of a song for the Antaek-gut music had a comparatively faster tempo than the other sutras. Also, it was only with 'Toesonggyeong' that the tone 'la' continuously appeared throughout the melody and showed 'a syllabic rhythm', while other places consisted of either a 'syncopation' or 'melismatic' rhythm. Finally, according to a brief investigation of the tone organization in accordance with each sutra, the tone 'la' was given more weight. The tone procedure showed a mainly ascending 'la-do'' and the descending 'la-mi' with minor third and perfect fourth. Also, the overall tempo proceeded with M.M.♩.=116-184, while the tempo for the Gut proceeded with M.M.♩.=120-140, which was suitable for reciting a Sutra.