• Korean Journal of Radiology
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• 제23권2호
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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.

• Korean Journal of Radiology
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• 제24권10호
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• pp.1028-1037
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• 2023

Objective: To evaluate the computed tomography (CT) features for diagnosing metastatic cervical lymph nodes (LNs) in patients with differentiated thyroid cancer (DTC) and validate the CT-based risk stratification system suggested by the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) guidelines. Materials and Methods: A total of 463 LNs from 399 patients with DTC who underwent preoperative CT staging and ultrasound-guided fine-needle aspiration were included. The following CT features for each LN were evaluated: absence of hilum, cystic changes, calcification, strong enhancement, and heterogeneous enhancement. Multivariable logistic regression analysis was performed to identify independent CT features associated with metastatic LNs, and their diagnostic performances were evaluated. LNs were classified into probably benign, indeterminate, and suspicious categories according to the K-TIRADS and the modified LN classification proposed in our study. The diagnostic performance of both classification systems was compared using the exact McNemar and Kosinski tests. Results: The absence of hilum (odds ratio [OR], 4.859; 95% confidence interval [CI], 1.593-14.823; P = 0.005), strong enhancement (OR, 28.755; 95% CI, 12.719-65.007; P < 0.001), and cystic changes (OR, 46.157; 95% CI, 5.07-420.234; P = 0.001) were independently associated with metastatic LNs. All LNs showing calcification were diagnosed as metastases. Heterogeneous enhancement did not show a significant independent association with metastatic LNs. Strong enhancement, calcification, and cystic changes showed moderate to high specificity (70.1%-100%) and positive predictive value (PPV) (91.8%-100%). The absence of the hilum showed high sensitivity (97.8%) but low specificity (34.0%). The modified LN classification, which excluded heterogeneous enhancement from the K-TIRADS, demonstrated higher specificity (70.1% vs. 62.9%, P = 0.016) and PPV (92.5% vs. 90.9%, P = 0.011) than the K-TIRADS. Conclusion: Excluding heterogeneous enhancement as a suspicious feature resulted in a higher specificity and PPV for diagnosing metastatic LNs than the K-TIRADS. Our research results may provide a basis for revising the LN classification in future guidelines.

• Korean Journal of Radiology
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• 제23권11호
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• pp.1102-1111
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• 2022

Objective: To evaluate the ultrasonography (US) features for diagnosing metastasis in cervical lymph nodes (LNs) in patients with thyroid cancer and compare the US classification of risk of LN metastasis between European and Korean guidelines. Materials and Methods: From January 2014 to December 2018, US-guided fine-needle aspiration was performed on 836 LNs from 714 patients for the preoperative nodal staging of thyroid cancer. The US features of LNs were retrospectively reviewed for the following features: size, presence of hilum, margin, orientation, cystic change, punctate echogenic foci (PEF), large echogenic foci, eccentric cortical thickening, abnormal vascularity, and cortical hyperechogenicity. A multiple logistic regression analysis was performed to identify the independent US features for the diagnosis of metastatic LNs. The diagnostic performance of independent US features was subsequently evaluated. LNs were categorized according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and European Thyroid Association (ETA) guidelines, and the correlation between the two sets of classifications was assessed. Results: Absence of the hilum, presence of cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features of metastatic LNs. Cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity showed high specificity (86.8%-99.6%). The absence of the hilum had the highest sensitivity yet low specificity (66.4%). When LNs were classified according to the ETA guidelines and K-TIRADS, they yielded similar categorizations of malignancy risks and were strongly correlated (Spearman coefficient, 0.9766 [95% confidence interval, 0.973-0.979]). According to the ETA guidelines, 9.8% (82/836) of LNs were classified as "not specified." Conclusion: Absence of hilum, cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features suggestive of metastatic LNs in thyroid cancer. Both K-TIRADS and the ETA guidelines provided similar risk stratification for metastatic LNs with a high correlation; however, the ETA guidelines failed to classify 9.8% of LNs into a specific risk stratum. These results may provide a basis for revising LN classification in future guidelines.

• Korean Journal of Radiology
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• 제20권5호
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• pp.812-822
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• 2019

Objective: To assess the diagnostic value of combining diffusion-weighted imaging (DWI) with conventional magnetic resonance imaging (MRI) for differentiating between pathologic and traumatic fractures at extremities from metastasis. Materials and Methods: Institutional Review Board approved this retrospective study and informed consent was waived. This study included 49 patients each with pathologic and traumatic fractures at extremities. The patients underwent conventional MRI combined with DWI. For qualitative analysis, two radiologists (R1 and R2) independently reviewed three imaging sets with a crossover design using a 5-point scale and a 3-scale confidence level: DWI plus non-enhanced MRI (NEMR; DW set), NEMR plus contrast-enhanced fat-saturated T1-weighted imaging (CEFST1; CE set), and DWI plus NEMR plus CEFST1 (combined set). McNemar's test was used to compare the diagnostic performances among three sets and perform subgroup analyses (single vs. multiple bone abnormality, absence/presence of extra-osseous mass, and bone enhancement at fracture margin). Results: Compared to the CE set, the combined set showed improved diagnostic accuracy (R1, 84.7 vs. 95.9%; R2, 91.8 vs. 95.9%, p < 0.05) and specificity (R1, 71.4% vs. 93.9%, p < 0.005; R2, 85.7% vs. 98%, p = 0.07), with no difference in sensitivities (p > 0.05). In cases of absent extra-osseous soft tissue mass and present fracture site enhancement, the combined set showed improved accuracy (R1, 82.9-84.4% vs. 95.6-96.3%, p < 0.05; R2, 90.2-91.1% vs. 95.1-95.6%, p < 0.05) and specificity (R1, 68.3-72.9% vs. 92.7-95.8%, p < 0.005; R2, 83.0-85.4% vs. 97.6-98.0%, p = 0.07). Conclusion: Combining DWI with conventional MRI improved the diagnostic accuracy and specificity while retaining sensitivity for differentiating between pathologic and traumatic fractures from metastasis at extremities.

• Korean Journal of Radiology
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• 제20권5호
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• pp.709-718
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• 2019

Objective: To investigate the association of myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) with troponin level and left ventricle (LV) function in patients with ST-segment elevated myocardial infarction (STEMI). Materials and Methods: Thirty-five STEMI patients who successfully had undergone reperfusion treatment within 1 week of their infarction were consecutively enrolled. All patients were referred for dynamic CT-MPI. Serial high-sensitivity troponin T (hs-TnT) levels and left ventricular ejection fraction (LVEF) measured by echocardiography were recorded. Twenty-six patients with 427 segments were included for analysis. Various quantitative parameters derived from dynamic CT-MPI were analyzed to determine if there was a correlation between hs-TnT levels and LVEF on admission and again at the 6-month mark. Results: The mean radiation dose for dynamic CT-MPI was 3.2 ± 1.1 mSv. Infarcted territories had significantly lower MBF (30.5 ± 7.4 mL/min/100 mL versus 73.4 ± 8.1 mL/min/100 mL, p < 0.001) and myocardial blood volume (MBV) (2.8 ± 0.9 mL/100 mL versus 4.2 ± 1.1 mL/100 mL, p = 0.044) compared with those of reference territories. MBF showed the best correlation with the level of peak hs-TnT (r = -0.682, p < 0.001), and MBV showed a moderate correlation with the level of peak hs-TnT (r = -0.437, p = 0.026); however, the other parameters did not show any significant correlation with hs-TnT levels. As for the association with LV function, only MBF was significantly correlated with LVEF at the time of admission (r = 0.469, p = 0.016) and at 6 months (r = 0.585, p = 0.001). Conclusion: MBF quantified by dynamic CT-MPI is significantly inversely correlated with the level of peak hs-TnT. In addition, patients with lower MBF tended to have impaired LV function at the time of their admission and at 6 months.

• 한국임상수의학회지
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• 제40권6호
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• pp.399-407
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• 2023

Chronic kidney disease (CKD) occurs in more than 15% of the dogs over 10 years of age and causes irreversible renal function deterioration. Therefore, it is important to diagnose CKD early and treat the disease properly. The purpose of this study aimed to to evaluate the clinical utility of urine albumin/creatinine ratio (ACR) using POC (point-of-care) device as an early detection urinary biomarker in CKD dogs and to confirm the correlation between ACR and other known CKD biomarkers. Urine and serum samples were obtained from 50 healthy dogs and 50 dogs with CKD. Serum blood urea nitrogen (BUN), creatinine, and symmetric dimethylarginine (SDMA) concentrations, and urine protein creatinine ratio (UPC) were measured. Urine specific gravity (USG) was evaluated using refractometer, and ACR was measured using an i-SENS A1Care analyzer. The ACR values of dogs with CKD were significantly different from those of healthy dogs (p < 0.001), as with other renal biomarkers. ACR showed significant differences between healthy dogs and dogs with CKD at every IRIS stage (p < 0.005), whereas no significant differences were observed between dogs with CKD IRIS stage I and healthy dogs with UPC. There are significant positive correlation between ACR and BUN (r = 0.611, p < 0.001), creatinine (r = 0.788, p < 0.001), SDMA (r = 0.747, p < 0.001), and UPC (r = 0.784, p < 0.001), and significant negative correlation between ACR and USG (r = -0.700, p < 0.001). In receiver operator characteristic curve analysis, the area under the curve (AUC) was 0.982 (95% CI 0.963-1.000, p < 0.001), with an optimal cut-off value of 64.20 mg/g (94% sensitivity and 94% specificity). Thus, ACR is a useful urinary biomarker for the early diagnosis of proteinuria in CKD and combined use of ACR and other renal biomarkers may be helpful for early diagnosis and prevention of CKD in dogs.

• Journal of Ecology and Environment
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• 제47권4호
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• pp.200-210
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• 2023

Background: Cambaroides similis is an endangered candidate species living in the stream of South Korea. Freshwater crayfish is known to decline rapidly not only domestically, but also internationally. Its decline is projected to be further exacerbated due to climate change. Understanding physical characteristics of the habitat is crucial for the conservation of an organism. However, comprehensive data regarding the distribution and physical habitat characteristics of C. similis are currently unavailable in South Korea. Thus, the objective of this study was to ascertain preferred ranges for water depth, current velocity, and streambed substrate of C. similis using Weibull model. Results: In this study, C. similis was found at 59 sites across 12 regions in South Korea. Its optimal water depth preferences ranged from 11.9 cm to 30.1 cm. Its current velocity preferences ranged from 9.8 cm s^-1 to 29.1 cm s^-1. Its substrate preferences ranged from -5.1 𝜱_m to -2.5 𝜱_m. Median values of central tendency were determined as follows: water depth of 21.4 cm, current velocity of 21.2 cm s^-1, and substrate of -4.1 𝜱_m. Mean values of central tendency were determined as follows: water depth of 21.8 cm, current velocity of 22.0 cm s^-1, and substrate of -4.4 𝜱_m. Mode values of central tendency were determined as follows: water depth of 21.7 cm, current velocity of 20.1 cm s^-1, and substrate of -3.7 𝜱_m. Conclusions: Based on habitat suitability analysis, physical microhabitat characteristics of C. similis within a stream were identified as Run section with coarse particle substrate, low water depth, and slow current velocity. Due to high sensitivity of these habitats to environmental changes, prioritized selection and assessment of threats should be carried out as a primary step.

• 한국구조물진단유지관리공학회 논문집
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• 제10권5호
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• pp.179-186
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• 2006

본 연구에서는 FRP Rebar로 보강된 철근콘크리트 보의 휨성능을 평가할 수 있는 모형을 개발하기 위하여 인공신경망 중 다층인식자 모형을 사용하였다. 인공신경망 모형에 사용될 학습자료들은 기존 연구자료들의 데이터를 이용하였다. 입력층의 독립변수는 휨성능에 주요 요소인 폭, 유효깊이, 압축강도, FRP 보강비, FRP 균형철근비을 사용하였다. 출력층 종속변수는 실험에서 측정된 모멘트 성능을 사용하였다. 개발된 인공신경망 모형은 GFRP, CFRP, AFRP Rebar 적용이 모두 가능하며, 모형의 검증은 다른 선행 연구자들이 수행한 자료를 이용하였다. 인공신경망 모형 추정결과 ANN(0.05) 모형의 경우에 비교적 정확한 휨성능 추정값을 나타낸 반면, ANN(0.1) 모형에서는 다소 오차가 발생하였다. 인공신경망 모형의 검증결과 주어진 실험 데이터 값과 비교적 일치하고 있음을 확인할 수 있었다. 또한, 휨성능 평가 변수에 대한 민감도 분석결과 유효깊이의 영향이 가장 크고 FRP 철근비, FRP 균형철근비, 압축강도, 폭으로 분석되었다.

• 대기
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• 제34권3호
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• pp.305-317
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• 2024

The study examines the effects of parameters that define the characteristics of raindrops on the simulated precipitation during the summer season over Korea using the Weather Research and Forecasting (WRF) Double-Moment 6-class (WDM6) cloud microphysics scheme. Prescribed parameters, defining the characteristics of hydrometeors in the WDM6 scheme such as a_R, b_R, and f_R in the fall velocity (V_R) - diameter (D_R) relationship and shape parameter (𝜇_R) in the number concentration (N_R) - D_R relationship, presents different values compared to the observed data from Two-Dimensional Video Disdrometer (2DVD) at Boseong standard meteorological observatory during 2018~2019. Three experiments were designed for the heavy rainfall event on August 8, 2022 using WRF version 4.3. These include the control (CNTL) experiment with original parameters in the WDM6 scheme; the MUR experiment, adopting the 50th percentile observation value for 𝜇_R; and the MEDI experiment, which uses the same 𝜇_R as MUR, but also includes fitted values for a_R, b_R, and f_R from the 50th percentile of the observed V_R - D_R relationship. Both sensitivity experiments show improved precipitation simulation compared to the CNTL by reducing the bias and increasing the probability of detection and equitable threat scores. In these experiments, the raindrop mixing ratio increases and its number concentration decreases in the lower atmosphere. The microphysics budget analysis shows that the increase in the rain mixing ratio is due to enhanced source processes such as graupel melting, vapor condensation, and accretion between cloud water and rain. Our study also emphasizes that applying the solely observed 𝜇_R produces more positive impact in the precipitation simulation.

• 문화기술의 융합
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• 제10권5호
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• pp.445-452
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• 2024

팬데믹을 거치며 음식배달시장 고도화에 따른 외식문화의 지형도가 급변하고 있다. 최근 쿠팡이츠가 요기요를 제치고 2위로 도약하면서 경쟁이 심화되고 있으며, 업계 1위 배달의민족(배민) 역시 구독제 도입을 준비 중이다. 시장의 성장세가 주춤한 가운데, 배달비와 음식가격 상승으로 인해 포장과 픽업 서비스 이용률이 높아지고 있다. 요컨대 젊은 세대가 앱 서비스를 활발히 사용하는데 영향을 미치는 요인으로 유용성 및 사용편의성, 비용민감성, 쾌락적 동기가 중요함이 선행연구를 통해 밝혀졌다. 실제로 최근 Z세대의 경우, 구독제 선택 대신 '징검다리형 소비'와 배달팟 과정을 거쳐 지출을 최소화하는 트렌드를 주도하고 있다. 이에 Z세대의 특성을 반영한 신규 배달앱의 기능개선과 활성화 방안을 제안함으로써 고객들에게 더 나은 경험을 선사하여 경쟁력 강화를 돕고자 한다. 전문가 델파이 조사결과, 누적할인 바로보기, 가족혜택 추가, 쿠폰강화 기능, SNS홍보, 픽업산책, 매장 내 홍보, 할인율 진열의 순서대로 영향도 평가점수를 받아 실무에 적용 검토할 것이다. 푸드테크 시장에 관한 학술적, 정책적 시사점을 함께 제시한다.