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Detection of Contralateral Breast Cancer Using Diffusion-Weighted Magnetic Resonance Imaging in Women with Newly Diagnosed Breast Cancer: Comparison with Combined Mammography and Whole-Breast Ultrasound

  • Su Min Ha;Jung Min Chang;Su Hyun Lee;Eun Sil Kim;Soo-Yeon Kim;Yeon Soo Kim;Nariya Cho;Woo Kyung Moon
    • Korean Journal of Radiology
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    • v.22 no.6
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    • pp.867-879
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    • 2021
  • Objective: To compare the screening performance of diffusion-weighted (DW) MRI and combined mammography and ultrasound (US) in detecting clinically occult contralateral breast cancer in women with newly diagnosed breast cancer. Materials and Methods: Between January 2017 and July 2018, 1148 women (mean age ± standard deviation, 53.2 ± 10.8 years) with unilateral breast cancer and no clinical abnormalities in the contralateral breast underwent 3T MRI, digital mammography, and radiologist-performed whole-breast US. In this retrospective study, three radiologists independently and blindly reviewed all DW MR images (b = 1000 s/mm2 and apparent diffusion coefficient map) of the contralateral breast and assigned a Breast Imaging Reporting and Data System category. For combined mammography and US evaluation, prospectively assessed results were used. Using histopathology or 1-year follow-up as the reference standard, cancer detection rate and the patient percentage with cancers detected among all women recommended for tissue diagnosis (positive predictive value; PPV2) were compared. Results: Of the 30 cases of clinically occult contralateral cancers (13 invasive and 17 ductal carcinoma in situ [DCIS]), DW MRI detected 23 (76.7%) cases (11 invasive and 12 DCIS), whereas combined mammography and US detected 12 (40.0%, five invasive and seven DCIS) cases. All cancers detected by combined mammography and US, except two DCIS cases, were detected by DW MRI. The cancer detection rate of DW MRI (2.0%; 95% confidence interval [CI]: 1.3%, 3.0%) was higher than that of combined mammography and US (1.0%; 95% CI: 0.5%, 1.8%; p = 0.009). DW MRI showed higher PPV2 (42.1%; 95% CI: 26.3%, 59.2%) than combined mammography and US (18.5%; 95% CI: 9.9%, 30.0%; p = 0.001). Conclusion: In women with newly diagnosed breast cancer, DW MRI detected significantly more contralateral breast cancers with fewer biopsy recommendations than combined mammography and US.

Diagnostic Performance of Spin-Echo Echo-Planar Imaging Magnetic Resonance Elastography in 3T System for Noninvasive Assessment of Hepatic Fibrosis

  • Se Woo Kim;Jeong Min Lee;Sungeun Park;Ijin Joo;Jeong Hee Yoon;Won Chang;Haeryoung Kim
    • Korean Journal of Radiology
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    • v.23 no.2
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    • pp.180-188
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    • 2022
  • Objective: To validate the performance of 3T spin-echo echo-planar imaging (SE-EPI) magnetic resonance elastography (MRE) for staging hepatic fibrosis in a large population, using surgical specimens as the reference standard. Materials and Methods: This retrospective study initially included 310 adults (155 undergoing hepatic resection and 155 undergoing donor hepatectomy) with histopathologic results from surgical liver specimens. They underwent 3T SE-EPI MRE ≤ 3 months prior to surgery. Demographic findings, underlying liver disease, and hepatic fibrosis pathologic stage according to METAVIR were recorded. Liver stiffness (LS) was measured by two radiologists, and inter-reader reproducibility was evaluated using the intraclass correlation coefficient (ICC). The mean LS of each fibrosis stage (F0-F4) was calculated in total and for each etiologic subgroup. Comparisons among subgroups were performed using the Kruskal-Wallis test and Conover post-hoc test. The cutoff values for fibrosis staging were estimated using receiver operating characteristic (ROC) curve analysis. Results: Inter-reader reproducibility was excellent (ICC, 0.98; 95% confidence interval, 0.97-0.99). The mean LS values were 1.91, 2.41, 3.24, and 5.41 kPa in F0-F1 (n = 171), F2 (n = 26), F3 (n = 38), and F4 (n = 72), respectively. The discriminating cutoff values for diagnosing ≥ F2, ≥ F3, and F4 were 2.18, 2.71, and 3.15 kPa, respectively, with the ROC curve areas of 0.97-0.98 (sensitivity 91.2%-95.9%, specificity 90.7%-99.0%). The mean LS was significantly higher in patients with cirrhosis (F4) of nonviral causes, such as primary biliary cirrhosis (9.56 kPa) and alcoholic liver disease (7.17 kPa) than in those with hepatitis B or C cirrhosis (4.28 and 4.92 kPa, respectively). There were no statistically significant differences in LS among the different etiologic subgroups in the F0-F3 stages. Conclusion: The 3T SE-EPI MRE demonstrated high interobserver reproducibility, and our criteria for staging hepatic fibrosis showed high diagnostic performance. LS was significantly higher in patients with non-viral cirrhosis than in those with viral cirrhosis.

Thrombocytopenia after Aortic Valve Replacement Using Sutureless Valves

  • Mil Hoo Kim;Soojin Lee;Juhyun Lee;Seohee Joo;You Kyeong Park;Kang Min Kim;Joon Chul Jung;Hyoung Woo Chang;Jae Hang Lee;Dong Jung Kim;Jun Sung Kim;Kay-Hyun Park;Cheong Lim
    • Journal of Chest Surgery
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    • v.57 no.4
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    • pp.371-379
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    • 2024
  • Background: Sutureless valves are widely used in aortic valve replacement surgery, with Perceval valves and Intuity valves being particularly prominent. However, concerns have been raised about postoperative thrombocytopenia with Perceval valves (Corcym, UK). We conducted a comparative analysis with the Intuity valve (Edwards Lifesciences, USA), and assessed how thrombocytopenia affected patient and transfusion outcomes. Methods: Among 595 patients who underwent aortic valve replacement from June 2016 to March 2023, sutureless valves were used in 53 (Perceval: n=23; Intuity: n=30). Platelet counts were monitored during hospitalization and outpatient visits. Daily platelet count changes were compared between groups, and the results from patients who underwent procedures using Carpentier Edwards Perimount Magna valves were used as a reference group. Results: Compared to the Intuity group, the Perceval group showed a significantly higher amount of platelet transfusion (5.48±1.64 packs vs. 0.60±0.44 packs, p=0.008). During the postoperative period, severe thrombocytopenia (<50,000/μL) was significantly more prevalent in the Perceval group (56.5%, n=13) than in the Intuity group (6.7%, n=2). After initial postoperative depletion, daily platelet counts increased, with significant differences observed in the extent of improvement between the Perceval and Intuity groups (p<0.001). However, there was no significant difference in early mortality or the incidence of neurological complications between the 2 groups. Conclusion: The severity of postoperative thrombocytopenia differed significantly between the Perceval and Intuity valves. The Perceval group showed a significantly higher prevalence of severe thrombocytopenia and higher platelet transfusion volumes. However, thrombocytopenia gradually recovered during the postoperative period in both groups, and the early outcomes were similar in both groups.

Assessment of the toxic effects of dichlofluanid using survival and relative growth rate on brown alga Undaria pinnatifida (미역(Undaria pinnatifida) 배우체의 생존 및 상대성장률을 이용한 dichlofluanid의 독성영향 평가)

  • Un-Ki Hwang;Yun-Ho Park;Bo-Ram Sim;Ju-Wook Lee
    • Korean Journal of Environmental Biology
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    • v.41 no.4
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    • pp.427-438
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    • 2023
  • Biocide dichlofluanid breaks down quickly and accumulates easily in sediment, potentially causing a persistent impact on various marine organisms. We analyzed the potential toxicity of dichlofluanid on major aquaculture species in Korea, Undaria pinnatifida. Female gametophytes of U. pinnatifida were exposed to dichlofluanid at concentrations of 0, 1, 2, 4, 8, 16, and 32 mg L-1, and their survival and relative growth rate were analyzed. The no observed effect concentration(NOEC), lowest observed effect concentration (LOEC), and median lethal concentration (LC50) for female gametophyte survival were determined as 1, 2, and 10.82 (95% CI: 8.87-13.23) mg L-1, respectively. The NOEC, LOEC, and median effective concentration (EC50) for relative growth rate were 1, 2, and 6.58 (95% CI: 6.03-7.17) mg L-1, respectively. Female gametophytes of U. pinnatifida were expected to experience toxic effects at concentrations above 2 mg L-1 of dichlofluanid. These research findings are expected to serve as important reference data for evaluating the toxicity effects of U. pinnatifida in its early life stages when exposed to dichlofluanid.

Relationship between of working hours, weekend work, and shift work and work-family conflicts among Korean manufacturers

  • Yohan Lee;SooYoung Lee;Yoon-Ji Kim;Youngki Kim;Se-Yeong Kim;Dongmug Kang
    • Annals of Occupational and Environmental Medicine
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    • v.34
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    • pp.20.1-20.12
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    • 2022
  • Background: In the manufacturing industry, work-family conflict (WFC) is related to working hour characteristics. Earlier studies on the relationship between working hour characteristics and WFC in the manufacturing industry have been limited to some regions in Korea. No study has addressed the data on a national scale. Thus, this study investigated the impact of weekly working hours, weekend work, and shift work on WFC using national-scale data. Methods: This study was based on the fifth Korean Working Conditions Survey of 5,432 manufacturers. WFC consists of 5 variables; WFC1 "kept worrying about work"; WFC2 "felt too tired after work"; WFC3 "work prevented time for family"; WFC4 "difficult to concentrate on work"; WFC5 "family responsibilities prevented time for work". As WFC refers to the inter-role conflict between the need for paid work and family work, WFC has been measured in two directions, work to family conflict (WTFC: WFC1, 2, 3) and family to work conflict (FTWC: WFC4, 5). With these WFC variables, we conducted multiple logistic analyses to study how working hours, weekend work, and shift work impact WFC. Results: Korean manufacturers' prolonged working hours increased all aspects of WFCs. Odds ratios (ORs) of WFCs based on working hours (reference of under 40 hours) of 41-52, 53-60, over 61 were 1.247, 1.611, 2.279 (WFC1); 1.111, 2.561, 6.442 (WFC2); 1.219, 3.495, 8.327 (WFC3); 1.076, 2.019, 2.656 (WFC4); and 1.166, 1.592, 1.946 (WFC5), respectively. Shiftwork in the WFC2 model showed a significantly higher OR of 1.390. Weekend work 'only on Saturday' had significant ORs with WFC2 (1.323) and WFC3 (1.552). Conclusions: An increase in working hours leads to the spending of less time attending to problems between work and family, causing both WTFC and FTWC to increase. As weekends, evenings, and nighttime are considered to be family-friendly to people, working on weekends and shift-work were highly correlated to WTFC.

Overall and cardiovascular mortality according to 10-year cardiovascular risk of the general health checkup: the Kangbuk Samsung Cohort Study

  • Youshik Jeong;Yesung Lee;Eunchan Mun;Eunhye Seo;Daehoon Kim;Jaehong Lee;Jinsook Jeong;Woncheol Lee
    • Annals of Occupational and Environmental Medicine
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    • v.34
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    • pp.40.1-40.9
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    • 2022
  • Background: According to the occupational accident status analysis in 2020, of 1,180 occupational deaths, 463 were caused by cardiovascular disease (CVD). Workers should be assessed for CVD risk at regular intervals to prevent work-related CVD in accordance with the rules on occupational safety and health standards. However, no previous study has addressed risk and mortality. Therefore, this longitudinal study was conducted to evaluate the relationship between 10-year cardiovascular risk of the general health checkup and mortality. Methods: The study included 545,859 participants who visited Kangbuk Samsung Total Healthcare Centers from January 1, 2002, to December 31, 2017. We performed 10-year cardiovascular risk assessment for the participants and the risk was divided into 4 groups (low, moderate, high, and very high). The study used death data from the Korea National Statistical Office for survival status as an outcome variable by December 31, 2019, and the cause of death based on the International Classification of Diseases, 10th Revision (ICD-10) was identified. Statistical analysis was performed using Cox proportional hazards regression analysis, and the sum of the periods from the first visit to the date of death or December 31, 2019, was used as a time scale. We also performed a stratified analysis for age at baseline and sex. Results: During 5,253,627.9 person-years, 4,738 overall deaths and 654 cardiovascular deaths occurred. When the low-risk group was set as a reference, in the multivariable-adjusted model, the hazard ratios (HRs) (95% confidence interval [CI]) for overall mortality were 3.36 (2.87-3.95) in the moderate-risk group, 11.08 (9.27-13.25) in the high-risk group, and 21.20 (17.42-25.79) in the very-high-risk group, all of which were statistically significant. In cardiovascular deaths, the difference according to the risk classification was more pronounced. The HRs (95% CI) were 8.57 (4.95-14.83), 38.95 (21.77-69.69), and 78.81 (42.62-145.71) in each group. As a result of a subgroup analysis by age and sex, the HRs of all-cause mortality and cardiovascular mortality tended to be higher in the high-risk group. Conclusions: This large-scale longitudinal study confirmed that the risk of death increases with the 10-year cardiovascular risk of general health checkup.

Comparing Gut Microbial Composition and Functional Adaptations between SPF and Non-SPF Pigs

  • Haesun Lee;Woncheoul Park;Jingu No;Nam Woong Hyung;Ju-Yeong Lee;Seokho Kim;Hyeon Yang;Poongyeon Lee;Eunju Kim;Keon Bong Oh;Jae Gyu Yoo;Seunghoon Lee
    • Journal of Microbiology and Biotechnology
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    • v.34 no.7
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    • pp.1484-1490
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    • 2024
  • The gut microbiota is a key factor significantly impacting host health by influencing metabolism and immune function. Its composition can be altered by genetic factors, as well as environmental factors such as the host's surroundings, diet, and antibiotic usage. This study aims to examine how the characteristics of the gut microbiota in pigs, used as source animals for xenotransplantation, vary depending on their rearing environment. We compared the diversity and composition of gut microbiota in fecal samples from pigs raised in specific pathogen-free (SPF) and conventional (non-SPF) facilities. The 16S RNA metagenome sequencing results revealed that pigs raised in non-SPF facilities exhibited greater gut microbiota diversity compared to those in SPF facilities. Genera such as Streptococcus and Ruminococcus were more abundant in SPF pigs compared to non-SPF pigs, while Blautia, Bacteroides, and Roseburia were only observed in SPF pigs. Conversely, Prevotella was exclusively present in non-SPF pigs. It was predicted that SPF pigs would show higher levels of processes related to carbohydrate and nucleotide metabolism, and environmental information processing. On the other hand, energy and lipid metabolism, as well as processes associated with genetic information, cell communication, and diseases, were predicted to be more active in the gut microbiota of non-SPF pigs. This study provides insights into how the presence or absence of microorganisms, including pathogens, in pig-rearing facilities affects the composition and function of the pigs' gut microbiota. Furthermore, this serves as a reference for tracing whether xenotransplantation source pigs were maintained in a pathogen-controlled environment.

Assessment of natural radioactivity in soil and olive mill pomace utilizing nal (TI) gamma-ray spectrometry and low background alpha/beta counting system

  • Amani Kraishan;Mohammad Abu Shayeb;Hafedh Belmabrouk;Ahmad Ali Husein Qwasmeh;Muzahir Ali Baloch
    • Nuclear Engineering and Technology
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    • v.56 no.5
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    • pp.1925-1931
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    • 2024
  • The study conducted in the northwest region of Jordan aimed to assess the levels of natural radioactivity in soil and olive mill pomace (OMP) samples. The researchers used Nal (TI) gamma-ray spectrometry to measure the activity concentrations of 226Ra, 232Th, 40K, and 137Cs in the samples. The average activity concentrations of 226Ra, 232Th, 40K, and 137Cs in the soil samples were found to be 18.624 ± 5.82, 12.276 ± 5.728, 518.33 ± 212.57, and 0.140 ± 0.09 (Bq, kg-1), respectively. In the OMP samples, the average activity concentrations of 226Ra, 232Th, and 40K were 7.272 ± 4.386, 3.454 ± 1.503, and 169.997 ± 81.873 (Bq kg-1), respectively, and no 137Cs was detected. The study also investigated fundamental parameters associated with radon, specifically the radon emanation coefficient (RnEC) and radon mass exhalation rate (Ex). The RnEC values ranged from 0.621 to 0.78 (Bq kg-1), with an average value of 0.71 ± 0.06 (Bq kg-1). The estimated Ex from the soil samples ranged from 65.83 to 124.86 (mBq kg-1h-1), with an average value of 99.74 ± 21.73 (mBq kg-1h-1). Regarding radiological hazards, the study examined various parameters, including radium equivalent activity, external and internal hazard indices, gamma and alpha indices, absorbed gamma dose rate, and excess lifetime cancer risk. All of these assessed values were found to be below the worldwide recommended limits for radiological safety. Additionally, the study analyzed the concentrations of gross alpha and gross beta radioactivities in soil and OMP samples. The soil samples had an average gross alpha activity of 4.642 ± 1.04 (Bq kg-1) and an average gross beta activity of 48.13 ± 14.50 (Bq kg-1). The OMP samples showed an average gross alpha activity of 0.32 ± 0.27 (Bq kg-1) and an average gross beta activity of 59.19 ± 12.94 (Bq kg-1). Overall, the obtained results are crucial for evaluating the radiological risks associated with natural radioactivity in the northwest region of Jordan. The findings establish baseline data for comparison and reference for radioactivity levels in the environment.

Agricultural Applicability of AI based Image Generation (AI 기반 이미지 생성 기술의 농업 적용 가능성)

  • Seungri Yoon;Yeyeong Lee;Eunkyu Jung;Tae In Ahn
    • Journal of Bio-Environment Control
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    • v.33 no.2
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    • pp.120-128
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    • 2024
  • Since ChatGPT was released in 2022, the generative artificial intelligence (AI) industry has seen massive growth and is expected to bring significant innovations to cognitive tasks. AI-based image generation, in particular, is leading major changes in the digital world. This study investigates the technical foundations of Midjourney, Stable Diffusion, and Firefly-three notable AI image generation tools-and compares their effectiveness by examining the images they produce. The results show that these AI tools can generate realistic images of tomatoes, strawberries, paprikas, and cucumbers, typical crops grown in greenhouse. Especially, Firefly stood out for its ability to produce very realistic images of greenhouse-grown crops. However, all tools struggled to fully capture the environmental context of greenhouses where these crops grow. The process of refining prompts and using reference images has proven effective in accurately generating images of strawberry fruits and their cultivation systems. In the case of generating cucumber images, the AI tools produced images very close to real ones, with no significant differences found in their evaluation scores. This study demonstrates how AI-based image generation technology can be applied in agriculture, suggesting a bright future for its use in this field.

Optimum Radiotherapy Schedule for Uterine Cervical Cancer based-on the Detailed Information of Dose Fractionation and Radiotherapy Technique (처방선량 및 치료기법별 치료성적 분석 결과에 기반한 자궁경부암 환자의 최적 방사선치료 스케줄)

  • Cho, Jae-Ho;Kim, Hyun-Chang;Suh, Chang-Ok;Lee, Chang-Geol;Keum, Ki-Chang;Cho, Nam-Hoon;Lee, Ik-Jae;Shim, Su-Jung;Suh, Yang-Kwon;Seong, Jinsil;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.143-156
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    • 2005
  • Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.