Publications by authors named "Sung-Hun Kim"

251 Publications

Automated breast US as the primary screening test for breast cancer among East Asian women aged 40-49 years: a multicenter prospective study.

Eur Radiol 2021 Mar 29. Epub 2021 Mar 29.

Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.

Objectives: To prospectively evaluate the diagnostic performance of screening ABUS as the primary screening test for breast cancer among Korean women aged 40-49 years.

Methods: This prospective, multicenter study included asymptomatic Korean women aged 40-49 years from three academic centers between February 2017 and October 2019. Each participant underwent ABUS without mammography, and the ABUS images were interpreted at each hospital with double-reading by two breast radiologists. Biopsy and at least 1 year of follow-up was considered the reference standard. Diagnostic performance of ABUS screening and subgroup analyses according to patient and tumor characteristics were evaluated.

Results: Reference standard data were available for 959 women. The recall rate was 9.8% (95% confidence interval [CI]: 7.9%, 11.7%; 94 of 959 women) and the cancer detection yield was 5.2 per 1000 women (95% CI: -0.6, 11.1; 5 of 959 women). There was only one interval cancer. The sensitivity was 83.3% (95% CI: 53.5%, 100%; 5 of 6 cancers) and the specificity was 90.7% (95% CI: 88.8%, 92.5%; 864 of 95. women). The positive predictive values of biopsies performed (PPV) was 20.0% (95% CI: 4.3%, 35.7%; 5 of 25 women). Women with heterogeneous background echotexture had a higher recall rate (p = .009) and lower specificity (p = .036). Women with body mass index values < 25 kg/m had a higher mean recall rate (p = .046).

Conclusion: In East Asia, screening automated breast US may be an alternative to screening mammography for detecting breast cancers in women aged 40-49 years.

Key Points: • Automated breast US screening for breast cancer in asymptomatic women aged 40-49 is effective with 5.2 per 1000 cancer detection yield. • Women with heterogeneous background echotexture had a higher recall rate and lower specificity. • Women with body mass index < 25 kg/m had a higher recall rate.
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http://dx.doi.org/10.1007/s00330-021-07864-3DOI Listing
March 2021

Image quality and diagnostic value of diffusion-weighted breast magnetic resonance imaging: Comparison of acquired and computed images.

PLoS One 2021 22;16(2):e0247379. Epub 2021 Feb 22.

Siemens Healthineers Ltd., Seoul, Republic of Korea.

Purpose: To compare the image quality of acquired diffusion-weighted imaging (DWI) and computed DWI and evaluate the lesion detectability and likelihood of malignancy in these datasets.

Materials And Methods: This prospective study was approved by our institutional review board. A total of 29 women (mean age, 43.5 years) underwent DWI between August 2018 and April 2019 for 32 breast cancers and 16 benign breast lesions. Three radiologists independently reviewed the acquired DWI with b-values of 1000 and 2000 s/mm2 (A-b1000 and A-b2000) and the computed DWI with a b-value of 2000 s/mm2 (C-b2000). Image quality was scored and compared between the three DWI datasets. Lesion detectability was recorded, and the lesion's likelihood for malignancy was scored using a five-point scale.

Results: The A-b1000 images were superior to the A-b2000 and C-b2000 images in chest distinction, fat suppression, and overall image quality. The A-b2000 and C-b2000 images showed comparable scores for all image quality parameters. C-b2000 showed the highest values for lesion detection among all readers, although there was no statistical difference in sensitivity, specificity, positive predictive value, negative predictive value, and accuracy between the DWI datasets. The malignancy scores of the DWI images were not significantly different among the three readers.

Conclusions: A-b1000 DWI is suitable for breast lesion evaluations, considering its better image quality and comparable diagnostic values compared to that of A-b2000 and C-b2000 images. The additional use of computed high b-value DWI may have the potential to increase the detectability of breast masses.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247379PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899336PMC
February 2021

Lithography Processable TaO Barrier-Layered Chitosan Electric Double Layer Synaptic Transistors.

Int J Mol Sci 2021 Jan 29;22(3). Epub 2021 Jan 29.

Department of Electronic Materials Engineering, Kwangwoon University, 447-1, Wolgye-dong, Nowon-gu, Seoul 139-701, Korea.

We proposed a synaptic transistor gated using a TaO barrier-layered organic chitosan electric double layer (EDL) applicable to a micro-neural architecture system. In most of the previous studies, a single layer of chitosan electrolyte was unable to perform lithography processes due to poor mechanical/chemical resistance. To overcome this limitation, we laminated a high- TaO thin film on chitosan electrolyte to ensure high mechanical/chemical stability to perform a lithographic process for micropattern formation. Artificial synaptic behaviors were realized by protonic mobile ion polarization in chitosan electrolytes. In addition, neuroplasticity modulation in the amorphous In-Ga-Zn-oxide (a-IGZO) channel was implemented by presynaptic stimulation. We also demonstrated synaptic weight changes through proton polarization, excitatory postsynaptic current modulations, and paired-pulse facilitation. According to the presynaptic stimulations, the magnitude of mobile proton polarization and the amount of weight change were quantified. Subsequently, the stable conductance modulation through repetitive potential and depression pulse was confirmed. Finally, we consider that proposed synaptic transistor is suitable for advanced micro-neural architecture because it overcomes the instability caused when using a single organic chitosan layer.
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http://dx.doi.org/10.3390/ijms22031344DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7866272PMC
January 2021

Improvement of Structural, Electrical, and Optical Properties of Sol-Gel-Derived Indium-Tin-Oxide Films by High Efficiency Microwave Irradiation.

J Nanosci Nanotechnol 2021 Mar;21(3):1875-1882

Department of Electronic Materials Engineering, Kwangwoon University, 447-1, Wolgye-dong, Nowon-gu, Seoul 139-701, Korea.

Herein, indium-tin-oxide (ITO) thin films are prepared by a solution-based spin-coating process followed by a heat-treatment process with microwave irradiation (MWI). The structural, electrical and optical properties of the films are investigated. The properties of the microwave-irradiated sol-gel ITO films are compared with those of as-spun ITO films and sol-gel ITO films subjected to conventional furnace annealing (CFA) or a rapid thermal process (RTP). After microwave irradiation, the sol-gel ITO thin films are found to have crystallized, and they indicate enhanced conductivity and transparency. Furthermore, the resistances of the ITO films are decreased considerably at increased microwave power levels, and the resistivity of the films almost saturate even at a low microwave power of 500 W. The improved physical properties of the MW-irradiated samples are mainly due to the increase in the electron concentration of the ITO films and the increase in the carrier mobility after MWI.
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http://dx.doi.org/10.1166/jnn.2021.18902DOI Listing
March 2021

Long-term follow-up of intersegmental displacement after orthognathic surgery using cone-beam computed tomographic superimposition.

Angle Orthod 2020 07;90(4):548-555

Objectives: To evaluate intersegmental displacement during long-term follow-up after bilateral sagittal split osteotomy (BSSO) by mandibular body area superimposition.

Materials And Methods: Cone-beam computed tomography (CBCT) images of 23 patients ages 18-37 years with class III malocclusion before orthognathic surgery were obtained. A three-dimensional (3D) CBCT examination was performed at four stages: surgery (T0), 6 months after surgery (T1), 1 year after surgery (T2), and long-term follow-up (6.1 ± 2.1 years, T3). The CBCT datasets were superimposed on the symphyseal area and the lower part of the distal segment of the mandible between T0 and the other time points (T1, T2, and T3). The reference points (both condyle, coronoid, and sigmoid) were estimated by the CBCT analyzed program.

Results: The coronoid, condylion, and sigmoid showed changes within 6 months after surgery, but there was no significant change in the intersegmental displacement between 6 months and 6 years after surgery. The distances between the left and right coronoid, condylion, and sigmoid from T0 to T3 were noted.

Conclusions: The change in intersegmental displacement between T0 and T3 affecting relapse after orthognathic surgery was not significantly different. This suggests that the mandible itself may have a stable morphology during the follow-up period.
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http://dx.doi.org/10.2319/061119-398DOI Listing
July 2020

Fully Automatic Assessment of Background Parenchymal Enhancement on Breast MRI Using Machine-Learning Models.

J Magn Reson Imaging 2021 03 20;53(3):818-826. Epub 2020 Nov 20.

Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Background: Automated measurement and classification models with objectivity and reproducibility are required for accurate evaluation of the breast cancer risk of fibroglandular tissue (FGT) and background parenchymal enhancement (BPE).

Purpose: To develop and evaluate a machine-learning algorithm for breast FGT segmentation and BPE classification.

Study Type: Retrospective.

Population: A total of 794 patients with breast cancer, 594 patients assigned to the development set, and 200 patients to the test set.

Field Strength/sequence: 3T and 1.5T; T -weighted, fat-saturated T -weighted (T W) with dynamic contrast enhancement (DCE).

Assessment: Manual segmentation was performed for the whole breast and FGT regions in the contralateral breast. The BPE region was determined by thresholding using the subtraction of the pre- and postcontrast T W images and the segmented FGT mask. Two radiologists independently assessed the categories of FGT and BPE. A deep-learning-based algorithm was designed to segment and measure the volume of whole breast and FGT and classify the grade of BPE.

Statistical Tests: Dice similarity coefficients (DSC) and Spearman correlation analysis were used to compare the volumes from the manual and deep-learning-based segmentations. Kappa statistics were used for agreement analysis. Comparison of area under the receiver operating characteristic (ROC) curves (AUC) and F1 scores were calculated to evaluate the performance of BPE classification.

Results: The mean (±SD) DSC for manual and deep-learning segmentations was 0.85 ± 0.11. The correlation coefficient for FGT volume from manual- and deep-learning-based segmentations was 0.93. Overall accuracy of manual segmentation and deep-learning segmentation in BPE classification task was 66% and 67%, respectively. For binary categorization of BPE grade (minimal/mild vs. moderate/marked), overall accuracy increased to 91.5% in manual segmentation and 90.5% in deep-learning segmentation; the AUC was 0.93 in both methods.

Data Conclusion: This deep-learning-based algorithm can provide reliable segmentation and classification results for BPE.

Level Of Evidence: 3 TECHNICAL EFFICACY STAGE: 2.
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http://dx.doi.org/10.1002/jmri.27429DOI Listing
March 2021

Comparison of maxillary basal arch forms using the root apex in adult women with different skeletal patterns: A pilot study.

Am J Orthod Dentofacial Orthop 2020 Oct 20;158(4):572-578. Epub 2020 Aug 20.

Department of Orthodontics, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, South Korea. Electronic address:

Introduction: This study aimed to establish maxillary basal arch forms using the root apices and to determine the differences in the basal arch forms in adult women with different sagittal skeletal patterns.

Methods: This retrospective study included 91 adult women, with either a Class I (n = 24), Class II Division 1 (n = 22), Class II Division 2 (n = 23), or Class III (n = 22) malocclusion, who underwent cone-beam computed tomography. Three-dimensional coordinates of the root apices were determined using the multiplanar reformation mode of OnDemand3D software (Cybermed Inc, Seoul, South Korea). Two-dimensional coordinates were converted from acquired 3-dimensional coordinates via projection on the palatal plane, and the Procrustes superimposition method was used to build the basal arch form. Finally, interroot width measurements were performed for basal arch form comparisons.

Results: There were significant differences among the 4 groups (P <0.05) with respect to the intercanine width. The intercanine width of Class II Division 1 group was significantly narrower than that of the other groups. The Class II Division 1 and Class II Division 2 groups tended to have tapered arch forms and squared arch forms, respectively.

Conclusions: We established maxillary basal arch forms using the root apices. The Class II Division 1 group had a significantly narrower intercanine distance. The use of the root apex to depict the basal arch form seems reasonable.
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http://dx.doi.org/10.1016/j.ajodo.2019.09.021DOI Listing
October 2020

Influence of Size and Shape Anisotropy on Optical Properties of CdSe Quantum Dots.

Nanomaterials (Basel) 2020 Aug 12;10(8). Epub 2020 Aug 12.

Department of Physics, Research Institute of Physics and Chemistry, Jeonbuk National University, Jeonju 54896, Korea.

We used low-temperature reactions to synthesize different-sized CdSe quantum dots (QDs) capped with fatty-acid and phosphine ligands. From the correlation of high-resolution transmission electron microscopy and X-ray diffraction (XRD) analyses of the synthesized QDs, we observed size-dependent shape anisotropy. In addition, the recorded XRD patterns revealed mixed crystal facets with zinc blende and wurtzite structures in small-sized QDs. Furthermore, from differential absorption (DA) spectra, we extracted the electronic transition energies for different-sized QDs, which were found to be similar to the calculated values of the quantum size levels associated with band mixing of CdSe QDs with a moderate bandgap. We found that the excitonic absorption peaks are increasingly "hidden" with decreasing QD size because of the crystal structure and crystalline quality. The results show good agreement with the obtained diffraction patterns and the estimation errors obtained from the DA spectra.
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http://dx.doi.org/10.3390/nano10081589DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7466547PMC
August 2020

What shear wave elastography parameter best differentiates breast cancer and predicts its histologic aggressiveness?

Ultrasonography 2021 Apr 15;40(2):265-273. Epub 2020 Jun 15.

Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Purpose: This study aimed to identify useful shear wave elastography (SWE) parameters for differentiating breast cancer and predicting associated immunohistochemical factors and subtypes.

Methods: From November 2018 to February 2019, a total of 211 breast lesions from 190 patients who underwent conventional breast ultrasonography and SWE were included. The Breast Imaging Reporting and Data System categories and qualitative and quantitative SWE parameters for each lesion were obtained. Pathologic results including immunohistochemical factors were evaluated. The diagnostic performance of each parameter and its correlation with histological characteristics, immunohistochemical factors, and subtypes of breast cancer were analyzed using analysis of variance, the independent t test, the Fisher exact test, logistic regression analysis, and the DeLong method.

Results: Among 211 breast lesions, 82 were malignant, and 129 were benign. Of the SWE parameters, Emax showed the highest area under the curve (AUC) for differentiating malignant from benign lesions (AUC, 0.891; cut-off>50.85). Poor tumor differentiation and progesterone receptor-negativity were correlated with higher SDmean and Emax (P<0.05). Ki-67-positive breast cancer showed higher SDmean and a heterogeneous color distribution (P<0.05). Ki-67 and cytokeratin 5/6-positive breast cancers showed higher Emax/Efat ratios (P<0.05). Luminal B, human epidermal growth factor receptor 2-enriched, and triple-negative (non-basal) subtypes showed somewhat higher SDmean values than the luminal A and triple-negative (basal) subtypes (P=0.028).

Conclusion: Emax is a reliable parameter for differentiating malignancies from benign breast lesions. In addition, high stiffness and SDmean values in tumors measured on SWE could be used to predict poorly differentiated, progesterone receptor-negative, or Ki-67-positive breast cancer.
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http://dx.doi.org/10.14366/usg.20007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7994732PMC
April 2021

Association between the body weight of growing pigs and the functional capacity of their gut microbiota.

Anim Sci J 2020 Jan-Dec;91(1):e13418

Department of Animal Resources Science, Dankook University, Cheonan, Republic of Korea.

Gastrointestinal microbiota impact host's biological activities, including digestion of indigestible feed components, energy harvest, and immunity. In this study, fecal microbiota of high body weight (HW) and low body weight (LW) growing pigs at 103 days of age were compared. Principal coordinates analysis separated the HW and LW groups into two clusters, indicating their potential differences between microbial community composition. Although the abundances of two major phyla, Firmicutes and Bacteroidetes, did not significantly differ between the HW and LW groups, some genera showed significant differences. Among them, Peptococcus and Eubacterium exhibited strong positive correlations with body weight (BW) and average daily gain (ADG) (Rho > 0.40), whereas Treponema, Desulfovibrio, Parabacteroides, and Ruminococcaceae_unclassified exhibited strong negative correlations with BW and ADG (Rho < -0.40). Based on these results, the structure of intestinal microbiota may affect growth traits in pigs through host-microbe interactions. Further in-depth studies will provide insights into how best to reshape host-microbe interactions in pigs and other animals as well.
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http://dx.doi.org/10.1111/asj.13418DOI Listing
October 2020

Dynamic association between AT(N) profile and cognition mediated by cortical thickness in Alzheimer's continuum.

Neuroimage Clin 2020 26;27:102282. Epub 2020 May 26.

Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address:

Background: The recently-proposed National Institute on Aging and Alzheimer's Association research framework organizes Alzheimer's disease (AD) biomarkers based on amyloid/tau/neurodegeneration (AT(N)). This study investigated the mediating effect of structural change in brain MRI on changes in cognitive function according to initial AT(N) profiles.

Methods: We included 576 subjects (cognitively unimpaired (N = 136), mild cognitive impairment (N = 294), dementia (N = 146)) from the Alzheimer's disease Neuroimaging Initiative study. The parallel-process latent growth curve model was applied to test the mediational effect of cortical thickness growth trajectory between the initial AT(N) profiles and cognitive growth trajectory.

Results: In Alzheimer's continuum, only the A + T + (N)+ profile showed a mediational effect of the cortical thickness growth trajectory. A + T - (N)- was not sufficient to induce direct or indirect effects on cognitive dysfunction, and A + T + (N)- showed a significant direct path from an altered cortical thickness to cognitive decline.

Conclusion: The sequential effect between changes in brain MRI and cognition varied by baseline AT(N) profile, suggesting the dynamic changes in the relationships among biomarkers in the current cascade model.
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http://dx.doi.org/10.1016/j.nicl.2020.102282DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322096PMC
March 2021

Prognostic Factors of Disease Recurrence in Breast Cancer Using Quantitative and Qualitative Magnetic Resonance Imaging (MRI) Parameters.

Sci Rep 2020 05 5;10(1):7598. Epub 2020 May 5.

Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

The purpose of this study was to investigate prognostic factors predicting recurrence of breast cancer, focusing on imaging factors including morphologic features, quantitative MR parameters, and clinicopathologic factors. This retrospective study was approved by our institutional review board, and the requirement to obtain informed consent was waived. A total of 267 patients with breast cancer were enrolled in this study, who underwent dynamic contrast-enhanced magnetic resonance imaging (MRI) before surgery from February 2014 to June 2016. Imaging parameters of MRI, including morphologic features, perfusion parameters, and texture analysis, were retrospectively reviewed by two expert breast radiologists. Clinicopathologic information of enrolled patients was also reviewed using medical records. Univariable and multivariable Cox proportional hazards regression analyses were used to identify factors associated with cancer recurrence. C statistics was used to discriminate low and high risk patients for disease recurrence. Using Kaplan-Meier survival analysis, disease-free survival was compared between patients who experienced recurrence and those who did not. At a median follow up of 49 months, 32 patients (12%) showed disease: six cases of ipsilateral breast or axilla recurrence, one case of contralateral breast recurrence, 24 cases of distant metastasis, and one case of both ipsilateral breast recurrence and distant metastasis. Of multiple imaging features and parameters, increased ipsilateral vascularity and higher positive skewness of texture analysis showed significant association with disease recurrence in every multivariable model regardless of tumor subtype and pathologic stage. Pathologic stage, especially if higher than stage II, showed significant association with disease recurrence and its highest hazard ratio was 3.45 [95% confidence interval (CI): 1.37-8.67, p = 0.008]. Of the multivariable models, the model including clinico-pathologic factors and both qualitative and quantitative imaging parameters showed good discrimination with a high C index value of 0.825 (95% CI: 0.755-0.896). In addition, recurrence associated factors were associated with short interval time to disease recurrence by Kaplan-Meier survival analysis. Therefore, comprehensive analysis using both clinico-pathologic factors and qualitative and quantitative imaging parameters is more effective in predicting breast cancer recurrence. Among those factors, higher pathologic stage, increased ipsilateral vascularity and higher positive skewness of texture analysis could be good predictors of breast cancer recurrence. Moreover, when these three factors are applied comprehensively, they may also be the predictors for poor survival.
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http://dx.doi.org/10.1038/s41598-020-64564-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7200757PMC
May 2020

Axillary lymph node dissection is not obligatory in breast cancer patients with biopsy-proven axillary lymph node metastasis.

Breast Cancer Res Treat 2020 Jun 23;181(2):403-409. Epub 2020 Apr 23.

Department of Surgery, Samsung Medical Center, Sungkyunkwan University, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.

Purpose: The ACOSOG Z0011 trial demonstrated that axillary lymph node dissection (ALND) is unnecessary in select patients with cT1-2N0 tumors undergoing breast-conserving therapy with 1-2 positive sentinel lymph nodes (SLNs). However, patients with preoperatively confirmed ALN metastasis were not included and may be subjected to unnecessary ALND. The aim of this study is to identify patients who can be considered for ALND omission when the preoperative ALN biopsy results are positive.

Methods: Breast cancer patients who underwent preoperative ALN biopsy and primary surgery were retrospectively reviewed. Among patients with positive ALN biopsy results, clinicopathological and imaging characteristics were compared according to LN disease burden (1-2 positive LNs vs. ≥ 3 positive LNs).

Results: A total of 542 patients were included in the analysis. Among them, 225 (41.5%) patients had a preoperative positive ALN biopsy. More than 40% of the patients (n = 99, 44.0%) with a positive biopsy had only 1-2 positive ALNs. The association between nodal burden and imaging factors was strongest when ≥ 2 suspicious LNs were identified on PET/CT images (HR 8.795, 95% CI 4.756 to 13.262). More than one imaging modality showing ≥ 2 suspicious LNs was also strongly correlated with ≥ 3 positive ALNs (HR 5.148, 95% CI 2.881 to 9.200).

Conclusions: Nearly half of patients with a preoperative biopsy-proven ALN metastasis had only 1-2 positive LNs on ALND. Patients meeting ACOSOG Z0011 criteria with only one suspicious LN on PET/CT or those presenting with few abnormal ALNs on only one imaging modality appear appropriate for SLNB and consideration of ALND omission.
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http://dx.doi.org/10.1007/s10549-020-05636-zDOI Listing
June 2020

Immediate effects of mandibular posterior displacement on the pharyngeal airway space: A preliminary study.

Korean J Orthod 2020 Mar 24;50(2):129-135. Epub 2020 Mar 24.

Department of Orthodontics, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Korea.

Objective: This study aimed to evaluate the immediate effects of mandibular posterior displacement on the pharyngeal airway space (PAS) by using cephalometric evaluations and to investigate how the surrounding structures are schematically involved.

Methods: In this retrospective study, 38 subjects with functional Class III malocclusion and two lateral cephalograms were selected. The first lateral cephalogram was taken with the mandible in the habitual occlusal position, and the second in anterior edge-to-edge bite. Paired -test was used to analyze changes in the PAS, hyoid bone, tongue, and soft palate, followed by mandibular posterior displacement. Pearson's correlation analysis was used to determine the relationship between the amount of mandibular posterior displacement and other variables.

Results: A statistically significant decrease was observed in the PAS following mandibular posterior displacement. Along with mandibular posterior displacement, the tongue decreased in length ( < 0.001) and increased in height ( < 0.05), while the soft palate increased in length, decreased in thickness, and was posteriorly displaced ( < 0.001). The hyoid bone was also posteriorly displaced ( < 0.05). There was no correlation between the amount of mandibular posterior displacement and the measured variables.

Conclusions: The PAS showed a statistically significant decrease following mandibular posterior displacement, which was a consequence of retraction of the surrounding structures. However, there were individual variances between the amount of mandibular posterior displacement and the measured variables.
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http://dx.doi.org/10.4041/kjod.2020.50.2.129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093667PMC
March 2020

Feasibility of abbreviated magnetic resonance imaging (AB-MRI) screening in women with a personal history (PH) of breast cancer.

PLoS One 2020 12;15(3):e0230347. Epub 2020 Mar 12.

Department of Surgery, The Catholic University of Korea, St. Vincent's Hospital, College of Medicine, Seoul, Korea.

Purpose: To investigate the feasibility of abbreviated magnetic resonance imaging (AB-MRI) in women with a personal history (PH) of breast cancer as a screening tool.

Materials And Methods: We retrospectively reviewed 1880 screening AB-MRIs in 763 women with a PH of breast cancer (median age, 55 years; range, 23-89 years) between October 2015 and October 2016. The total acquisition times of AB-MRI were 8.3 min and 2.8 min with and without T2-weighted imaging, respectively. The tissue diagnosis or one-year follow-up status was used as the reference standard. The characteristics of tumor recurrences detected on AB-MRI screenings were analyzed. The cancer detection rates (CDRs) and additional CDRs for the 1st round and overall rounds of AB-MRI screening were calculated. The recall rate, sensitivity, specificity, positive predictive values for recall (PPV1) and biopsy (PPV3) for the 1st round of AB-MRI screening were calculated. The diagnostic performance of the combination of mammography and ultrasonography was compared with that of AB-MRI by receiver operating characteristic (ROC) curve analysis.

Results: Fifteen of a total of 21 recurrences were detected on the 1st round of AB-MRI screening: 93.3% were node-negative T1 tumors (median tumor size, 1.02 cm; range, 0.1-2 cm) or Tis; 66.7% were high-grade tumors; 8 of these 15 were mammographically and ultrasonographically occult. The CDR and additional CDR for the 1st round of AB-MRI screening were 0.019 and 0.010 per woman, respectively. The sensitivity, specificity, recall rate, PPV1 and PPV3 for the 1st round of AB-MRI screening were 100%, 96.0%, 14.3%, 13.8% and 58.3%, respectively. For detecting secondary cancer, AB-MRI showed a higher sensitivity and PPV than the combination of mammography and ultrasonography (95.2%, 57.1% vs 47.6%, 38.5%). The area under the ROC curve was higher for AB-MRI (0.966; 95% CI: 0.951-0.978) than the combination of mammography and ultrasonography (0.727; 95% CI: 0.694-0.759) (P<0.0001).

Conclusion: AB-MRI improved cancer detection with a high specificity, sensitivity and PPV in women with a PH of breast cancer. AB-MRI could be a useful screening tool for detecting secondary cancer considering its high diagnostic performance and short examination time.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0230347PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7067463PMC
July 2020

Performance Enhancement of Channel-Engineered Al-Zn-Sn-O Thin-Film Transistors with Highly Conductive In-Ga-Zn-O Buried Layer via Vacuum Rapid Thermal Annealing.

J Nanosci Nanotechnol 2020 Aug;20(8):4671-4677

Department of Electronic Materials Engineering, Kwangwoon University, Seoul 139-701, Republic of Korea.

In this study, we propose, fabricate, and examine the electrical characteristics of high-performance channel-engineered amorphous aluminum-doped zinc tin oxide (-AZTO) thin-film transistors (TFTs). Amorphous indium gallium zinc oxide (-IGZO) film with improved conductivity (obtained via rapid thermal annealing in vacuum) is applied as the local conductive buried layer (LCBL) of the channel-engineered -AZTO TFTs. The optical transmittance of the -IGZO and -AZTO films in the visible region is >85%. The -IGZO LCBL reduces the resistance of the -AZTO channel, thereby resulting in increased drain current and improved device performance. We find that our fabricated channel-engineered -AZTO TFTs with LCBLs are superior to non-channel-engineered -AZTO TFTs without LCBLs in terms of electrical properties such as the threshold voltage, mobility, subthreshold swing, and on-off current ratios. In particular, as the -IGZO LCBL length at the bottom of the channel increases, the channel resistance gradually decreases, eventually resulting in a mobility of 22.8 cm²/V · s, subthreshold swing of 470 mV/dec, and on-off current ratio of 3.98×10. We also investigate the effect of the -IGZO LCBL on the operational reliability of -AZTO TFTs by measuring the variation in the threshold voltage for positive gate bias temperature stress (PBTS), negative gate bias temperature stress (NBTS), and negative gate bias temperature illumination stress (NBTIS). The results indicate that the TFT instability for temperature and light is not affected by the LCBL. Therefore, our proposed channel-engineered -AZTO TFT can form a promising high-performance high-reliability switching device for next-generation displays.
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http://dx.doi.org/10.1166/jnn.2020.17802DOI Listing
August 2020

Second-look breast ultrasonography after galactography in patients with nipple discharge.

Med Ultrason 2020 03;22(1):58-64

Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea.

Aim: The objective of this study was to evaluate the diagnostic performance of second-look breast ultrasound (US) immediately after galactography in patients with nipple discharge.

Materials And Methods: Between January 2010 and November 2018, 89 patients with nipple discharge were retrospectively analyzed. All patients were examined by galactography and US. US was performed twice, before and after galactography. Galactography, mammography and US findings were categorized according to the Breast Imaging Reporting and Data System (BI-RADS). The final diagnosis was established by histopathological examination.

Results: Out of 89 patients, 25 (28.1%) patients had positive findings as evident by US before galactography. Forty-eight (53.9%) patients had positive findings as demonstrated by galactography. Fifty-nine (66.3%) patients had positive findings as evident by second-look US after galactography (13 patients with benign, 37 with borderline and 9 with malignant lesions). Second-look US after galactography showed the highest diagnostic accuracy (83.2%), sensitivity (95.8%) and negative predictive value (93.3%) for borderline and malignant lesions. For the detection of malignant lesions, secondlook US after galactography showed the highest sensitivity (90%) and negative predictive value (96.7%). Agreement between imaging and histological result using Bland-Altman analysis exhibited no significant difference between the size establishedby ultrasound and galactography.

Conclusion: The second-look US after galactography is a powerful diagnostic tool for the detection of lesions in patients with nipple discharge and demonstrates high diagnostic accuracy, sensitivity and negative predictive value.
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http://dx.doi.org/10.11152/mu-2141DOI Listing
March 2020

Colour stability and surface properties of high-translucency restorative materials for digital dentistry after simulated oral rinsing.

Eur J Oral Sci 2020 04 7;128(2):170-180. Epub 2020 Feb 7.

Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.

High-translucency restorative materials are commonly used in the restoration of anterior teeth where aesthetics is a critical factor. In this in vitro study, the impact of mouthwash on the colour stability and surface characteristics of high-translucency computer-aided design and computer-aided manufacturing (CAD-CAM) dental restorative materials was evaluated. Two-hundred specimens were fabricated from five high-translucency CAD-CAM materials: a resin nano ceramic; a polymer-infiltrated ceramic network; a feldspathic ceramic; a lithium disilicate glass ceramic; and high-translucency zirconia. Each group of ceramic specimens was then divided into four subgroups: conventional mouthwash (LISTERINE); whitening mouthwash (LISTERINE Healthy White); chlorhexidine gluconate; and distilled water. Oral rinsing was simulated at 100 rpm for 180 h, representing 15 yr of clinical simulation. The specimens were then evaluated for colour, translucency, gloss, roughness, and surface morphology. Two-way ANOVA and linear mixed models were used for intergroup comparisons (α = 0.05). The polymer-infiltrated ceramic network and feldspathic ceramic became brighter, more opaque, less glossy, and rougher after rinsing with the whitening mouthwash. The long-term use of specific mouthwashes can cause deterioration of the optical and surface properties of high-translucency CAD-CAM dental restorations.
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http://dx.doi.org/10.1111/eos.12676DOI Listing
April 2020

Changes in High-Density Lipoprotein Cholesterol and Risks of Cardiovascular Events: A Post Hoc Analysis from the PICASSO Trial.

J Stroke 2020 Jan 31;22(1):108-118. Epub 2020 Jan 31.

Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background And Purpose: Whether pharmacologically altered high-density lipoprotein cholesterol (HDL-C) affects the risk of cardiovascular events is unknown. Recently, we have reported the Prevention of Cardiovascular Events in Asian Patients with Ischaemic Stroke at High Risk of Cerebral Haemorrhage (PICASSO) trial that demonstrated the non-inferiority of cilostazol to aspirin and superiority of probucol to non-probucol for cardiovascular prevention in ischemic stroke patients (clinicaltrials.gov: NCT01013532). We aimed to determine whether on-treatment HDL-C changes by cilostazol and probucol influence the treatment effect of each study medication during the PICASSO study.

Methods: Of the 1,534 randomized patients, 1,373 (89.5%) with baseline cholesterol parameters were analyzed. Efficacy endpoint was the composite of stroke, myocardial infarction, and cardiovascular death. Cox proportional hazards regression analysis examined an interaction between the treatment effect and changes in HDL-C levels from randomization to 1 month for each study arm.

Results: One-month post-randomization mean HDL-C level was significantly higher in the cilostazol group than in the aspirin group (1.08 mmol/L vs. 1.00 mmol/L, P<0.001). The mean HDL-C level was significantly lower in the probucol group than in the non-probucol group (0.86 mmol/L vs. 1.22 mmol/L, P<0.001). These trends persisted throughout the study. In both study arms, no significant interaction was observed between HDL-C changes and the assigned treatment regarding the risk of the efficacy endpoint.

Conclusions: Despite significant HDL-C changes, the effects of cilostazol and probucol treatment on the risk of cardiovascular events were insignificant. Pharmacologically altered HDL-C levels may not be reliable prognostic markers for cardiovascular risk.
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http://dx.doi.org/10.5853/jos.2019.02551DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7005357PMC
January 2020

Primary angiosarcoma of the breast: a case report.

Int J Clin Exp Pathol 2019 1;12(2):664-668. Epub 2019 Feb 1.

Department of Hospital Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine Seoul, Republic of Korea.

Background: Primary angiosarcoma of the breast is extremely rare, accounting for less than 0.05% of all primary malignancies of the breast. Here, we report here a case of primary angiosarcoma with full description of radiology and histology, including electron microscopic findings.

Case Presentation: A 39-year-old woman complained of a diffuse hard mass in her right breast. She did not have any history of radiation exposure. Ultrasonography revealed a 7 cm sized mass with an irregular anechoic cystic portion replacing the entire right breast. Modified radical mastectomy was performed. The diagnosis of intermediate grade angiosarcoma was made by microscopic examination, immunohistochemical staining, and electron microscopic examination. The patient underwent four cycles of adriamycin-ifosfamide chemotherapy and received radiation therapy. Multiple bone metastases occurred 9 months after surgery and palliative treatment was given. Follow up was lost at post-operative 22 months.

Conclusions: We report a rare case of intermediate grade primary angiosarcoma with detailed radiological and histological findings. Despite postoperative chemoradiation therapy, multiple metastases suggest that intermediate grade may have a more aggressive behavior.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6945096PMC
February 2019

Automated Breast Ultrasound Screening for Dense Breasts.

Korean J Radiol 2020 01;21(1):15-24

Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Mammography is the primary screening method for breast cancers. However, the sensitivity of mammographic screening is lower for dense breasts, which are an independent risk factor for breast cancers. Automated breast ultrasound (ABUS) is used as an adjunct to mammography for screening breast cancers in asymptomatic women with dense breasts. It is an effective screening modality with diagnostic accuracy comparable to that of handheld ultrasound (HHUS). Radiologists should be familiar with the unique display mode, imaging features, and artifacts in ABUS, which differ from those in HHUS. The purpose of this study was to provide a comprehensive review of the clinical significance of dense breasts and ABUS screening, describe the unique features of ABUS, and introduce the method of use and interpretation of ABUS.
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http://dx.doi.org/10.3348/kjr.2019.0176DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6960307PMC
January 2020

Notch1 in Tumor Microvascular Endothelial Cells and Tumoral miR-34a as Prognostic Markers in Locally Advanced Triple-Negative Breast Cancer.

J Breast Cancer 2019 Dec 12;22(4):562-578. Epub 2019 Dec 12.

Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Purpose: Triple-negative breast cancer (TNBC) is associated with poor prognosis with limited treatment options. Angiogenesis is known to be involved in the progression of TNBC, and targeting this pathway results in modest clinical benefits. In this study, we analyzed the role of tumor microvascular endothelial Notch1 (EC Notch1) and tumoral miR-34a as prognostic markers in patients with TNBC.

Methods: The expression of miR-34a was analyzed using archival tumor tissues from 114 patients with TNBC. Simultaneously, archival tumor tissues were also checked for the expression of CD34 and Notch1 by immunostaining. The ratio of Notch1-microvascular density (MVD) to CD34-MVD was defined as EC Notch1. The association between the expression of miR-34a or EC Notch1 and clinicopathological characteristics was analyzed.

Results: In the overall patient population, patients with low expression of EC Notch1 was associated with better overall survival (OS, = 0.041) than those with high expression of EC Notch1. In lymph node-positive TNBC patients, high levels of miR-34a and low levels of EC Notch1 correlated significantly with higher survival benefits in terms of OS ( = 0.026), disease-free survival ( = 0.009), and metastasis-free survival ( = 0.038) relative to that in other patients. Decreased expression of EC Notch1 and increased expression of miR-34a also showed a survival benefit in locally advanced TNBC.

Conclusion: The fact that miR-34a and EC Notch1 are associated with the angiogenesis suggests that angiogenesis may play a role in the development and progression of TNBC.
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http://dx.doi.org/10.4048/jbc.2019.22.e56DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6933032PMC
December 2019

Implant-assisted removable prosthetic rehabilitation after distraction osteogenesis in a patient with ameloblastoma recurrence: A case report.

Medicine (Baltimore) 2019 Dec;98(49):e18290

Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.

Introduction: A resected mandibular edentulous ridge resulting from an ameloblastoma and marginal mandibulectomy is a restorative challenge. To maintain oral hygiene, recurrent examinations, and for long-term maintenance, a removable dental prosthesis is preferred to an implant-supported fixed dental prosthesis.

Patient Concerns: A 28-year-old Asian man was referred for evaluation of a radiolucent area on the right side of the mandible. The right mandibular area had increasingly enlarged over a period of ≥5 months. Marginal resection and inferior alveolar nerve repositioning of the mandible were performed by oral surgeons, followed by reconstruction of the resected mandible with distraction osteogenesis. After 6 years, the patient presented with swelling of the same area.

Diagnosis: Histopathological examination revealed recurrence of benign ameloblastoma in the mandible. After mass excision of the recurrent benign tumor, dental implants were installed. To aid with recurrent examinations and oral hygiene maintenance, a treatment plan using implant-assisted removable dental prosthesis, instead of a fixed prosthesis, was formulated.

Interventions: The edentulous area was rehabilitated with a tooth- and implant-assisted removable partial denture. Due to the insufficient intermaxillary clearance, the removable prosthesis was designed in such a manner that retention, support, and stability could be ensured by separate components.

Outcomes: The tooth- and implant-assisted removable partial denture showed satisfactory function and esthetics. No complications were observed in the dental prosthesis and supporting tissues during the 3-year follow-up period.

Conclusion: In recurrent ameloblastoma cases, a removable dental prosthesis may be an effective treatment option for oral rehabilitation. The type of denture design used in this study is novel for implant-assisted removable partial denture rehabilitation.
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http://dx.doi.org/10.1097/MD.0000000000018290DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6919522PMC
December 2019

Triple-negative breast cancer: Pretreatment magnetic resonance imaging features and clinicopathological factors associated with recurrence.

Magn Reson Imaging 2020 02 28;66:36-41. Epub 2019 Nov 28.

Department of Hospital Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, Republic of Korea.

Purpose: We aimed to investigate the magnetic resonance imaging (MRI) features and clinicopathologic factors with recurrence of triple-negative breast cancer (TNBC).

Patients And Methods: We identified 281 patients with 288 surgically confirmed TNBC lesions who underwent pretreatment MRI between 2009 and 2015. The presence of intratumoral high signal on T2-weighted images, high-signal rim on diffusion-weighted images (DWI), and rim enhancement on the dynamic contrast-enhanced MRI and clinicopathological data were collected. Cox proportional analysis was performed.

Results: Of the 288 lesions, 36 (12.5%) recurred after a median follow-up of 18 months (range, 3.6-68.3 months). Rim enhancement (hazard ratio [HR] = 3.15; 95% confidence interval [CI] = 1.01, 9.88; p = .048), and lymphovascular invasion (HR = 2.73, 95% CI = 1.20, 6.23; p = .016) were independently associated with disease recurrence. While fibroglandular volume, background parenchymal enhancement, intratumoral T2 high signal, and high-signal rim on DWI, were not found to be risk factors for recurrence.

Conclusion: Pretreatment MRI features may help predict a high risk of recurrence in patients with TNBC.
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http://dx.doi.org/10.1016/j.mri.2019.10.001DOI Listing
February 2020

Contemporary full-mouth rehabilitation using a digital smile design in combination with conventional and computer-aided design/manufacturing restorative materials in a patient with bruxism: A case report.

Medicine (Baltimore) 2019 Nov;98(48):e18164

Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.

Rationale: Full-mouth rehabilitation of patients with bruxism and severely worn dentition poses a great challenge to clinicians. Several treatment planning methods and restorative materials are used to treat tooth wear in modern dentistry. Clinicians should be able to select the most suitable treatment planning methods and materials for individual patients depending on their specific situation.

Patient Concerns: A 47-year-old male was referred for evaluation of a severely worn dentition.

Diagnoses: Clinical and radiographic evaluation revealed tooth wear in the entire dentition. The interocclusal distance at rest was 4 mm, and the patient had a parafunctional habit of bruxism.

Interventions: A digital smile design was used to formulate a treatment plan. Full-mouth rehabilitation was performed using a combination of conventional and digital materials and methods.

Outcomes: The full-mouth restoration showed satisfactory functions and esthetics. No complications were observed in the restorations, supporting tissues, and temporomandibular joints during 2-year follow-up.

Lessons: In clinical practice, it is important to determine the optimal combination of the available methods for treatment planning. This case report details the formulation of a unique treatment plan for the dental rehabilitation of a severely worn out dentition, which is considered challenging due to the limitations imposed by biological tissues and restorative materials. The use of conventional and digital tools for treatment planning, patient education, and treatment execution was demonstrated.
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http://dx.doi.org/10.1097/MD.0000000000018164DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6890298PMC
November 2019

Analysis of the molecular subtypes of preoperative core needle biopsy and surgical specimens in invasive breast cancer.

J Pathol Transl Med 2020 Jan 13;54(1):87-94. Epub 2019 Nov 13.

Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Background: Accurate molecular classification of breast core needle biopsy (CNB) tissue is important for determining neoadjuvant systemic therapies for invasive breast cancer. The researchers aimed to evaluate the concordance rate (CR) of molecular subtypes between CNBs and surgical specimens.

Methods: This study was conducted with invasive breast cancer patients who underwent surgery after CNB at Seoul St. Mary's Hospital between December 2014 and December 2017. Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki67 were analyzed using immunohistochemistry. ER and PR were evaluated by Allred score (0-8). HER2 was graded from 0 to +3, and all 2+ cases were reflex tested with silver in situ hybridization. The labeling index of Ki67 was counted by either manual scoring or digital image analysis. Molecular subtypes were classified using the above surrogate markers.

Results: In total, 629 patients were evaluated. The CRs of ER, PR, HER2, and Ki67 were 96.5% (kappa, 0.883; p<.001), 93.0% (kappa, 0.824; p<.001), 99.7% (kappa, 0.988; p<.001), and 78.7% (kappa, 0.577; p<.001), respectively. Digital image analysis of Ki67 in CNB showed better concordance with Ki67 in surgical specimens (CR, 82.3%; kappa, 0.639 for digital image analysis vs. CR, 76.2%; kappa, 0.534 for manual counting). The CRs of luminal A, luminal B, HER2, and triple negative types were 89.0%, 70.0%, 82.9%, and 77.2%, respectively.

Conclusions: CNB was reasonably accurate for determining ER, PR, HER2, Ki67, and molecular subtypes. Using digital image analysis for Ki67 in CNB produced more accurate molecular classifications.
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http://dx.doi.org/10.4132/jptm.2019.10.14DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6986971PMC
January 2020

Anatomical relationship between the maxillary posterior teeth and the sinus floor according to an anterior overbite.

Orthod Craniofac Res 2020 May 11;23(2):160-165. Epub 2019 Nov 11.

Department of Orthodontics, Pusan National University Dental Hospital, Yangsan, South Korea.

Objective: To evaluate the vertical relationship between the maxillary sinus floor (MSF) and the maxillary posterior teeth (MPT) according to an anterior overbite.

Settings And Sample Population: The patients were divided into three groups according to an anterior overbite. The open bite group (OBG) included patients with an anterior overbite of ≤0 mm, the normal overbite group (NBG) included patients with an overbite of 0-3 mm, and the deep bite group (DBG) included patients with an overbite ≥3 mm. Thirty patients were randomly matched into each group based on age and sex.

Materials And Methods: The distances and vertical relationship between the MSF and the MPT was analysed using cone-beam computer tomography. The vertical relationship between the two was classified as either favourable or unfavourable for the intrusion of the posterior teeth.

Results: A higher ratio of patients in the OBG had MPT positioned close to the MSF than the DBG. Intrusion of the posterior teeth was unfavourable for an average of 87.2%, 77.2% and 70.2% molars in the OBG, NBG and DBG, respectively.

Conclusions: The vertical distance between the MSF and the MPT is associated with an anterior overbite. The posterior teeth were in an unfavourable position for the orthodontic intrusion in the OBG as compared to the other groups. Additional caution is needed when planning orthodontic intrusion treatment for patients with an anterior open bite. But, there were some individual variations within each group.
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http://dx.doi.org/10.1111/ocr.12354DOI Listing
May 2020

Evaluation of the effect of computer aided diagnosis system on breast ultrasound for inexperienced radiologists in describing and determining breast lesions.

Med Ultrason 2019 Aug;21(3):239-245

Department of Radiology Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea.

Aim: To investigate the effect of a computer-aided diagnosis (CAD) system on breast ultrasound (US) for inexperienced radiologists in describing and determining breast lesions.

Materials And Methods: Between October 2015 to January 2017, 500 suspicious or probable benign lesions in 413 patients were reviewed. Five experienced readers retrospectively reviewed for each of 100 lesions according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon and category, with CAD system (S-detectTM). The readers then made final decisions by combining CAD results to their US results. Using the nested experiment design, five inexperienced readers were asked to select the appropriate BI-RADS lexicons, categories, CAD results, and combination results for each of the 100 lesions, retrospectively. Diagnostic performance of experienced and inexperienced radiologists and CAD were assessed. For each case, agreements in the lexicons and categories were analyzed among the experienced reader, inexperienced reader and CAD.

Results: Indicators of the diagnostic performance for breast malignancy of the experienced group (AUC=0.83, 95%CI [0.80, 0.86]) were similar or higher than those of CAD (AUC = 0.79, 95%CI[0.74, 0.83], p=0.101), except for specificity. Conversely, indicators of diagnostic performance of inexperienced group (AUC=0.65, 95%CI[0.58, 0.71]) did not differ from or were lower than those of CAD(AUC=0.73, 95%CI[0.67, 0.78], p=0.013). Also, the diagnostic performance of the inexperienced group after combination with the CAD result was significantly improved (0.71, 95% CI [0.65, 0.77], p=0.001), whereas that of the experienced group did not change after combination with the CAD result, except for specificity and positive predictive value (PPV). Kappa values for the agreement of the categorization between CAD and each radiologist group were increased after applying the CAD result to their result of general US. Especially, the increase of the Kappa value was higher in the inexperienced group than in the experienced group. Also, for all the lexicons, the Kappa values between the experienced group and CAD were higher than those between the inexperienced group and CAD.

Conclusion: By using the CAD system for classification of breast lesions, diagnostic performance of the inexperienced radiologists for malignancy was significantly improved, and better agreement was observed in lexicons between the experienced group and CAD than between the inexperienced group and CAD. CAD may be beneficial and educational for the inexperienced group.
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http://dx.doi.org/10.11152/mu-1889DOI Listing
August 2019

The effect of build angle on the tissue surface adaptation of maxillary and mandibular complete denture bases manufactured by digital light processing.

J Prosthet Dent 2020 Mar 18;123(3):473-482. Epub 2019 Jun 18.

Professor and Dean, Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.

Statement Of Problem: The effect of different build angles on the tissue surface adaptation of complete denture bases manufactured by digital light processing (DLP) is unclear.

Purpose: The purpose of this in vitro study was to evaluate the effect of build angle on the tissue surface adaptation of DLP-printed complete denture bases.

Material And Methods: Both maxillary and mandibular denture bases were virtually designed based on reference casts and fabricated by the DLP technique. For each arch, a total of 40 denture bases were fabricated with 4 different build angle conditions (90, 100, 135, and 150 degrees) and divided into 4 groups (90D, 100D, 135D, and 150D; 10 denture bases per group). The scanned intaglio surface of each DLP denture base was superimposed on the scanned edentulous area of the reference cast to compare the degree of tissue surface adaptation. Root-mean-square estimate, positive average deviation, and negative average deviation values were measured and displayed with a color deviation map. The Mann-Whitney test and Kruskal-Wallis analysis of variance were used for statistical analyses (α=.05).

Results: No statistically significant differences were found for root-mean-square estimate values among any build angle groups in either the maxillary or mandibular arch. With the increase of build angles, the area of positive deviation in the maxillary arch moved from the palatal region to the posterior palatal seal area, and negative deviation became pronounced at the posterior tuberosity. In the maxillary arch, the 135D group showed favorable color distribution of surface deviation. In the mandibular arch, a positive deviation was detected at the labial slope to the crest of the ridge, whereas a negative deviation was observed at the buccal shelf and the retromolar pad. The 100D group showed favorable distribution of surface deviation in the mandible.

Conclusions: In both arches, the difference of overall tissue surface adaptation was not statistically significant in the 4 different build angles. However, the color deviation map revealed that the 135-degree build angle may be appropriate in the maxillary DLP-printed denture base and the 100-degree angle, in the mandibular denture base.
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http://dx.doi.org/10.1016/j.prosdent.2018.12.014DOI Listing
March 2020

Climate change and tropical cyclone trend.

Nature 2019 06 5;570(7759):E3-E5. Epub 2019 Jun 5.

Guy Carpenter Asia-Pacific Climate Impact Centre, School of Energy and Environment, City University of Hong Kong, Kowloon Tong, Hong Kong, China.

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http://dx.doi.org/10.1038/s41586-019-1222-3DOI Listing
June 2019