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Cho C, Kim B, Kim DS, Hwang MY, Shim I, Song M, Lee YC, Jung SH, Cho SK, Park WY, Myung W, Kim BJ, Do R, Choi HK, Merriman TR, Kim YJ, Won HH. Large-scale cross-ancestry genome-wide meta-analysis of serum urate. Nat Commun 2024; 15:3441. [PMID: 38658550 PMCID: PMC11043400 DOI: 10.1038/s41467-024-47805-4] [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: 08/08/2023] [Accepted: 04/10/2024] [Indexed: 04/26/2024] Open
Abstract
Hyperuricemia is an essential causal risk factor for gout and is associated with cardiometabolic diseases. Given the limited contribution of East Asian ancestry to genome-wide association studies of serum urate, the genetic architecture of serum urate requires exploration. A large-scale cross-ancestry genome-wide association meta-analysis of 1,029,323 individuals and ancestry-specific meta-analysis identifies a total of 351 loci, including 17 previously unreported loci. The genetic architecture of serum urate control is similar between European and East Asian populations. A transcriptome-wide association study, enrichment analysis, and colocalization analysis in relevant tissues identify candidate serum urate-associated genes, including CTBP1, SKIV2L, and WWP2. A phenome-wide association study using polygenic risk scores identifies serum urate-correlated diseases including heart failure and hypertension. Mendelian randomization and mediation analyses show that serum urate-associated genes might have a causal relationship with serum urate-correlated diseases via mediation effects. This study elucidates our understanding of the genetic architecture of serum urate control.
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Affiliation(s)
- Chamlee Cho
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Beomsu Kim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Dan Say Kim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Mi Yeong Hwang
- Division of Genome Science, Department of Precision Medicine, National Institute of Health, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Injeong Shim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Minku Song
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Yeong Chan Lee
- Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Sang-Hyuk Jung
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sung Kweon Cho
- Department of Pharmacology, Ajou University School of Medicine (AUSOM), Suwon, Republic of Korea
| | - Woong-Yang Park
- Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Bong-Jo Kim
- Division of Genome Science, Department of Precision Medicine, National Institute of Health, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Ron Do
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hyon K Choi
- Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Tony R Merriman
- Biochemistry Department, University of Otago, Dunedin, New Zealand
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Young Jin Kim
- Division of Genome Science, Department of Precision Medicine, National Institute of Health, Cheongju-si, Chungcheongbuk-do, Republic of Korea.
| | - Hong-Hee Won
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea.
- Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Kwon SS, Jang Y, You JS, Lee CW, Yu H, Yoon J, Park YS, Ryoo HA, Lee D, Cho N, Ihm HK, Lee YC, Won HH, Kang HS, Ha TH, Myung W. Interpersonal sensitivity and childhood trauma in patients with major depressive disorder, bipolar I, and II disorder. Eur Arch Psychiatry Clin Neurosci 2024; 274:537-547. [PMID: 37195522 DOI: 10.1007/s00406-023-01619-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 05/04/2023] [Indexed: 05/18/2023]
Abstract
Childhood trauma and interpersonal sensitivity impact the development of mood disorders. In this study, we investigate the association between childhood trauma and interpersonal sensitivity in patients with mood disorders. A total 775 patients (major depressive disorder [MDD, n = 241], bipolar I disorder [BD I, n = 119], and bipolar II disorder [BD II, n = 415]) and 734 controls. For evaluation, we used the Childhood Trauma Questionnaire-Short Form (CTQ) and Interpersonal Sensitivity Measure (IPSM). We examined between-group differences for each subscale in the CTQ and IPSM. Patients with BD II had significantly higher IPSM total scores than patients with MDD, BD I, or controls. The CTQ total score was related to the IPSM total score in all participants and subgroups. Among the CTQ subscales, emotional abuse showed the highest correlation with the IPSM total score, while separation anxiety and fragile inner self showed higher positive correlations with CTQ than the other subscales of IPSM in all patient groups and the control group, respectively. The findings reveal that childhood trauma and interpersonal sensitivity are positively correlated among patients with MDD, BD I, and BD II, and that interpersonal sensitivity is higher in patients with BD II than those with BD I or MDD. Childhood trauma is associated with interpersonal sensitivity, and each trauma type has a different impact on mood disorders. We expect that this study will encourage future research on interpersonal sensitivity and childhood trauma in mood disorders to improve treatment approaches.
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Affiliation(s)
- Sarah Soonji Kwon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Yoonjeong Jang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
- Department of Health Science and Technology, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| | - Ji Seon You
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
- Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea
| | - Chan Woo Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Hyeona Yu
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Joohyun Yoon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Yun Seong Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Hyun A Ryoo
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Daseul Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Nayoung Cho
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Hong Kyu Ihm
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
| | - Yeong Chan Lee
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Hong-Hee Won
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyo Shin Kang
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Tae Hyon Ha
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 29, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13619, Republic of Korea.
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Kim JE, Lee YC, Kim TS, Kim ER, Hong SN, Kim YH, Kim K, Chang DK. Rebamipide Prevents the Hemoglobin Drop Related to Mucosal-Damaging Agents at a Level Comparable to Proton Pump Inhibitors. Gut Liver 2024:gnl230372. [PMID: 38468192 DOI: 10.5009/gnl230372] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 03/13/2024] Open
Abstract
Background/Aims : The effect of proton pump inhibitors (PPIs) on the lower gastrointestinal (GI) tract is uncertain, with potential to worsen damage. This study aimed to find the best method for protecting the entire GI tract from mucosal damage. Methods : A retrospective cohort study at Samsung Medical Center (2002-2019) included 195,817 patients prescribed GI mucosa-damaging agents. The primary goal was to assess the effectiveness of GI protective agents in preventing significant hemoglobin drops (>2 g/dL), indicating overall GI mucosal damage. Self-controlled case series and landmark analysis were used to address biases in real-world data. Results : The incidence rate ratios for rebamipide, PPI, and histamine-2 receptor antagonist (H2RA) were 0.34, 0.33, and 0.52, respectively. Rebamipide showed a significantly lower incidence rate than H2RA and was comparable to PPIs. Landmark analysis revealed significant reductions in hemoglobin drop risk with rebamipide and H2RA, but not with PPI. Conclusions : Rebamipide, like PPIs, was highly effective in preventing blood hemoglobin level decreases, as shown in real-world data. Rebamipide could be a comprehensive strategy for protecting the entire GI tract, especially when considering PPIs' potential side effects on the lower GI tract.
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Affiliation(s)
- Ji Eun Kim
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeong Chan Lee
- Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Tae Se Kim
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Ran Kim
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Noh Hong
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-Ho Kim
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyunga Kim
- Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Dong Kyung Chang
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim GH, Lee YC, Kim TJ, Hong SN, Chang DK, Kim YH, Yang DH, Moon CM, Kim K, Kim HG, Kim ER. Trends in colorectal cancer incidence according to an increase in the number of colonoscopy cases in Korea. World J Gastrointest Oncol 2024; 16:51-60. [PMID: 38292837 PMCID: PMC10824123 DOI: 10.4251/wjgo.v16.i1.51] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/26/2023] [Accepted: 11/08/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND The incidence of colorectal cancer (CRC) and preinvasive CRC (e.g., early colon cancer and advanced adenoma) is gradually increasing in several countries. AIM To evaluate the trend in incidence of CRC and preinvasive CRC according to the increase in the number of colonoscopies performed in Korea. METHODS This retrospective cohort study enrolled Korean patients from 2002 to 2020 to evaluate the incidence of CRC and preinvasive CRC, and assess the numbers of diagnostic colonoscopies and colonoscopic polypectomies. Colonoscopy-related complications by age group were also determined. RESULTS The incidence of CRC showed a rapid increase, then decreased after 2012 in the 50-75 year-age group. During the study period, the rate of incidence of preinvasive CRC increased at a similar level in patients under 50 and 50-75 years of age. Since 2009, the increase has been rapid, showing a pattern similar to the increase in colonoscopies. The rate of colonoscopic polypectomy in patients aged under 50 was similar to the rate in patients over 75 years of age after 2007. The rate of complications after colonoscopy and related deaths within 3 mo was high for those over 75 years of age. CONCLUSION The diagnosis of preinvasive CRC increased with the increase in the number of colonoscopies performed. As the risk of colonoscopy-related hospitalization and death is high in the elderly, if early lesions at risk of developing CRC are diagnosed and treated under or at the age of 75, colonoscopy-related complications can be reduced for those aged 76 years or over.
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Affiliation(s)
- Ga Hee Kim
- Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Yeong Chan Lee
- Department of Digital Health, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Tae Jun Kim
- Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Sung Noh Hong
- Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Dong Kyung Chang
- Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Young-Ho Kim
- Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Dong-Hoon Yang
- Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
| | - Chang Mo Moon
- Division of Gastroenterology, Department of Internal Medicine, Ewha Womans University, Seoul 07985, South Korea
| | - Kyunga Kim
- Biomedical Statistics Center, Samsung Medical Center, Seoul 06351, South Korea
| | - Hyun Gun Kim
- Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul 04401, South Korea
| | - Eun-Ran Kim
- Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
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de Vente C, Vermeer KA, Jaccard N, Wang H, Sun H, Khader F, Truhn D, Aimyshev T, Zhanibekuly Y, Le TD, Galdran A, Ballester MAG, Carneiro G, Devika RG, Sethumadhavan HP, Puthussery D, Liu H, Yang Z, Kondo S, Kasai S, Wang E, Durvasula A, Heras J, Zapata MA, Araujo T, Aresta G, Bogunovic H, Arikan M, Lee YC, Cho HB, Choi YH, Qayyum A, Razzak I, van Ginneken B, Lemij HG, Sanchez CI. AIROGS: Artificial Intelligence for Robust Glaucoma Screening Challenge. IEEE Trans Med Imaging 2024; 43:542-557. [PMID: 37713220 DOI: 10.1109/tmi.2023.3313786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
The early detection of glaucoma is essential in preventing visual impairment. Artificial intelligence (AI) can be used to analyze color fundus photographs (CFPs) in a cost-effective manner, making glaucoma screening more accessible. While AI models for glaucoma screening from CFPs have shown promising results in laboratory settings, their performance decreases significantly in real-world scenarios due to the presence of out-of-distribution and low-quality images. To address this issue, we propose the Artificial Intelligence for Robust Glaucoma Screening (AIROGS) challenge. This challenge includes a large dataset of around 113,000 images from about 60,000 patients and 500 different screening centers, and encourages the development of algorithms that are robust to ungradable and unexpected input data. We evaluated solutions from 14 teams in this paper and found that the best teams performed similarly to a set of 20 expert ophthalmologists and optometrists. The highest-scoring team achieved an area under the receiver operating characteristic curve of 0.99 (95% CI: 0.98-0.99) for detecting ungradable images on-the-fly. Additionally, many of the algorithms showed robust performance when tested on three other publicly available datasets. These results demonstrate the feasibility of robust AI-enabled glaucoma screening.
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Lee YC, Kim TJ, Kim JH, Lee E, Park WY, Kim K, Son HJ. Short-term effects of ambient temperature on acute exacerbation of inflammatory bowel disease: A nationwide case-crossover study with external validation. PLoS One 2023; 18:e0291713. [PMID: 38157370 PMCID: PMC10756522 DOI: 10.1371/journal.pone.0291713] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/04/2023] [Indexed: 01/03/2024] Open
Abstract
Inflammatory bowel disease (IBD) is an idiopathic inflammatory disorder characterized by chronic and relapsing manifestations. Several environmental factors are known as triggers for exacerbation of IBD. However, an association between exacerbation of IBD and ambient temperature is uncertain. This study aimed to estimate the risk of acute exacerbation of IBD due to ambient temperature. We performed a bidirectional case-crossover study using a nationwide claim data from South Korea. The external validation was conducted with a large prospective cohort in the United Kingdom. We confirmed significant associations between acute exacerbation of IBD and the short-term ambient temperature changes toward severe temperatures, in the cold weather (-19.4°C-4.3°C) (odd ratio [OR] = 1.13, 95% confidence interval [CI]: 1.13-1.14) and in the hot weather (21.3°C-33.5°C) (OR = 1.16, 95% CI: 1.15-1.17). However, the association was not significant in the moderate weather (4.3°C-21.3°C). The external validation suggested consistent results with additional elevation of acute exacerbation risk in the colder weather (-13.4°C to 2.6°C) (OR = 1.90, 95% CI: 1.62-2.22) and in the hotter weather (15.7°C-28.4°C) (OR = 1.41, 95% CI: 1.32-1.51). We observed and validated that the short-term ambient temperature changes were associated with acute exacerbation of IBD in the cold and hot weathers. Our findings provide evidence that temperature changes are associated with the acute exacerbation of IBD.
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Affiliation(s)
- Yeong Chan Lee
- Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Tae Jun Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jong-Hun Kim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Eunjin Lee
- Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Woong-Yang Park
- Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyunga Kim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
- Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Hee Jung Son
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Li ST, Chou YH, Huang HJ, Chang HC, Lee YC. Exploring the Benefits of 3D-Printed Bolus in Cone Beam CT for Modified Radical Mastectomy Breast Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e685. [PMID: 37786014 DOI: 10.1016/j.ijrobp.2023.06.2152] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To improve the accuracy of superficial dose coverage for patients undergoing modified radical mastectomy (MRM), boluses are frequently applied to the skin surface of targeted region during radiotherapy. The irregular curvature of MRM breast cases results in discrepancies of dosimetry and poor contact. Additionally, the presence of an air gap causes unnecessary high-dose escalation and uncertainty in dose calculation, making the use of commercial flat bolus problematic. This study evaluated the effectiveness of 3D-printed bolus by comparing it to commercial bolus in setup variations and dosimetric compliance through daily cone-beam computed tomography (CBCT) scans. MATERIALS/METHODS Ten patients underwent MRM were divided into 2 groups. 5 patients treated with 0.5 cm commercial bolus as group A while the other 5 patients covered by 3D Bolus as group B. 3D bolus was made of polylactic acid filament (PLA) and contoured in advance with thickness of 0.5 cm on the surface of target. Positional errors were recorded through daily image guidance and compared with the images. Both groups had right-sided breast with neck lymph nodes involved and received 50 Gy in 25 fractions using 4 partial arcs of the volumetric modulated arc therapy (VMAT) technique. The CBCTs were recalculated through treatment planning system (TPS) to assess superficial dose coverage. A two-tailed student's t-test was applied. RESULTS Groups A and B pitch angles were -0.203 ± 0.837° and 0.334 ± 0.909° (p = 0.0003). Roll angle were 0.313 ± 0.728° and -0.633 ± 1.286° (p = 0.0000013). Yaw angle were -0.034 ± 0.872° and 0.018 ± 0.883° (p = 0.721). There was a trend of differences in the Z-axis and significant statistical differences in the pitch and roll angles due to aligning gel layers directly with group A's body surface, while 3D bolus rigidly adherence to group B's delineated curve. In the planned target volume (PTV), the CI and HI of group A were 0.9448±0.0208 and 1.2061±0.0448, respectively, while 0.9776±0.0144 and 1.1472±0.0206 (p<0.005) were for group B. As for the superficial region, which is defined from body surface to 0.5cm inside PTV, CI and HI of A were 0.8290±0.0599 and 1.4675±0.2434, while for B, they were 0.9753±0.0214 and 1.1330±0.0126, respectively (p<0.005). CONCLUSION The study analyzed the results through image comparison and investigated the CI and HI between two types of boluses. The 3D bolus reduces setup errors and improves dose coverage especially when superficial region is concerned. Better consistency of patient repositioning and dosimetry can be achieved and proved by daily assessment of CBCT scan. The customization of 3D bolus with integration of TPS and CT scans provides a solution to the inadequacies of commercial bolus. The results suggest that the use of 3D bolus is a promising development in radiation therapy for MRM breast cancer patients.
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Affiliation(s)
- S T Li
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Y H Chou
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - H J Huang
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - H C Chang
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Y C Lee
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
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Yang HF, Ke YF, Tsai PF, Chan HM, Chen HL, Lee YC. The Effectiveness of Music Interventions for Improving Anxiety Symptoms in Cancer Patients Undergoing Radiation Therapy. Int J Radiat Oncol Biol Phys 2023; 117:e453. [PMID: 37785457 DOI: 10.1016/j.ijrobp.2023.06.1641] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Being alone in the treatment room during radiation therapy (RT) often causes anxiety which may lead to treatment failure. The benefit of music interventions in reducing anxiety among cancer patients during RT simulations is still controversial. The goal of this study is to evaluate the effect of music on anxiety symptoms among patients undergoing initial RT and a randomized trial was conducted. MATERIALS/METHODS Patients who received RT for the first time were enrolled and were randomly allocated into groups of experiment and control. The questionnaire of mood thermometer (BSRS-5), distress thermometer (DT), and the Beck Anxiety Inventory (BAI-C) and were given before and after RT. We also measured the changes in physiological symptoms for ten consecutive days since the first day of RT. The experimental group was given music during RT, while the control group was not. The generalized linear mixed model was used to estimate the pre-post difference of music interventions on the BSRS-5, DT, and BAI-C compared with control group after considering the random intercept and the unstructured residual variance-covariance matrix. RESULTS A total of 50 patients in the experimental group and 50 patients in the control group were enrolled in this study. The satisfaction degree of treatment in the experimental group was 100%, but it was 96% in control group (p = 0.0048). The pre-test BSRS-5 was 3.4±2.3 for the experimental group versus 2.6±2.3 for the control group (p = 0.0815), the post-test BSRS-5 score was significantly reduced in the experimental group (1.6±1.4 for experimental group versus 2.7±2.2 for the control group, p = 0.0057), the significant pre-post difference of BSRS-5 between group was found (p = 0.0024). When the experimental group withdrew from the music intervention, the BSRS-5 rebounded to 3.7±3.0. The pre-test DT was 4.3±1.5 and 3.4±1.7 in the experimental group and control group (p = 0.0051), and the post-test DT score was significantly reduced in the experimental group (2.7±1.2 for the experimental group and 3.5±1.3 for the control group, p = 0.0021), the significant pre-post difference of DT between group was found (p<.0001). When the experimental group withdrew from the music intervention, the DT rebounded to 3.7±1.4. The pre-test BAI-C was 6.7±11.7 and 7.8±8.5 in the experimental group and control group (p = 0.5878), and the post-test BAI-C score was significantly lower in the experimental group (1.7±3.7 for the experimental group and 7.4±8.0 for the control group, p<.0001), however, the pre-post difference of BAI-C between group was not significant (p = 0.0619). When the experimental group withdrew from the music intervention, the BAI-C rebounded to 6.5±8.7. There is a significantly increased systolic blood pressure in the control group compared with the patients had music intervention. CONCLUSION This study's results provide evidence that playing music routinely (music intervention) during RT can be an excellent way to relieve patients' anxiety and improve their comfort.
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Affiliation(s)
- H F Yang
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Y F Ke
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - P F Tsai
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - H M Chan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - H L Chen
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Y C Lee
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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9
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Yarlagadda S, Kutuk T, Saxena A, Roy M, Tolakanahalli RP, Appel H, La Rosa de Los Rios AF, Tom MC, Hall MD, Wieczorek DJ, Lee YC, McDermott MW, Ahluwalia M, Gutierrez A, Mehta MP, Kotecha R. Stereotactic Radiosurgery for Small Intact Brain Metastasis: A Comparative Evaluation of 3 Different Single Fraction Prescription Doses. Int J Radiat Oncol Biol Phys 2023; 117:e159-e160. [PMID: 37784753 DOI: 10.1016/j.ijrobp.2023.06.989] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) While single-fraction stereotactic radiosurgery (SRS) in the treatment of small brain metastases (SBM, ≤ 2 cm) is well established, prescription dosing varies considerably across institutions and clinical trials. The choice of prescription dose is a delicate balance between local failure (LF) and radiation necrosis (RN) risks. In the modern era, historically-established dosing thresholds may no longer be applicable. To evaluate the impact of prescription dose on outcomes, we performed a comparative analysis of patients with SBM treated with definitive SRS using three different prescriptions, at a single tertiary institution. MATERIALS/METHODS Consecutive patients with intact SBM treated with SRS from January 2017 and December 2021 were analyzed. Baseline patient characteristics and dosing parameters were abstracted from the medical record. To limit the integral brain dose when treating multiple brain metastases, the institutional practice was to reduce prescription dose as the total number of lesions increased (i.e., 24 Gy for ≤10 lesions, 22 Gy for 11-20, and 20 Gy for >20). A per lesion analysis, where each lesion was followed from the date of SRS to the last follow-up, was conducted with primary endpoints of LF and RN. Gray's test was used to compare the cumulative incidence of the LF and RN, with death as a competing risk. Factors affecting LF were analyzed using Cox hazard regression analysis. RESULTS A total of 1318 SBM in 250 patients received SRS and met the inclusion criteria. The median age was 62 years (range: 18-90), median KPS was 90 (range: 50-100) and 66% were female. The most common primary tumors were lung (55.5%) and breast cancers (26.4%). With a median follow-up of 12 months, 136 (11%) LF in 44 patients and 70 (5.7%) RN events in 46 patients occurred. The actuarial 1-year cumulative rate of LF was lower in lesions treated with 24 Gy (6.4%, 95% CI: 4.7-8.6%) or 22 Gy (5.8%, 95% CI: 3.7-8.7%) compared to 20 Gy (15.4%, 95% CI: 10.9-20.5%) (p<0.01). 22 Gy and 24 Gy prescription doses were associated with a 44% and 52% reduction in risk in LF compared to 20 Gy (HR: 0.56; 95% CI: 0.36-0.9; p = 0.01 and HR: 0.48; 95% CI: 0.31-0.74; p<0.01, respectively). In a subset analysis of radiosensitive tumors, 1-year LF rate was still lower with 24 Gy (7.4%, 95% CI: 5.3-9.9%) and 22 Gy (6.1%, 95% CI: 3.7-9.4%) than 20 Gy (15.7%, 95% CI: 11.2-21%) (p = 0.01). The cumulative 1-year RN rate numerically declined with dose, but was not statistically significantly different, with 3.6% (95% CI: 2.3-5.3%) for 24 Gy, 2.6% (95% CI: 1.3-4.8%) for 22 Gy and 1.4% (95% CI: 0.4-3.7%) for 20 Gy. CONCLUSION Patients treated with single fraction SRS to intact SBM were at increased risk of LF with prescription doses of 20 Gy compared to 22-24 Gy, without an increased risk of RN. Even in patients with radiosensitive histologies, higher LF rates were still observed following 20 Gy compared to 22-24 Gy.
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Affiliation(s)
- S Yarlagadda
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - T Kutuk
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - A Saxena
- Department of Biostatistics, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - M Roy
- Department of Biostatistics, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - R P Tolakanahalli
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL; Department of Radiation Oncology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL
| | - H Appel
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - A F La Rosa de Los Rios
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - M C Tom
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - M D Hall
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL; Department of Radiation Oncology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL
| | - D J Wieczorek
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL; Department of Radiation Oncology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL
| | - Y C Lee
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL; Department of Radiation Oncology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL
| | - M W McDermott
- Department of Neurosurgery, Miami Neuroscience Institute, Baptist Health South Florida, Miami, FL
| | - M Ahluwalia
- Department of Medical Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - A Gutierrez
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL; Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - M P Mehta
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL; Department of Radiation Oncology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL
| | - R Kotecha
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL; Department of Radiation Oncology, Florida International University, Herbert Wertheim College of Medicine, Miami, FL
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Chang BJ, Lee YC. Src Kinase Activates Signal Transducer and Activator of Transcription 3 to Enhance Radioresistance in Triple Negative Breast Cancer Cells. Int J Radiat Oncol Biol Phys 2023; 117:e244. [PMID: 37784959 DOI: 10.1016/j.ijrobp.2023.06.1176] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Triple-negative breast cancer (TNBC) is known to be insensitive to radiation therapy, and it requires to development radiosensitizer for TNBC. MATERIALS/METHODS We previously established a radioresistant sub-line from MDA-MB-231 cells, called 231-RR, and have demonstrated that 231-RR cells displayed high cancer stem cell (CSC) activity. And 231-RR cells were treated with dasatinib, a Src inhibitor. RESULTS In the present study, we discovered that the activation of Src kinase was increased in 231-RR cells. Treatment of dasatinib, an Src inhibitor, sensitized 231-RR cells to radiotherapy, along with the increased p-γH2Axser139, indicated the enhancement of DNA damage. Dasatinib also caused the downregulation of cancer stemness factors, including c-Myc, OCT4, and the Notch intracellular domain, as well as the decrease of phosphorylation of Signal Transducer and Activator of Transcription 3 (STAT3). The treatment of C188-9, a STAT3 inhibitor, also sensitized 231-RR cells toward radiotherapy along with the increased p-γH2Axser139, but without changing the phosphorylation of Src, indicating that STAT3 is a downstream event of Src activation. CONCLUSION In conclusion, our data suggests that the inhibitors of Src or STAT3 could function as radiosensitizers or CSC targeting agents for TNBC radiotherapy.
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Affiliation(s)
- B J Chang
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Y C Lee
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
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11
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Kim JE, Choi YH, Lee YC, Seong G, Song JH, Kim TJ, Kim ER, Hong SN, Chang DK, Kim YH, Shin SY. Deep learning model for distinguishing Mayo endoscopic subscore 0 and 1 in patients with ulcerative colitis. Sci Rep 2023; 13:11351. [PMID: 37443370 PMCID: PMC10344868 DOI: 10.1038/s41598-023-38206-6] [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: 04/15/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
The aim of this study was to address the issue of differentiating between Mayo endoscopic subscore (MES) 0 and MES 1 using a deep learning model. A dataset of 492 ulcerative colitis (UC) patients who demonstrated MES improvement between January 2018 and December 2019 at Samsung Medical Center was utilized. Specifically, two representative images of the colon and rectum were selected from each patient, resulting in a total of 984 images for analysis. The deep learning model utilized in this study consisted of a convolutional neural network (CNN)-based encoder, with two auxiliary classifiers for the colon and rectum, as well as a final MES classifier that combined image features from both inputs. In the internal test, the model achieved an F1-score of 0.92, surpassing the performance of seven novice classifiers by an average margin of 0.11, and outperforming their consensus by 0.02. The area under the receiver operating characteristic curve (AUROC) was calculated to be 0.97 when considering MES 1 as positive, with an area under the precision-recall curve (AUPRC) of 0.98. In the external test using the Hyperkvasir dataset, the model achieved an F1-score of 0.89, AUROC of 0.86, and AUPRC of 0.97. The results demonstrate that the proposed CNN-based model, which integrates image features from both the colon and rectum, exhibits superior performance in accurately discriminating between MES 0 and MES 1 in patients with UC.
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Affiliation(s)
- Ji Eun Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Yoon Ho Choi
- Department of Artificial Intelligence and Informatics Research, Mayo Clinic, Jacksonville, FL, USA
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Yeong Chan Lee
- Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea
| | - Gyeol Seong
- Department of Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, South Korea
| | - Joo Hye Song
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Tae Jun Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Eun Ran Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Sung Noh Hong
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Dong Kyung Chang
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Young-Ho Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Soo-Yong Shin
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea.
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12
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Lee YC, Jung SH, Kumar A, Shim I, Song M, Kim MS, Kim K, Myung W, Park WY, Won HH. ICD2Vec: Mathematical representation of diseases. J Biomed Inform 2023; 141:104361. [PMID: 37054960 DOI: 10.1016/j.jbi.2023.104361] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND The International Classification of Diseases (ICD) codes represent the global standard for reporting disease conditions. The current ICD codes connote direct human-defined relationships among diseases in a hierarchical tree structure. Representing the ICD codes as mathematical vectors helps to capture nonlinear relationships in medical ontologies across diseases. METHODS We propose a universally applicable framework called "ICD2Vec" designed to provide mathematical representations of diseases by encoding corresponding information. First, we present the arithmetical and semantic relationships between diseases by mapping composite vectors for symptoms or diseases to the most similar ICD codes. Second, we investigated the validity of ICD2Vec by comparing the biological relationships and cosine similarities among the vectorized ICD codes. Third, we propose a new risk score called IRIS, derived from ICD2Vec, and demonstrate its clinical utility with large cohorts from the UK and South Korea. RESULTS Semantic compositionality was qualitatively confirmed between descriptions of symptoms and ICD2Vec. For example, the most diseases most similar to COVID-19 were found to be the common cold (ICD-10: J00), unspecified viral hemorrhagic fever (ICD-10: A99), and smallpox (ICD-10: B03). We show the significant associations between the cosine similarities derived from ICD2Vec and the biological relationships using disease-to-disease pairs. Furthermore, we observed significant adjusted hazard ratios (HR) and area under the receiver operating characteristics (AUROC) between IRIS and risks for eight diseases. For instance, the higher IRIS for coronary artery disease (CAD) can be the higher probability for the incidence of CAD (HR: 2.15 [95% CI 2.02-2.28] and AUROC: 0.587 [95% CI 0.583-0.591]). We identified individuals at substantially increased risk of CAD using IRIS and 10-year atherosclerotic cardiovascular disease risk (adjusted HR, 4.26, 95% CI, 3.59-5.05). CONCLUSIONS ICD2Vec, a proposed universal framework for converting qualitatively measured ICD codes into quantitative vectors containing semantic relationships between diseases, exhibited a significant correlation with actual biological significance. In addition, the IRIS was a significant predictor of major diseases in a prospective study using two large-scale Biobank EHR datasets. Based on this clinical validity and utility evidence, we suggest that publicly available ICD2Vec can be used in diverse research and clinical practices and has important clinical implications.
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Affiliation(s)
- Yeong Chan Lee
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Sang-Hyuk Jung
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Aman Kumar
- Department of Computer Science and Engineering, Indian Institute of Technology Kharagpur, West Bengal, India
| | - Injeong Shim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Minku Song
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Min Seo Kim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyunga Kim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea; Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Woong-Yang Park
- Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Hong-Hee Won
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea.
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13
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Lee YC, Cha J, Shim I, Park WY, Kang SW, Lim DH, Won HH. Multimodal deep learning of fundus abnormalities and traditional risk factors for cardiovascular risk prediction. NPJ Digit Med 2023; 6:14. [PMID: 36732671 PMCID: PMC9894867 DOI: 10.1038/s41746-023-00748-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 01/06/2023] [Indexed: 02/04/2023] Open
Abstract
Cardiovascular disease (CVD), the leading cause of death globally, is associated with complicated underlying risk factors. We develop an artificial intelligence model to identify CVD using multimodal data, including clinical risk factors and fundus photographs from the Samsung Medical Center (SMC) for development and internal validation and from the UK Biobank for external validation. The multimodal model achieves an area under the receiver operating characteristic curve (AUROC) of 0.781 (95% confidence interval [CI] 0.766-0.798) in the SMC and 0.872 (95% CI 0.857-0.886) in the UK Biobank. We further observe a significant association between the incidence of CVD and the predicted risk from at-risk patients in the UK Biobank (hazard ratio [HR] 6.28, 95% CI 4.72-8.34). We visualize the importance of individual features in photography and traditional risk factors. The results highlight that non-invasive fundus photography can be a possible predictive marker for CVD.
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Affiliation(s)
- Yeong Chan Lee
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
- Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jiho Cha
- Graduate School of Future Strategy, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Injeong Shim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Woong-Yang Park
- Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Se Woong Kang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong Hui Lim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea.
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Hong-Hee Won
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea.
- Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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14
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Na JE, Kim TJ, Lee YC, Kim JE, Kim ER, Hong SN, Chang DK, Kim YH. Risk of prostate cancer in patients with inflammatory bowel disease: a nationwide cohort study in South Korea. Therap Adv Gastroenterol 2022; 15:17562848221137430. [PMID: 36458049 PMCID: PMC9706079 DOI: 10.1177/17562848221137430] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/04/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Several studies have suggested an association between inflammatory bowel disease (IBD) and the risk of prostate cancer development. However, these findings are inconsistent, and studies based on Asian populations are limited. OBJECTIVES We compared the risk of prostate cancer according to IBD status using the Korean National Health Insurance Service database. DESIGN A population-based retrospective cohort of age-matched 59,044 non-IBD patients and 14,761 IBD patients between January 2009 and December 2011 was analyzed up to December 2017. METHODS The risk of prostate cancer was compared between patients with IBD and controls using the Cox proportional hazards regression model and Kaplan-Meier survival analysis. RESULTS During a median follow-up of 6 years, the incidence rate of prostate cancer was 264 per 100,000 person-years in non-IBD patients and 242 per 100,000 person-years in patients with IBD. IBD status was not associated with the risk of prostate cancer compared to non-IBD [adjusted hazard ratio (aHR) 0.93, 95% confidence interval (CI): 0.80-1.08, p = 0.32). The cumulative incidence of prostate cancer did not differ by IBD status (non-IBD patients versus IBD patients: log-rank p = 0.27; non-IBD patients versus ulcerative colitis versus Crohn's disease: log-rank p = 0.42). In multivariate analysis, age was an independent risk factor for the development of prostate cancer (HR 1.03, 95% CI: 1.02-1.03, p < 0.001). CONCLUSION In our population-based study, IBD status was not associated with the risk of prostate cancer.
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Affiliation(s)
- Ji Eun Na
- Department of Medicine, Inje University
Haeundae Paik Hospital, Busan, Republic of Korea
| | - Tae Jun Kim
- Division of Gastroenterology, Department of
Medicine, Samsung Medical Center, Sungkyunkwan University School of
Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Yeong Chan Lee
- Department of Digital Health, Samsung Advanced
Institute for Health Sciences & Technology, Sungkyunkwan University,
Seoul, Republic of Korea
| | - Ji Eun Kim
- Department of Medicine, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eun Ran Kim
- Department of Medicine, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Noh Hong
- Department of Medicine, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong Kyung Chang
- Department of Medicine, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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15
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You JS, Lee CW, Park JY, Jang Y, Yu H, Yoon J, Kwon SS, Oh S, Park YS, Ryoo HA, Lee JH, Lee D, Lee J, Kim Y, Cho N, Ihm HK, Park CHK, Lee YC, Won HH, Kang HS, Beak JH, Ha TH, Myung W. Borderline Personality Pathology in Major Depressive Disorder, Bipolar I and II Disorder, and Its Relationship With Childhood Trauma. Psychiatry Investig 2022; 19:909-918. [PMID: 36444154 PMCID: PMC9708861 DOI: 10.30773/pi.2022.0114] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/21/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Mood disorder and borderline personality pathology (BPP) are frequently comorbid and relate to childhood trauma. We investigated the relationship between childhood trauma and BPP features in mood disorder patients versus controls. METHODS A total of 488 mood disorder patients, particularly major depressive disorder (MDD), bipolar I disorder (BD I), and bipolar II disorder (BD II), and 734 controls were included. We examined between-group BPP-related differences and correlated between BPP and childhood trauma using the Childhood Trauma Questionnaire-Short Form (CTQ) and the Personality Assessment Inventory-Borderline Features Scale. RESULTS BD II patients showed significantly higher BPP. Emotional abuse and neglect were prominently associated with BPP, while affective instability and negative relationships exhibited a stronger association with childhood trauma. We also found a positive relationship between childhood trauma and BPP in MDD, BD I, and BD II patients. CONCLUSION The findings of the present study imply that BPP features are more likely to be found in patients with BD II than BD I or MDD. Mood disorder patients with severe childhood trauma may have higher BPP features. Thus, further study of the relationship between childhood trauma and BPP features could improve the therapeutic approaches and help understand patients with mood disorders.
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Affiliation(s)
- Ji Seon You
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea
| | - Chan Woo Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ji Yoon Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yoonjeong Jang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyeona Yu
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Joohyun Yoon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sarah Soonji Kwon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sunghee Oh
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yun Seong Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyun A Ryoo
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jong Hun Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Daseul Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jakyung Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yeoju Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Nayoung Cho
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hong Kyu Ihm
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - C Hyung Keun Park
- Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea
| | - Yeong Chan Lee
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Hong-Hee Won
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyo Shin Kang
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Ji Hyun Beak
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tae Hyon Ha
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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16
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Na JE, Lee YC, Kim TJ, Lee H, Won HH, Min YW, Min BH, Lee JH, Rhee PL, Kim JJ. Utility of a deep learning model and a clinical model for predicting bleeding after endoscopic submucosal dissection in patients with early gastric cancer. World J Gastroenterol 2022; 28:2721-2732. [PMID: 35979158 PMCID: PMC9260866 DOI: 10.3748/wjg.v28.i24.2721] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 03/25/2022] [Accepted: 05/08/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Bleeding is one of the major complications after endoscopic submucosal dissection (ESD) in early gastric cancer (EGC) patients. There are limited studies on estimating the bleeding risk after ESD using an artificial intelligence system.
AIM To derivate and verify the performance of the deep learning model and the clinical model for predicting bleeding risk after ESD in EGC patients.
METHODS Patients with EGC who underwent ESD between January 2010 and June 2020 at the Samsung Medical Center were enrolled, and post-ESD bleeding (PEB) was investigated retrospectively. We split the entire cohort into a development set (80%) and a validation set (20%). The deep learning and clinical model were built on the development set and tested in the validation set. The performance of the deep learning model and the clinical model were compared using the area under the curve and the stratification of bleeding risk after ESD.
RESULTS A total of 5629 patients were included, and PEB occurred in 325 patients. The area under the curve for predicting PEB was 0.71 (95% confidence interval: 0.63-0.78) in the deep learning model and 0.70 (95% confidence interval: 0.62-0.77) in the clinical model, without significant difference (P = 0.730). The patients expected to the low- (< 5%), intermediate- (≥ 5%, < 9%), and high-risk (≥ 9%) categories were observed with actual bleeding rate of 2.2%, 3.9%, and 11.6%, respectively, in the deep learning model; 4.0%, 8.8%, and 18.2%, respectively, in the clinical model.
CONCLUSION A deep learning model can predict and stratify the bleeding risk after ESD in patients with EGC.
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Affiliation(s)
- Ji Eun Na
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan 48108, South Korea
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Yeong Chan Lee
- Department of Digital Health, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul 06351, South Korea
| | - Tae Jun Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Hyuk Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Hong-Hee Won
- Department of Digital Health, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul 06351, South Korea
| | - Yang Won Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Byung-Hoon Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Jun Haeng Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Poong-Lyul Rhee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
| | - Jae J Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
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17
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Yu JY, Hong S, Lee YC, Lee KH, Lee I, Seo Y, Kang M, Kim K, Cha WC, Shin SY. Stakeholders’ Requirements for Artificial Intelligence for Healthcare in Korea. Healthc Inform Res 2022; 28:143-151. [PMID: 35576982 PMCID: PMC9117806 DOI: 10.4258/hir.2022.28.2.143] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/04/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives The outlook of artificial intelligence for healthcare (AI4H) is promising. However, no studies have yet discussed the issues from the perspective of stakeholders in Korea. This research aimed to identify stakeholders’ requirements for AI4H to accelerate the business and research of AI4H. Methods We identified research funding trends from the Korean National Science and Technology Knowledge Information Service (NTIS) from 2015 and 2019 using “healthcare AI” and related keywords. Furthermore, we conducted an online survey with members of the Korean Society of Artificial Intelligence in Medicine to identify experts’ opinions regarding the development of AI4H. Finally, expert interviews were conducted with 13 experts in three areas (hospitals, industry, and academia). Results We found 160 related projects from the NTIS. The major data type was radiology images (59.4%). Dermatology-related diseases received the most funding, followed by pulmonary diseases. Based on the survey responses, radiology images (23.9%) were the most demanding data type. Over half of the solutions were related to diagnosis (33.3%) or prognosis prediction (31%). In the expert interviews, all experts mentioned healthcare data for AI solutions as a major issue. Experts in the industrial field mainly mentioned regulations, practical efficacy evaluation, and data accessibility. Conclusions We identified technology, regulatory, and data issues for practical AI4H applications from the perspectives of stakeholders in hospitals, industry, and academia in Korea. We found issues and requirements, including regulations, data utilization, reimbursement, and human resource development, that should be addressed to promote further research in AI4H.
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Affiliation(s)
- Jae Yong Yu
- Department of Digital Health, Samsung Advanced Institute of Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul,
Korea
| | - Sungjun Hong
- Department of Digital Health, Samsung Advanced Institute of Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul,
Korea
| | - Yeong Chan Lee
- Department of Digital Health, Samsung Advanced Institute of Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul,
Korea
| | - Kyung Hyun Lee
- Department of Digital Health, Samsung Advanced Institute of Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul,
Korea
| | - Ildong Lee
- Department of Digital Health, Samsung Advanced Institute of Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul,
Korea
| | - Yeoni Seo
- Department of International Health and Health Policy, Clinical & Public Health Convergence, Ewha Womans University, Seoul,
Korea
| | - Mira Kang
- Department of Digital Health, Samsung Advanced Institute of Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul,
Korea
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Kyunga Kim
- Department of Digital Health, Samsung Advanced Institute of Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul,
Korea
- Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul,
Korea
| | - Won Chul Cha
- Department of Digital Health, Samsung Advanced Institute of Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul,
Korea
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
- Digital Innovation Center, Samsung Medical Center, Seoul,
Korea
| | - Soo-Yong Shin
- Department of Digital Health, Samsung Advanced Institute of Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul,
Korea
- Digital Innovation Center, Samsung Medical Center, Seoul,
Korea
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon,
Korea
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18
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Kim GH, Lee YC, Kim TJ, Kim ER, Hong SN, Chang DK, Kim YH. Risk of Neurodegenerative Diseases in Patients with Inflammatory Bowel Disease: A Nationwide Population-based Cohort Study. J Crohns Colitis 2022; 16:436-443. [PMID: 34499125 DOI: 10.1093/ecco-jcc/jjab162] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Although recent studies have reported that inflammatory bowel disease [IBD] is associated with the development of neurodegenerative diseases via chronic intestinal inflammation and the gut-brain axis, there is insufficient evidence supporting this notion. The aim of this study was to determine the risk of neurodegenerative diseases including Parkinson's disease [PD] and Alzheimer's disease [AD] in patients with IBD. METHODS Using the National Health Insurance Service data for the entire Korean population, we identified patients with IBD and controls from 2009 to 2011 and followed them up until 2017. We selected the controls in a 1:4 ratio based on age and sex for comparison with cases. RESULTS Of 24 830 IBD patients and 99 320 non-IBD controls, 98 IBD patients and 256 controls developed PD, and 644 IBD patients and 2303 controls developed AD. The overall neurodegenerative disease risk was higher in IBD patients (PD: adjusted hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.24-1.97; AD: adjusted HR, 1.14; 95% CI, 1.05-1.25). Younger IBD patients aged 40-65 years had a higher risk of PD compared with controls [adjusted HR, 2.34; 1.63-3.35]. In contrast, patients aged ≥65 years had an increased risk of AD compared with controls [adjusted HR, 1.14; 1.04-1.25]. In a nested case-control study of the IBD cohort, patients aged ≥65 years and the female sex were risk factors for AD, whereas living in an urban area was protective against AD. CONCLUSIONS The risk of neurodegenerative diseases was higher in IBD patients than in the non-IBD population.
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Affiliation(s)
- Ga Hee Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yeong Chan Lee
- Department of Digital Health, SAIHST, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Tae Jun Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Eun Ran Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung Noh Hong
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dong Kyung Chang
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young-Ho Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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19
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Kim JE, Kim TJ, Lee H, Lee YC, Chung HH, Min YW, Min BH, Lee JH, Kim JJ. Aspirin Use Is Not Associated with the Risk of Metachronous Gastric Cancer in Patients without Helicobacter pylori Infection. J Clin Med 2021; 11:jcm11010193. [PMID: 35011936 PMCID: PMC8745470 DOI: 10.3390/jcm11010193] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 12/19/2022] Open
Abstract
Introduction: Helicobacter pylori (H. pylori) eradication can prevent metachronous gastric cancer (MGC) after the performance of an endoscopic resection for early gastric cancer (EGC). However, 50% of infections persist after eradication, and the identification of MGC protective factors is important. The anti-tumor activity of aspirin has been demonstrated, but its efficacy in preventing MGC remains controversial. We evaluated the effect of aspirin on metachronous recurrence in H. pylori-negative patients. Methods: A total of 4351 patients were evaluated between January 2007 and December 2016, and 2151 patients who met the inclusion criteria were analyzed. The primary outcome was the cumulative incidence of MGC after an endoscopic resection for EGC. Results: During a 5-year median follow-up (interquartile range, 3.5–6.2), MGC developed in 176 (7.7%) patients, with a cumulative incidence of 89.4% in aspirin users and 92.7% in non-users; this difference was not statistically significant (p = 0.64). The duration of aspirin uses and the occurrence of MGC in both groups were not significantly different. There was no significant difference between groups when the duration of aspirin use was categorized into ≤1 year (hazard ratio (HR), 0.64; 0.20–2.01, p = 0.45), 1–4 years (HR, 1.35; 0.66–2.76, p = 0.41), and >4 years (HR, 1.17; 0.67–2.03, p = 0.58). Conclusions: Aspirin use was not associated with a lower risk of MGC in H. pylori-negative patients. Further prospective studies are needed.
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Affiliation(s)
- Ji Eun Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (J.E.K.); (T.J.K.); (H.H.C.); (Y.W.M.); (B.-H.M.); (J.H.L.); (J.J.K.)
| | - Tae Jun Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (J.E.K.); (T.J.K.); (H.H.C.); (Y.W.M.); (B.-H.M.); (J.H.L.); (J.J.K.)
| | - Hyuk Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (J.E.K.); (T.J.K.); (H.H.C.); (Y.W.M.); (B.-H.M.); (J.H.L.); (J.J.K.)
- Correspondence: ; Tel.: +82-2-3410-3409
| | - Yeong Chan Lee
- Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
| | - Hwe Hoon Chung
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (J.E.K.); (T.J.K.); (H.H.C.); (Y.W.M.); (B.-H.M.); (J.H.L.); (J.J.K.)
| | - Yang Won Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (J.E.K.); (T.J.K.); (H.H.C.); (Y.W.M.); (B.-H.M.); (J.H.L.); (J.J.K.)
| | - Byung-Hoon Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (J.E.K.); (T.J.K.); (H.H.C.); (Y.W.M.); (B.-H.M.); (J.H.L.); (J.J.K.)
| | - Jun Haeng Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (J.E.K.); (T.J.K.); (H.H.C.); (Y.W.M.); (B.-H.M.); (J.H.L.); (J.J.K.)
| | - Jae J. Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (J.E.K.); (T.J.K.); (H.H.C.); (Y.W.M.); (B.-H.M.); (J.H.L.); (J.J.K.)
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20
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Abstract
Despite the growing recognition of a host genetic effect on shaping gut microbiota composition, the genetic determinants of oral microbiota remain largely unexplored, especially in the context of oral diseases. Here, we performed a microbiome genome-wide association study in 2 independent cohorts of patients with oral squamous cell carcinoma (OSCC, n = 144 and 67) and an additional group of noncancer individuals (n = 104). Besides oral bacterial dysbiosis and signatures observed in OSCC, associations of 3 loci with the abundance of genus-level taxa and 4 loci with β diversity measures were detected (q < 0.05) at the discovery stage. The most significant hit (rs10906082 with the genus Lachnoanaerobaculum, P = 3.55 × 10-9 at discovery stage) was replicated in a second OSCC cohort. Moreover, the other 2 taxonomical associations, rs10973953 with the genus Kingella (P = 1.38 × 10-9) and rs4721629 with the genus Parvimonas (P = 3.53 × 10-8), were suggestive in the meta-analysis combining 2 OSCC cohorts. Further pathway analysis revealed that these loci were enriched for genes in regulation of oncogenic and angiogenic responses, implicating a genetic anchor to the oral microbiome in estimation of casual relationships with OSCC. Our findings delineate the role of host genotypes in influencing the structure of oral microbial communities.
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Affiliation(s)
- S F Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - C W Lin
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan.,Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - C Y Chuang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Y C Lee
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - W H Chung
- Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan.,Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - H C Lai
- Department of Medical Biotechnology and Laboratory Science, and Microbiota Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Central Research Laboratory, XiaMen Chang Gung Hospital, XiaMen, China
| | - L C Chang
- Department of Mathematical Sciences, Florida Atlantic University, Boca Raton, FL, USA
| | - S C Su
- Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan.,Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.,Central Research Laboratory, XiaMen Chang Gung Hospital, XiaMen, China
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21
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Hennige SJ, Larsson AI, Orejas C, Gori A, De Clippele LH, Lee YC, Jimeno G, Georgoulas K, Kamenos NA, Roberts JM. Using the Goldilocks Principle to model coral ecosystem engineering. Proc Biol Sci 2021; 288:20211260. [PMID: 34375552 PMCID: PMC8354746 DOI: 10.1098/rspb.2021.1260] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The occurrence and proliferation of reef-forming corals is of vast importance in terms of the biodiversity they support and the ecosystem services they provide. The complex three-dimensional structures engineered by corals are comprised of both live and dead coral, and the function, growth and stability of these systems will depend on the ratio of both. To model how the ratio of live : dead coral may change, the ‘Goldilocks Principle’ can be used, where organisms will only flourish if conditions are ‘just right’. With data from particle imaging velocimetry and numerical smooth particle hydrodynamic modelling with two simple rules, we demonstrate how this principle can be applied to a model reef system, and how corals are effectively optimizing their own local flow requirements through habitat engineering. Building on advances here, these approaches can be used in conjunction with numerical modelling to investigate the growth and mortality of biodiversity supporting framework in present-day and future coral reef structures.
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Affiliation(s)
- S J Hennige
- Changing Oceans Group, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - A I Larsson
- Department of Marine Sciences, Tjärnö Marine Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - C Orejas
- Instituto Español de Oceanografía, Centro Oceanográfico de Gijón, IEO, CSIC, Gijón, Spain
| | - A Gori
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Universitat de Barcelona, Barcelona, Spain
| | - L H De Clippele
- Changing Oceans Group, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Y C Lee
- School of Engineering, Computing and Mathematics, University of Plymouth, Devon, UK
| | - G Jimeno
- School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, UK
| | - K Georgoulas
- Changing Oceans Group, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - N A Kamenos
- School of Geographical and Earth Sciences, University of Glasgow, Glasgow, UK
| | - J M Roberts
- Changing Oceans Group, School of GeoSciences, University of Edinburgh, Edinburgh, UK
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22
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Pyo JH, Kim TJ, Lee H, Choi SC, Cho SJ, Choi YH, Min YW, Min BH, Lee JH, Kang M, Lee YC, Kim JJ. Proton pump inhibitors use and the risk of fatty liver disease: A nationwide cohort study. J Gastroenterol Hepatol 2021; 36:1235-1243. [PMID: 32886822 DOI: 10.1111/jgh.15236] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 08/03/2020] [Accepted: 08/25/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM Proton pump inhibitor (PPI)-induced hypochondria can change the composition of the gut microbiota, inducing overgrowth of small bowel bacteria, which has been suggested to promote the development of fatty liver disease through the gut-liver axis. In this study, we aimed to investigate the association between PPI use and the risk of fatty liver disease. METHODS A retrospective cohort study was conducted using the Korean National Health Insurance Service-National Sample Cohort, a nationwide population-based representative sample, from January 1, 2002, to December 31, 2015. PPI use was identified from treatment claims and considered as a time-varying variable. RESULTS During 1 463 556 person-years of follow-up, 75 727 patients had at least one PPI prescription, and 3735 patients developed fatty liver disease. The hazard ratio for fatty liver disease comparing PPI users with non-PPI users was 1.68 (95% confidence interval, 1.61-1.75). When adjusted for multiple confounders, including age, sex, body mass index, smoking, alcohol intake, exercise, income level, and comorbidities, the association was still significant (hazard ratio, 1.50; 95% confidence interval, 1.44-1.57). After considering the amounts of PPIs stratified by cumulative defined daily dose, the dose-response effect was observed until 180 days. Subgroup analysis also revealed that PPI use was correlated to an increased risk of fatty liver disease. CONCLUSIONS This current national wide cohort study suggests that PPI use was associated with an increased risk of fatty liver disease compared with non-use of PPIs. Clinicians should consider fatty liver as a potential risk when prescribing PPI.
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Affiliation(s)
- Jeung Hui Pyo
- Center for Health Promotion, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Tae Jun Kim
- Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Hyuk Lee
- Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Sung Chul Choi
- Center for Health Promotion, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Soo-Jin Cho
- Center for Health Promotion, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Yoon-Ho Choi
- Center for Health Promotion, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Yang Won Min
- Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Byung-Hoon Min
- Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Jun Haeng Lee
- Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Minwoong Kang
- Department of Digital Health, SAIHST, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Yeong Chan Lee
- Department of Digital Health, SAIHST, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Jae J Kim
- Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
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23
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Hayashi K, Nikolos F, Lee YC, Jain A, Tsouko E, Gao H, Kasabyan A, Leung HE, Osipov A, Jung SY, Kurtova AV, Chan KS. Tipping the immunostimulatory and inhibitory DAMP balance to harness immunogenic cell death. Nat Commun 2020; 11:6299. [PMID: 33288764 PMCID: PMC7721802 DOI: 10.1038/s41467-020-19970-9] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 11/04/2020] [Indexed: 12/21/2022] Open
Abstract
Induction of tumor cell death is the therapeutic goal for most anticancer drugs. Yet, a mode of drug-induced cell death, known as immunogenic cell death (ICD), can propagate antitumoral immunity to augment therapeutic efficacy. Currently, the molecular hallmark of ICD features the release of damage-associated molecular patterns (DAMPs) by dying cancer cells. Here, we show that gemcitabine, a standard chemotherapy for various solid tumors, triggers hallmark immunostimualtory DAMP release (e.g., calreticulin, HSP70, and HMGB1); however, is unable to induce ICD. Mechanistic studies reveal gemcitabine concurrently triggers prostaglandin E2 release as an inhibitory DAMP to counterpoise the adjuvanticity of immunostimulatory DAMPs. Pharmacological blockade of prostaglandin E2 biosythesis favors CD103+ dendritic cell activation that primes a Tc1-polarized CD8+ T cell response to bolster tumor rejection. Herein, we postulate that an intricate balance between immunostimulatory and inhibitory DAMPs could determine the outcome of drug-induced ICD and pose COX-2/prostaglandin E2 blockade as a strategy to harness ICD.
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Affiliation(s)
- K Hayashi
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Graduate Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| | - F Nikolos
- Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Y C Lee
- Graduate Institute of Medical Sciences, Taipei Medical University, Taipei City, Taiwan
| | - A Jain
- Alkek Center for Molecular Discovery, Proteomics Core, Baylor College of Medicine, Houston, TX, 77030, USA
| | - E Tsouko
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | - H Gao
- Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - A Kasabyan
- Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - H E Leung
- Alkek Center for Molecular Discovery, Proteomics Core, Baylor College of Medicine, Houston, TX, 77030, USA
| | - A Osipov
- Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - S Y Jung
- Alkek Center for Molecular Discovery, Proteomics Core, Baylor College of Medicine, Houston, TX, 77030, USA
| | - A V Kurtova
- Graduate Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| | - K S Chan
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
- Samuel Oschin Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
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24
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Lee H, Kim K, Lee YC, Kim S, Won HH, Yu TY, Lee EM, Kang JM, Lewis M, Kim DK, Myung W. Associations between vascular risk factors and subsequent Alzheimer's disease in older adults. Alzheimers Res Ther 2020; 12:117. [PMID: 32979926 PMCID: PMC7520023 DOI: 10.1186/s13195-020-00690-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 09/15/2020] [Indexed: 01/21/2023]
Abstract
Background The clinical guidelines related to the primary prevention of Alzheimer’s disease (AD) have focused on the management of vascular risk factors. However, the link between vascular risk factors and AD in older adults remains unclear. This study aimed to determine the association between vascular risk factors and subsequent AD in 178,586 older adults (age ≥ 65 years). Methods Participants were recruited from 2009 through 2010 and followed up for 6 years. We assessed various vascular risk factors (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], triglycerides [TG], fasting glucose [FG], systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], and body mass index [BMI]) and their association with AD incidence, categorizing each vascular factor using current clinical guidelines. Results AD was observed in 6.0% of participants at follow-up. All lipid profiles (TC, LDL-C, HDL-C and TG) were positively associated with the risk of AD. SBP and PP were in negative associations with AD, and DBP was positively associated with AD. BMI exhibited a negative association with AD incidence. We found no significant association between FG and AD risk. The sex difference was observed to have effects on vascular risk factors. Conclusions In this study, we comprehensively investigated the association between eight vascular risk factors and the risk of incident AD. Our findings suggest that multiple vascular risk factors are related to the development of AD in older adults. These results can help inform future guidelines for reducing AD risk.
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Affiliation(s)
- Hyewon Lee
- Department of Health Administration and Management, College of Medical Sciences, Soonchunhyang University, Asan, South Korea
| | - Kiwon Kim
- Department of Psychiatry, Veteran Health Service Medical Center, Seoul, South Korea
| | - Yeong Chan Lee
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, South Korea
| | - Soyeon Kim
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, South Korea
| | - Hong-Hee Won
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, South Korea
| | - Tae Yang Yu
- Division of Endocrinology and Metabolism, Department of Medicine, Wonkwang Medical Center, Wonkwang University School of Medicine, Iksan, South Korea
| | - Eun-Mi Lee
- Department of Health Science, Dongduk Women's University, Seoul, South Korea
| | - Jae Myeong Kang
- Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Matthew Lewis
- The Department of General Practice, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
| | - Doh Kwan Kim
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam-si, South Korea.
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25
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Min YW, Lee YC, Kim K, Ryu S, Hong KS, Jeon HH, Kim YS, Park JH, Son HJ, Rhee PL. Proton pump inhibitor use is associated with hip fracture development: a nationwide population-based cohort study. Korean J Intern Med 2020; 35:1084-1093. [PMID: 31671930 PMCID: PMC7487306 DOI: 10.3904/kjim.2018.331] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 11/13/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND/AIMS Effect of proton pump inhibitor (PPI) use on the risk of hip fracture is controversial. This study aimed to clarify the association between PPI use and hip fracture risk using a large cohort. METHODS This study recruited participants from the nationwide cohort (n = 1,025,340). After exclusion of participants who had hip fractures or were aged less than 40 years during the baseline period (2002 to 2004), 371,806 participants were followed to 2013. Participants prescribed PPIs for more than 90 days during baseline period were defined as users. Fracture cases were defined when participants were hospitalized with claims of a hip fracture. RESULTS During 4,159,343 person-years of follow-up, fractures developed more often in PPI users than in nonusers (relative risk [RR], 1.787; 95% confidence interval [CI], 1.260 to 2.534; p = 0.002). The results persisted after adjusting for age, sex, and many drugs relevant to osteoporosis or influential in bone health. Furthermore, fracture risk associated with PPI use increased with duration of use (p trend < 0.001). The fully adjusted RRs of hip fracture development were 1.350 (95% CI, 1.203 to 1.515) for 1- to 90-day users, 1.487 (95% CI, 0.957 to 2.311) for 91- to 180-day users, and 1.771 (95% CI, 0.931 to 3.368) for > 180-day users. The positive association between PPI use and fracture was also confirmed in a subgroup with health screening data where further adjustment for body mass index, smoking status, alcohol consumption, and physical activity was available (adjusted RR, 2.025; 95% CI, 1.151 to 3.564, p = 0.014). CONCLUSION PPI use is associated with hip fracture development.
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Affiliation(s)
- Yang Won Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeong Chan Lee
- Department of Digital Health, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
| | - Kyunga Kim
- Department of Digital Health, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Seungho Ryu
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University School of Medicine, Seoul, Korea
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyoung Sub Hong
- Department of Gastroenterology, Mediplex Sejong Hospital, Incheon, Korea
| | - Han Ho Jeon
- Division of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
| | - Yong Sung Kim
- Department of Gastroenterology, Wonkwang Digestive Disease Research Institute, Wonkwang University Sanbon Hospital, Gunpo, Korea
| | - Jong Heon Park
- Big Data Steering Department, National Health Insurance Service, Wonju, Korea
| | - Hee Jung Son
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Hee Jung Son, M.D. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea Tel: +82-2-3410-3409, Fax: +82-2-3410-6983, E-mail:
| | - Poong-Lyul Rhee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Correspondence to Poong-Lyul Rhee, M.D. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea Tel: +82-2-3410-3409, Fax: +82-2-3410-6983, E-mail:
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26
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Abstract
PURPOSE As the designated tertiary referral centre for infectious diseases in Hong Kong, our hospital received the city's first group of patients diagnosed with coronavirus disease 2019 (COVID-19). Herein, we studied the earliest patients admitted to our centre in order to clarify the typical radiological findings, particularly computed tomography (CT) findings, associated with COVID-19. METHODS From 22 January 2020 to 29 February 2020, 19 patients with confirmed COVID-19 underwent high-resolution or conventional CT scans of the thorax in our centre. The CT imaging findings of these patients with confirmed COVID-19 in Hong Kong were reviewed in this study. RESULTS Ground-glass opacities (GGO) with peripheral subpleural distribution were found in all patients (100%). No specific zonal predominance was observed. All lobes were involved in 16 (84.2%) patients, focal subsegmental consolidations were observed in 14 (73.7%) patients, and interlobular septal thickening was present in 12 (63.2%) patients. No mediastinal lymph node enlargement, centrilobular nodule, or pleural effusion was detected in any of the patients. Other imaging features present in several patients include bronchial dilatation, bronchial wall thickening, and crazy-paving patterns. CONCLUSIONS Peripheral subpleural GGO without zonal predominance in the absence of centrilobular nodule, pleural effusion, and lymph node enlargement were consistent findings in patients with confirmed COVID-19. The observed radiological patterns on CT scans can help identify COVID-19 and assess affected patients in the context of the ongoing outbreak.
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Affiliation(s)
- S K Li
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - F H Ng
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - K F Ma
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - W H Luk
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - Y C Lee
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - K S Yung
- Department of Radiology, Princess Margaret Hospital, Hong Kong
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Koh J, Kim Y, Lee KY, Hur JY, Kim MS, Kim B, Cho HJ, Lee YC, Bae YH, Ku BM, Sun JM, Lee SH, Ahn JS, Park K, Ahn MJ. MDSC subtypes and CD39 expression on CD8 + T cells predict the efficacy of anti-PD-1 immunotherapy in patients with advanced NSCLC. Eur J Immunol 2020; 50:1810-1819. [PMID: 32510574 PMCID: PMC7689686 DOI: 10.1002/eji.202048534] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/02/2020] [Accepted: 06/05/2020] [Indexed: 12/15/2022]
Abstract
The major suppressive immune cells in tumor sites are myeloid derived suppressor cells (MDSCs), tumor‐associated macrophages (TAMs), and Treg cells, and the major roles of these suppressive immune cells include hindering T‐cell activities and supporting tumor progression and survival. In this study, we analyzed the pattern of circulating MDSC subtypes in patients with non‐small cell lung cancer (NSCLC) whether those suppressive immune cells hinder T‐cell activities leading to poor clinical outcomes. First, we verified PMN‐MDSCs, monocytic‐MDSCs (M‐MDSCs), and Treg cells increased according to the stages of NSCLC, and MDSCs effectively suppressed T‐cell activities and induced T‐cell exhaustion. The analysis of NSCLC patients treated with anti‐PD‐1 immunotherapy demonstrated that low PMN‐MDSCs, M‐MDSCs, and CD39+CD8+ T cells as an individual and all together were associated with longer progression free survival and overall survival, suggesting PMN‐MDSCs, M‐MDSCs, and CD39+CD8+ T cells frequencies in peripheral blood might be useful as potential predictive and prognostic biomarkers.
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Affiliation(s)
- Jiae Koh
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Youjin Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Division of Hematology-Oncology, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Kyoung Young Lee
- Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joon Young Hur
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Soon Kim
- Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Boram Kim
- Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jin Cho
- Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeong Chan Lee
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Yeon Hee Bae
- Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Bo Mi Ku
- Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong-Mu Sun
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se-Hoon Lee
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Seok Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keunchil Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myung-Ju Ahn
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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28
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Ju HJ, Kwon JW, Lee YC, Bae JM. Seasonal variation in chronic skin diseases: real-world evidence from a nationwide population-based study in Korea. J Eur Acad Dermatol Venereol 2020; 34:e793-e795. [PMID: 32386445 DOI: 10.1111/jdv.16612] [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: 11/28/2022]
Affiliation(s)
- H J Ju
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - J-W Kwon
- Department of Ophthalmology, St. Vincent's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Y C Lee
- Department of Otolaryngology - Head & Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - J M Bae
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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29
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Lee YC, Kang JM, Lee H, Kim K, Kim S, Yu TY, Lee EM, Kim CT, Kim DK, Lewis M, Won HH, Jessen F, Myung W. Subjective cognitive decline and subsequent dementia: a nationwide cohort study of 579,710 people aged 66 years in South Korea. Alzheimers Res Ther 2020; 12:52. [PMID: 32375880 PMCID: PMC7203882 DOI: 10.1186/s13195-020-00618-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/13/2020] [Indexed: 02/06/2023]
Abstract
Background Subjective cognitive decline (SCD) is a potential risk factor for dementia. We aimed to investigate the association between SCD and subsequent dementia in a nationwide population-based cohort in South Korea. Methods This cohort included 579,710 66-year-old adults who were followed for a total of 3,870,293 person-years (average 6.68 ± 1.33 years per person). All subjects completed a questionnaire about subjective memory impairment, the Pre-screening Korean Dementia Screening Questionnaire (KDSQ-P), which included a validated 5-item derivative, and were determined to have SCD based on a single question assessing memory decline. Depressive symptoms were assessed in all subjects using a 3-item modified geriatric depression scale. Hazard ratios were estimated using the Cox proportional hazards model and compared between subjects with and without SCD. Results Compared to subjects without SCD, those with SCD were more likely to develop dementia (incidence per 1000 person-years: non-SCD, 5.66; SCD, 8.59). After adjusting for potential confounding factors, the risk of subsequent dementia significantly increased in subjects with SCD, with an adjusted hazard ratio (aHR) of 1.38 (95% confidence interval [CI] 1.34 to 1.41). The risk of subsequent dementia was greatly increased in subjects with higher KDSQ-P scores (aHR = 2.77, 95% CI 2.35 to 3.27). A significant association between SCD and dementia was observed in both depressive and non-depressive symptom groups (aHR = 1.50, 95% CI 1.42 to 1.57 in subjects with depressive symptoms; aHR = 1.33, 95% CI 1.29 to 1.37 in subjects without depressive symptoms; P = 0.001). Conclusions In this population of 66-year-old individuals, SCD was significantly associated with an increased risk of subsequent dementia. This association was found in both depressive and non-depressive groups, with an increased risk of dementia in the presence of depressive symptoms. Our findings suggest that SCD indicates a risk for dementia. Further studies are needed to delineate potential approaches to preventing the development of dementia in individuals with SCD.
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Affiliation(s)
- Yeong Chan Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital Hospital, 29 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, 13619, Gyeonggi-do, Republic of Korea.,Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jae Myeong Kang
- Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Hyewon Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital Hospital, 29 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, 13619, Gyeonggi-do, Republic of Korea.,Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Kiwon Kim
- Department of Psychiatry, Veteran Health Service Medical Center, Seoul, Republic of Korea
| | - Soyeon Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital Hospital, 29 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, 13619, Gyeonggi-do, Republic of Korea.,Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Tae Yang Yu
- Division of Endocrinology and Metabolism, Department of Medicine, Wonkwang Medical Center, Wonkwang University School of Medicine, Iksan, Republic of Korea
| | - Eun-Mi Lee
- Department of Health Science, Dongduk Women's University, Seoul, Republic of Korea
| | - Clara Tammy Kim
- Institute of Life and Death Studies, Hallym University, Chuncheon, Gangwon-do, Republic of Korea
| | - Doh Kwan Kim
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Matthew Lewis
- The Department of General Practice, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Hong-Hee Won
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
| | - Frank Jessen
- Department of Psychiatry, University of Cologne, Cologne, Germany
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital Hospital, 29 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, 13619, Gyeonggi-do, Republic of Korea.
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30
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Woo SC, Yung KS, Wong T, Yu ELM, Li SK, Chan HF, Chan CH, Lee YC, Chan JMC, Leung WS. Imaging findings of critically ill patients with COVID-19 pneumonia: a case series. Hong Kong Med J 2020; 26:236-239. [PMID: 32362589 DOI: 10.12809/hkmj208441] [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: 11/05/2022] Open
Affiliation(s)
- S C Woo
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - K S Yung
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - T Wong
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - E L M Yu
- Clinical Research Centre, Princess Margaret Hospital, Hong Kong
| | - S K Li
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - H F Chan
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - C H Chan
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - Y C Lee
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - J M C Chan
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong
| | - W S Leung
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong
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31
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Ng FH, Li SK, Lee YC, Ma JKF. Temporal changes in computed tomography of COVID-19 pneumonia with perilobular fibrosis. Hong Kong Med J 2020; 26:250.e1-251.e2. [PMID: 32362587 DOI: 10.12809/hkmj208490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- F H Ng
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - S K Li
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - Y C Lee
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - J K F Ma
- Department of Radiology, Princess Margaret Hospital, Hong Kong
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32
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Lee YC, Buraidah MH, Woo HJ. Poly(acrylamide-co-acrylic acid) gel polymer electrolyte incorporating with water-soluble sodium sulfide salt for quasi-solid-state quantum dot-sensitized solar cell. HIGH PERFORM POLYM 2020. [DOI: 10.1177/0954008320902232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Rapid decay of photoanode, leakage from sealant, and evaporation of electrolyte are always the major concerns of quantum dot-sensitized solar cells (QDSCs) based on liquid electrolyte. Subsequently, gel polymer electrolyte (GPE) appears as an attractive solution in addition to lower cost, lighter weight, and flexibility. Poly(acrylamide- co-acrylic acid) (PAAm-PAA) is of special interest to act as a polymer host to entrap liquid electrolyte because it provides high transparency, good gelatinizing properties, and excellent compatibility with the liquid electrolyte. In this work, the electrical and transport properties of PAAm-PAA GPE incorporating with water-soluble sodium sulfide were characterized by impedance spectroscopy. An increment of ionic conductivity was observed with the incorporation of ethylene carbonate (EC) and potassium chloride (KCl). The highest room temperature ionic conductivity of PAAm-PAA GPE is 70.82 mS·cm−1. QDSC based on PAAm-PAA GPE with the composition of 1.3 wt% of KCl, 0.9 wt% of EC, 55.3 wt% of PAAm-PAA, 38.5 wt% of sodium sulfide, and 4.0 wt% of sulfur can present up to 1.80% of light-to-electricity conversion efficiency.
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Affiliation(s)
- YC Lee
- Centre for Ionics University of Malaya, Department of Physics, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - MH Buraidah
- Centre for Ionics University of Malaya, Department of Physics, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - HJ Woo
- Centre for Ionics University of Malaya, Department of Physics, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
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33
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Cho KS, Sohn W, Lee YC, Chi SA, Cho JY, Kim K, Paik YH. Use of cyclooxygenase inhibitor and the risk of hepatocellular carcinoma in patients with chronic hepatitis B: A nested case-control study using a nationwide population-based data. J Viral Hepat 2020; 27:68-73. [PMID: 31505085 DOI: 10.1111/jvh.13201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/22/2019] [Accepted: 08/12/2019] [Indexed: 02/04/2023]
Abstract
The study aimed to investigate the relationship between the use of COX inhibitors and the risk of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis B (CHB) using a nationwide population-based data. A nested case-control study was conducted using the National Health Insurance Service-National Sample Cohort (NHIS-NSC) from 2002 to 2013 in Korea. We compared the use of COX inhibitors between HCC cases and matched controls by categorizing 5 groups according to the cumulative defined daily dose (cDDD, <28, 28-90, 91-180, 181-360, and >360) adjusting the use of antiviral agents. A total of 4980 patients with CHB were analysed as 996 HCC cases and 3984 matched controls. The number of COX inhibitor users (≥28 cDDD) was 358 patients (36%) and 1814 patients (45%) in the HCC group and control group, respectively. The use of COX inhibitors was significantly associated with a decreased risk of HCC development compared with nonusers (adjusted odds ratio [OR] 0.62, 95% confidence interval [CI] 0.52-0.73, P < .001). There was a dose-dependent inverse relationship between the use of COX inhibitors and the risk of HCC. The adjusted ORs were 0.75 (95% CI: 0.63-0.90), 0.41 (95% CI: 0.31-0.56), 0.38 (95% CI: 0.25-0.57) and 0.49 (95% CI: 0.31-0.79) for the 28-90, 91-180, 181-360 and >360 cDDDs, respectively (P < .01). In conclusion, the use of COX inhibitors was associated with a reduced risk of HCC in CHB. COX inhibitor may have a chemopreventive role in HCC development in patients with chronic liver disease.
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Affiliation(s)
- Kyoung Sun Cho
- Department of Digital Health, Samsung Advanced Institute for Health Science and Technology, Sunkyunkwan University, Seoul, Korea
| | - Won Sohn
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Korea
| | - Yeong Chan Lee
- Department of Digital Health, Samsung Advanced Institute for Health Science and Technology, Sunkyunkwan University, Seoul, Korea
| | - Sang Ah Chi
- Department of Health Science and Technology, Samsung Advanced Institute for Health Science and Technology, Sunkyunkwan University, Seoul, Korea
| | - Ju-Yeon Cho
- Division of Gastroenterology and Hepatology, Department of Medicine, Chosun University, Gwang-Ju, Korea
| | - Kyunga Kim
- Department of Health Science and Technology, Samsung Advanced Institute for Health Science and Technology, Sunkyunkwan University, Seoul, Korea.,Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Korea
| | - Yong-Han Paik
- Department of Digital Health, Samsung Advanced Institute for Health Science and Technology, Sunkyunkwan University, Seoul, Korea.,Department of Health Science and Technology, Samsung Advanced Institute for Health Science and Technology, Sunkyunkwan University, Seoul, Korea.,Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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34
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Affiliation(s)
- YC Lee
- Diagnostic Radiology Department, Princess Margaret Hospital, Laichikok, Hong Kong
| | - NY Pan
- Diagnostic Radiology Department, Princess Margaret Hospital, Laichikok, Hong Kong
| | - HF Chan
- Diagnostic Radiology Department, Princess Margaret Hospital, Laichikok, Hong Kong
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35
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Porwal P, Pachade S, Kokare M, Deshmukh G, Son J, Bae W, Liu L, Wang J, Liu X, Gao L, Wu T, Xiao J, Wang F, Yin B, Wang Y, Danala G, He L, Choi YH, Lee YC, Jung SH, Li Z, Sui X, Wu J, Li X, Zhou T, Toth J, Baran A, Kori A, Chennamsetty SS, Safwan M, Alex V, Lyu X, Cheng L, Chu Q, Li P, Ji X, Zhang S, Shen Y, Dai L, Saha O, Sathish R, Melo T, Araújo T, Harangi B, Sheng B, Fang R, Sheet D, Hajdu A, Zheng Y, Mendonça AM, Zhang S, Campilho A, Zheng B, Shen D, Giancardo L, Quellec G, Mériaudeau F. IDRiD: Diabetic Retinopathy - Segmentation and Grading Challenge. Med Image Anal 2019; 59:101561. [PMID: 31671320 DOI: 10.1016/j.media.2019.101561] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 09/09/2019] [Accepted: 09/16/2019] [Indexed: 02/07/2023]
Abstract
Diabetic Retinopathy (DR) is the most common cause of avoidable vision loss, predominantly affecting the working-age population across the globe. Screening for DR, coupled with timely consultation and treatment, is a globally trusted policy to avoid vision loss. However, implementation of DR screening programs is challenging due to the scarcity of medical professionals able to screen a growing global diabetic population at risk for DR. Computer-aided disease diagnosis in retinal image analysis could provide a sustainable approach for such large-scale screening effort. The recent scientific advances in computing capacity and machine learning approaches provide an avenue for biomedical scientists to reach this goal. Aiming to advance the state-of-the-art in automatic DR diagnosis, a grand challenge on "Diabetic Retinopathy - Segmentation and Grading" was organized in conjunction with the IEEE International Symposium on Biomedical Imaging (ISBI - 2018). In this paper, we report the set-up and results of this challenge that is primarily based on Indian Diabetic Retinopathy Image Dataset (IDRiD). There were three principal sub-challenges: lesion segmentation, disease severity grading, and localization of retinal landmarks and segmentation. These multiple tasks in this challenge allow to test the generalizability of algorithms, and this is what makes it different from existing ones. It received a positive response from the scientific community with 148 submissions from 495 registrations effectively entered in this challenge. This paper outlines the challenge, its organization, the dataset used, evaluation methods and results of top-performing participating solutions. The top-performing approaches utilized a blend of clinical information, data augmentation, and an ensemble of models. These findings have the potential to enable new developments in retinal image analysis and image-based DR screening in particular.
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Affiliation(s)
- Prasanna Porwal
- Shri Guru Gobind Singhji Institute of Engineering and Technology, Nanded, India; School of Biomedical Informatics, University of Texas Health Science Center at Houston, USA.
| | - Samiksha Pachade
- Shri Guru Gobind Singhji Institute of Engineering and Technology, Nanded, India; School of Biomedical Informatics, University of Texas Health Science Center at Houston, USA
| | - Manesh Kokare
- Shri Guru Gobind Singhji Institute of Engineering and Technology, Nanded, India
| | | | | | | | - Lihong Liu
- Ping An Technology (Shenzhen) Co.,Ltd, China
| | | | - Xinhui Liu
- Ping An Technology (Shenzhen) Co.,Ltd, China
| | | | - TianBo Wu
- Ping An Technology (Shenzhen) Co.,Ltd, China
| | - Jing Xiao
- Ping An Technology (Shenzhen) Co.,Ltd, China
| | | | | | - Yunzhi Wang
- School of Electrical and Computer Engineering, University of Oklahoma, USA
| | - Gopichandh Danala
- School of Electrical and Computer Engineering, University of Oklahoma, USA
| | - Linsheng He
- School of Electrical and Computer Engineering, University of Oklahoma, USA
| | - Yoon Ho Choi
- Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
| | - Yeong Chan Lee
- Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
| | - Sang-Hyuk Jung
- Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
| | - Zhongyu Li
- Department of Computer Science, University of North Carolina at Charlotte, USA
| | - Xiaodan Sui
- School of Information Science and Engineering, Shandong Normal University, China
| | - Junyan Wu
- Cleerly Inc., New York, United States
| | | | - Ting Zhou
- University at Buffalo, New York, United States
| | - Janos Toth
- University of Debrecen, Faculty of Informatics 4002 Debrecen, POB 400, Hungary
| | - Agnes Baran
- University of Debrecen, Faculty of Informatics 4002 Debrecen, POB 400, Hungary
| | | | | | | | | | - Xingzheng Lyu
- College of Computer Science and Technology, Zhejiang University, Hangzhou, China; Machine Learning for Bioimage Analysis Group, Bioinformatics Institute, A*STAR, Singapore
| | - Li Cheng
- Machine Learning for Bioimage Analysis Group, Bioinformatics Institute, A*STAR, Singapore; Department of Electric and Computer Engineering, University of Alberta, Canada
| | - Qinhao Chu
- School of Computing, National University of Singapore, Singapore
| | - Pengcheng Li
- School of Computing, National University of Singapore, Singapore
| | - Xin Ji
- Beijing Shanggong Medical Technology Co., Ltd., China
| | - Sanyuan Zhang
- College of Computer Science and Technology, Zhejiang University, Hangzhou, China
| | - Yaxin Shen
- Department of Computer Science and Engineering, Shanghai Jiao Tong University, China; MoE Key Lab of Artificial Intelligence, AI Institute, Shanghai Jiao Tong University, China
| | - Ling Dai
- Department of Computer Science and Engineering, Shanghai Jiao Tong University, China; MoE Key Lab of Artificial Intelligence, AI Institute, Shanghai Jiao Tong University, China
| | | | | | - Tânia Melo
- INESC TEC - Institute for Systems and Computer Engineering, Technology and Science, Porto, Portugal
| | - Teresa Araújo
- INESC TEC - Institute for Systems and Computer Engineering, Technology and Science, Porto, Portugal; FEUP - Faculty of Engineering of the University of Porto, Porto, Portugal
| | - Balazs Harangi
- University of Debrecen, Faculty of Informatics 4002 Debrecen, POB 400, Hungary
| | - Bin Sheng
- Department of Computer Science and Engineering, Shanghai Jiao Tong University, China; MoE Key Lab of Artificial Intelligence, AI Institute, Shanghai Jiao Tong University, China
| | - Ruogu Fang
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, USA
| | | | - Andras Hajdu
- University of Debrecen, Faculty of Informatics 4002 Debrecen, POB 400, Hungary
| | - Yuanjie Zheng
- School of Information Science and Engineering, Shandong Normal University, China
| | - Ana Maria Mendonça
- INESC TEC - Institute for Systems and Computer Engineering, Technology and Science, Porto, Portugal; FEUP - Faculty of Engineering of the University of Porto, Porto, Portugal
| | - Shaoting Zhang
- Department of Computer Science, University of North Carolina at Charlotte, USA
| | - Aurélio Campilho
- INESC TEC - Institute for Systems and Computer Engineering, Technology and Science, Porto, Portugal; FEUP - Faculty of Engineering of the University of Porto, Porto, Portugal
| | - Bin Zheng
- School of Electrical and Computer Engineering, University of Oklahoma, USA
| | - Dinggang Shen
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, USA; Department of Brain and Cognitive Engineering, Korea University, Seoul 02841, Republic of Korea
| | - Luca Giancardo
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, USA
| | | | - Fabrice Mériaudeau
- Department of Electrical and Electronic Engineering, Universiti Teknologi PETRONAS, Malaysia; ImViA/IFTIM, Université de Bourgogne, Dijon, France
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Kim TJ, Kim ER, Hong SN, Kim YH, Lee YC, Kim HS, Kim K, Chang DK. Effectiveness of acid suppressants and other mucoprotective agents in reducing the risk of occult gastrointestinal bleeding in nonsteroidal anti-inflammatory drug users. Sci Rep 2019; 9:11696. [PMID: 31406189 PMCID: PMC6690955 DOI: 10.1038/s41598-019-48173-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 04/27/2018] [Accepted: 07/31/2019] [Indexed: 02/07/2023] Open
Abstract
Acid suppressants such as histamine-2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) are effective in preventing gastrointestinal (GI) bleeding in nonsteroidal anti-inflammatory drugs (NSAIDs) users. Despite widespread acid suppressant use, there remain concerns about several potential risks of long-term use. Therefore, we investigated whether gastroprotective agents (GPAs) other than acid suppression therapy are effective in preventing NSAID-related GI injury. To this end, we studied 9,133 patients with osteoarthritis or rheumatoid arthritis who used NSAIDs for ≥1 month. A decrease of 2 g/dL or more in the hemoglobin level was considered a GI injury indicator. The GPAs included acid suppressants and other mucoprotective agents. Acid suppressants included PPIs and H2RAs. Other mucoprotective agents included misoprostol, rebamipide, and eupatilin. During a median follow-up period of 27 (range, 4.3-51.3) weeks, occult GI bleeding occurred in 1,191 (13%) patients. A comparison of patients who used GPAs concomitantly with that of nonusers in a multivariable analysis revealed the hazard ratios (HRs; 95% confidence intervals [CIs]) for occult GI bleeding were 0.30 (0.20-0.44), 0.35 (0.29-0.43), 0.47 (0.23-0.95), 0.43 (0.35-0.51), and 0.98 (0.86-1.12) for PPIs, H2RAs, misoprostol, rebamipide, and eupatilin, respectively. Compared to PPI co-treatment, H2RA, misoprostol, rebamipide, and eupatilin co-treatments were associated with occult GI bleeding HRs (95% CIs) of 1.19 (0.79-1.79), 1.58 (0.72-3.46), 1.44 (0.96-2.16), and 3.25 (2.21-4.77), respectively. Our findings suggest that mucoprotective agents, such as rebamipide and misoprostol, as well as acid suppressants, are effective in reducing the risk for GI injury in NSAID users.
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Affiliation(s)
- Tae Jun Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Eun Ran Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung Noh Hong
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young-Ho Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yeong Chan Lee
- Department of Digital Health, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hye Seung Kim
- Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyunga Kim
- Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - Dong Kyung Chang
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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Bak G, Choi JH, Jang HI, Jang JS, Jeon SH, Joo KK, Ju K, Jung DE, Kim JG, Kim JH, Kim JY, Kim SB, Kim SY, Kim W, Kwon E, Lee DH, Lee HG, Lee YC, Lim IT, Moon DH, Pac MY, Park YS, Rott C, Seo H, Seo JW, Seo SH, Shin CD, Yang JY, Yoo J, Yu I. Fuel-Composition Dependent Reactor Antineutrino Yield at RENO. Phys Rev Lett 2019; 122:232501. [PMID: 31298906 DOI: 10.1103/physrevlett.122.232501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 05/16/2019] [Indexed: 06/10/2023]
Abstract
We report a fuel-dependent reactor electron antineutrino (ν[over ¯]_{e}) yield using six 2.8 GW_{th} reactors in the Hanbit nuclear power plant complex, Yonggwang, Korea. The analysis uses 850 666 ν[over ¯]_{e} candidate events with a background fraction of 2.0% acquired through inverse beta decay (IBD) interactions in the near detector for 1807.9 live days from August 2011 to February 2018. Based on multiple fuel cycles, we observe a fuel ^{235}U dependent variation of measured IBD yields with a slope of (1.51±0.23)×10^{-43} cm^{2}/fission and measure a total average IBD yield of (5.84±0.13)×10^{-43} cm^{2}/fission. The hypothesis of no fuel-dependent IBD yield is ruled out at 6.6σ. The observed IBD yield variation over ^{235}U isotope fraction does not show significant deviation from the Huber-Mueller (HM) prediction at 1.3 σ. The measured fuel-dependent variation determines IBD yields of (6.15±0.19)×10^{-43} and (4.18±0.26)×10^{-43} cm^{2}/fission for two dominant fuel isotopes ^{235}U and ^{239}Pu, respectively. The measured IBD yield per ^{235}U fission shows the largest deficit relative to the HM prediction. Reevaluation of the ^{235}U IBD yield per fission may mostly solve the reactor antineutrino anomaly (RAA) while ^{239}Pu is not completely ruled out as a possible contributor to the anomaly. We also report a 2.9 σ correlation between the fractional change of the 5 MeV excess and the reactor fuel isotope fraction of ^{235}U.
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Affiliation(s)
- G Bak
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - J H Choi
- Institute for High Energy Physics, Dongshin University, Naju 58245, Korea
| | - H I Jang
- Department of Fire Safety, Seoyeong University, Gwangju 61268, Korea
| | - J S Jang
- GIST College, Gwangju Institute of Science and Technology, Gwangju 61005, Korea
| | - S H Jeon
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - K K Joo
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - K Ju
- Department of Physics, KAIST, Daejeon 34141, Korea
| | - D E Jung
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - J G Kim
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - J H Kim
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - J Y Kim
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - S B Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - S Y Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - W Kim
- Department of Physics, Kyungpook National University, Daegu 41566, Korea
| | - E Kwon
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - D H Lee
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - H G Lee
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - Y C Lee
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - I T Lim
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - D H Moon
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - M Y Pac
- Institute for High Energy Physics, Dongshin University, Naju 58245, Korea
| | - Y S Park
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - C Rott
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - H Seo
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - J W Seo
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - S H Seo
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - C D Shin
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - J Y Yang
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - J Yoo
- Institute for Basic Science, Daejeon 34047, Korea
- Department of Physics, KAIST, Daejeon 34141, Korea
| | - I Yu
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
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Bak G, Choi JH, Jang HI, Jang JS, Jeon SH, Joo KK, Ju K, Jung DE, Kim JG, Kim JH, Kim JY, Kim SB, Kim SY, Kim W, Kwon E, Lee DH, Lee HG, Lee YC, Lim IT, Moon DH, Pac MY, Park YS, Rott C, Seo H, Seo JW, Seo SH, Shin CD, Yang JY, Yoo J, Yu I. Measurement of Reactor Antineutrino Oscillation Amplitude and Frequency at RENO. Phys Rev Lett 2018; 121:201801. [PMID: 30500262 DOI: 10.1103/physrevlett.121.201801] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/13/2018] [Indexed: 06/09/2023]
Abstract
The RENO experiment reports more precisely measured values of θ_{13} and |Δm_{ee}^{2}| using ∼2200 live days of data. The amplitude and frequency of reactor electron antineutrino (ν[over ¯]_{e}) oscillation are measured by comparing the prompt signal spectra obtained from two identical near and far detectors. In the period between August 2011 and February 2018, the far (near) detector observed 103 212 (850 666) ν[over ¯]_{e} candidate events with a background fraction of 4.8% (2.0%). A clear energy and baseline dependent disappearance of reactor ν[over ¯]_{e} is observed in the deficit of the measured number of ν[over ¯]_{e}. Based on the measured far-to-near ratio of prompt spectra, we obtain sin^{2}2θ_{13}=0.0896±0.0048(stat)±0.0047(syst) and |Δm_{ee}^{2}|=[2.68±0.12(stat)±0.07(syst)]×10^{-3} eV^{2}.
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Affiliation(s)
- G Bak
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - J H Choi
- Institute for High Energy Physics, Dongshin University, Naju 58245, Korea
| | - H I Jang
- Department of Fire Safety, Seoyeong University, Gwangju 61268, Korea
| | - J S Jang
- GIST College, Gwangju Institute of Science and Technology, Gwangju 61005, Korea
| | - S H Jeon
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - K K Joo
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - K Ju
- Department of Physics, KAIST, Daejeon 34141, Korea
| | - D E Jung
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - J G Kim
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - J H Kim
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - J Y Kim
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - S B Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - S Y Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - W Kim
- Department of Physics, Kyungpook National University, Daegu 41566, Korea
| | - E Kwon
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - D H Lee
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - H G Lee
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - Y C Lee
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - I T Lim
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - D H Moon
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - M Y Pac
- Institute for High Energy Physics, Dongshin University, Naju 58245, Korea
| | - Y S Park
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - C Rott
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - H Seo
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - J W Seo
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - S H Seo
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - C D Shin
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - J Y Yang
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - J Yoo
- Institute for Basic Science, Daejeon 34047, Korea
- Department of Physics, KAIST, Daejeon 34141, Korea
| | - I Yu
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
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Lee YC, Kwan HH, Wong T, Pan NY, Lai HY, Ma KF. Self-inflicted transorbital brain injury by chopsticks in a patient with acute psychosis. Hong Kong Med J 2018; 23:313-4. [PMID: 28572523 DOI: 10.12809/hkmj154644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Y C Lee
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - H H Kwan
- Division of Neurology, Department of Medicine, Princess Margaret Hospital, Laichikok, Hong Kong
| | - T Wong
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - N Y Pan
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - H Y Lai
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - K F Ma
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
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Lu CK, Lee YC, Sun PL, Liang CL, Liliang PC. Life-Threatening Bleeding from the Pubic Branch of the Inferior Epigastric Artery after Pubic Ramus Fracture. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791001700411] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Isolated pubic ramus fracture with concurrent life-threatening bleeding caused by injury to the inferior epigastric artery (IEA) or its branches has rarely been reported and can frequently be overlooked. This paper reports two cases of isolated pubic ramus fracture with concomitant injury to the pubic branch of the IEA, causing serious bleeding and hemodynamic instability. Pelvic angiography showed leakage of contrast from the pubic branch of the IEA. The complication in both cases was successfully treated with transcatheter arterial embolisation.
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Affiliation(s)
- CK Lu
- E-Da Hospital, Department of Orthopedics, I-Shou University, No. 1, Yi-Da Road, Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung County, 824, Taiwan
| | - YC Lee
- E-Da Hospital, Department of Radiology, I-Shou University, No. 1, Yi-Da Road, Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung County, 824, Taiwan
| | - PL Sun
- E-Da Hospital, Department of Radiology, I-Shou University, No. 1, Yi-Da Road, Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung County, 824, Taiwan
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41
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Chen PY, Chen TY, Lee YC, Liliang PC. Kernohan-Woltman Notch Phenomenon Caused by Acute Traumatic Subdural Haematoma. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791402100204] [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] Open
Abstract
A 27-year-old man suffered from right hemiparesis after a closed head injury. Computed tomography (CT) revealed a right hemisphere subdural haematoma with midline structure shifted to the left. The CT finding was believed to be mislabeled because the site of haematoma did not correlate with an ipsilateral hemiparesis. Magnetic resonance imaging revealed a right transtentorial uncal herniation and a small lesion within left cerebral peduncle, suggesting Kernohan-Woltman notch phenomenon (KWNP). KWNP has been rarely seen in patients with acute traumatic subdural haemorrhage. Anatomical small maximum tentorial notch width is the possible anatomical factor predisposing our patient to this phenomenon. (Hong Kong j.emerg.med. 2014;21:116-119)
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Affiliation(s)
| | | | - YC Lee
- E-Da Hospital, I-Shou University, Department of Radiology, Kaohsiung, Taiwan
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42
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Lee YC, Kwon OE, Park JM, Eun YG. Do laryngoscopic findings reflect the characteristics of reflux in patients with laryngopharyngeal reflux? Clin Otolaryngol 2017; 43:137-143. [PMID: 28605121 DOI: 10.1111/coa.12914] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To analyse the association between 24-hour multichannel intraluminal impedance-pH (24-h MII-pH) parameters and each item of the reflux finding score (RFS) to determine whether the laryngoscopic findings of the RFS could reflect the characteristics of reflux in patients with laryngopharyngeal reflux (LPR). STUDY DESIGN Prospective cohort study. SETTINGS Tertiary care referral medical centre. PARTICIPANTS Patients complaining of LPR symptoms were evaluated via a 24-hour MII-pH. Among them, 99 patients whose LPR was confirmed via 24-hour MII-pH were enrolled in this study. MAIN OUTCOME MEASURES Correlations between RFS ratings and 24-hour MII-pH parameters were evaluated and compared between patients with or without each laryngoscopic finding used in the RFS. RESULTS Subglottic oedema had a statistically significant positive correlation with number of non-acid LPR and non-acid full column reflux events. Ventricular obliteration and posterior commissure hypertrophy showed a significant correlation with non-acid exposure time and total reflux exposure time. We also found a significant correlation between granuloma/granulation score and number of acid LPR events. The numbers of non-acid LPR and full column reflux events in patients with subglottic oedema were significantly higher than those without subglottic oedema. CONCLUSION Among the laryngoscopic findings used in the RFS, subglottic oedema is specific for non-acid reflux episodes, and granuloma/granulation is specific for acid reflux episodes.
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Affiliation(s)
- Y C Lee
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - O E Kwon
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - J M Park
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Y G Eun
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
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43
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Kim YJ, Lee YC, Eun YG, Lee JW. Re: Segmental mandibulectomies made easier: a simple drill guide. Br J Oral Maxillofac Surg 2017. [PMID: 28625411 DOI: 10.1016/j.bjoms.2017.03.007] [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: 11/25/2022]
Affiliation(s)
- Y J Kim
- Korea Institute of Science and Technology, Seoul, Republic of Korea
| | - Y C Lee
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Y G Eun
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - J W Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.
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44
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Chang JS, Kim KH, Yoon HI, Hyung WJ, Rha SY, Kim HS, Lee YC, Lim JS, Noh SH, Koom WS. Locoregional relapse after gastrectomy with D2 lymphadenectomy for gastric cancer. Br J Surg 2017; 104:877-884. [PMID: 28245053 DOI: 10.1002/bjs.10502] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 10/09/2016] [Accepted: 01/09/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Risk for and site of locoregional relapse have not been well studied in patients undergoing gastrectomy with D2 lymphadenectomy for gastric cancer. METHODS Patients who had undergone gastrectomy with D2 lymphadenectomy for gastric cancer between 2004 and 2007 were identified from an institutional database. The locoregional relapse rate was estimated by competing risk analysis, and risk groups were derived according to locoregional relapse risk using recursive partitioning analysis (RPA). The locations of nodal relapses were evaluated according to Japanese Classification of Gastric Carcinoma criteria. RESULTS Some 2618 patients were included. With a median follow-up of 78·0 (range 28·5-122·6) months, relapse was diagnosed in 471 of 2618 patients (18·0 per cent). The cumulative incidence of locoregional relapse at 5 years was 8·5 (95 per cent c.i. 7·4 to 9·6) per cent. The 5-year locoregional recurrence rates for high-risk (N3), intermediate-risk (N1-2) and low-risk (N0) groups were 32·4, 12·3 and 1·7 per cent respectively (P < 0·001). Among patients with regional relapse, 90·4 per cent had involvement outside the D2 dissected area, and the most commonly involved site was station 16b1. This pattern was maintained in the RPA risk groups (P = 0·329). CONCLUSION Locoregional relapse at 5 years after gastrectomy with D2 lymphadenectomy was 8·5 per cent, and was most often seen outside the D2 dissected area.
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Affiliation(s)
- J S Chang
- Department of Radiation Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - K H Kim
- Department of Radiation Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - H I Yoon
- Department of Radiation Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - W J Hyung
- Department of Surgery, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - S Y Rha
- Division of Medical Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - H S Kim
- Division of Medical Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - Y C Lee
- Division of Gastroenterology, Department of Internal Medicine, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - J S Lim
- Department of Radiology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - S H Noh
- Department of Surgery, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
| | - W S Koom
- Department of Radiation Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea
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45
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Mize B, Salame G, Maglantay R, Chen NN, Lee YC. Rapidly progressing central-type primitive neuroectodermal tumor of the ovary: a case report. EUR J GYNAECOL ONCOL 2017; 38:290-293. [PMID: 29953798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Primitive neuroectodermal tumors (PNET) belong to a group of highly malignant tumors comprised of small round cells of neu- roectodermal origin. These tumors can be either of peripheral-type (Ewing family tumors/PNET) or central-type. A number of case re- ports have described PNET involving the gynecologic organs and the prognosis is generally poor. The authors describe the case of a 53-year-old woman with a rapidly progressing central-type PNET of the ovary.
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Marahatta A, Baek IH, Pyo JS, Bhandary B, Kim HK, Bang JS, Yoon H, Rhew KY, Chai OH, Lee YC. Pharmacokinetics and Bronchopulmonary Disposition of PI3KDelta Inhibitor IC87114 after Intratracheal Administration in a Severe Asthma Model. Indian J Pharm Sci 2017. [DOI: 10.4172/pharmaceutical-sciences.1000317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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47
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Rhee K, Kim JH, Jung DH, Han JW, Lee YC, Lee SK, Shin SK, Park JC, Chung HS, Park JJ, Youn YH, Park H. Self-expandable metal stents for malignant esophageal obstruction: a comparative study between extrinsic and intrinsic compression. Dis Esophagus 2016; 29:224-8. [PMID: 25708695 DOI: 10.1111/dote.12325] [Citation(s) in RCA: 6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Self-expandable metal stents (SEMSs) are effective for malignant esophageal obstruction, but usefulness of SEMSs in extrinsic lesions is yet to be elucidated. This study is aimed at evaluating the clinical usefulness of SEMSs in the extrinsic compression compared with intrinsic. A retrospective review was conducted for 105 patients (intrinsic, 85; extrinsic, 20) with malignant esophageal obstruction who underwent endoscopic SEMSs placement. Technical and clinical success rates were evaluated and clinical outcomes were compared between extrinsic and intrinsic group. Extrinsic group was mostly pulmonary origin. Overall technical and clinical success rate was 100% and 91%, respectively, without immediate complications. Extrinsic and intrinsic group did not differ significantly in clinical success rate. The median stent patency time was 131.3 ± 85.8 days in intrinsic group while that of extrinsic was 54.6 ± 45.1 due to shorter survival after stent insertion. The 4-, 8-, and 12-week patency rates were 90.5%, 78.8%, and 64.9% respectively in intrinsic group, while stents of extrinsic group remained patent until death. Uncovered, fully covered, and double-layered stent were used evenly and the types did not influence patency in both groups. In conclusion, esophageal SEMSs can safely and effectively be used for malignant extrinsic compression as well as intrinsic.
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Affiliation(s)
- K Rhee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - J-H Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - D H Jung
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - J W Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Y C Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - S K Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - S K Shin
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - J C Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - H S Chung
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - J J Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Y H Youn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - H Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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48
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Oh CY, Kim DY, Jin SM, Kim TK, Kim JP, Jeong ED, Hyun MH, Sim EK, Lee YC, Jin JS. Self-Assembled Silica Nanostructures: Simultaneous Discrimination of Handedness, Pitch and Diameter of Helical Silica Nanotubes. J Nanosci Nanotechnol 2016; 16:1988-1992. [PMID: 27433714 DOI: 10.1166/jnn.2016.11956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The left- and right-handed helical silica nanostructures were obtained with the aid of organic templates, the formation of the nanostructures might follow a co-operation self-assembly mechanism. The chirality of the organogel self-assemblies was successfully transcribed in to the silica. The helical pitch and pore size of the silica nanotubes sensitively depended on the optical purity of the neutral gelator in the reaction mixtures.
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49
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Liu CC, Lee YC, Tsai VFS, Cheng KH, Wu WJ, Bao BY, Huang CN, Yeh HC, Tsai CC, Wang CJ, Huang SP. The interaction of serum testosterone levels and androgen receptor CAG repeat polymorphism on the risk of erectile dysfunction in aging Taiwanese men. Andrology 2015. [PMID: 26216079 DOI: 10.1111/andr.12068] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Testosterone has been found to play important roles in men's sexual function. However, the effects of testosterone can be modulated by androgen receptor (AR) CAG repeat polymorphism. It could also contribute to the risk of erectile dysfunction (ED). The aim of this study is to evaluate the interaction of serum testosterone levels and AR CAG repeat polymorphism on the risk of ED in aging Taiwanese men. This cross-sectional data of Taiwanese men older than 40 years were collected from a free health screening held between August 2010 and August 2011 in Kaohsiung city, Taiwan. All participants completed a health questionnaires included five-item version of the International Index of Erectile Function (IIEF-5) and the International Prostate Symptoms Score, received a detailed physical examination and provided 20 cm3 whole blood samples for biochemical and genetic evaluation. The IIEF-5 was used to evaluate ED. Serum albumin, total testosterone (TT), and sex hormone-binding globulin levels were measured. Free testosterone level was calculated. AR gene CAG repeat polymorphism was determined by direct sequencing. Finally, 478 men with the mean age of 55.7 ± 4.8 years were included. When TT levels were above 330 ng/dL, the effect of testosterone level on erectile function seemed to reach a plateau and a significantly negative correlation between AR CAG repeat length and the score of IIEF-5 was found (r = -0.119, p = 0.034). After adjusting for other covariates, the longer AR CAG repeat length was still an independent risk factor for ED in subjects with TT above 330 ng/dL (p = 0.006), but not in TT of 330 ng/dL or below. In conclusion, both serum testosterone levels and AR CAG repeat polymorphism can influence erectile function concomitantly. In subjects with normal TT concentration, those with longer AR CAG repeat lengths have a higher risk of developing ED.
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Affiliation(s)
- C C Liu
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Depratment of Urology, Pingtung Hospital, Ministry of Health and Welfare, Executive Yuan, Pingtung, Taiwan
| | - Y C Lee
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - V F S Tsai
- Department of Urology, Ten-Chan General Hospital, Taoyuan, Taiwan
| | - K H Cheng
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - W J Wu
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - B Y Bao
- Department of Pharmacy, China Medical University, Taichung, Taiwan
| | - C N Huang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - H C Yeh
- Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - C C Tsai
- Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - C J Wang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - S P Huang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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50
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Goh SY, Ang SB, Bee YM, Chen YT, Gardner DS, Ho ET, Adaikan K, Lee YC, Lee CH, Lim FS, Lim HB, Lim SC, Seow J, Soh AW, Sum CF, Tai ES, Thai AC, Wong TY, Yap F. Ministry of Health Clinical Practice Guidelines: Diabetes Mellitus. Singapore Med J 2015; 55:334-47. [PMID: 25017409 DOI: 10.11622/smedj.2014079] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [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]
Abstract
The Ministry of Health (MOH) have updated the clinical practice guidelines on Diabetes Mellitus to provide doctors and patients in Singapore with evidence-based treatment for diabetes mellitus. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on Diabetes Mellitus, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
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Affiliation(s)
- S Y Goh
- Department of Endocrinology, Singapore General Hospital, Outram Road, Singapore 169608.
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