Jin Sil Kim;Dong Wook Kim;Kyoung Won Kim;Gi Won Song;Sung Gyu Lee
Korean Journal of Radiology
/
v.23
no.1
/
pp.52-59
/
2022
Objective: To investigate whether the diagnostic performance of CT angiography (CTA) could be improved by modifying the conventional criterion (anastomosis site abnormality) to diagnose hepatic artery occlusion (HAO) after liver transplantation (LT) in suspected patients with Doppler ultrasound (US) abnormalities. Materials and Methods: One hundred thirty-four adult LT recipients (88 males and 46 females; mean age, 52.7 years) with suspected HAO on Doppler US (40 HAO and 94 non-HAO according to the reference standards) were included. We evaluated 1) abnormalities in the HA anastomosis, categorized as a cutoff, ≥ 50% stenosis at the anastomotic site, or diffuse stenosis at both graft and recipient sides around the anastomosis, and 2) abnormalities in the distal run-off, including invisibility or irregular, faint, and discontinuous enhancement. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the conventional (considering anastomosis site abnormalities alone) and modified CTA criteria (abnormalities in both the anastomosis site and distal run-off) for the diagnosis of HAO were calculated and compared using the McNemar test. Results: By using the conventional criterion to diagnose HAO, the sensitivity, specificity, PPV, NPV, and accuracy were 100% (40/40), 74.5% (70/94), 62.5% (40/64), 100% (70/70), and 82.1% (110/134), respectively. The modified criterion for diagnosing HAO showed significantly increased specificity (93.6%, 88/94) and accuracy (93.3%, 125/134) compared to that with the conventional criterion (p = 0.001 and 0.002, respectively), although the sensitivity (92.5%, 37/40) decreased slightly without statistical significance (p = 0.250). Conclusion: The modified criterion considering abnormalities in both the anastomosis site and distal run-off improved the diagnostic performance of CTA for HAO in suspected patients with Doppler US abnormalities, particularly by increasing the specificity.
Journal of the korean academy of Pediatric Dentistry
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v.31
no.4
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pp.587-597
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2004
Over the past 20 years, great strides have been made in research regarding the mechanisms involved in the progression of carious lesions, but new equipment and research tools need to be developed to continue these advancements in caries research. Various methods have been applied to reduce the incidence of carious lesions, which have led to a significant decrease in the number of occlusal caries, but a concurrent increase in the proportion of proximal carious lesions. New diagnostic equipment has been developed to detect early stage carious lesions, and these have demonstrated excellent laboratory results and show promise in clinical applications. The research presented here examines the efficacy of the newly developed $DIFOTI^{TM}$ system in detecting proximal carious lesions compared to traditional intraoral exam and bitewing radiography, possible problems or deficiencies of using the system in clinic, possible improvements that can be made to the system, and the efficacy of detecting early, reversible carious lesions that can be remineralized by preventative fluoride applications. The subject pool consisted of 23 grammer school age patients just prior to entering the mixed dentition phase. Each patient was given a thorough oral examination, radiographic examination consisting of bitewing radiographs of the posterior teeth, and $DIFOTI^{TM}$ examination of the anterior and posterior teeth. Each examination was carried out two times by two examiners, and the data were statistically analyzed. The results are as follows: 1. The mean alpha value of reliability test of the visual oral examination was as follows; occlusal surface was 0.8470. mesial surface was 0.6430, distal surface was 0.5727. lingual surface was 0.2807 and distal surface was 0.2339. When the examination was limited to posterior teeth, the mean alpha value was as follows; occlusal surface was 0.8577, distal surface was 0.8211, lingual surface was 0.7728, buccal surface was 0.7152 and mesial surface was 0.6782. 2. The alpha value of reliability test of the radiographic analysis of carious lesions of the occlusal, mesial, and distal surfaces was 0.8500. 3. The alpha value of reliability test of the $DIFOTI^{TM}$ diagnostic analysis of carious lesions of the occlusal, buccal, lingual, mesial, and distal surfaces was determined to be 0.7917. 4. The $DIFOTI^{TM}$ diagnostic system was found to be the most accurate means of detecting occlusal, buccal, and lingual surface carious lesions (p<0.05), while mesial and distal proximal carious lesions were most accurately assessed using bitewing radiography (p<0.05).
The purpose of this study was to evaluate expression and prognostic value of matrix metalloproteinase-7 (MMP-7) in colorectal cancer (CRC) patients. CRC tissues and corresponding distal normal mucosa tissues of 118 CRC patients were assessed by immunohistochemistry. Correlations between MMP-7 expression, patients' clinic pathological features, and overall survival rate were analyzed. We found that positive expression of MMP-7 in CRC tissues was significantly higher than that in distal normal mucosa (61.0% vs. 39.8%, p =0.001). Poor histological differentiation, advanced clinical stage and lymph node metastasis were significantly correlated with MMP-7 expression in CRC. The overall survival rate was significantly higher in the MMP-7 negative group than the positive group (Log-rank test= 9.957, p= 0.002). MMP-7 appeared as a significant independent prognostic factor through multivariate survival analysis. Collectively, we found MMP-7 expression to be correlated with progression and metastasis of CRC and thus could be used as a predictive marker of prognosis in CRC patients.
Purpose: The aim of this study was to determine clinical significance of dual-probe esophageal pH monitoring and to compare four pH monitoring parameters between proximal and distal esophagus in pathological gastroesophageal reflux disease with recurrent respiratory symptoms. Methods: Among the thirty-four patients who were performed 24 hr pH monitoring, seventeen patients with pathological distal reflux were classified into two groups: Group I (n:12) had recurrent respiratory symptoms and Group II (n:5) hadn't recurrent respiratory symptoms. The ambulatory dual-probe esophageal pH monitoring was performed for 18~24 hr. A pathologic GER was defined when reflux index (percent of the investigation time a pH<4) exceeded the 95th percentile of normal value. Results: Among the sixteen patients with recurrent respiratory symptoms, twelve patients (75%) have pathological distal reflux. Whereas among the eighteen patients without recurrent respiratory symptom, five patients (28%) have pathological distal reflux. In the Group I, the significant differences between proximal and distal esophageal pH recordings persisted for all parameters, but didn't persist in group II except for longest episode. Comparing esophageal pH four parameters between group I and group II at the proximal esophageal site, all parameters didn't show statistically significant differences. Conclusion: Regardless of respiratory symptoms, patients with pathological distal reflux didn't show statistically significant differences in the all parameters at the proximal esophageal site. Therefore we may reconsider usefulness of dual probe pH meter in patients with recurrent respiratory symptoms.
Backgrounds/Aims: The goal of the present study was to evaluate the prognostic value of lymph node ratio (LNR) in distal cholangiocarcinoma (DCC) after curative intended surgery. Methods: Clinicopathological data of 162 DCC patients who underwent radical intended surgery between 2012 and 2020 were analyzed retrospectively. Prognostic factors related to overall survival (OS) and disease-free survival (DFS) were evaluated. Results: Median OS time and DFS time were 41 and 29 months, and 5-year OS rate and DFS rate were 44.7% and 38.1%, respectively. In the univariate analysis, significant prognostic factors for OS were histologic differentiation, American Joint Committee on Cancer (AJCC) stage, positive lymph node count, LNR, R1 resection, and perineural invasion. Preoperative carcinoembryonic antigen, carbohydrate antigen 19-9, infiltrative type, histologic differentiation, AJCC stage, positive lymph node count, LNR, R1 resection, perineural invasion, and lymph-vascular invasion were significant prognostic factors for DFS in the univariate analysis. In the multivariate analysis, histologic differentiation, R1 resection, and LNR were the independent prognostic factors for both OS and DFS. The LNR ≥ 0.2 group had a significantly poor prognosis in terms of OS (hazard ratio, 3.915; p = 0.002) and DFS (hazard ratio, 5.840; p < 0.001). Conclusions: LNR has significant value as a prognostic factor of DCC related to OS and DFS. LNR has the potential to be used as a modified staging system with furthermore studies.
Journal of the Korean Institute of Rural Architecture
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v.24
no.4
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pp.85-95
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2022
This study is about the story of 'Saemi', existing in the Sacheon Alluvial fan area. Saemi is a local word for Dumbeong, which is the traditional water irrigation facilities in this area that could be formed according to the geographical characteristics of a Alluvial fan site. In the meantime, although Saemi has been an important source of water, related research has been mainly done from an ecological point of view. Accordingly, the researcher paid attention to the functional aspects of Saemi itself, grasped its location, distribution status, and usage including the construction method, and considered its intrinsic value through classification and characteristic analysis of Saemi. As a result of five field surveys from September 2021 to October 2022, 129 Saemies remained in the Sacheon alluvial fan area. According to the structure and shape, Saemi could be divided into basic type, complex type, and buried type. The basic type was subdivided into bucket-type and stairs-type along with the complex type, and the buried type was subdivided into all buried-type and some buried-type. Saemies were mainly distributed at the distal end of the Sacheon alluvial fan site, individual Saemies were built on farmland, and common Saemies were usually built along roadsides adjacent to villages. The reason why the Saemies are concentrated at the distal end is the geographical characteristics of the alluvial fan where the water underflows. Saemi was an important multifunctional water supply source equivalent to the main water source for people at the distal end of the pond who did not receive a stable supply of water from the reservoir. Saemi was at the center of the underground water irrigation network agricultural system in the Sacheon alluvial fan area according to the principles of 'bbaeim(drop out)' and 'gaepim(pooling)' It has provided a foundation for establishing itself as an appropriate technology in this area. Such Saemi contributed to the rural landscape and agricultural biodiversity through its own system and served as a public interest function. It is necessary to know, conserve, manage, and continuously utilize the value of this Saemi as an agricultural heritage.
In this paper, we propose a method of measuring bone mineral density in a peripheral-type clinical X-ray CT using a phantom, and we propose a method of classifying osteoporosis using bone mineral density and bone structure parameters together. It segments the trabecular bone region and cortical bone region for the six sections of the phantom and calculates the average HU value of the segmented regions. By using these values, it derives an expression converting HU value to bone mineral density. It segments trabecular bone of 1 cm region in the end part of distal radius and extracts the bone mineral density and structural parameters for the trabecular bone region. We extracted bone mineral density and structural parameters for the 18 subjects each of normal and osteoporotic group. We carried out classification experiments using three classification methods; SAD, SVM, ANN. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, likelihood ratio of the classification was improved in the order of ANN, SVM and SAD. Also, The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, likelihood ratio of the classification was improved when we use the bone mineral density and structural parameters together.
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.17
no.1
/
pp.271-278
/
1987
The purpose of the present study was to investigate associations between periapical and bitewing techniques by assessing the crestal alveolar bone. This article also reports the ability of these two techniques to correctly detect evidence of interproximal dental caries, and comparison between the interproximal overlapping of teeth. Bitewing and periapical radiographs were used from posterior quardants of 243 dental students in Seoul National University. The distance from cemento-enamel junction to the alveolar crest (CEJ-AC) was measured for each proximal surface from the distal of cuspid to the distal of second molar. Data were arranged according to the proximal surface examined, and bitewing and periapical measurements were compared using paired tests. The obtained results were as follows: 1. In maxilla, a significant t ratio with a P value of 0.05 or less reached for 100% and in mandible, reached for 94%. 2. The anatomic limitations imposed on periapical radiographic technique, most often result in somewhat foreshortened radiographic images. This situation would tend to be accentuated by the anatomical restrictions of the hard palate. 3. Consequently, since the significant differences frequently exist between measurements obtained from bitewing and periapical techniques, it is important to define which technique is used. 4. The number of the interproximal overlapping was the largest medial side of the maxillary second molar, while the smallest at the distal side of the mandibular second premolar. And the overall number of the interproximal overlapping was more (538) in the periapical technique than in the bitewing technique (372). 5. The interproximal dental carious lesions were detected more (74) on the bitewing films than on the periapical ones (23). The fact was resulted from the small number of interproximal overlapping and relative easi- ness of obtaining horizontal angulation in taking the bitewing radiographs.
Treatment of esophageal perforation when diagnosed late remains controversial. Ten consecutive patients since 1990 were treated late(later than 24 hours) for esophageal perforation with primary repair. Four perforations were iatrogenic, 3 were spontaneous, 2 were foreign body aspiraton and 1 was trauma. The interval from perforation to operation was 116 hours in mean and 48 hours in median value. The principles of repair included (1) a local esophagomyotomy proximal and distal to the tear to expose the mucosal defect and intact mucosa beyond, (2) debridement of the mucosal defect and closure, (3) reapproximation of the muscle, and (4) adequate drainage. The repair was buttressed with parietal pleura or pericardial fat in 9 patients. Associated distal obstruction was treated with dilation and esophagomyotomy intraoperatively. There was one mortality and cause of death was massive gastric bleeding due to gastric ulcer on 33rd day after operation. Five patients had leak at the site of repair and these cases were treated completely with conservative treatment except a mortality case. In conclusion, in the absence of malignant or irreversible distal obstruction, meticulous repair of perforated esophagus and adequate drainage are preferred approach, regardless of the duration from the injury to the operation.
Objective: To investigate the value of stimulated intrauterine insemination (IUI) in women with unilateral tubal occlusion. Methods: Superovulation and IUI was performed during 2003-2010 and the medical records were reviewed retrospectively. Thirty-seven infertile women (52 cycles) with unilateral tubal occlusion diagnosed by hysterosalpingography and without other causes of infertility were selected. One-hundred fourteen patients with unexplained infertility served as a control group (182 cycles). The main outcome was the clinical pregnancy rate per cycle. Results: The pregnancy rate per cycle was similar, 17.3% for the unilateral tubal occlusion group and 16.5% for the unexplained infertility group. The rate of miscarriage (11.1% vs. 23.3%) and ectopic pregnancy (11.1% vs. 6.7%) was similar between the two groups. The pregnancy rate was higher in patients with proximal occlusion (25.0%) compared with distal occlusion (13.9%) or unexplained infertility, but not statistically significant. Conclusion: Stimulated IUI can be suggested as the initial treatment option in women with unilateral proximal or distal tubal occlusion.
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