Earticle

Purpose: In this study, we performed motion morphological analysis during rising from the supine to the erect position in patients with stroke. Methods: This study included 75 patients with stroke in whom we used the Van Sant’s classification to analyze patient behavior in a standing position. We performed morphological classification using six patterns in the upper extremities, four patterns in the head and trunk region, and four patterns in the lower extremities and used multiple response frequency analysis. Results: Multiple response frequency analysis showed that push and reach was the most common (69.33%) and symmetrical reach was the least common (2.67%) pattern in the upper extremities. With regard to head-body patterns, rotation-induced symmetrical interruption was the most common (65.33%) and symmetrical (8.00%) was the least common pattern. With regard to lower extremity patterns, asymmetrical squats were the most common (64.00%), followed by symmetrical squats (25.33%). Conclusion: In this study, we developed an effective exercise program and posture training method to cope with falls based on the general appearance of a patient who rises from the supine to the erect position.

This study starts in propositions that pedagogical grammar has to exist for easiness of studying. Currently, various particles and combinational forms of ending are drilled commonly at Korean language educational field. However, the examination that presentation of a united form is how effective is rarely performed. Therefore, this study executed simple experiment in order to investigate the effect of it. The experiment was performed to lead the advanced Korean learners to use united form endings which are already learned. In consequence, the way that presenting a great number of united form endings and memorizing that was ineffective. A lot of grammar items rather gave a bad influence to studying. Thus, this study proposed a teaching method used morphologic analysis and united form endings together. This method can bind a lot of grammar items in one category of a high rank. This reduces a number of grammar expressions so lessens a burden of grammar study for learners also. And this can explain regarding a grammar expression by the roots and will help learners to understand it easily. However, the suggestion can expect the effect of study when the follow three presuppositions precede others. First, this method must be presented at levels higher than an intermediate grade. Second, this method must apply to a grammar item which is able to bind a high rank category only, not the all kinds of grammar items. Third, instead of reducing a number of grammar items, examples which include various usages shall be presented more.

Background: The aim of this study was to document the optimal spacing of two cannulae to form continuous strip lesions and maximal surface area by using water-cooled bipolar radiofrequency technology. Methods: Two water-cooled needle probes (15 cm length, 18-gauge probe with 6 mm electrode tip) were placed in a parallel position 10, 20, 24, 26, and 28 mm apart and submerged in egg white. Temperatures of the probes were raised from $35^{\circ}C$ to $90^{\circ}C$ and the progress of lesion formation was photographed every 1 minute with the increase of the tip temperature. Approximately 30 photographs were taken. The resultant surface areas of the lesions were measured with the digital image program. Results: Continuous strip lesions were formed when the cannulae were spaced 24 mm or less apart; monopolar lesions around each cannula resulted if they were spaced more than 26 mm apart. Maximal surface areas through the formation of continuous strip lesion were 221 $mm^2$, 375 $mm^2$, and 476 $mm^2$ in 10, 20, and 24 mm, respectively. Summations of maximal surface area of each monopolar lesions were 394 $mm^2$ and 103 $mm^2$ in 26 and 28 mm, respectively. Conclusions: Water-cooled bipolar Radiofrequency technology creates continuous "strip" lesions proportional in size to the distance between the probes till the distance between cannulae is 24 mm or less. Spacing the cannulae 24 mm apart and treating about $80^{\circ}C$ for 24 minutes maximizes the surface area of the lesion.

C-shaped canal configuration is very difficult to treat because that clues about preoperative canal anatomy cannot be ascertained from clinical crown morphology and limited information can be derived from the radiographic examination. This study was done to get more informations about the root and canal configuration of C-shaped root by 3-dimentionally reconstructing for the purpose of enhancing success rate of endodontic treatment. 30 mandibular molars with C-shaped root were selected. Teeth had been extracted from periodontal problems with sound crown and root portion, including teeth with caries lesion limited crown portion only.(omitted)

C-shaped canal configuration is very difficult to treat because that clues about preoperative canal anatomy cannot be ascertained from clinical crown morphology and limited information can be derived from the radiographic examination. This study was done to get more informations about the root and canal configuration of C-shaped root by 3-dimentionally reconstructing for the purpose of enhancing success rate of endodontic treatment. 30 mandibular molars with C-shaped root were selected. Teeth had been extracted from periodontal problems with sound crown and root portion, including teeth with caries lesion limited crown portion only.(omitted)

Background: The cytopathic effects of cytomegalovirus (CMV) infection have been well described since the virus was first reported; however, the morphology of CMV infection has not been clearly studied. We examined the difference in detailed cytologic findings in bronchial washing cytology between liquid-based and conventionally prepared smears. Methods: Bronchial washing cytology was processed using either the conventional preparation (CP) or liquid-based preparation (LBP). Sixty-nine cells with typical cytopathic effects of CMV infection were detected on CP slides and 18 cells on LBP slides. Using the image analyzer, area, circumference, major axis, and minor axis of the cytoplasm, nucleus, and intranuclear inclusion were measured in singly scattered CMV-infected cells, and histiocytes were used as a control. Results: The mean cytoplasmic area of CMVinfected cells was 1.47 times larger than that of histiocytes in CP and 2.92 times larger in LBP (p < .05). The mean nuclear area of CMV-infected cells was 2.61 times larger than that of histiocytes in CP and 4.25 times larger in LBP (p < .05). The nucleus to cytoplasm ratio and intranuclear inclusion to cytoplasm ratio of the mean area, circumference, major axis, and minor axis in CP were larger than those in LBP (p < .05). Conclusions: The sizes of cytoplasm, nucleus, and intranuclear inclusion were larger in LBP than in CP, indicating that CMV-infected cells are easily detectable in LBP. However, the nucleus-to-cytoplasm ratio was larger in CP, suggesting that differentiation from malignancy or regenerative atypia requires caution in CP.

Background: Few studies on how to diagnose pulmonary neuroendocrine tumors through morphometric analysis have been reported. In this study, we measured and analyzed the characteristic parameters of pulmonary neuroendocrine tumors using an image analyzer to aid in diagnosis. Methods: Sixteen cases of typical carcinoid tumor, 5 cases of atypical carcinoid tumor, 15 cases of small cell carcinoma, and 51 cases of large cell neuroendocrine carcinoma were analyzed. Using an image analyzer, we measured the nuclear area, perimeter, and the major and minor axes. Results: The mean nuclear area was 0.318±0.101 μm2 in typical carcinoid tumors, 0.326±0.119 μm2 in atypical carcinoid tumors, 0.314±0.107 μm2 in small cell carcinomas, and 0.446±0.145 μm2 in large cell neuroendocrine carcinomas. The mean nuclear circumference was 2.268±0.600 μm in typical carcinoid tumors, 2.408±0.680 μm in atypical carcinoid tumors, 2.158±0.438 μm in small cell carcinomas, and 3.247±1.276 μm in large cell neuroendocrine carcinomas. All parameters were useful in distinguishing large cell neuroendocrine carcinoma from other tumors (p=0.001) and in particular, nuclear circumference was the most effective (p=0.001). Conclusions: Pulmonary neuroendocrine tumors showed nuclear morphology differences by subtype. Therefore, evaluation of quantitative nuclear parameters improves the accuracy and reliability of diagnosis.

Purpose: The aim of the study was to investigate and analyze bilateral incidence and morphology of complete discoid lateral meniscus (DLM) with possible relation to tears and symptoms in knee joints. Materials and Methods: Thirty-eight consecutivepatients with symptomatic or already-torn complete DLM on magnetic resonance imaging in a unilateral knee underwent diagnostic arthroscopy on both knee joints upon agreement. The presence and shape of complete DLM as well as presence and pattern of tear were recorded accordingly. Results: In total, 89.5% (34 of 38 patients) showed bilateral complete DLM, and 84.2% yielded bilateralism with identical shape. Cape-slab was the most frequent shape, comprising 68.8% of patients with identically-shaped bilateral DLM overall. Tear patterns were more frequent,in the order of longitudinal, simple horizontal, radial, and degenerative; however,the morphological shape of complete DLM was not significantly related to tear incidence or pattern. Meniscus tears and knee symptoms occurred in the contralateralknee with incidences of 32.4% and 26.5% in patients with bilateral completeDLM, respectively. Conclusion: Based on these findings, more aggressive warning on the presence of discoid pathology and the need for evaluation on the contralateral knee should be considered during consultation with patients with symptomatic complete DLM in a unilateral knee in the outpatient clinic.

Background: We reviewed a series of 188 resected pulmonary mucinous adenocarcinomas (MAs) to clarify the prognostic significance of lepidic and non-lepidic patterns. Methods: Non-lepidic patterns were divided into bland, non-distorted acini with uncertain invasiveness (pattern 1), unequivocal invasion into stroma (pattern 2), or invasion into alveolar spaces (pattern 3). Results: The mean proportion of invasive patterns (patterns 2 and 3) was lowest in small (≤ 3 cm) tumors, and gradually increased in intermediate (> 3 cm and ≤ 7 cm) and large (> 7 cm) tumors (8.4%, 34.3%, and 50.1%, respectively). Adjusted T (aT) stage, as determined by the size of invasive patterns, was positively correlated with adverse histologic and clinical features including older age, male sex, and ever smokers. aTis tumors, which were exclusively composed of lepidic pattern (n = 9), or a mixture of lepidic and pattern 1 (n = 40) without any invasive patterns, showed 100% disease-free survival (DFS). The aT1mi tumors, with minimal (≤ 5 mm) invasive patterns (n = 63), showeda 95.2% 5-year DFS, with recurrences (n = 2) limited to tumors greater than 3 cm in total size (n = 23). Both T and aT stage were significantly associated with DFS; however, survival within the separate T-stage subgroups was stratified according to the aT stage, most notably in the intermediatestage subgroups. In multivariate analysis, the size of invasive patterns (p = .020), pleural invasion (p < .001), and vascular invasion (p = .048) were independent predictors of recurrence, whereas total size failed to achieve statistical significance (p = .121). Conclusions: This study provides a rationale for histologic risk stratification in pulmonary MA based on the extent of invasive growth patterns with refined criteria for invasion.

Background/Aims: The Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST) or European Organization for Research and Treatment of Cancer (EORTC) criteria are used to assess metabolic tumor responses. However, tumor responses have shown considerable discrepancies between the morphologic criteria (Response Evaluation Criteria in Solid Tumors [RECIST]) and metabolic criteria. We performed this pooled study to compare the RECIST and metabolic criteria in the assessment of tumor responses. Methods: Electronic databases were searched for eligible articles with the terms “RECIST,” “PERCIST,” or “EORTC criteria.” The level of concordance in the tumor responses between the two criteria was estimated using κ statistics. Results: A total of 216 patients were collected from eight studies comparing the RECIST and EORTC criteria. The agreement of tumor responses between the two criteria was moderate (κ = 0.447). Eighty-six patients (39.8%) showed disagreement: tumor response was upgraded in 70 patients and downgraded in 16 when adopting the EORTC criteria. The EORTC criteria significantly increased the overall response rate (53% vs. 28%, p < 0.0001). The agreement of tumor responses between the RECIST and PERCIST was deemed fair (κ = 0.389). Of 407 patients from nine studies, 181 (44.5%) showed a discrepancy: using the PERCIST, tumor response were upgraded in 151 patients and downgraded in 30. When adopting the PERCIST, the overall response rate was also significantly increased from 30% to 55% (p < 0.0001). Conclusions: This pooled analysis demonstrates that the concordance of tumor responses between the morphologic criteria and metabolic criteria is not excellent. When adopting the metabolic criteria instead of the RECIST, overall response rates were significantly increased.

셋째종아리근은 종아리뼈의 안쪽면에서 시작하여 다섯째발허리뼈의 몸쪽부분에 부착하는 근육이다. 본 연구의 목적은 한국인 시신을 대상으로 셋째종아리근의 닿는곳의 형태를 분류하고 위치를 계측하여 다섯째발허리뼈의 찢김골절의 발생 기전에 작용하는 셋째종아리근힘줄의 역할에 대한 해부학적 근거를 마련하고자 함이었다. 이를 위하여 포르말린으로 고정된 한국인 시신의 발 89쪽 (남자 61쪽, 여자 28쪽)의 발을 해부하였다. 셋째종아리근힘줄에서 닿는곳의 형태학적 분류는 Ercikti 등의 분류법을 사용하였고, 다섯째발허리뼈에 닿는 셋째종아리근의 너비를 측정하여 유형별로 분석하였다. 연구 결과, 셋째종아리근힘줄은 없는 경우를 제외하고 1유형 (한갈래) 56%, 2유형 (두갈래) 44%였다. 힘줄이 없는 경우가 7쪽이었으며 (7.9%), 1a유형은 2쪽 (2.2%), 1b유형은 26쪽 (29.2%), 1c유형은 16쪽(18.0%), 1d유형은 2쪽 (2.2%)이었으며, 2a유형은 35쪽 (39.3%), 2b유형은 1쪽 (1.1%)이었다. 다섯째발허리뼈에 닿는 셋째종아리근힘줄의 너비는 1a유형이 15.50±2.12 mm, 1b유형이 19.23±3.91 mm, 1c유형이 17.43±3.91 mm, 1d유형이 12.22±7.07 mm였고, 2a유형이 20.42±5.12 mm, 2b유형이 20.00 mm였다. 각 유형별로 통계적으로 유의한 차이는 없었다. 셋째종아리근힘줄의 너비는 성별과 좌우에 따른 차이가 없었다. 본 연구를 통해 셋째종아리근힘줄 닿는곳이 넓은 형태 (1b유형, 1c유형, 2a유형)가 총 86.5%가 되는 것을 확인할 수 있었다. 결론적으로, 셋째종아리근힘줄의 닿는곳 형태는 다섯째발허리뼈의 몸쪽부착부위에 부하가 가능할 것으로 예측되었으며, 이를 근거로 다섯째발허리뼈찢김골절과 관련하여 셋째종아리근힘줄의 닿는곳의 도식화 연구나 생체역학연구의 필요성을 제시하는 바이다.

The fibularis tertius muscle originates on the medial surface of the fibula and attaches to the proximal portion of the fifth metatarsal bone. The aim of this study is to provide an anatomical basis for the role of the fibularis tertius tendon in the mechanism of fifth metatarsal avulsion fracture by classifying the shape and location of the fibularis tertius tendon in Korean cadavers. For this study, 89 feet were dissected using formalin-fixed Korean cadavers. There were 61 male and 28 female, and the average at death age was 78.79±11.00 years. Ercikti’s method was applied for classification according to the shape of the insertion in the fibularis tertius tendon, and the width of the footprint of insertion was measured additionally. As a result, the fibularis tertius tendon was type 1 (one-branch) in 56% and type 2 (two-branch) in 44%. Tendons were absent in 7 feet (7.9%), type 1a in 2 feet (2.2%), type 1b in 26 feet (29.2%), type 1c had 16 feet (18.0%), type 1d had 2 feet (2.2%), type 2a had 35 feet (39.3%), and type 2b) was 1 feet (1.1%). The width of the fibularis tertius tendon attachment site was 15.50±2.12 mm in types 1a, 19.23±3.91 mm in types 1b, 17.43±3.91 mm in types 1c, 12.22±7.07 mm in types 1d, 20.42±5.12 mm in type 2a, 20.00 mm in type 2b. There was no difference in the width of the fibularis tertius tendon according to gender and side. In conclusion, the shape of the fibularis tertius tendon contact point would be able to load the proximal attachment part of the fifth metatarsal bone. Based on this, we suggest the need for a schematic study or biomechanical study of the fibularis tertius tendon in relation to the fifth metatarsal avulsion fracture.

dynamic relations with other craniofacial structures and is also influenced by them during development. Moreover, the mosaic structure of the septum is constituted through ossification. The purpose of this study was to evaluate the anatomical characteristics of the deviated nasal septum with preoperative computed tomography (CT) and calculations during surgery. Subjects and MethodZZWe studied 62 patients with nasal septal deviation on one side, who underwent septoplasty between July 2008 and February 2009. The area of the septal cartilage,vomer, and perpendicular plate of the ethmoid bone was calculated with sagittal imaging using preoperative CT. The angle of deviation was also measured with coronal imaging. The length between the anterior nasal spine and sphenoidal sinus and that of the sphenoidal process was measured during surgery. ResultsZZThe deviation angle increased significantly with the length of the sphenoidal process (p<0.01). The area of the septal cartilage decreased with age due to the progression of ossification. ConclusionZZNasal septal deviation without a history of trauma is influenced by the progression of nasal septal ossification. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:89-93

본 논문에서는 폐암의 변이 형태 분석을 위한 정량적 분석 방법을 연구하였다. 보다 객관적인 분석의 필수적 요인인 정확한 분할을 이해 질감 특징과 통계학적 분류방법을 이용하였으며, 변이 형태 분석을 위해서 분할된 ROI 로부터 여러 가지 형태학적 특성값과 질감 특성값을 추출하여 변이 형태에 따라 비교분석하였다. 이러한 폐암의 변이 형태 분석을 위한 방법은 다른 기관으로의 원격전이가 쉬운 종양의 특성평가에 대한 객관적 병리진단의 보조도구로 사용될 수 있을 것이다.

사상의학은 한의학의 독특하고 뛰어난 의료 체계이나 체질 감별에 객관성이 확보되지 않아 원래의 가치를 인정 받지 못하고 있다. 이를 위해 본 연구에서는 용모사기론을 기반으로 안면 형태학적 특징 분석을 통한 진단시스템을 만드는 것을 목표로 하고 있다. 이를 통해 정확하고 편리하게 체질을 분류 할수 있는 방법을 제시하고 정확한 사상체질 분류 진단기기의 개발을 위한 정면 얼굴과 측면 얼굴에서의 주요 영역을 추출하는 방법을 제안하고자 한다.

컴퓨터의 사용이 보편화됨에 따라 컴퓨터와 사용자 사이의 쉽고 자연스러운 의사 소통을 위한 자연어 인터페이스에 대한 연구가 활발히 진행되고 있다. 이 중에서 특히, 음성인식 분야는 음성명령, 받아쓰기 시스템 등 일반적인 컴퓨터 사용자의 요구를 충족시켜 줄 수 있는 분야로 주목을 받고 있다. 그러나 음성인식은 인식 자체만으로는 인식률에 한계가 있으며, 인식 결과를 향상시키기 위해서는 후처리 단계가 필요하다. 본 논문에서는 음성 인식의 성능을 향상시키기 위해 음성 인식의 결과로 들어온 연속된 한국어 음성을 올바른 음절로 복원시켜 주는 시스템을 구현하였다. 이 시스템에서는 어절단위의 연속된 한국어 음성을 입력으로 받아 한국어 발음 규칙을 역으로 적용하여 원래의 음절로 복원시키고, 형태소 분석기를 이용하여 복원된 음절이 올바른지를 확인하고 수정한다. 초등학교 교과서에 나오는 문장을 대상으로 본 시스템의 성능을 실험한 결과, 90.42%의 복원율을 나타내었다. 현재 정확하게 복원이 되지 않는 것 중에는 동음이의어가 차지하는 비중이 크며, 이 문제는 구문분석이나 의미분석을 이용하여 어느 정도 개선할 수 있을 것으로 보인다.

Background and Objectives：Some pathologies, such as otitis media or E-tube dysfunction, may cause sclerosis in the temporalbone, which then tends to shrink in size. The aim of this study is to evaluate morphologic changes that result from sclerosis in thetemporal bone. Subjects and Method：We measured 9 variables on 2 axial images and 7 variables on 2 coronal images in healthyears and diseased ears of 37 unilateral chronic otitis media patients. We also measured the volume of the mastoid pneumatization.Results：The mastoid volume in the sclerotic temporal bones was significantly smaller than that in the pneumatic ones. Thedistance from sigmoid sinus to Henles spine was most significantly correlated to the degree of volume reduction, and it accountedfor about 17.7% of the total variation in volume reduction. There was no difference in sigmoid sinus types between sclerotic andpneumatic mastoids. Conclusion：The sclerosis of the temporal bone reduces the volume of mastoid pneumatization. However,the large portion of volume reduction may result from the sclerotic change in the air cell system, rather than from the shrinkage ofthe mastoid bone. So, the location of surgically-important structures in the middle and inner ears is rarely changed in the sclerotictemporal bone.

목 적 : 천식의 병인기전을 연구하고 새로운 치료약물을 개발하기 위한 방법의 하나로 동물을 이용한 천식모형을 만들어서 연구하는 경우도 있다. 저자들은 동물 실험 모델에서 항원 유발 후 나타나는 초기 반응과 후기 반응의 시간 경과에 따른 기본적인 형태학적 소견을 연구하기 위하여 본 연구를 시행하였다. 방 법 : Sprague-Dowley 숫쥐에 난알부민을 항원으로, 백일해 백신과 수산화 알루미늄을 보조제로 사용하여 감작 및 유발을 하여 폐 조직의 광학 현미경 및 전자 현미경적인 소견을 분석하였다.결 과 : 초기 반응은 15분 군에서 나타났는데 기관지 상피 세포의 급성 손상 소견(세포질 공포화 및 내강 내로의 탈락이 주된 소견이었고, 호산구 등 염증 세포의 증가나 기관지 근육층의 변화는 없었다. 후기 반응은 4시간 군부터 나타났고 주된 소견은 점막과 점막 하 조직에 호산구 침윤 증가, 기관지 점막 기저막하의 교원질 침착 증가와 기관지 근육 층의 형태학적 변화, 즉 근육세포 핵의 위축, 세포질 내 사립체 수 증가, 세포질 내 actin filaments의 불규칙적인 분포, 근육 세포의 세포질 팽창 등이었다. 호산구 침윤은 4시간 군에서, 근육세포의 형태학적 변화는 6시간 군부터, 근육세포 세포질의 팽창은 1주군에서 가장 현저하였다. 감작만 한 군은 정상 군과 유사한 형태학적 소견을 보였으며, 유발만 한 군에서는 호산구 침윤과 근육세포 세포질의 사립체 증가 소견이 있었다.

Analysis of Antigen-induced Pulmonary MorphologicChanges in Sensitized RatsSung Won Kim, M.D. and Mi Young Sul, M.D.*

Background : The histological subtypes of focal segmental glomerulosclerosis (FSGS) have different significance and influence clinical presentations and outcomes in patients with FSGS. However, no such data has been reported in Korea. Methods : We reviewed renal biopsy specimens of 69 adult patients who were diagnosed with idiopathic FSGS between 2000 and 2008, subclassified them according to the Columbia classification and correlated the results with clinical findings. Results : The frequencies of the FSGS subtypes were not otherwise specified (NOS) (n = 28), tip (n = 21), perihilar (n = 11), collapsing (n = 5) and cellular types (n = 4) in descending order. Nephrotic syndrome was more common in patients with the tip and collapsing types than the perihilar type. The prevalence of chronic kidney disease stage 4/5 at the time of renal biopsy was significantly higher in patients with the cellular type than the NOS or the tip type. The remission rate after treatment tended to be higher in patients with the NOS type (22.0%) and the tip type (15.2%) than the perihilar (6.8%) and collapsing types (3.4%). Conclusions : Classifying FSGS subtypes may be helpful to predict of clinical features and renal outcomes.