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Kim HH, Kim DW, Woo J, Lee K. Explicable prioritization of genetic variants by integration of rule-based and machine learning algorithms for diagnosis of rare Mendelian disorders. Hum Genomics 2024; 18:28. [PMID: 38509596 PMCID: PMC10956189 DOI: 10.1186/s40246-024-00595-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 03/03/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND In the process of finding the causative variant of rare diseases, accurate assessment and prioritization of genetic variants is essential. Previous variant prioritization tools mainly depend on the in-silico prediction of the pathogenicity of variants, which results in low sensitivity and difficulty in interpreting the prioritization result. In this study, we propose an explainable algorithm for variant prioritization, named 3ASC, with higher sensitivity and ability to annotate evidence used for prioritization. 3ASC annotates each variant with the 28 criteria defined by the ACMG/AMP genome interpretation guidelines and features related to the clinical interpretation of the variants. The system can explain the result based on annotated evidence and feature contributions. RESULTS We trained various machine learning algorithms using in-house patient data. The performance of variant ranking was assessed using the recall rate of identifying causative variants in the top-ranked variants. The best practice model was a random forest classifier that showed top 1 recall of 85.6% and top 3 recall of 94.4%. The 3ASC annotates the ACMG/AMP criteria for each genetic variant of a patient so that clinical geneticists can interpret the result as in the CAGI6 SickKids challenge. In the challenge, 3ASC identified causal genes for 10 out of 14 patient cases, with evidence of decreased gene expression for 6 cases. Among them, two genes (HDAC8 and CASK) had decreased gene expression profiles confirmed by transcriptome data. CONCLUSIONS 3ASC can prioritize genetic variants with higher sensitivity compared to previous methods by integrating various features related to clinical interpretation, including features related to false positive risk such as quality control and disease inheritance pattern. The system allows interpretation of each variant based on the ACMG/AMP criteria and feature contribution assessed using explainable AI techniques.
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Affiliation(s)
- Ho Heon Kim
- Research and Development Center, 3billion, 14th floor, 416 Teheran-ro, Gangnam-gu, Seoul, 06193, Republic of Korea
| | - Dong-Wook Kim
- Research and Development Center, 3billion, 14th floor, 416 Teheran-ro, Gangnam-gu, Seoul, 06193, Republic of Korea
| | - Junwoo Woo
- Research and Development Center, 3billion, 14th floor, 416 Teheran-ro, Gangnam-gu, Seoul, 06193, Republic of Korea
| | - Kyoungyeul Lee
- Research and Development Center, 3billion, 14th floor, 416 Teheran-ro, Gangnam-gu, Seoul, 06193, Republic of Korea.
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Choi Y, Kim HH. Social capital, food insecurity, and health outcomes in the US during the COVID-19 pandemic. Perspect Public Health 2024; 144:39-51. [PMID: 35836405 DOI: 10.1177/17579139221106339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS The purpose of this study was first, to investigate the harmful effects of food insufficiency on health outcomes - self-rated health (SRH) and self-assessed depressive symptoms - during the COVID-19 pandemic and, second, to test whether these effects fluctuated across the US in terms of state-level social capital. METHODS Data were drawn from the Census Household Pulse Survey (fielded between April 2020 and February 2021) consisting of community-dwelling American adults (N = 1.5M+). Social capital measures were taken from the 'Social Capital Project' sponsored by the US Congress. We estimated three-level mixed effects models to analyze multiple waves of repeated cross-sectional surveys. RESULTS Post-COVID-19 food insufficiency was significantly negatively associated with SRH and positively associated depression, adjusting for controls including food insufficiency prior to the onset of the pandemic. These relationships were also more pronounced in areas with higher aggregate social capital. CONCLUSIONS The health burdens of the new coronavirus disease have fallen disproportionately on the economically marginalized, as measured by food insufficiency. Contrary to the conventional literature, living in a state with a greater stock of social capital worsened its health effects.
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Affiliation(s)
- Y Choi
- Department of Sociology, Chung-Ang University, Seoul, Republic of Korea
| | - H H Kim
- Department of Sociology, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Republic of Korea
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Kim HH, Popova E. Unifying principles of cryopreservation protocols for new plant materials based on alternative cryoprotective agents (cpas) and a systematic approach. Cryo Letters 2023; 44:1-12. [PMID: 36629836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This review addresses a frequently encountered problem of designing an effective cryopreservation procedure for new (not previously cryopreserved) or difficult plant materials. This problem hinders worldwide efforts of applying cryopreservation across a wide genetic base of wild and a number of cultivated plants. We review recent advances in modifications of routinely applied cryoprotective solutions (CPAs) and suggest a practical approach to protocol development which embraces the physiological complexity of plant tissues as well as a wide spectrum of behaviours under CPA treatment. We suggest that vegetative plant materials are classified into four categories based on their size, structure, and the response to osmotic and chemical stresses provoked by CPA mixtures of varied composition and concentration, including alternative osmoprotection and vitrification solutions. A number of up to 15 preset protocols designed specifically for each category is then applied to the material. The protocols resulting in the best regrowth are then combined into the optimized procedure. The main advantage of this system over a conventional "trial-and-error" search for working cryopreservation protocol is a minimal amount of starting materials required for the tests and a relatively accurate prediction of material behaviour under cryopreservation stress provided by the relatively few CPAs treatments. The unifying principles revealed by this approach could broaden a spectrum of wild species and materials which can be safely conserved by cryopreservation. Also anticipated is application of this approach to plant materials of biotechnological value as well as cultivars of agricultural and horticultural crops which do not respond well to standard protocols developed for their kind. doi.org/10.54680/fr23110110112.
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Affiliation(s)
- H H Kim
- Department of Agricultural Life Science, Sunchon National University, Suncheon, Korea.
| | - E Popova
- К А Timiryazev Institute of Plant Physiology of Russian Academy of Sciences, Moscow, 127276, Russia.
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Kim HH, Lee J, Kim HH, Hwang S, Yi I, Kao S, Kim D, Sohn HS, Kim J, Choi Y, Yoon S, Park YR. Correction: Digital Device Exposure and Cognition Levels of Children in Low- and Middle-Income Countries: Cross-sectional Study in Cambodia. J Med Internet Res 2022; 24:e44106. [PMID: 36473173 PMCID: PMC9768652 DOI: 10.2196/44106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
[This corrects the article DOI: .].
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Affiliation(s)
- Hye Hyeon Kim
- Department of Biomedical Systems InformaticsYonsei University College of MedicineSeoulRepublic of Korea
| | - JooHyun Lee
- Department of Biomedical Systems InformaticsYonsei University College of MedicineSeoulRepublic of Korea
| | - Ho Heon Kim
- Department of Biomedical Systems InformaticsYonsei University College of MedicineSeoulRepublic of Korea
| | - Sangho Hwang
- Department of Biomedical Systems InformaticsYonsei University College of MedicineSeoulRepublic of Korea
| | - Ilcheong Yi
- United Nations Research Institute for Social DevelopmentGenevaSwitzerland
| | - Sambath Kao
- Department of Malnutrition and NeurologyNational Pediatric HospitalPhnom PenhCambodia
| | | | - Hyuk-Sang Sohn
- Graduate School of Public Policy & Civic EngagementKyung Hee UniversitySeoulRepublic of Korea
| | - Joohye Kim
- Department of Special EducationBaekseok UniversityCheonanRepublic of Korea
| | | | - Sangchul Yoon
- Department of Medical Humanities and Social SciencesYonsei University College of MedicineSeoulRepublic of Korea
| | - Yu Rang Park
- Department of Biomedical Systems InformaticsYonsei University College of MedicineSeoulRepublic of Korea
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Leung T, Lee J, Kim HH, Hwang S, Yi I, Kao S, Kim D, Sohn HS, Kim J, Choi Y, Yoon S, Park YR. Digital Device Exposure and Cognition Levels of Children in Low- and Middle-Income Countries: Cross-sectional Study in Cambodia. J Med Internet Res 2022; 24:e31206. [PMID: 36044246 PMCID: PMC9475408 DOI: 10.2196/31206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 06/18/2022] [Accepted: 07/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Policy makers and practitioners in low- and middle-income countries (LMICs) are increasingly focusing on the effectiveness of digital devices in the delivery of medical and educational services to children under resource constraints. It is widely known that digital literacy can be fostered through exposure to and education regarding digital devices, which can improve children's academic performance as well as their search and communication skills in the digital era. However, the correlation between the cognitive function of children and exposure and intensity of the exposure to digital devices has rarely been studied, and the association between digital device exposure and the socioeconomic characteristics and cognitive development of children in LMICs is unknown. OBJECTIVE This study examines the association among exposure to digital devices, socioeconomic status, and cognitive function in children aged 3 to 9 years in Cambodia. METHODS We used a survey of 232 children that gathered data on familiarity with digital devices, demographic characteristics, and socioeconomic status, as well as a Cambridge Neuropsychological Test Automated Battery test for cognitive function, to examine the association between possible barriers and factors that may influence the cognitive function of children in 2 Cambodian schools from April 22, 2019, to May 4, 2019. A comparative analysis was performed with and without digital exposure, and an association analysis was performed among the variables from the survey and cognitive function. RESULTS Significant differences were observed in demographic and socioeconomic characteristics such as school location, family type, and family income according to digital device exposure. The results of the Cambridge Neuropsychological Test Automated Battery tests, except for 1 test related to executive function, indicated no significant differences (P>.05) between group A and group B or among the 4 subgroups. Pretest digital device experience and amount of time spent using digital devices during the test had no significant impacts on the cognitive development of the children. Conversely, the multivariate analyses showed that cognitive function was associated with educational expenses per child, school (location), family type, and family income. CONCLUSIONS These results provide evidence to policy makers and practitioners on the importance of improving socioeconomic conditions, leading to investment in education by implementing programs for children's cognitive development through digital devices in LMICs.
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Affiliation(s)
| | - JooHyun Lee
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ho Heon Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sangho Hwang
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ilcheong Yi
- United Nations Research Institute for Social Development, Geneva, Swaziland
| | - Sambath Kao
- Department of Malnutrition and Neurology, National Pediatric Hospital, Phnom Penh, Cambodia
| | - DooRa Kim
- DoBrain Inc, Seoul, Republic of Korea
| | - Hyuk-Sang Sohn
- Graduate School of Public Policy & Civic Engagement, Kyung Hee University, Seoul, Republic of Korea
| | - Joohye Kim
- Department of Special Education, Baekseok University, Cheonan, Republic of Korea
| | | | - Sangchul Yoon
- Department of Medical Humanities and Social Sciences, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
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Kim HR, Sung M, Park JA, Jeong K, Kim HH, Lee S, Park YR. Analyzing adverse drug reaction using statistical and machine learning methods: A systematic review. Medicine (Baltimore) 2022; 101:e29387. [PMID: 35758373 PMCID: PMC9276413 DOI: 10.1097/md.0000000000029387] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 04/12/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Adverse drug reactions (ADRs) are unintended negative drug-induced responses. Determining the association between drugs and ADRs is crucial, and several methods have been proposed to demonstrate this association. This systematic review aimed to examine the analytical tools by considering original articles that utilized statistical and machine learning methods for detecting ADRs. METHODS A systematic literature review was conducted based on articles published between 2015 and 2020. The keywords used were statistical, machine learning, and deep learning methods for detecting ADR signals. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) guidelines. RESULTS We reviewed 72 articles, of which 51 and 21 addressed statistical and machine learning methods, respectively. Electronic medical record (EMR) data were exclusively analyzed using the regression method. For FDA Adverse Event Reporting System (FAERS) data, components of the disproportionality method were preferable. DrugBank was the most used database for machine learning. Other methods accounted for the highest and supervised methods accounted for the second highest. CONCLUSIONS Using the 72 main articles, this review provides guidelines on which databases are frequently utilized and which analysis methods can be connected. For statistical analysis, >90% of the cases were analyzed by disproportionate or regression analysis with each spontaneous reporting system (SRS) data or electronic medical record (EMR) data; for machine learning research, however, there was a strong tendency to analyze various data combinations. Only half of the DrugBank database was occupied, and the k-nearest neighbor method accounted for the greatest proportion.
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Affiliation(s)
- Hae Reong Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - MinDong Sung
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji Ae Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyeongseob Jeong
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Ho Heon Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Suehyun Lee
- Department of Biomedical Informatics, Konyang University College of Medicine, Daejeon, South Korea
| | - Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
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Kim HH, Kim Y, Michaelides A, Park YR. Weight Loss Trajectories and Related Factors in a 16-Week Mobile Obesity Intervention Program: Retrospective Observational Study. J Med Internet Res 2022; 24:e29380. [PMID: 35436211 PMCID: PMC9055473 DOI: 10.2196/29380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/21/2021] [Accepted: 02/17/2022] [Indexed: 12/11/2022] Open
Abstract
Background In obesity management, whether patients lose ≥5% of their initial weight is a critical factor in clinical outcomes. However, evaluations that take only this approach are unable to identify and distinguish between individuals whose weight changes vary and those who steadily lose weight. Evaluation of weight loss considering the volatility of weight changes through a mobile-based intervention for obesity can facilitate understanding of an individual’s behavior and weight changes from a longitudinal perspective. Objective The aim of this study is to use a machine learning approach to examine weight loss trajectories and explore factors related to behavioral and app use characteristics that induce weight loss. Methods We used the lifelog data of 13,140 individuals enrolled in a 16-week obesity management program on the health care app Noom in the United States from August 8, 2013, to August 8, 2019. We performed k-means clustering with dynamic time warping to cluster the weight loss time series and inspected the quality of clusters with the total sum of distance within the clusters. To identify use factors determining clustering assignment, we longitudinally compared weekly use statistics with effect size on a weekly basis. Results The initial average BMI value for the participants was 33.6 (SD 5.9) kg/m2, and it ultimately reached 31.6 (SD 5.7) kg/m2. Using the weight log data, we identified five clusters: cluster 1 (sharp decrease) showed the highest proportion of participants who reduced their weight by >5% (7296/11,295, 64.59%), followed by cluster 2 (moderate decrease). In each comparison between clusters 1 and 3 (yo-yo) and clusters 2 and 3, although the effect size of the difference in average meal record adherence and average weight record adherence was not significant in the first week, it peaked within the initial 8 weeks (Cohen d>0.35) and decreased after that. Conclusions Using a machine learning approach and clustering shape-based time series similarities, we identified 5 weight loss trajectories in a mobile weight management app. Overall adherence and early adherence related to self-monitoring emerged as potential predictors of these trajectories.
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Affiliation(s)
- Ho Heon Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Youngin Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
- Noom Inc, New York, NY, United States
| | | | - Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
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Kim HH, Popova E. Unifying principles of cryopreservation protocols for new plant materials based on alternative cryoprotective agents (cpas) and a systematic approach. Cryo Letters 2022; 44:1-12. [PMID: 36625870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
This review addresses a frequently encountered problem of designing an effective cryopreservation procedure for new (not previously cryopreserved) or difficult plant materials. This problem hinders worldwide efforts of applying cryopreservation across a wide genetic base of wild and a number of cultivated plants. We review recent advances in modifications of routinely applied cryoprotective solutions (CPAs) and suggest a practical approach to protocol development which embraces the physiological complexity of plant tissues as well as a wide spectrum of behaviours under CPA treatment. We suggest that vegetative plant materials are classified into four categories based on their size, structure, and the response to osmotic and chemical stresses provoked by CPA mixtures of varied composition and concentration, including alternative osmoprotection and vitrification solutions. A number of up to 15 preset protocols designed specifically for each category is then applied to the material. The protocols resulting in the best regrowth are then combined into the optimized procedure. The main advantage of this system over a conventional "trial-and-error" search for working cryopreservation protocol is a minimal amount of starting materials required for the tests and a relatively accurate prediction of material behaviour under cryopreservation stress provided by the relatively few CPAs treatments. The unifying principles revealed by this approach could broaden a spectrum of wild species and materials which can be safely conserved by cryopreservation. Also anticipated is application of this approach to plant materials of biotechnological value as well as cultivars of agricultural and horticultural crops which do not respond well to standard protocols developed for their kind. doi.org/10.54680/fr23110110112.
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Affiliation(s)
- H H Kim
- Department of Agricultural Life Science, Sunchon National University, Suncheon, Korea.
| | - E Popova
- К А Timiryazev Institute of Plant Physiology of Russian Academy of Sciences, Moscow, 127276, Russia.
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Lee H, Park H, Popova E, Lee YY, Park SU, Kim HH. Ammonium-free medium is critical for regeneration of shoot tips of the endangered species Pogostemon yatabeanus cryopreserved using droplet-vitrification. Cryo Letters 2021; 42:290-299. [PMID: 35363850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Pogostemon yatabeanus, synonym Dysophylla yatabeana, (Labiatae) is an endangered wild species in Korea. It has has a limited natural habitat and requires urgent conservation measures. OBJECTIVE To develop an efficient cryopreservation protocol using in vitro shoot tips to complement traditional conservation approaches in case seeds are unavailable, or insufficient in number for conservation programs. MATERIALS AND METHODS Node-cutting induced shoot tips of in vitro plants were produced and cryopreserved using a droplet-vitrification method following improvements in preculture, osmoprotection, vitrification solution (VS) and regrowth treatments. The starting protocol included preculture with 10% sucrose for 31 h, followed by osmoprotection with C4-35% (17.5% glycerol + 17.5% sucrose) for 40 min, and cryoprotection with A3-80% (33.3% glycerol + 13.3% DMSO + 13.3% EG + 20.1% sucrose) for 60 min on ice, cooling and warming using aluminum foil strips, and regrowth in MS hormone-free medium. RESULTS Shoot tips of Pogostemon yatabeanus were sensitive to the osmotic stress evidenced by low survival after step-wise preculture with 17.5% sucrose and cryopreservation without osmoprotection. Among VS tested, including PVS2, PVS3 and their alternatives, A3-80% on ice for 60 min resulted in the highest post-cryopreservation survival (80%) and regeneration (20%). Post-cryopreservation regeneration significantly improved (up to 73%) by incubation of cryopreserved shoot tips on ammonium-free medium followed by GA X3-containing medium and medium without growth regulators. CONCLUSION Cryopreservation of in vitro shoot tips using droplet-vitrification was developed as a complementary conservation approach for D. yatabeana. Adjustment of medium composition during the recovery stage was important for regeneration of healthy plants from both cryoprotected-control and cryopreserved shoot tips.
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Affiliation(s)
- H Lee
- Department of Agricultural Life Science, Sunchon National University, Suncheon, 57922, Korea
| | - H Park
- Department of Agricultural Life Science, Sunchon National University, Suncheon, 57922, Korea
| | - E Popova
- К.А. Timiryazev Institute of Plant Physiology of Russian Academy of Sciences, Moscow, 127276, Russia
| | - Y Y Lee
- National Agrobiodiversity Center, NIAS, RDA, Suwon, 16613, Korea
| | - S U Park
- Division Plant Science and Resources, Chungnam National University, Daejeon, 34134, Korea
| | - H H Kim
- Department of Agricultural Life Science, Sunchon National University, Suncheon, 57922, Korea.
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Kim HH, An JI, Park YR. A Prediction Model for Detecting Developmental Disabilities in Preschool-Age Children Through Digital Biomarker-Driven Deep Learning in Serious Games: Development Study. JMIR Serious Games 2021; 9:e23130. [PMID: 34085944 PMCID: PMC8214184 DOI: 10.2196/23130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 10/15/2020] [Accepted: 04/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background Early detection of developmental disabilities in children is essential because early intervention can improve the prognosis of children. Meanwhile, a growing body of evidence has indicated a relationship between developmental disability and motor skill, and thus, motor skill is considered in the early diagnosis of developmental disability. However, there are challenges to assessing motor skill in the diagnosis of developmental disorder, such as a lack of specialists and time constraints, and thus it is commonly conducted through informal questions or surveys to parents. Objective This study sought to evaluate the possibility of using drag-and-drop data as a digital biomarker and to develop a classification model based on drag-and-drop data with which to classify children with developmental disabilities. Methods We collected drag-and-drop data from children with typical development and developmental disabilities from May 1, 2018, to May 1, 2020, via a mobile application (DoBrain). We used touch coordinates and extracted kinetic variables from these coordinates. A deep learning algorithm was developed to predict potential development disabilities in children. For interpretability of the model results, we identified which coordinates contributed to the classification results by applying gradient-weighted class activation mapping. Results Of the 370 children in the study, 223 had typical development, and 147 had developmental disabilities. In all games, the number of changes in the acceleration sign based on the direction of progress both in the x- and y-axes showed significant differences between the 2 groups (P<.001; effect size >0.5). The deep learning convolutional neural network model showed that drag-and-drop data can help diagnose developmental disabilities, with an area under the receiving operating characteristics curve of 0.817. A gradient class activation map, which can interpret the results of a deep learning model, was visualized with the game results for specific children. Conclusions Through the results of the deep learning model, we confirmed that drag-and-drop data can be a new digital biomarker for the diagnosis of developmental disabilities.
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Affiliation(s)
- Ho Heon Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Il An
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
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Park JA, Sung MD, Kim HH, Park YR. Weight-Based Framework for Predictive Modeling of Multiple Databases With Noniterative Communication Without Data Sharing: Privacy-Protecting Analytic Method for Multi-Institutional Studies. JMIR Med Inform 2021; 9:e21043. [PMID: 33818396 PMCID: PMC8056295 DOI: 10.2196/21043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 11/16/2020] [Accepted: 03/03/2021] [Indexed: 01/22/2023] Open
Abstract
Background Securing the representativeness of study populations is crucial in biomedical research to ensure high generalizability. In this regard, using multi-institutional data have advantages in medicine. However, combining data physically is difficult as the confidential nature of biomedical data causes privacy issues. Therefore, a methodological approach is necessary when using multi-institution medical data for research to develop a model without sharing data between institutions. Objective This study aims to develop a weight-based integrated predictive model of multi-institutional data, which does not require iterative communication between institutions, to improve average predictive performance by increasing the generalizability of the model under privacy-preserving conditions without sharing patient-level data. Methods The weight-based integrated model generates a weight for each institutional model and builds an integrated model for multi-institutional data based on these weights. We performed 3 simulations to show the weight characteristics and to determine the number of repetitions of the weight required to obtain stable values. We also conducted an experiment using real multi-institutional data to verify the developed weight-based integrated model. We selected 10 hospitals (2845 intensive care unit [ICU] stays in total) from the electronic intensive care unit Collaborative Research Database to predict ICU mortality with 11 features. To evaluate the validity of our model, compared with a centralized model, which was developed by combining all the data of 10 hospitals, we used proportional overlap (ie, 0.5 or less indicates a significant difference at a level of .05; and 2 indicates 2 CIs overlapping completely). Standard and firth logistic regression models were applied for the 2 simulations and the experiment. Results The results of these simulations indicate that the weight of each institution is determined by 2 factors (ie, the data size of each institution and how well each institutional model fits into the overall institutional data) and that repeatedly generating 200 weights is necessary per institution. In the experiment, the estimated area under the receiver operating characteristic curve (AUC) and 95% CIs were 81.36% (79.37%-83.36%) and 81.95% (80.03%-83.87%) in the centralized model and weight-based integrated model, respectively. The proportional overlap of the CIs for AUC in both the weight-based integrated model and the centralized model was approximately 1.70, and that of overlap of the 11 estimated odds ratios was over 1, except for 1 case. Conclusions In the experiment where real multi-institutional data were used, our model showed similar results to the centralized model without iterative communication between institutions. In addition, our weight-based integrated model provided a weighted average model by integrating 10 models overfitted or underfitted, compared with the centralized model. The proposed weight-based integrated model is expected to provide an efficient distributed research approach as it increases the generalizability of the model and does not require iterative communication.
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Affiliation(s)
- Ji Ae Park
- Department of Biomedical System Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Dong Sung
- Department of Biomedical System Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ho Heon Kim
- Department of Biomedical System Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yu Rang Park
- Department of Biomedical System Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
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Kim HH, Kim Y, Park YR. Interpretable Conditional Recurrent Neural Network for Weight Change Prediction: Algorithm Development and Validation Study. JMIR Mhealth Uhealth 2021; 9:e22183. [PMID: 33779574 PMCID: PMC8088842 DOI: 10.2196/22183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/15/2020] [Accepted: 01/17/2021] [Indexed: 01/19/2023] Open
Abstract
Background In recent years, mobile-based interventions have received more attention as an alternative to on-site obesity management. Despite increased mobile interventions for obesity, there are lost opportunities to achieve better outcomes due to the lack of a predictive model using current existing longitudinal and cross-sectional health data. Noom (Noom Inc) is a mobile app that provides various lifestyle-related logs including food logging, exercise logging, and weight logging. Objective The aim of this study was to develop a weight change predictive model using an interpretable artificial intelligence algorithm for mobile-based interventions and to explore contributing factors to weight loss. Methods Lifelog mobile app (Noom) user data of individuals who used the weight loss program for 16 weeks in the United States were used to develop an interpretable recurrent neural network algorithm for weight prediction that considers both time-variant and time-fixed variables. From a total of 93,696 users in the coaching program, we excluded users who did not take part in the 16-week weight loss program or who were not overweight or obese or had not entered weight or meal records for the entire 16-week program. This interpretable model was trained and validated with 5-fold cross-validation (training set: 70%; testing: 30%) using the lifelog data. Mean absolute percentage error between actual weight loss and predicted weight was used to measure model performance. To better understand the behavior factors contributing to weight loss or gain, we calculated contribution coefficients in test sets. Results A total of 17,867 users’ data were included in the analysis. The overall mean absolute percentage error of the model was 3.50%, and the error of the model declined from 3.78% to 3.45% by the end of the program. The time-level attention weighting was shown to be equally distributed at 0.0625 each week, but this gradually decreased (from 0.0626 to 0.0624) as it approached 16 weeks. Factors such as usage pattern, weight input frequency, meal input adherence, exercise, and sharp decreases in weight trajectories had negative contribution coefficients of –0.021, –0.032, –0.015, and –0.066, respectively. For time-fixed variables, being male had a contribution coefficient of –0.091. Conclusions An interpretable algorithm, with both time-variant and time-fixed data, was used to precisely predict weight loss while preserving model transparency. This week-to-week prediction model is expected to improve weight loss and provide a global explanation of contributing factors, leading to better outcomes.
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Affiliation(s)
- Ho Heon Kim
- Department of Biomedical Systems Informatics, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | | | - Yu Rang Park
- Department of Biomedical Systems Informatics, College of Medicine, Yonsei University, Seoul, Republic of Korea
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Kwon H, Kim HH, An J, Lee JH, Park YR. Lifelog Data-Based Prediction Model of Digital Health Care App Customer Churn: Retrospective Observational Study. J Med Internet Res 2021; 23:e22184. [PMID: 33404511 PMCID: PMC7817354 DOI: 10.2196/22184] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 11/02/2020] [Accepted: 11/05/2020] [Indexed: 01/22/2023] Open
Abstract
Background Customer churn is the rate at which customers stop doing business with an entity. In the field of digital health care, user churn prediction is important not only in terms of company revenue but also for improving the health of users. Churn prediction has been previously studied, but most studies applied time-invariant model structures and used structured data. However, additional unstructured data have become available; therefore, it has become essential to process daily time-series log data for churn predictions. Objective We aimed to apply a recurrent neural network structure to accept time-series patterns using lifelog data and text message data to predict the churn of digital health care users. Methods This study was based on the use data of a digital health care app that provides interactive messages with human coaches regarding food, exercise, and weight logs. Among the users in Korea who enrolled between January 1, 2017 and January 1, 2019, we defined churn users according to the following criteria: users who received a refund before the paid program ended and users who received a refund 7 days after the trial period. We used long short-term memory with a masking layer to receive sequence data with different lengths. We also performed topic modeling to vectorize text messages. To interpret the contributions of each variable to model predictions, we used integrated gradients, which is an attribution method. Results A total of 1868 eligible users were included in this study. The final performance of churn prediction was an F1 score of 0.89; that score decreased by 0.12 when the data of the final week were excluded (F1 score 0.77). Additionally, when text data were included, the mean predicted performance increased by approximately 0.085 at every time point. Steps per day had the largest contribution (0.1085). Among the topic variables, poor habits (eg, drinking alcohol, overeating, and late-night eating) showed the largest contribution (0.0875). Conclusions The model with a recurrent neural network architecture that used log data and message data demonstrated high performance for churn classification. Additionally, the analysis of the contribution of the variables is expected to help identify signs of user churn in advance and improve the adherence in digital health care.
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Affiliation(s)
- Hongwook Kwon
- Department of Biomedical Systems Informatics, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Ho Heon Kim
- Department of Biomedical Systems Informatics, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Jaeil An
- Department of Biomedical Systems Informatics, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Jae-Ho Lee
- Department of Information Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea.,Department of Emergency Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Yu Rang Park
- Department of Biomedical Systems Informatics, College of Medicine, Yonsei University, Seoul, Republic of Korea
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Kim HH, Kwon HW, Kao S, Sohn HS, Kim J, Choi Y, Kim D, Kang M, Park YR. A Study of the Possibility of Detecting Pediatric Mild Developmental Delay Through a Serious Game: A Randomized Cluster Trial in Cambodia. Stud Health Technol Inform 2020; 270:736-740. [PMID: 32570480 DOI: 10.3233/shti200258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Although early diagnosis of developmental delay is important, there are challenges in identifying cognitive status in developing countries because of limited human and financial resources to perform diagnostic tests. Moreover, diagnosis stability of developmental delay in children using neuropsychological tests (NPTs) can remain unsettled. The aim of this study is (1) to verify the effectiveness of a serious game (DoBrain), (2) to identify existing inconsistencies between NPTs, and (3) to explore the potential of the serious game as a complement to diagnostic tools. Eligible children who had completed results of NPTs were selected (n=119/235; 116/235; case, control). With these children's scores, we performed the Mann- Whitney U test to investigate the effectiveness of the serious game by comparing the improvement of scores in both groups. Among the participants, we additionally selected a case group to identify the potential of the serious game for detecting mild developmental delay. Using the results of the CGI-S as a baseline, we defined the participants whose scores indicated more than mild illness (>=2 points) in at least one area as the suspected group. The score improvement related to memory in case group was greater than that of the control group (p<0.05). Furthermore, four of the NPTs were not inconsistent, and the sensitivity/specificity of DDST-II was the highest score considering CGI-S results as the ground truth (0.43; 0.96). Additionally, games measuring discrimination, velocity, memory, and spatial perception showed statistical significance (p<0.05). This study verifies that the serious game can help specific cognitive areas and suggests that the serious game could be used as a low-cost and unconstrained spatiotemporal alternative to NPTs.
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Affiliation(s)
- Ho Heon Kim
- Department of Biomedical Systems Informatics Yonsei University College of Medicine, Korea
| | - Hong Wook Kwon
- Department of Biomedical Systems Informatics Yonsei University College of Medicine, Korea
| | | | | | | | | | | | | | - Yu Rang Park
- Department of Biomedical Systems Informatics Yonsei University College of Medicine, Korea
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Kim HH, Kim B, Joo S, Shin SY, Cha HS, Park YR. Why Do Data Users Say Health Care Data Are Difficult to Use? A Cross-Sectional Survey Study. J Med Internet Res 2019; 21:e14126. [PMID: 31389335 PMCID: PMC6701164 DOI: 10.2196/14126] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/27/2019] [Accepted: 06/29/2019] [Indexed: 12/27/2022] Open
Abstract
Background There has been significant effort in attempting to use health care data. However, laws that protect patients’ privacy have restricted data use because health care data contain sensitive information. Thus, discussions on privacy laws now focus on the active use of health care data beyond protection. However, current literature does not clarify the obstacles that make data usage and deidentification processes difficult or elaborate on users’ needs for data linking from practical perspectives. Objective The objective of this study is to investigate (1) the current status of data use in each medical area, (2) institutional efforts and difficulties in deidentification processes, and (3) users’ data linking needs. Methods We conducted a cross-sectional online survey. To recruit people who have used health care data, we publicized the promotion campaign and sent official documents to an academic society encouraging participation in the online survey. Results In total, 128 participants responded to the online survey; 10 participants were excluded for either inconsistent responses or lack of demand for health care data. Finally, 118 participants’ responses were analyzed. The majority of participants worked in general hospitals or universities (62/118, 52.5% and 51/118, 43.2%, respectively, multiple-choice answers). More than half of participants responded that they have a need for clinical data (82/118, 69.5%) and public data (76/118, 64.4%). Furthermore, 85.6% (101/118) of respondents conducted deidentification measures when using data, and they considered rigid social culture as an obstacle for deidentification (28/101, 27.7%). In addition, they required data linking (98/118, 83.1%), and they noted deregulation and data standardization to allow access to health care data linking (33/98, 33.7% and 38/98, 38.8%, respectively). There were no significant differences in the proportion of responded data needs and linking in groups that used health care data for either public purposes or commercial purposes. Conclusions This study provides a cross-sectional view from a practical, user-oriented perspective on the kinds of data users want to utilize, efforts and difficulties in deidentification processes, and the needs for data linking. Most users want to use clinical and public data, and most participants conduct deidentification processes and express a desire to conduct data linking. Our study confirmed that they noted regulation as a primary obstacle whether their purpose is commercial or public. A legal system based on both data utilization and data protection needs is required.
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Affiliation(s)
- Ho Heon Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bora Kim
- Emphasis Information Technology Inc, Seoul, Republic of Korea
| | - Segyeong Joo
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Soo-Yong Shin
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, SungKyunKwan University, Seoul, Republic of Korea.,Big Data Research Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyo Soung Cha
- Cancer Big Data Center, National Cancer Center, Gyeonggi-do, Republic of Korea
| | - Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
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Yang DK, Cho IS, Kim HH. Strategies for controlling dog-mediated human rabies in Asia: using 'One Health' principles to assess control programmes for rabies. REV SCI TECH OIE 2019; 37:473-481. [PMID: 30747133 DOI: 10.20506/rst.37.2.2816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Over 99% of human rabies cases in endemic areas are transmitted by dogs. Without the elimination of dog rabies, it is not easy to reduce human rabies infection. Controlling dog rabies, especially in ownerless or free-roaming dogs, is critical if we are to decrease the rate of human rabies infection. There are several components in a strategy to eliminate dog-mediated rabies in Asia. Each government must make sure that rabies is either a reportable disease or a notifiable disease and enforce the reporting requirements accordingly. They must also focus on organising and operating special rabies control committees that work with relevant agencies under the 'One Health' banner. They should also implement a national rabies control programme that includes mass dog vaccination, laboratory-based surveillance, stable budget allocation, a rapidreporting system, management of dog populations, international cooperation, prevention of animal introductions from other countries, and risk assessment to analyse the programme's weaknesses. As several developed countries have shown, an effective rabies control strategy leads to rabies-free status. In the Republic of Korea, human rabies has not occurred since 2004, and there have not been any confirmed cases of dog rabies or cases of rabies in wild animals, including raccoon dogs, since 2014. The successful implementation of the key strategies used to eliminate rabies in the Republic of Korea will enable other Asian countries to eliminate dog-mediated human rabies.
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Choi CH, Popova E, Lee H, Park SU, Ku J, Kang JH, Kim HH. Cryopreservation of Endangered Wild Species, Aster altaicus var. uchiyamae Kitam, Using Droplet-Vitrification Procedure. Cryo Letters 2019; 40:113-122. [PMID: 31017611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Aster altaicus var. uchiyamae Kitam is an endemic and endangered species in urgent need of a comprehensive conservation strategy. OBJECTIVE To develop an efficient cryopreservation protocol using in vitro shoot tips to complement traditional conservation approaches in case seeds are not available or insufficient for conservation programs. METHODS Shoot tips of in vitro plants were cryopreserved using a droplet-vitrification method following improvement of pre-culture, osmoprotection, vitrification solution (VS), unloading and post-culture treatments. The starting protocol included step-wise pre-culture with 10% and 17.5% sucrose for 55 h and 17 h, respectively, followed by osmoprotection with C4-35% (17.5% glycerol + 17.5% sucrose) for 30 min, and cryoprotection with B5-80% (40% glycerol + 40% sucrose) for 60 min. RESULTS Shoot tips of A. altaicus were found to be moderately sensitive to the osmotic stress. Pre-culture and osmoprotection were not critical for the regeneration of cryopreserved explants when either of these treatments was applied. Osmoprotection with C4-35% on ice for 60 min followed by cryoprotection with A3-80%, a modified and diluted PVS2, on ice for 60 min resulted in the highest (65.3%) regeneration of cryopreserved shoot tips. Among alternative VSs tested, A3-80% and B5-80% were superior to PVS2 and PVS3 used under the same conditions. Step-wise recovery of shoot tips on ammonium-free medium followed by GA3-containing medium and medium without growth regulators were critical for the normal regeneration of both VS-treated and cryopreserved shoot tips. CONCLUSIONS Cryopreservation of in vitro shoot tips using droplet-vitrification was developed as a complementary conservation approach for A. altaicus. Adjustment of the composition of regrowth media depending on recovery stage was important for the regeneration of healthy plants from cryopreserved shoot tips.
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Affiliation(s)
- C H Choi
- Gyeonggi-do Forestry Environment Research Center, Osan-si, 52319, Korea
| | - E Popova
- National Cell Culture Collection, Institute of Plant Physiology, Russian Academy of Sciences, Moscow, Russia
| | - H Lee
- Dept. of Well-being Resources, Sunchon National University, Suncheon, 57922, Korea
| | - S U Park
- Div. Plant Science and Resources, Chungnam National University, Daejeon 34134, Korea
| | - J Ku
- Forest Policy Division, Korea Forest Service, 189 Cheongsa-ro, Daejeon 35208, Korea
| | - J H Kang
- Hantaek Botanical Garden Foundation, 2 Hantaek-ro, Yongin-si, 17183, Korea
| | - H H Kim
- Dept. of Well-being Resources, Sunchon National University, Suncheon, 57922, Korea.
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Kim SI, Kim HH, Seong BJ, Jee MG, Lee KS, Kim HG, Kweon KB. Influence of Soil Flooding with Organic Matters Amendment on Reducing the Root Rot Disease and Content of Ginsenosides in Ginseng Crops. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- SI Kim
- Ginseng & Medicinal Plant Research Institute, CNARES, Geumsan-gun, Korea, Republic of (South)
| | - HH Kim
- Ginseng & Medicinal Plant Research Institute, CNARES, Geumsan-gun, Korea, Republic of (South)
| | - BJ Seong
- Ginseng & Medicinal Plant Research Institute, CNARES, Geumsan-gun, Korea, Republic of (South)
| | - MG Jee
- Ginseng & Medicinal Plant Research Institute, CNARES, Geumsan-gun, Korea, Republic of (South)
| | - KS Lee
- Ginseng & Medicinal Plant Research Institute, CNARES, Geumsan-gun, Korea, Republic of (South)
| | - HG Kim
- Department of Applied Biology, Chungnam National University, Daejeon, Korea, Republic of (South)
| | - KB Kweon
- Department of Herbal Crop Research, NIHHS, RDA, Eumseong, Korea, Republic of (South)
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Han E, Popova E, Cho G, Park S, Lee S, Pritchard HW, Kim HH. POST-HARVEST EMBRYO DEVELOPMENT IN GINSENG SEEDS INCREASES DESICCATION SENSITIVITY AND NARROWS THE HYDRATION WINDOW FOR CRYOPRESERVATION. Cryo Letters 2016; 37:284-294. [PMID: 27925011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Despite its self-pollinating characteristics, Korean ginseng germplasm is mainly maintained in clonal gene banks as there is no defined approach to the long-term conservation of its seed, including the most appropriate stage of embryo development for storage. OBJECTIVE The aim of this study was to reveal the effect of embryo development on desiccation tolerance and cryopreservation success in ginseng seeds. MATERIALS AND METHODS Seeds of Korean ginseng (Panax ginseng C.A. Meyer) at three post-harvest stages (immediately after harvesting and following treatments to enable internal growth of the embryo) were desiccated and cryopreserved. RESULTS The hydration window for the >80% dehiscence and germination of cryopreserved ginseng seeds varied with embryo developmental stage: 3-9% moisture content (MC) for both unpulped and undehisced seeds when the embryo was 0.1 the length of the endosperm, 7-10% MC for dehisced seeds (0.5 embryo:endosperm) and 9-11% MC for seeds with fully developed embryos (0.9 embryo:endosperm). Whilst dried (4-8% moisture content) and undehisced seeds within fruits (unpulped seeds) lost more than half their viability during 1 year's storage at room temperature, cryopreservation enabled germination levels of c. 90%. Overall, 432 accessions of Korean ginseng landraces have been cryopreserved using undehisced seeds with or without fruits. CONCLUSION Post-harvest treatment of Korean ginseng seeds to enable embryo development decreases tolerance of very low MCs, and thus narrows the hydration window for cryopreservation. Fresh-harvested and unpulped seeds that have been dried to c. 5% MC are recommended for long-term cryogenic storage.
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Affiliation(s)
- E Han
- National Agrobiodiversity Center, RDA-NAAS, Suwon, Korea
| | - E Popova
- Gosling Research Institute for Plant Preservation, Department of Plant Agriculture, Univ. Guelph, Ontario N1G 2W1, Canada
| | - G Cho
- National Agrobiodiversity Center, RDA-NAAS, Suwon, Korea
| | - S Park
- Division of Plant Science and Resources, Chungnam National University, Daejeon, Korea
| | - S Lee
- Dept. of Well-being Resources, Sunchon National University, Suncheon, Korea
| | - H W Pritchard
- Royal Botanic Gardens, Kew, Wakehurst Place, Ardingly, West Sussex RH17 6TN, UK
| | - H H Kim
- Dept. of Well-being Resources, Sunchon National University, Suncheon, Korea.
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Sukegawa M, Chihara N, Suzuki H, Watanabe M, Nomura S, Uchida E, Napoliello D, Mykytiuk S, Vlasov V, Pidmurniak O, Prystupa M, Latynskyi E, Pidoprygora YU, Brytanchuk R, Demiryas S, Kucuk Y, Umman V, Ulualp K, Ertem M, Tasci I, Ahn S, Park DJ, Kim HH, Morgell A, Nilsson H, Nordin P, Angerås U, Sandblom G. Topic: Femoral Hernia - Approach, results. Hernia 2015; 19 Suppl 1:S220-2. [PMID: 26518808 DOI: 10.1007/bf03355357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- M Sukegawa
- Institute of Gastroenterology, Nippon Medical School - Musashikosugi Hospital, Kawasaki, Japan
| | - N Chihara
- Institute of Gastroenterology, Nippon Medical School - Musashikosugi Hospital, Kawasaki, Japan
| | - H Suzuki
- Institute of Gastroenterology, Nippon Medical School - Musashikosugi Hospital, Kawasaki, Japan
| | - M Watanabe
- Institute of Gastroenterology, Nippon Medical School - Musashikosugi Hospital, Kawasaki, Japan
| | - S Nomura
- Institute of Gastroenterology, Nippon Medical School - Musashikosugi Hospital, Kawasaki, Japan
| | - E Uchida
- Department of Surgery, Nippon Medical School, Tokyo, Japan
| | - D Napoliello
- Sarasota Memoral Healthcare System, Sarasota, USA
| | - S Mykytiuk
- Khmelnytskyi Basic Medical College, Khmelnytskyi, Ukraine
| | - V Vlasov
- Vinnitsa National Medical University, Khmelnytskyi, Ukraine
| | - O Pidmurniak
- Surgical Department of Khmelnytskyi Regional Hospital, Khmelnytskyi, Ukraine
| | - M Prystupa
- Surgical Department of Khmelnytskyi Regional Hospital, Khmelnytskyi, Ukraine
| | - E Latynskyi
- Surgical Department of Khmelnytskyi Regional Hospital, Khmelnytskyi, Ukraine
| | - Y U Pidoprygora
- Surgical Department of Khmelnytskyi Regional Hospital, Khmelnytskyi, Ukraine
| | - R Brytanchuk
- Surgical Department of Khmelnytskyi Regional Hospital, Khmelnytskyi, Ukraine
| | - S Demiryas
- Cerrahpasa Medical Faculty, Department of General Surgery, Istanbul University, Istanbul, Turkey
| | - Y Kucuk
- Cerrahpasa Medical Faculty, Department of General Surgery, Istanbul University, Istanbul, Turkey
| | - V Umman
- Cerrahpasa Medical Faculty, Department of General Surgery, Istanbul University, Istanbul, Turkey
| | - K Ulualp
- Cerrahpasa Medical Faculty, Department of General Surgery, Istanbul University, Istanbul, Turkey
| | - M Ertem
- Cerrahpasa Medical Faculty, Department of General Surgery, Istanbul University, Istanbul, Turkey
| | - I Tasci
- Cerrahpasa Medical Faculty, Department of General Surgery, Istanbul University, Istanbul, Turkey
| | - S Ahn
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - D J Park
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - H H Kim
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - A Morgell
- Karolinska Universitetssjukhuset, Stockholm, Sweden
| | - H Nilsson
- Sahlgrenska Universitetssjukhuset, Göteborg, Sweden
| | - P Nordin
- Östersunds Sjukhus, Östersund, Sweden
| | - U Angerås
- Sahlgrenska Universitetssjukhuset, Göteborg, Sweden
| | - G Sandblom
- Karolinska Universitetssjukhuset, Stockholm, Sweden
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Park SU, Kim HH. CRYOPRESERVATION OF SWEET POTATO SHOOT TIPS USING A DROPLET-VITRIFICATION PROCEDURE. Cryo Letters 2015; 36:344-352. [PMID: 26574682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Sweet potato is a staple food worldwide, but a problematic species in terms of long term storage, as it is not suitable for germplasm conservation. OBJECTIVE This study aimed to develop cryopreservation protocols for sweet potato shoot tips based on a droplet-vitrification procedure. METHODS As a standard procedure, sweet potato shoot tips were precultured in a liquid MS medium supplemented with 10% sucrose (S-10%) and 17.5% sucrose (S-17.5%) for 31 and 17 h, respectively. They were then osmoprotected with C4-35% (17.5% glycerol + 17.5% sucrose) for 50 min and cryoprotected with PVS3 (50% glycerol + 50% sucrose) for 60 min. A set of experiments was designed to investigate critical factors, i.e. stepwise sucrose preculture, osmoprotection, cryoprotection with PVS2- and PVS3-based vitrification solutions, and their combinational effect, as well as temperature alteration through placement in a cooling/rewarming container. RESULTS Sucrose preculture was determined to be necessary for the adaptation of sweet potato shoot tips to cryoprotection with PVS3, and the highest post-thaw (LN) regeneration rate was observed in a preculture with S-10% for 31 h → S-17.5% for 17 h (19.0%). The effect of one-step or two-step osmoprotection was not significant on survival or regeneration of either the cryoprotected-control (LNC) or LN shoot tips. Responses of sweet potato shoot tips to osmoprotection and cryoprotection were linked to the level of sucrose preculture. The use of alumimium foil strips (droplet-vitrification) resulted in significantly higher LN survival (89.8%) and regeneration (19.0%), compared to those using cryovials (vitrification, 67.2% and 0%, respectively). LN regeneration increased by 67.5% when cryopreserved shoot tips were transferred to a new postculture medium. CONCLUSIONS This study demonstrates that the combination of stepwise sucrose preculture with a higher final concentration (up to 17.5%), cryoprotection with PVS3 and cooling with foil strip is crucial to the regeneration of LN sweet potato shoot tips.
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Affiliation(s)
- S U Park
- Division of Plant Science and Resources, Chungnam National University, Daejeon, Korea
| | - H H Kim
- Department of Well-being Resources, Sunchon National University, Suncheon, Korea.
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Jeon TY, Lee SY, Kim HH, Cho YH, Cho AR. Short-term effect of gastric resection on circulating levels of ghrelin, peptide YY3-36 and obestatin in patients with early gastric cancer. Horm Metab Res 2015; 47:297-302. [PMID: 25719735 DOI: 10.1055/s-0034-1398663] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The short-term responses of gut hormones and the compensative interaction during a one-week period after subtotal gastrectomy in early gastric cancer (EGC) patients were assessed. Previous studies have reported gut hormonal changes after Roux-en-Y gastric bypass surgery. Blood samples were collected from 40 patients with EGC preoperatively, at 1 h after gastric resection, and on postoperative day (POD) 1, 3, and 7. Levels of active ghrelin, total ghrelin, obestatin, and PYY3-36 were measured. Total ghrelin level rapidly reached a nadir of 69.1%, while active ghrelin level had increased to 135.5% at 1 h after resection. Then, both returned to preoperative level. On the contrary, active/total ghrelin reached its nadir quickly at 1 h after resection and had returned to the preoperative level by POD 3. The nadir PYY3-36 level was 71.4% on POD 1, followed by a gradual recovery, and had increased to 116.5% by POD 7. The same pattern was observed for obestatin. Active ghrelin/obestatin showed an increase on POD 1 while total ghrelin/obestatin showed a decrease on POD 3. Then, both returned to preoperative level. These results suggest that a rapid interactive compensatory mechanism of gut hormones does exist in the remnant gastrointestinal tract after abrupt changes in the production reservoir in nonobese people.
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Affiliation(s)
- T Y Jeon
- Department of Surgery, Pusan National University School of Medicine, Gyeongsangnam-do, South Korea
| | - S Y Lee
- Medical Education Unit and Medical Research Institute, Pusan National University School of Medicine, Gyeongsangnam-do, South Korea
| | - H H Kim
- Department of Laboratory Medicine, Pusan National University Hospital, Busan, South Korea
| | - Y H Cho
- Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam-do, South Korea
| | - A R Cho
- Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam-do, South Korea
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Ku JH, Kang M, Kim HS, Jeong CW, Kwak C, Kim HH. The prognostic value of pretreatment of systemic inflammatory responses in patients with urothelial carcinoma undergoing radical cystectomy. Br J Cancer 2015; 112:461-7. [PMID: 25584490 PMCID: PMC4453653 DOI: 10.1038/bjc.2014.631] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 11/06/2014] [Accepted: 11/30/2014] [Indexed: 12/12/2022] Open
Abstract
Background: Systemic inflammatory response (SIR) is important in the relationship between the tumour, the host, and outcome in cancer patients. However, limited data exist regarding the prognostic significance of SIR in bladder cancer. We investigate the utility of pretreatment SIR in patients with urothelial carcinoma undergoing radical cystectomy. Methods: The study cohort consisted of 419 patients with a median follow-up of 37.7 months. The SIRs used for each described prognostic nomogram are consistent with previously published data: C-reactive protein, albumin, white cell count, neutrophil count, lymphocyte count, and platelet count. Primary end point was disease-specific survival (DSS) and overall survival (OS) after surgery. Cox regression models were used to determine the time to disease-specific and overall mortality. Multivariate regression coefficients of the predictors were used to develop nomograms for predicting 5-year DSS and OS probability. Results: Multivariate Cox regression analyses revealed that albumin, lymphocyte count, and platelet count were significantly associated with a significantly increased risk for death from bladder cancer. The nomograms including each index were developed to predict the probability of 5-year DSS and OS after radical cystectomy. The C statistics were 77.8% and 77.3%, respectively, and exceeded the 2002 AJCC (72.0% and 70.3%, respectively). In the decision curve analyses, the nomograms including SIR demonstrated higher net benefit gains compared with the models without SIR. Conclusions: Cellular components of SIR have better prognostic values compared with acute-phase protein in patients undergoing radical cystectomy for bladder cancer.
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Affiliation(s)
- J H Ku
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - M Kang
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - H S Kim
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - C W Jeong
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - C Kwak
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - H H Kim
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
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Cao GP, Arooj M, Thangapandian S, Park C, Arulalapperumal V, Kim Y, Kwon YJ, Kim HH, Suh JK, Lee KW. A lazy learning-based QSAR classification study for screening potential histone deacetylase 8 (HDAC8) inhibitors. SAR QSAR Environ Res 2015; 26:397-420. [PMID: 25986171 DOI: 10.1080/1062936x.2015.1040453] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Histone deacetylases 8 (HDAC8) is an enzyme repressing the transcription of various genes including tumour suppressor gene and has already become a target of human cancer treatment. In an effort to facilitate the discovery of HDAC8 inhibitors, two quantitative structure-activity relationship (QSAR) classification models were developed using K nearest neighbours (KNN) and neighbourhood classifier (NEC). Molecular descriptors were calculated for the data set and database compounds using ADRIANA.Code of Molecular Networks. Principal components analysis (PCA) was used to select the descriptors. The developed models were validated by leave-one-out cross validation (LOO CV). The performances of the developed models were evaluated with an external test set. Highly predictive models were used for database virtual screening. Furthermore, hit compounds were subsequently subject to molecular docking. Five hits were obtained based on consensus scoring function and binding affinity as potential HDAC8 inhibitors. Finally, HDAC8 structures in complex with five hits were also subjected to 5 ns molecular dynamics (MD) simulations to evaluate the complex structure stability. To the best of our knowledge, the NEC classification model used in this study is the first application of NEC to virtual screening for drug discovery.
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Affiliation(s)
- G P Cao
- a Department of Biochemistry, Division of Applied Life Science (BK21 Plus Program) , Systems and Synthetic Agrobiotech Centre (SSAC), Plant Molecular Biology and Biotechnology Research Centre (PMBBRC), Research Institute of Natural Science (RINS), Gyeongsang National University , Jinju , Republic of Korea
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25
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Kim H, Kim HH, Park JS, Shin HJ, Cha JH, Chae EY, Choi WJ. Prediction of pathological complete response of breast cancer patients undergoing neoadjuvant chemotherapy: usefulness of breast MRI computer-aided detection. Br J Radiol 2014; 87:20140142. [PMID: 25162970 DOI: 10.1259/bjr.20140142] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the usefulness of MR computer-aided detection (CAD) in patients undergoing neoadjuvant chemotherapy for prediction of the pathological complete response of tumours. METHODS 148 patients with breast cancer (mean age, 47.3 years; range, 29-72 years) who underwent neoadjuvant chemotherapy were included in our study. They underwent MRI before and after neoadjuvant chemotherapy, and we reviewed the pathological result as the gold standard. The computer-generated kinetic features for each lesion were recorded, and the features analysed included "threshold enhancement" at 50% and 100% minimum thresholds; degree of initial peak enhancement; and enhancement profiles comprising lesion percentages of washout, plateau and persistent enhancement. The final pathological size and character of tumours were correlated with post-chemotherapy mammography, ultrasonography and MR CAD findings. Kruskal-Wallis test and intraclass correlation coefficient were used to analyse the findings. RESULTS We divided the 148 patients into complete pathological response and non-complete pathological response groups. A complete pathological response was defined as no histopathological evidence of any residual invasive cancer cells in the breast or axillary lymph nodes. 39 patients showed complete pathological response, and 109 patients showed non-complete pathological response. Between enhancement profiles of MR CAD, plateau proportion of tumours was significantly correlated with the pathological response of tumours (mean proportion of plateau on complete pathological response group was 27%, p = 0.007). CONCLUSION When plateau proportion of tumours is high, we can predict non-complete pathological response of neoadjuvant chemotherapy. ADVANCES IN KNOWLEDGE MR CAD can be a useful tool for the assessment of response to neoadjuvant chemotherapy and prediction of pathological results.
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Affiliation(s)
- H Kim
- 1 Department of Radiology, Seoul Medical Center, Seoul, Republic of Korea
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Mun HS, Kim HH, Shin HJ, Cha JH, Ruppel PL, Oh HY, Chae EY. Assessment of extent of breast cancer: comparison between digital breast tomosynthesis and full-field digital mammography. Clin Radiol 2013; 68:1254-9. [PMID: 23969151 DOI: 10.1016/j.crad.2013.07.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 06/10/2013] [Accepted: 07/09/2013] [Indexed: 10/26/2022]
Abstract
AIM To compare the accuracy of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) in preoperative assessment of local extent of breast cancer. MATERIALS AND METHODS Lesion sizes of breast cancers on DBT and FFDM images were independently evaluated by breast radiologists. Each lesion was flagged as either mis-sized or not depending on whether the assessment of size at imaging was within 1 cm of the lesion size at surgery. Additional analyses were made by mammographic parenchymal density and by lesion size, using 2 cm as the boundary to separate the two subgroups. Statistical comparisons were performed using a repeated measures linear model on the percent mis-sized. P-values < 0.05 were considered statistically significant. RESULTS The dataset included 173 malignant breast lesions (mean size 23.8 mm, 43% of lesions were ≤2 cm in size) in 169 patients, two-thirds of which had heterogeneously or extremely dense breasts. Overall, the percentage of lesions mis-sized at DBT was significantly lower than at FFDM (19% versus 29%, p = 0.003). There was significantly less mis-sizing at DBT in both heterogeneously dense breasts (11.1% difference between DBT and FFDM, p = 0.016) and extremely dense breasts (15.8% difference, p = 0.024). DBT also had significantly less mis-sizing than FFDM in the subgroup of lesions that were ≤2 cm in size (14.7% difference, p = 0.005). CONCLUSION DBT was significantly superior to FFDM for the evaluation of lesion size overall, and specifically for small lesions and for lesions in dense breasts. The superiority of DBT versus FFDM increased with parenchymal density.
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Affiliation(s)
- H S Mun
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea; Severance Check-up, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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27
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Kim HH, Choi SR, Lee HW, Ahn DH, Kang EK, Kwak MH. Dynamic water gravity rotation for endoscopic submucosal dissection: changing the location of the lesion. Endoscopy 2013; 44 Suppl 2 UCTN:E283-4. [PMID: 22933257 DOI: 10.1055/s-0032-1310020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- H H Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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Jo JC, Kang MJ, Ahn JH, Jung KH, Kim JE, Gong G, Kim HH, Ahn SD, Kim SS, Son BH, Ahn SH, Kim SB. Abstract P3-12-05: Clinical features and outcomes of leptomeningeal metastasis in patients with breast cancer: a single center experience. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p3-12-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Leptomeningeal metastasis (LM) is one of the major problems in managing metastatic breast cancer because of LM typically carries a devastating prognosis and often represents a terminal event. We analyzed the clinical features and outcomes of LM in patients with breast cancer.
Methods: We retrospectively reviewed the medical records of patients who were diagnosed with LM from breast cancer between 2002 and 2012 at Asan Medical Center.
Results: Of the 95 LM patients by cytologically proven (n = 81) or radiologically diagnosed (n = 14), 57 (60%) had an ECOG performance status (PS) ≥ 3, and the median age was 47 years (range, 26–72 years). The patients were diagnosed with LM after a median of 10.3 months (95% CI, 5.5–15.0 months) from the time of diagnosis of metastatic breast cancer. LM was present in 2 patients at the time of initial diagnosis. Twenty-three patients (24.2%) had isolated CNS metastasis, and 6 (6.3%) had only LM without any detectable metastasis sites. At the time of diagnosis of LM, 46 patients (48.4%) presented with coincidental failure of systemic disease control. Seventy-eight patients (82.1%) underwent intrathecal chemotherapy (methotrexate; n=78, thiotepa; n=11), resulting in one-third of cytologic negative conversion (n = 26), and 41 (43.2%) received systemic chemotherapy. The overall median survival time was 3.3 months (95% CI, 2.5–4.2 months) and 7.8% of the patients survived for more than 1 year. Overall survival tended to be better in patients who achieved cytologic negative conversion to intrathecal chemotherapy than those did not (median 4.5 months versus 3.2 months, P = 0.241). Overall survival was not different according to subtypes; hormone receptor (+), HER2 (+), and triple negative (median 3.6 months, 3.3 months, and 3.2 months, P = 0.937). Multivariate analysis demonstrated that ECOG PS ≥ 3 (HR = 2.09, 95% CI 1.21–3.58, P = 0.007), coincidental failure of systemic disease control at LM (HR = 3.01, 95% CI 1.76–5.15, P < 0.001), and systemic chemotherapy after LM (HR = 0.40, 95% CI 0.24–0.68, P = 0.001) were independent factors associated with survival.
Conclusions: The prognosis for patients with LM from breast cancer was still poor. Systemic chemotherapy in addition to intrathecal chemotherapy might confer a survival benefit, even after the detection of LM.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-12-05.
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Affiliation(s)
- J-C Jo
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - MJ Kang
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J-H Ahn
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - KH Jung
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - JE Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - G Gong
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - HH Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - SD Ahn
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - SS Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - BH Son
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - SH Ahn
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S-B Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Cho JY, Ahn SH, Lee JW, Yu JH, Koh BS, Kim HJ, Lee JW, Son BH, Gong GY, Kim HH. Abstract P3-01-02: Correlation of Mammographic breast density and tumor characteristics in Korean breast cancer patients. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p3-01-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Western studies have demonstrated high breast density as a strong risk factor for breast cancer, it is poorly understood whether breast density affects the diverse phenotypes of breast cancer. We examined the association between various tumor characteristics and mammographic breast density in women with breast cancer.
Methods: We conducted a cross-sectional analysis in 910 Korean women diagnosed with breast cancer to evaluate the associations between breast density and tumor size, lymph node status, lymphovascular invasion, histologic grade, estrogen receptor, progesterone receptor, HER2. Breast density was classified as fatty (percent density less than 50% by a computer-assisted thresholding program, named “Cumulus™”; n = 470) or dense (percent density 50% or more; n = 440) for the cancer-free breast at the time of operation. Logistic regression was used to examine whether the relationships were modified by adjustment for body mass index, age at diagnosis, age at first birth, menopausal status, history of breast-feeding, and breast cancer staging.
Results: Total 910 patients were involved, the mean age and median age at the operation was 48 years old (range 20–82), and the mean percent density was 48.09 (SD = 9.62 %: normally distributed, Kolmogorov-Smirnov test p = 0.32). Crude analysis shows that tumor size over than 0.5cm were more likely to have dense breasts compared with women with a tumor size <=0.5 cm (OR = 3.21, 95% CI = 1.59–6.45, p = 0.001 for tumor sizes 0.6–1.0cm; OR = 2.02, 95% CI = 1.09–3.74, p = 0.03 for tumor sizes 1.1–1.5cm; OR = 1.8, 95% CI = 0.97–3.33, p = 0.06 for tumor sizes 1.6–2.0cm; and OR = 1.64, 95% CI = 0.92–2.94, p = 0.1 for tumor sizes 2.1cm or more). PD and histologic grade shows reverse association between histologic grade 1 and grade 2,3. Progesteron receptor positive patients tend to have more dense(OR = 1.27, 95% CI=0.97–1.66, p = 0.07) breast than receptor negative patients, although after adjustment of age the statistical significant disappeared. Percent density was not significantly associated with, ER (p = 0.74), HER2 (p = 0.72).
Conclusion: These results suggest that breast density is associated with tumor size and histologic grade and progesterone receptor positivity. Additional studies are needed to address whether these associations are due to just density masking the detection of some tumors, biological causation, or both.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-01-02.
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Affiliation(s)
- JY Cho
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - SH Ahn
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - JW Lee
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - JH Yu
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - BS Koh
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - HJ Kim
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - JW Lee
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - BH Son
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - G-y Gong
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - HH Kim
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
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Kim HH, Popova EV, Shin DJ, Bae CH, Baek HJ, Park SU, Engelmann F. Development of a droplet-vitrification protocol for cryopreservation of Rubia akane (Nakai) hairy roots using a systematic approach. Cryo Letters 2012; 33:506-517. [PMID: 23250410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A systematic approach using a set of 13 treatments was applied to develop a droplet-vitrification protocol for Rubia akane hairy roots, based on their responses to preculture, loading, dehydration and cooling/rewarming steps. The roots were very sensitive to osmotic stress induced by both preculture in liquid sucrose-enriched medium (up to 0.5 M sucrose) and by dehydration with highly concentrated vitrification solutions (VSs). Loading was necessary before dehydration of explants with VS, and the composition of the loading solution (LS) significantly affected their post-cryopreservation regeneration. Due to high sensitivity of roots to both chemical cytotoxicity and osmotic stress produced by VSs, cryoprotection with alternative VSs, i.e. B5-80 percent (40 percent glycerol + 40 percent sucrose, w/v) at room temperature for 15 min or with A3-70 percent (29.2 percent glycerol + 11.7 percent DMSO + 11.7 percent EG + 17.4 percent sucrose, w/v) at 0 degree C for 20 min ensured the highest post-cryopreservation regeneration. However, when using these solutions, endothermic peaks (enthalpies) with -2.9 and -5.8 J per gram fresh weight, respectively, were recorded by differential scanning calorimetry (DSC) during the rewarming phase. Droplet-vitrification using foil strips showed higher post-cryopreservation regeneration (86 percent) compared with vitrification in cryovials (59 percent), possibly due to the higher cooling and rewarming rates achieved with droplet-vitrification. The developed protocol was applied to hairy roots of five other species with minor modifications in explant type, the duration of the last subculture before explant excision, and the dehydration duration with VS B5-80 percent.
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Affiliation(s)
- H H Kim
- National Agrobiodiversity Center, RDA-NAAS, Suwon, Korea
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Kim HH, Park SJ, Park MI, Moon W. Hyaluronic acid injection for sustained control of bleeding from a sclerotic ulcer base. Endoscopy 2012; 44 Suppl 2 UCTN:E169-70. [PMID: 22622726 DOI: 10.1055/s-0031-1291756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- H H Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
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Shin DJ, Kong H, Popova EV, Moon HK, Park SY, Park SU, Lee SC, Kim HH. Cryopreservation of Kalopanax septemlobus embryogenic callus using vitrification and droplet-vitrification. Cryo Letters 2012; 33:402-410. [PMID: 23224373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A cryopreservation protocol has been developed for embryogenic callus cultures of castor aralia (Kalopanax septemlobus), a deciduous tree which is widely used in oriental medicine and in landscape design. Three preculture treatments, four loading and six vitrification solutions were tested in a vitrification procedure. Preculture of embryogenic callus (EC) with high sucrose concentrations (up to 0.7 M) showed no effect on regrowth after cryopreservation. Loading for 20 min at ambient temperature improved regrowth of cryopreserved EC by 70-75 percent compared with non-loaded samples, regardless of the composition of the loading solution. Among vitrification solutions, the highest regrowth of 95-100 percent after cryopreservation was obtained after incubation of EC in a vitrification solution A3-80 percent comprising (w/v) 33.3 percent glycerol + 13.3 percent DMSO + 13.3 percent EG + 20.1 percent sucrose for 40 min at 0°C. Profiling of crystallization and recrystallization events using differential scanning calorimetry (DSC) confirmed that freezing injury was minimized in samples after loading and cryoprotection with this vitrification solution. Unlike many other papers, the droplet-vitrification protocol did not produce higher post-cryopreservation regrowth of Kalopanax EC, compared with the vitrification procedure. When samples are sufficiently cryoprotected during VS treatment, vitrification using cryovials may be preferred, since droplet-vitrification is more complex and requires skilled personnel. Cryopreserved callus grew rapidly and produced numerous somatic embryos, which developed similarly to embryos obtained from non-cryopreserved samples.
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Affiliation(s)
- D J Shin
- Species Restoration Center, Korea National Park Service, Gurye, Korea
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Affiliation(s)
- H H Kim
- Division of Gastroenterology, Department of Internal Medicine, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea
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Abstract
The new allele B*40:186 shows a one nucleotide substitution compared with B*40:01:02 at codon 56 (GGG → AGG) resulting in coding change, Gly to Arg.
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Affiliation(s)
- S Y Kim
- Department of Laboratory Medicine, Pusan National University Hospital, Busan, Republic of Korea
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Kim HH, Kim YS, Lee JM, Jung HG, Lee JH, Moon JS. Ischaemic colitis mimicking ascending colon cancer. Intern Med J 2012; 42:727-8. [PMID: 22697158 DOI: 10.1111/j.1445-5994.2012.02802.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- H H Kim
- Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Abstract
INTRODUCTION Lifting the stomach using laparoscopic instruments during laparoscopic gastrectomy is difficult and increases the risk of crushing the tumor. In this study, we present a stomach hanging technique using gauze pieces that reduces the risk to the tumor. MATERIALS AND SURGICAL TECHNIQUE After a partial omentectomy and the opening of the lesser sac, the antrum was wrapped with a 15-20-cm gauze piece. Next, a straight needle with 2-0 monofilament suture material pierced the abdominal cavity through the right subcostal area on the mid-clavicular line, and the gauze was then sutured twice in a figure of eight manner. The needle was removed percutaneously through the right middle quadrant of the abdomen. Another suture was applied to wrap the left side of the stomach. The stomach was easily lifted and positioned by pulling the four suture strings in different directions. After the suture materials were fastened to the abdominal wall using hemostat forceps, the surgical field was sufficiently exposed, facilitating lymph node dissection on the superior surface of the pancreas. This method freed the assistant from holding the stomach and enabled this individual to assist the operation in other ways. DISCUSSION This stomach lifting technique using gauze is a good option for exposing the surgical field, enables the assistant to perform other tasks, and reduces the risk of crushing the tumor during laparoscopic gastrectomy.
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Affiliation(s)
- S H Kong
- Department of Surgery, Seoul National University College of Medicine, Korea
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Lee HJ, Shiraishi N, Kim HH, Hiki N, Uyama I, Choi SH, Yang HK, Kitano S. Standard of practice on laparoscopic gastric cancer surgery in Korea and Japan: experts' survey. Asian J Endosc Surg 2012; 5:5-11. [PMID: 22776335 DOI: 10.1111/j.1758-5910.2011.00111.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 08/24/2011] [Accepted: 09/05/2011] [Indexed: 01/11/2023]
Abstract
INTRODUCTION As the laparoscopic approach has become a popular gastric cancer treatment in Korea and Japan, the need for sharing current practices of surgeons who are experienced in laparoscopic gastric cancer surgery has increased. METHODS We sent a questionnaire on laparoscopic instruments, image documentation, preoperative evaluation, surgical indication, operative methods, and postoperative management to laparoscopic experts in Korea and Japan, and 24 (14 from Korea and 10 from Japan) responded. RESULTS Endoscopic ultrasound and preoperative endoscopy-guided clipping are routinely employed, respectively, by 14 (58%) and 20 (83%) of the surgeons. Surgeons perform laparoscopy-assisted distal gastrectomy (LADG) based on varying indications. Five surgeons (21%) performed LADG only for cases of stage T1 cancer, 15 (63%) performed LADG on patients with less than T2 lesions, and 4 (17%) performed LADG on patients with less than T3 lesions. With regard to postoperative anastomosis, 18 surgeons (75%) preferred extracorporeal anastomosis and 6 (25%) preferred intracorporeal anastomosis. The mean postoperative hospital stay was 6.5 days in Korea and 10.1 days in Japan (P < 0.001). CONCLUSION This survey can help to inform the current practice of laparoscopic gastric cancer surgery in Korea and Japan, where laparoscopic surgery is frequently performed.
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Affiliation(s)
- H J Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Korea
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Kim HH, Popova E, Shin DJ, Yi JY, Kim CH, Lee JS, Yoon MK, Engelmann F. Cryobanking of Korean allium germplasm collections: results from a 10 year experience. Cryo Letters 2012; 33:45-57. [PMID: 22434122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This paper reviews a 10-year experience in establishing a cryopreserved Allium germplasm collection at the genebank of the National Agrobiodiversity Center, Republic of Korea. A systematic approach to Allium cryopreservation included: 1. revealing the most critical factors that affected regeneration after cryostorage; 2. understanding the mechanisms of cryoprotection by analyzing the thermal behavior of explants and cryoprotectant solutions using DSC and influx/efflux of cryoprotectants using HPLC; 3. assessing genetic stability of regenerants; and 4. revealing the efficiency of cryotherapy. Bulbil primordia, i.e. asexual bulbs formed on unripe inflorescences, proved to be the most suitable material for conservation of bolting varieties due to high post-cryopreservation regrowth and lower microbial infection level, followed by apical shoot apices from single bulbs and cloves. A total of 1,158 accessions of garlic as well as some Allium species have been cryopreserved during 2005-2010 using the droplet-vitrification technique with a mean regeneration percentage of 65.9 percent after cryostorage. These results open the door for large-scale implementation of cryostorage and for simplifying international exchange for clonal Allium germplasm.
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Affiliation(s)
- H H Kim
- National Agrobiodiversity Center, RDA-NAAS, Suwon 441-707, Korea.
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Lee HE, Park DJ, Kim WH, Kim HH, Lee HS. High FOXP3+ regulatory T-cell density in the sentinel lymph node is associated with downstream non-sentinel lymph-node metastasis in gastric cancer. Br J Cancer 2011; 105:413-9. [PMID: 21730981 PMCID: PMC3172906 DOI: 10.1038/bjc.2011.248] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: We aimed to evaluate the immunologic nature of sentinel lymph nodes (SLNs) in gastric cancer patients and to determine whether it can predict non-SLN metastasis. Methods: Sentinel lymph node samples were collected from 64 gastric carcinoma patients who had undergone gastrectomy with SLN biopsy. One representative SLN sample was selected from each patient and was subjected to immunostaining for CD8, CD57, FOXP3, and DC-LAMP. The numbers of marker-positive cells in each sample were counted. The relationships between various immune cell densities and clinicopathologic parameters or metastasis status of SLNs and non-SLNs were sought. Results: High FOXP3+ Treg density of the SLN was found to be significantly associated with the presence of metastasis in either SLNs or non-SLNs. DC-LAMP+ cell density of the SLN was the highest at the isolated tumours cell level, and this decreased along with an increase in tumour metastasis in either SLNs or non-SLNs. Univariate and multivariate logistic regression models revealed that high FOXP3+ Treg density of the SLN was an independently significant predictor of non-SLN metastasis. Conclusions: This study is the first to indicate an important role of SLNs in metastatic dissemination of gastric cancer. Our findings suggest that Tregs could be a new therapeutic target for regulating the metastasis of gastric cancer.
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Affiliation(s)
- H E Lee
- Department of Pathology, Seoul National University Hospital, 28 Yeongon-dong, Jongno-gu, Seoul 110-744, Korea
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Shin HJ, Kim HH, Ahn JH, Kim SB, Jung KH, Gong G, Son BH, Ahn SH. Comparison of mammography, sonography, MRI and clinical examination in patients with locally advanced or inflammatory breast cancer who underwent neoadjuvant chemotherapy. Br J Radiol 2010; 84:612-20. [PMID: 21081579 DOI: 10.1259/bjr/74430952] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES The purpose of this study was to determine the relative accuracies of mammography, sonography, MRI and clinical examination in predicting residual tumour size and pathological response after neoadjuvant chemotherapy for locally advanced or inflammatory breast cancer. Each prediction method was compared with the gold standard of surgical pathology. METHODS 43 patients (age range, 25-62 years; mean age, 42.7 years) with locally advanced or inflammatory breast cancer who had been treated by neoadjuvant chemotherapy were enrolled prospectively. We compared the predicted residual tumour size and the predicted response on imaging and clinical examination with residual tumour size and response on pathology. Statistical analysis was performed using weighted kappa statistics and intraclass correlation coefficients (ICC). RESULTS The ICC values between predicted tumour size and pathologically determined tumour size were 0.65 for clinical examination, 0.69 for mammography, 0.78 for sonography and 0.97 for MRI. Agreement between the response predictions at mid-treatment and the responses measured by pathology had kappa values of 0.28 for clinical examination, 0.32 for mammography, 0.46 for sonography and 0.68 for MRI. Agreement between the final response predictions and the responses measured by pathology had kappa values of 0.43 for clinical examination, 0.44 for mammography, 0.50 for sonography and 0.82 for MRI. CONCLUSION Predictions of response and residual tumour size made on MRI were better correlated with the assessments of response and residual tumour size made upon pathology than were predictions made on the basis of clinical examination, mammography or sonography. Thus, the evaluation of predicted response using MRI could provide a relatively sensitive early assessment of chemotherapy efficacy.
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Affiliation(s)
- H J Shin
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Songpa-Gu, Seoul, Korea
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Jo SH, Park HM, Kim SM, Kim HH, Hur CG, Choi D. Unraveling the sequence dynamics of the formation of genus-specific satellite DNAs in the family solanaceae. Heredity (Edinb) 2010; 106:876-85. [PMID: 21063436 DOI: 10.1038/hdy.2010.131] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Tandemly repeated DNAs, referred to as satellite DNAs, often occur in a genome in a genus-specific manner. However, the mechanisms for generation and evolution for these sequences are largely unknown because of the uncertain origins of the satellite DNAs. We found highly divergent genus-specific satellite DNAs that showed sequence similarity with genus-specific intergenic spacers (IGSs) in the family Solanaceae, which includes the genera Nicotiana, Solanum and Capsicum. The conserved position of the IGS between 25S and 18S rDNA facilitates comparison of IGS sequences across genera, even in the presence of very low sequence similarity. Sequence comparison of IGS may elucidate the procedure of the genesis of complex monomer units of the satellite DNAs. Within the IGS of Capsicum species, base substitutions and copy number variation of subrepeat monomers were causes of monomer divergence in IGS sequences. At the level of inter-generic IGS sequences of the family Solanaceae, however, genus-specific motif selection, motif shuffling between subrepeats and differential amplification among motifs were involved in formation of genus-specific IGS. Therefore, the genus-specific satellite DNAs in Solanaceae plants can be generated from differentially organized repeat monomers of the IGS rather than by accumulation of mutations from pre-existent satellite DNAs.
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Affiliation(s)
- S-H Jo
- Plant Systems Engineering Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Korea
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Shin HJ, Kim HH, Huh MO, Kim MJ, Yi A, Kim H, Son BH, Ahn SH. Correlation between mammographic and sonographic findings and prognostic factors in patients with node-negative invasive breast cancer. Br J Radiol 2010; 84:19-30. [PMID: 20682592 DOI: 10.1259/bjr/92960562] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study was to correlate sonographic and mammographic findings with prognostic factors in patients with node-negative invasive breast cancer. METHODS Sonographic and mammographic findings in 710 consecutive patients (age range 21-81 years; mean age 49 years) with 715 node-negative invasive breast cancers were retrospectively evaluated. Pathology reports relating to tumour size, histological grade, lymphovascular invasion (LVI), extensive intraductal component (EIC), oestrogen receptor (ER) status and HER-2/neu status were reviewed and correlated with the imaging findings. Statistical analysis was performed using logistic regression analysis and intraclass correlation coefficient (ICC). RESULTS On mammography, non-spiculated masses with calcifications were associated with all poor prognostic factors: high histological grade, positive LVI, EIC, HER-2/neu status and negative ER. Other lesions were associated with none of these poor prognostic factors. Hyperdense masses on mammography, the presence of mixed echogenicity, posterior enhancement, calcifications in-or-out of masses and diffusely increased vascularity on sonography were associated with high histological grade and negative ER. Associated calcifications on both mammograms and sonograms were correlated with EIC and HER-2/neu overexpression. The ICC value for the disease extent was 0.60 on mammography and 0.70 on sonography. CONCLUSION Several sonographic and mammographic features can have a prognostic value in the subsequent treatment of patients with node-negative invasive breast cancer. Radiologists should pay more attention to masses that are associated with calcifications because on both mammography and sonography associated calcifications were predictors of positive EIC and HER-2/neu overexpression.
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Affiliation(s)
- H J Shin
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan, Songpa-Gu, Seoul, Korea
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Jeon TY, Lee S, Kim HH, Kim YJ, Lee JG, Jeong DW, Kim YJ. Long-term changes in gut hormones, appetite and food intake 1 year after subtotal gastrectomy with normal body weight. Eur J Clin Nutr 2010; 64:826-31. [PMID: 20485300 DOI: 10.1038/ejcn.2010.83] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES No prospective study on the long-term effects of gastric resection on gastrointestinal hormonal changes in patients with normal body weight has been reported. The aim of this study was to evaluate the 1-year effect of subtotal gastrectomy on ghrelin and peptide YY (PYY)(3-36) levels. SUBJECTS/METHODS Eighteen patients with early gastric cancer underwent subtotal gastrectomy with Billroth I reconstruction. We assessed appetite, food intake, body composition, and ghrelin and PYY(3-36) levels preoperatively and 1 year after surgery. RESULTS There were no significant difference in the preoperative daily food intake and 1 year after subtotal gastrectomy. Weight loss occurred in all study subjects; 11.7% (n=2), 55.5% (n=10) and 33.3% (n=6) of the patients lost <5%, 5-10% and >10% of their preoperative body weight, respectively. Body mass index, waist circumference and body fat significantly decreased 1 year after subtotal gastrectomy. There were no significant differences in the appetite visual analogue scale preoperatively and 1 year after subtotal gastrectomy. The plasma ghrelin concentration decreased significantly (P=0.006), whereas PYY(3-36) did not show a significant change 1 year after subtotal gastrectomy. CONCLUSIONS Ghrelin levels and body fat decreased significantly, whereas PYY(3-36) levels as well as appetite and food intake did not change significantly 1 year after subtotal gastrectomy with normal body weight. These findings suggest that decreased ghrelin might contribute directly to reduced body fat.
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Affiliation(s)
- T Y Jeon
- Department of Surgery, Pusan National University Hospital, Busan, South Korea
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Lee KW, Bang SM, Kim S, Lee HJ, Shin DY, Koh Y, Lee YG, Cha Y, Kim YJ, Kim JH, Park DJ, Kim HH, Oh D, Lee JS. The incidence, risk factors and prognostic implications of venous thromboembolism in patients with gastric cancer. J Thromb Haemost 2010; 8:540-7. [PMID: 20040044 DOI: 10.1111/j.1538-7836.2009.03731.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Data on venous thromboembolism (VTE) in gastric cancer (GC) are very scarce. OBJECTIVE To investigate the incidence, risk factors and prognostic implications of VTE in Asian GC patients. METHODS Prospective databases containing clinical information on GC patients (n = 2,085) were used. RESULTS The 2-year cumulative incidences of all VTE events were 0.5%, 3.5% and 24.4% in stages I, II-IV(M0) and IV(M1), respectively. Advanced stage, older age and no major surgery were independent risk factors for developing VTE. When the VTE cases were classified into extremity venous thrombosis (EVT), pulmonary thromboembolism (PTE) or intra-abdominal venous thrombosis (IVT), IVTs (62%) were more common than EVTs (21%) or PTEs (17%). Although peri-operative pharmacologic thromboprophylaxis was not routinely administered, the VTE incidence after major surgery was only 0.2%. During chemotherapy, EVT/PTE developed more frequently than IVT (54% vs. 19%); however, during untreated or treatment-refractory periods, IVT developed more frequently than EVT/PTE (69% vs. 36%). In multivariate models, the development of EVT/PTE was a significant predictor of early death when compared with no occurrence of VTE (P < 0.05). However, IVT did not affect survival. CONCLUSION This is the largest study that specially focused on VTE in GC and the VTE incidence in Asian GC patients was first demonstrated. Considering the low incidence of post-operative VTE development, the necessity of peri-operative pharmacologic thromboprophylaxis should be evaluated separately in Asian patients. The clinical situation of the development of EVT/PTE and IVT differed. Only EVT/PTE had an adverse effect on survival and IVT had no prognostic significance.
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Affiliation(s)
- K W Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul, South Korea
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Lim YA, Kim HH, Joung US, Kim CY, Shin YH, Lee SW, Kim HJ. The development of a national surveillance system for monitoring blood use and inventory levels at sentinel hospitals in South Korea. Transfus Med 2009; 20:104-12. [PMID: 20015060 DOI: 10.1111/j.1365-3148.2009.00986.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We developed a web-based program for a national surveillance system to determine baseline data regarding the supply and demand of blood products at sentinel hospitals in South Korea. Sentinel hospitals were invited to participate in a 1-month pilot-test. The data for receipts and exports of blood from each hospital information system were converted into comma-separated value files according to a specific conversion rule. The daily data from the sites could be transferred to the web-based program server using a semi-automated submission procedure: pressing a key allowed the program to automatically compute the blood inventory level as well as other indices including the minimal inventory ratio (MIR), ideal inventory ratio (IIR), supply index (SI) and utilisation index (UI). The national surveillance system was referred to as the Korean Blood Inventory Monitoring System (KBIMS) and the web-based program for KBIMS was referred to as the Blood Inventory Monitoring System (BMS). A total of 30 256 red blood cell (RBC) units were submitted as receipt data, however, only 83% of the receipt data were submitted to the BMS server as export data (25 093 RBC units). Median values were 2.67 for MIR, 1.08 for IIR, 1.00 for SI, 0.88 for UI and 5.33 for the ideal inventory day. The BMS program was easy to use and is expected to provide a useful tool for monitoring hospital inventory levels. This information will provide baseline data regarding the supply and demand of blood products in South Korea.
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Affiliation(s)
- Y A Lim
- Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea.
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Cho GS, Kim W, Kim HH, Ryu SW, Kim MC, Ryu SY. Multicentre study of the safety of laparoscopic subtotal gastrectomy for gastric cancer in the elderly. Br J Surg 2009; 96:1437-42. [PMID: 19918857 DOI: 10.1002/bjs.6777] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The aim of this study was to assess the safety and short-term value of laparoscopic gastrectomy in the elderly with gastric cancer compared with a younger cohort. METHODS Data on all patients with gastric cancer undergoing laparoscopic gastrectomy at ten institutions in Korea between May 1998 and December 2005 were collected. Patients under the age of 45 years and those undergoing total gastrectomy, proximal gastrectomy and pylorus-preserving gastrectomy were excluded. An analysis of clinicopathological data for patients aged 45-69 years (average-age group) and those aged 70 years or more (elderly group) was undertaken. RESULTS Co-morbidity was more common and postoperative hospital stay was longer in elderly patients. Pre-existing pulmonary and cardiovascular disease in the elderly contributed to respiratory dysfunction and intraperitoneal complications respectively. Tumour size and location, stage, methods of reconstruction and the number of combined operations were similar in the two groups. There were no significant differences in postoperative morbidity or mortality. CONCLUSION Although elderly patients had greater co-morbidity, laparoscopic gastrectomy was a safe treatment for gastric cancer in this age group.
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Affiliation(s)
- G S Cho
- Department of Surgery, Soonchunhyang University, Bucheon, Korea
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Im CH, Kang EH, Ki JY, Shin DW, Choi HJ, Chang EJ, Lee EY, Lee YJ, Lee EB, Kim HH, Song YW. Receptor activator of nuclear factor kappa B ligand-mediated osteoclastogenesis is elevated in ankylosing spondylitis. Clin Exp Rheumatol 2009; 27:620-625. [PMID: 19772794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Ankylosing spondylitis (AS) is an inflammatory arthritis involving the axial skeleton. Decreased bone mineral density has also been reported in AS patients. This study sought to determine whether osteoclastogenesis and osteoclast activity are increased in AS. METHODS Twenty patients with AS were evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and other clinical parameters. Mononuclear cells were separated out from peripheral blood samples taken from AS patients and normal healthy controls and cultured with monocyte colony stimulating factor and receptor activator of the nuclear factor kappa B ligand (RANKL). Multi-nucleated, tartrate-resistant acid phosphatase stain-positive osteoclasts were counted after 9 days, and the areas of calcium absorption on calcium-coated plates were determined. RESULTS Osteoclastogenesis was significantly greater in AS patients than in normal controls (number of osteoclasts/1106 mononuclear cells, median, 518.0 vs. 362.5, p=0.036). No differences were observed between AS patients and controls in terms of calcium absorption areas or the serum concentrations of tumor necrosis factor and RANKL. Osteoclastogenesis was greater in AS patients with sacroiliac joint ankylosis than in those without. Osteoclastogenesis and the calcium absorption area were not found to be correlated with BASDAI nor with other clinical parameters including age, erythrocyte sedimentation rate, and C-reactive protein levels. CONCLUSION Osteoclastogenesis is elevated in AS patients, especially in those with sacroiliac joint ankylosis. Increased osteoclastogenesis may be related to osteopenia in AS patients.
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Affiliation(s)
- C H Im
- Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine; Seoul, Korea
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Kim HH, Lee YG, Park SU, Lee SC, Baek HJ, Cho EG, Engelmann F. Development of alternative loading solutions in droplet-vitrification procedures. Cryo Letters 2009; 30:291-299. [PMID: 19789826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In plant vitrification protocols, the loading treatment, which involves treating the explants with a moderately concentrated cryoprotectant solution, precedes dehydration of explants with highly concentrated vitrification solutions in order to reduce the toxicity which can be induced by their direct exposure to such highly concentrated solutions. This study aimed at developing alternative loading solutions composed of mixtures of glycerol and sucrose at various concentrations. Differential scanning calorimetry runs of loading solutions and of loaded and dehydrated explants were performed to assay thermal events occurring during cooling and warming. These loading solutions were applied to two model species, viz. garlic and chrysanthemum which were cryopreserved using a droplet-vitrification procedure. The loading treatment proved to be beneficial to both garlic and chrysanthemum and increased recovery of cryopreserved explants. However, response to the loading solutions tested varied between the two model species employed: with garlic, all the loading solutions had a similar effect, whereas survival of chrysanthemum shoot tips was significantly influenced by the composition of the loading solution employed. A loading solution comprising 1.9 M glycerol and 0.5 M sucrose was the most effective. The loading treatment may thus act as an osmotic stress neutralizer and/or induce the physiological adaptation of tissues and cells, including membranes, to both dehydration and freezing.
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Affiliation(s)
- H H Kim
- National Academy of Agricultural Science, RDA, Suwon, Korea.
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Abstract
The purpose of this paper was to characterize cytochrome P450 (CYP) enzymes involved in N-dealkylation of a new oral erectogenic, DA-8159 to DA-8164, a major circulating active metabolite, in human liver microsomes and to investigate the inhibitory potential of DA-8159 on CYP enzymes. CYP3A4 was identified as the major enzyme responsible for DA-8159 N-dealkylation to DA-8164 based on correlation analysis and specific CYP inhibitor and antibody-mediated inhibition study in human liver microsomes, and DA-8159 metabolism in cDNA expressed CYP enzymes. There is the possibility of drug-drug interactions when prescribing DA-8159 concomitantly with known inhibitors or inducers of CYP3A4. DA-8159 was found to be only a very weak inhibitor of eight major CYPs (1A2, 2A6, 2C8, 2C9, 2C19, 2D6, 2E1 and 3A4), the largest inhibition occurring against CYP2D6 (IC5o 67.7 microM) in human liver microsomes. Drug-drug interactions would not be predicted on the basis of DA-8159 inhibiting the metabolism of coadministered drugs.
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Affiliation(s)
- H Y Ji
- Drug Metabolism and Bioanalysis Laboratory, College of Pharmacy and Phytofermentation Research Center, Wonkwang University, Iksan 570-749, Korea
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Huang H, Chang EJ, Lee Y, Kim JS, Kang SS, Kim HH. A genome-wide microarray analysis reveals anti-inflammatory target genes of paeonol in macrophages. Inflamm Res 2008; 57:189-98. [PMID: 18363035 DOI: 10.1007/s00011-007-7190-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Paeony root has long been used for its anti-inflammatory effects. In this study, the effects of albiflorin, paeoniflorin, and paeonol, compounds from paeony root, on gene expression profiles were examined in macrophages challenged with the inflammation inducer lipopolysaccharide (LPS). METHODS The RAW264.7 macrophages were treated with LPS in the presence or absence of albiflorin, paeoniflorin, or paeonol. Global mRNA expression levels were detected by using an oligonucleotide microarray platform covering the mouse whole genome. RESULTS Treatment with LPS caused expression level changes in 1,270 genes by 2 folds or more. Paeonol attenuated the induction level of 355 LPS-responsive genes. Classification of the genes targeted by paeonol according to the Panther group analysis revealed 20 biological processes, 24 molecular functions, and 22 signaling pathways. The Panther signaling pathways highly affected by paeonol included the 'inflammation mediated by chemokine and cytokine signaling', 'interleukin signaling', and 'Toll receptor signaling'. CONCLUSION Our results demonstrate that paeonol has extensive inhibitory effects on the regulation of inflammation associated gene expression by LPS in macrophages. In addition, the predominant effect of paeonol among the tested compounds suggests that paeonol may be a major ingredient for the anti-inflammatory effect of paeony root.
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Affiliation(s)
- H Huang
- Department of Cell and Developmental Biology, BK21 Program, Seoul National University, School of Dentistry, 28 Yeongon-Dong, Chongno-Gu, Seoul 110-749, Korea
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