OBJECTIVES: This study evaluated and validated the reliability of smartphones as measuring equipment for the dorsi-plantar flexion of ankle joint position sense (JPS) ability. METHODS: The subjects were 20 healthy young students in their 20s. We confirmed the concurrent validity by comparison with existing electrogoniometer data. The reliability of the smartphone was confirmed using the test-retest method. RESULTS: In the case of dorsiflexion, there was no significant difference between the smartphone and electrogoniometer groups (p > 0.05). Regarding the correlation, it was significantly high (r = 0.65, p < 0.05), and ICC(3,1) was good (ICC(3,1) = 0.79). For the case of plantar flexion, there was no significant difference between the smartphone and electrogoniometer groups (p > 0.05), the correlation was significantly high (r = 0.69, p < 0.05), and the ICC(3,1) was very good (ICC(3,1) = 0.82). In the case of dorsiflexion, there was no significant difference between test and retest (p > 0.05), the correlation was intermediate (r = 0.59, p < 0.05), and the ICC(3,1) value was good (ICC(3,1) = 0.74). For plantar flexion, there was no significant difference between test and retest (p > 0.05), the correlation was significantly high (r = 0.63, p < 0.05), and the ICC(3,1) was good (ICC(3,1) = 0.76). CONCLUSIONS: The results showed that smartphones provide high validity and reliability as measurement equipment for JPS of dorsi-plantar flexion of the ankle. Finally, the study also considers that smartphone-based JPS measuring methods may replace the traditional and expensive methods that are currently being used for the same purpose.
Ankle Joint ; Ankle* ; Humans ; Joints* ; Methods ; Proprioception* ; Reproducibility of Results ; Smartphone*

Biomarkers are characteristic biological properties that can be detected and measured in a variety of biological matrices in the human body, including the blood and tissue, to give an indication of whether there is a threat of disease, if a disease already exists, or how such a disease may develop in an individual case. Along the continuum from exposure to clinical disease and progression, exposure, internal dose, biologically effective dose, early biological effect, altered structure and/or function, clinical disease, and disease progression can potentially be observed and quantified using biomarkers. While the traditional discovery of biomarkers has been a slow process, the advent of molecular and genomic medicine has resulted in explosive growth in the discovery of new biomarkers. In this review, issues in evaluating biomarkers will be discussed and the biomarkers of environmental exposure, early biologic effect, and susceptibility identified and validated in epidemiological studies will be summarized. The spectrum of genomic approaches currently used to identify and apply biomarkers and strategies to validate genomic biomarkers will also be discussed.
Disease Progression ; Environmental Exposure ; *Epidemiologic Studies ; *Genetic Markers ; Humans ; Molecular Epidemiology/*methods ; Neoplasms/epidemiology ; Republic of Korea/epidemiology

PURPOSE: We wanted to develop and test an artificial intelligence (AI) to assist physicians in making the thin-section CT diagnosis of diffuse pulmonary diseases. MATERIALS AND METHODS: The AI was composed of knowledge bases (KB) of 12 diffuse pulmonary diseases and an inference engine (IE). The KB of a disease included both the inclusion criteria (IC) and the exclusion criteria (EC), which were the clinical or thin-section CT findings that were known to be present or absent in that particular disease, respectively. From imputing the clinical or thin-section CT findings by the operator who was reading the thin-section CT, AI instantly executed the following two steps. First, the IE eliminated all diseases from the list which the EC had for those particular findings. Next, from a list of remaining diseases, the AI selected those diseases having those findings in its IC to formulate the 1st-step differential diagnosis (DD1). For the differential diagnosis in the next step, the reader could choose one more clinical or thin-section CT finding from the new list: [(all the findings in the IC or EC of DD1) - (the findings in the IC common to all the DD1s)]. The reader could proceed even further if needed. The system was tested on 10 radiology residents who solved 24 problems (two problems for each of 12 diffuse pulmonary diseases) without and then with the aid of the AI. The scores were compared using the Wilcoxon signed rank test. RESULTS: An AI was made; it was composed of 280 rules (214 IC and 66 EC) and three interfaces (two for program management and another for problem solving). Contestants scored higher (p = 0.0078) using the AI (167 vs. 110 respectively), and they responded that they felt that the program was helpful in making decisions. CONCLUSION: AI appeared to be helpful in making thin-section CT diagnosis.
Artificial Intelligence* ; Diagnosis* ; Diagnosis, Differential ; Knowledge Bases ; Lung ; Lung Diseases*

PURPOSE: To evaluate the usefulness of transcatheter arterial chemoembolization (TACE) in the management of gastrointestinal leiomyosarcoma metastatic to the liver. MATERIALS AND METHODS: Ten patients with gastrointestinal leiomyosarcoma and hepatic metastasis underwent TACE after surgical resection of the primary tumor. All of the leiomyosarcomas originated from the stomach (n=5), duodenum (n=1) or jejunum(n=4), and the interval between primary tumor resection and hepatic metastasis was 1-120 (mean 26) months. Using an emulsion of 3-20 mL of Lipiodol and 15-60 mg of doxorubicin. TACE was performed, and in five patients, gelfoam embolization was added. Therapeutic response was evaluated by follow-up CT, and nine patients underwent repeated TACE (range :2-9 times ; interval : 1-9 months). RESULTS: On celiac arteriography, all cases showed hypervascular tumor staining. As an initial therapeutic response based on CT assessment, more than 50% regression of the tumor (partial remission) was achieved in seven patients, and in the remaining three, regression was 20-30% (stable disease) ; neither complete remission nor progression was seen. With regard to long-term survival, five patients died at 5, 8, 14, 20 and 49 (median, 19) months after initial TACE. The remaining five, in whom follow-up has extended for 13-54 months, are still alive. Overall, survival time ranged from 5-54 (median, 19) months, and except for postembolization syndrome, there was no specific complication. The period of durable tumor regression before progression ranged from 6 to 54 (median, 17) months. CONCLUSION: TACE can be a safe and effective method for the palliation of gastrointestinal leiomyosarcoma metastatic to the liver.
Angiography ; Doxorubicin ; Duodenum ; Ethiodized Oil ; Follow-Up Studies ; Gelatin Sponge, Absorbable ; Humans ; Leiomyosarcoma* ; Liver* ; Neoplasm Metastasis* ; Stomach

We compared the surgical outcome with electrode positions after bilateral subthalamic nucleus (STN) stimulation surgery for Parkinson's disease. Fifty-seven patients treated with bilateral STN stimulations were included in this study. Electrode positions were determined in the fused images of preoperative MRI and postoperative CT taken at six months after surgery. The patients were divided into three groups: group I, both electrodes in the STN; group II, only one electrode in the STN; group III, neither electrode in the STN. Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr stage, and activities of daily living scores significantly improved at 6 and 12 months after STN stimulation in both group I and II. The off-time UPDRS III speech subscore significantly improved (1.6 +/- 0.7 at baseline vs 1.3 +/- 0.8 at 6 and 12 months, P < 0.01) with least L-dopa equivalent daily dose (LEDD) (844.6 +/- 364.1 mg/day at baseline; 279.4 +/- 274.6 mg/day at 6 months; and 276.0 +/- 301.6 mg/day at 12 months, P < 0.001) at 6 and 12 months after STN deep brain stimulation (DBS) in the group I. Our findings suggest that the better symptom relief including speech with a reduced LEDD is expected in the patients whose electrodes are accurately positioned in both STN.
Adult ; Aged ; Antiparkinson Agents/adverse effects/*therapeutic use ; Combined Modality Therapy ; *Deep Brain Stimulation/adverse effects/instrumentation/methods ; *Electrodes, Implanted ; Female ; Humans ; Levodopa/adverse effects/therapeutic use ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Parkinson Disease/drug therapy/*therapy ; Severity of Illness Index ; Subthalamic Nucleus/*physiology ; Treatment Outcome

Although noise-induced hearing loss (NIHL) is the most prevalent occupational disease in Korea, only 10% of the diagnosed cases are compensated. Old (1989-94) and current diagnostic criteria, criteria for workers' compensation of NIHL in Korea, compensation formulas of American Medical Association/American association of Ophthalmology and Otolaryngology (AMA/AAOO), the Committee on Hearing, Bio-Acoustics, Biomechanics (CHABA), American Academy of Otolaryngology (AAO) recommendation were compared. Each criterion was applied on the audiomety data of 4044 workers (8023 ears), who had received the second line screening test of Special Periodic Health Examination Program for noise-exposed workers during 1991-2. First, the resulting proportions of NIHL cases by employing each criterion were compared and strength of agreement was measured using kappa value. Temporary Threshold Shift (TTS) was corrected by noise free interval, and the reduction ratio of NIHL cases was calculated. Theoretical progression model of NIHL was reconstructed from previous studies on the natural course of NIHL to evaluate the change of diagnosis result of each criterion in the model. The kappa value between old and current criteria was 0.19, 0.55 for current criteria and workers' corn. criteria, ranging from 0.08 to 0.78, highest coincidence was observed between current criteria and CHABA formula. The current criteria produce most similar results with CHABA formula. If TTS is corrected for NFI, there is about 14 % reduction of NIHL cases. The results of applying on NIHL progression model divided the formulas roughly into 3 groups, of which compensation criteria was the most, old criteria and AAO the least conservative. In conclusion. The result of 4 KHZ audiometry should be excluded in evaluation of hearing level and a new hearing conservation program should be set out. Current diagnostic criteria has an ambiguity in that managerial concept for prevention arid! purpose of compensation is mixed up. The current diagnostic criteria and compensation criteria could be incorporated'into 'a new formula which is based on the state of the art test for estimating everyday hearing disability.
Audiometry ; Compensation and Redress ; Diagnosis ; Hearing Loss* ; Hearing Loss, Noise-Induced ; Hearing* ; Korea* ; Mass Screening ; Noise* ; Occupational Diseases ; Ophthalmology ; Otolaryngology ; Workers' Compensation ; Zea mays

PURPOSE: Various embolic agents have been used for embolization of acute gastrointestinal (GI) arterial bleeding. N-butyl cyanoacrylate (NBCA) is not easy to handle, but it is a useful embolic agent. In this retrospective study, we describe our experience with NBCA embolization of acute gastroduodenal ulcer bleeding. MATERIALS AND METHODS: NBCA embolization was performed in seven patients with acute upper GI arterial bleeding; they had five gastric ulcers and two duodenal ulcers. NBCA embolization was done in the left gastric artery (n = 3), right gastric artery (n = 2), gastroduodenal artery (n = 1) and pancreaticoduodenal artery (n = 1). Coil was used along with NBCA in a gastric bleeding patient because of difficulty in selecting a feeding artery. NBCA was mixed with Lipiodol at the ratio of 1:1 to 1:2. The blood pressure and heart rate around the time of embolization, the serial hemoglobin and hematocrit levels and the transfusion requirements were reviewed to evaluate hemostasis and rebleeding. RESULTS: Technical success was achieved in all the cases. Two procedure-related complications happened; embolism of the NBCA mixture to the common hepatic artery occurred in a case with embolization of the left gastric artery, and reflux of the NBCA mixture occurred into the adjacent gastric tissue, but these did not cause any clinical problems. Four of seven patients did not present with rebleeding, but two had rebleeding 10 and 16 days, respectively, after embolization and they died of cardiac arrest at 2 months and 37 days, respectively. One other patient died of sepsis and respiratory failure within 24 hours without rebleeding. CONCLUSION: NBCA embolization with or without other embolic agents could be safe and effective for treating acute gastroduodenal ulcer bleeding.
Arteries ; Blood Pressure ; Cyanoacrylates* ; Duodenal Ulcer ; Embolism ; Embolization, Therapeutic* ; Ethiodized Oil ; Heart Arrest ; Heart Rate ; Hematocrit ; Hemorrhage* ; Hemostasis ; Hepatic Artery ; Humans ; Peptic Ulcer* ; Respiratory Insufficiency ; Retrospective Studies ; Sepsis ; Stomach Ulcer

PURPOSE: Various embolic agents have been used for embolization of acute gastrointestinal (GI) arterial bleeding. N-butyl cyanoacrylate (NBCA) is not easy to handle, but it is a useful embolic agent. In this retrospective study, we describe our experience with NBCA embolization of acute gastroduodenal ulcer bleeding. MATERIALS AND METHODS: NBCA embolization was performed in seven patients with acute upper GI arterial bleeding; they had five gastric ulcers and two duodenal ulcers. NBCA embolization was done in the left gastric artery (n = 3), right gastric artery (n = 2), gastroduodenal artery (n = 1) and pancreaticoduodenal artery (n = 1). Coil was used along with NBCA in a gastric bleeding patient because of difficulty in selecting a feeding artery. NBCA was mixed with Lipiodol at the ratio of 1:1 to 1:2. The blood pressure and heart rate around the time of embolization, the serial hemoglobin and hematocrit levels and the transfusion requirements were reviewed to evaluate hemostasis and rebleeding. RESULTS: Technical success was achieved in all the cases. Two procedure-related complications happened; embolism of the NBCA mixture to the common hepatic artery occurred in a case with embolization of the left gastric artery, and reflux of the NBCA mixture occurred into the adjacent gastric tissue, but these did not cause any clinical problems. Four of seven patients did not present with rebleeding, but two had rebleeding 10 and 16 days, respectively, after embolization and they died of cardiac arrest at 2 months and 37 days, respectively. One other patient died of sepsis and respiratory failure within 24 hours without rebleeding. CONCLUSION: NBCA embolization with or without other embolic agents could be safe and effective for treating acute gastroduodenal ulcer bleeding.
Arteries ; Blood Pressure ; Cyanoacrylates* ; Duodenal Ulcer ; Embolism ; Embolization, Therapeutic* ; Ethiodized Oil ; Heart Arrest ; Heart Rate ; Hematocrit ; Hemorrhage* ; Hemostasis ; Hepatic Artery ; Humans ; Peptic Ulcer* ; Respiratory Insufficiency ; Retrospective Studies ; Sepsis ; Stomach Ulcer

OBJECTIVE: To describe the thin-section CT findings of arc-welders' pneumoco-niosis. MATERIALS AND METHODS: Eighty-five arc-welders with a three to 30 (mean, 15)-year history of exposure underwent thin-section CT scanning. The extent of abnormalities detected was correlated with the severity of dyspnea and pulmonary function tests. For comparison, images of 43 smoking males (mean 25 pack-year) who underwent thin-section CT for other reasons (smokers' group) were also analyzed. RESULTS: Fifty-four welders (63.5%) and six smokers (14.0%) showed positive findings. Predominant thin-section CT findings were poorly-defined centrilobular micronodules (30/54, 55.6%), branching linear structure (18/54, 33.3%), and ground-glass attenuation (6/54, 11.1%). In the smokers' group, poorly-defined micronodules were found in four patients, branching linear structures in one, and ground-glass attenuation in one. In welders, the extent of abnormalities seen on thin-section CT showed no significant correlation with the severity of dyspnea or the results of pulmonary funotion test. CONCLUSION: Poorly-defined centrilobular micronodules and branching linear structures were the thin-section CT findings most frequently seen in patients with arc-welders' pneumoconiosis. Less commonly, extensive ground-glass attenua-tion was also seen
Adult ; Case-Control Studies ; Comparative Study ; Female ; *Ferric Compounds ; Human ; Male ; Pneumoconiosis/etiology/*radiography ; Smoking/adverse effects ; Support, Non-U.S. Gov't ; *Tomography, X-Ray Computed ; *Welding

OBJECTIVE: To describe the thin-section CT findings of arc-welders' pneumoco-niosis. MATERIALS AND METHODS: Eighty-five arc-welders with a three to 30 (mean, 15)-year history of exposure underwent thin-section CT scanning. The extent of abnormalities detected was correlated with the severity of dyspnea and pulmonary function tests. For comparison, images of 43 smoking males (mean 25 pack-year) who underwent thin-section CT for other reasons (smokers' group) were also analyzed. RESULTS: Fifty-four welders (63.5%) and six smokers (14.0%) showed positive findings. Predominant thin-section CT findings were poorly-defined centrilobular micronodules (30/54, 55.6%), branching linear structure (18/54, 33.3%), and ground-glass attenuation (6/54, 11.1%). In the smokers' group, poorly-defined micronodules were found in four patients, branching linear structures in one, and ground-glass attenuation in one. In welders, the extent of abnormalities seen on thin-section CT showed no significant correlation with the severity of dyspnea or the results of pulmonary funotion test. CONCLUSION: Poorly-defined centrilobular micronodules and branching linear structures were the thin-section CT findings most frequently seen in patients with arc-welders' pneumoconiosis. Less commonly, extensive ground-glass attenua-tion was also seen
Adult ; Case-Control Studies ; Comparative Study ; Female ; *Ferric Compounds ; Human ; Male ; Pneumoconiosis/etiology/*radiography ; Smoking/adverse effects ; Support, Non-U.S. Gov't ; *Tomography, X-Ray Computed ; *Welding