Publications by authors named "Jae Jun Lee"

200 Publications

Preoperative Inflammatory Markers and the Risk of Postoperative Delirium in Patients Undergoing Lumbar Spinal Fusion Surgery.

J Clin Med 2022 Jul 14;11(14). Epub 2022 Jul 14.

Institute of New Frontier Research Team, Hallym University College of Medicine, Chuncheon-si 24252, Korea.

We investigated the possible associations between postoperative delirium (POD) and routinely available preoperative inflammatory markers in patients undergoing lumbar spinal fusion surgery (LSFS) to explore the role of neuroinflammation and oxidative stress as risk factors for POD. We analyzed 11 years' worth of data from the Smart Clinical Data Warehouse. We evaluated whether preoperative inflammatory markers, such as the neutrophil-to-lymphocyte ratio (NLR), the monocyte-to-lymphocyte ratio (MLR), and the CRP-to-albumin ratio (CAR), affected the development of POD in patients undergoing LSFS. Of the 3081 subjects included, 187 (7.4%) developed POD. A significant increase in NLR, MLR, and CAR levels was observed in POD patients ( < 0.001). A multivariate analysis showed that the second, third, and highest quartiles of the NLR were significantly associated with the development of POD (adjusted OR (95% CI): 2.28 (1.25-4.16], 2.48 (1.3-4.73], and 2.88 (1.39-5.96], respectively). A receiver operating characteristic curve analysis showed that the discriminative ability of the NLR, MLR, and CAR for predicting POD was low, but almost acceptable (AUC (95% CI): 0.60 (0.56-0.64], 0.61 (0.57-0.65], and 0.63 (0.59-0.67], respectively, < 0.001). Increases in preoperative inflammatory markers, particularly the NLR, were associated with the development of POD, suggesting that a proinflammatory state is a potential pathophysiological mechanism of POD.
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http://dx.doi.org/10.3390/jcm11144085DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9324332PMC
July 2022

Deep-Learning for the Diagnosis of Esophageal Cancers and Precursor Lesions in Endoscopic Images: A Model Establishment and Nationwide Multicenter Performance Verification Study.

J Pers Med 2022 Jun 27;12(7). Epub 2022 Jun 27.

Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon 24253, Korea.

Background: Suspicion of lesions and prediction of the histology of esophageal cancers or premalignant lesions in endoscopic images are not yet accurate. The local feature selection and optimization functions of the model enabled an accurate analysis of images in deep learning.

Objectives: To establish a deep-learning model to diagnose esophageal cancers, precursor lesions, and non-neoplasms using endoscopic images. Additionally, a nationwide prospective multicenter performance verification was conducted to confirm the possibility of real-clinic application.

Methods: A total of 5162 white-light endoscopic images were used for the training and internal test of the model classifying esophageal cancers, dysplasias, and non-neoplasms. A no-code deep-learning tool was used for the establishment of the deep-learning model. Prospective multicenter external tests using 836 novel images from five hospitals were conducted. The primary performance metric was the external-test accuracy. An attention map was generated and analyzed to gain the explainability.

Results: The established model reached 95.6% (95% confidence interval: 94.2-97.0%) internal-test accuracy (precision: 78.0%, recall: 93.9%, F1 score: 85.2%). Regarding the external tests, the accuracy ranged from 90.0% to 95.8% (overall accuracy: 93.9%). There was no statistical difference in the number of correctly identified the region of interest for the external tests between the expert endoscopist and the established model using attention map analysis ( = 0.11). In terms of the dysplasia subgroup, the number of correctly identified regions of interest was higher in the deep-learning model than in the endoscopist group, although statistically insignificant ( = 0.48).

Conclusions: We established a deep-learning model that accurately classifies esophageal cancers, precursor lesions, and non-neoplasms. This model confirmed the potential for generalizability through multicenter external tests and explainability through the attention map analysis.
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http://dx.doi.org/10.3390/jpm12071052DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9320232PMC
June 2022

Updated Genome-wide Association Study of Intracranial Aneurysms by Genotype Correction and Imputation in Koreans.

World Neurosurg 2022 Jul 2. Epub 2022 Jul 2.

Department of Neurosurgery, Hallym University College of Medicine, Chuncheon, Gangwon-do, Republic of Korea. Electronic address:

Objective: Compared to European, Japanese, and Chinese populations, genetic studies on intracranial aneurysms (IA) in Koreans are lacking. We conducted an updated genome-wide association study (GWAS) to more accurately identify candidate variations predicting IA by genotype correction and imputation than in the first Korean GWAS.

Methods: We performed a high-throughput imputation of single-nucleotide polymorphisms (SNPs) and genotype missing values for 250 IA and 296 controls. Out of a total 7,333,746 sites with an imputation R score of ≥ 0.5, 6,105,212 SNPs were analyzed. A high-throughput GWAS was performed after adjusting for clinical variables and four principal component analysis values.

Results: A total of 39 SNPs reached a significant genome-wide threshold (p < 5×10). After pruning by pairwise linkage disequilibrium (LD) (r < 0.8), 11 SNPs were consistently associated with IA. Six tagging SNPs including rs3120004, rs1851347, rs1522095, rs7779989, rs12935558, rs3826442, and rs2440154 showed strong LD tower tagging haplotype structures. Among them, rs3120004 tagged a large and strong haplotype structure between LOC440704 and RGS18 genes in the 1q31.2 (OR [odds ratio] = 2.34, 95% CI [confidence interval]: 1.74-3.14; p = 1.4×10). The rs2440154 (SLC47A1, 17p11.2) SNP increased the risk of IA most significantly (OR = 2.90, 95% CI: 2.07-4.08; p = 8.2×10). The region encompassing rs3826442 (MYH13, 17p13.1) showed a high recombination rate of approximately 70 cM/Mbp.

Conclusions: Our updated GWAS using high-throughput imputation approaches can be an informative milestone in understanding IA formation via susceptibility loci in this stage before large-scale GWA meta-analysis.
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http://dx.doi.org/10.1016/j.wneu.2022.06.113DOI Listing
July 2022

No-Code Platform-Based Deep-Learning Models for Prediction of Colorectal Polyp Histology from White-Light Endoscopy Images: Development and Performance Verification.

J Pers Med 2022 Jun 12;12(6). Epub 2022 Jun 12.

Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang 10556, Korea.

Background: The authors previously developed deep-learning models for the prediction of colorectal polyp histology (advanced colorectal cancer, early cancer/high-grade dysplasia, tubular adenoma with or without low-grade dysplasia, or non-neoplasm) from endoscopic images. While the model achieved 67.3% internal-test accuracy and 79.2% external-test accuracy, model development was labour-intensive and required specialised programming expertise. Moreover, the 240-image external-test dataset included only three advanced and eight early cancers, so it was difficult to generalise model performance. These limitations may be mitigated by deep-learning models developed using no-code platforms.

Objective: To establish no-code platform-based deep-learning models for the prediction of colorectal polyp histology from white-light endoscopy images and compare their diagnostic performance with traditional models.

Methods: The same 3828 endoscopic images used to establish previous models were used to establish new models based on no-code platforms Neuro-T, VLAD, and Create ML-Image Classifier. A prospective multicentre validation study was then conducted using 3818 novel images. The primary outcome was the accuracy of four-category prediction.

Results: The model established using Neuro-T achieved the highest internal-test accuracy (75.3%, 95% confidence interval: 71.0-79.6%) and external-test accuracy (80.2%, 76.9-83.5%) but required the longest training time. In contrast, the model established using Create ML-Image Classifier required only 3 min for training and still achieved 72.7% (70.8-74.6%) external-test accuracy. Attention map analysis revealed that the imaging features used by the no-code deep-learning models were similar to those used by endoscopists during visual inspection.

Conclusion: No-code deep-learning tools allow for the rapid development of models with high accuracy for predicting colorectal polyp histology.
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http://dx.doi.org/10.3390/jpm12060963DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225479PMC
June 2022

Highly stable semitransparent multilayer graphene/LaVOvertical-heterostructure photodetectors.

Nanotechnology 2022 Jul 4;33(39). Epub 2022 Jul 4.

Department of Applied Physics, Institute of Natural Sciences, and Integrated Education Institute for Frontier Science and Technology (BK21 Four), Kyung Hee University, Yongin 17104, Republic of Korea.

A heterostructure composed of a combination of semi-metallic graphene (Gr) and high-absorption LaVOis ideal for high-performance translucent photodetector (PD) applications. Here, we present multilayer Gr/LaVOvertical-heterostructure semitransparent PDs with various layer numbers (). At= 2, the PD shows the best performance with a responsivity () of 0.094 A Wand a specific detectivity (*) of 7.385 × 10cm HzWat 532 nm. Additionally, the average visible transmittance of the PD is 63%, i.e. it is semitransparent. We increased photocurrent (PC) by approximately 13%, from 0.564 to 0.635A cmby using an Al reflector on the semitransparent PD. The PC of an unencapsulated PD maintains about 86% (from 0.571 to 0.493A cm) of its initial PC value after 2000 h at 25 °C temperature/30% relative humidity, showing good stability. This behavior is superior to that of previously reported graphene-based PDs. These results show that these PDs have great potential for semitransparent optoelectronic applications.
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http://dx.doi.org/10.1088/1361-6528/ac73a1DOI Listing
July 2022

Mild Traumatic Brain Injury and Subsequent Acute Pulmonary Inflammatory Response.

J Korean Neurosurg Soc 2022 May 16. Epub 2022 May 16.

Department of Neurosurgery, Hallym University College of Medicine, Chuncheon, Korea.

Background: The influence of moderate-to-severe traumatic brain injury (TBI) on acute pulmonary injury is well established, but the association between acute pulmonary injury and mild TBI has not been well studied. Here, we evaluated the histological changes and fluctuations in inflammatory markers in the lungs to determine whether an acute pulmonary inflammatory response occurred after mild TBI.

Methods: Mouse models of mild TBI (n=24) were induced via open-head injuries using a stereotaxic impactor. The brain and lungs were examined 6 hours, 24 hours, and 72 hours after injury and compared to sham-operated controls (n=24). Fluoro-Jade B (FJB) staining and Astra blue and hematoxylin staining were performed to assess cerebral neuronal degeneration and pulmonary histological architecture. Quantitative real-time polymerase chain reaction (qRT-PCR) analysis was done to measure inflammatory cytokines.

Results: Increased neuronal degeneration and the mRNA expression of IL-6, TNF-α, IL-10, and TGF-β were observed after mild TBI. The IL-6, TNF-α, and TGF-β levels in mice with mild TBI were significantly different compared to those of sham-operated mice 24 hours after injury, and this was more pronounced at 72 hours. Mild TBI induced acute pulmonary interstitial edema with cell infiltration and alveolar morphological changes. In particular, a significant infiltration of mast cells was observed. Among the inflammatory cytokines, TNF-α was significantly increased in the lungs at 6 hours, but there was no significant difference 24 and 72 hours after injury.

Conclusions: Mild TBI induced acute pulmonary interstitial inflammation and alveolar structural changes, which are likely to worsen the patient's prognosis.
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http://dx.doi.org/10.3340/jkns.2021.0310DOI Listing
May 2022

Expression of antimicrobial peptides in the amniotic fluid of women with cervical insufficiency.

Am J Reprod Immunol 2022 08 23;88(2):e13577. Epub 2022 May 23.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, South Korea.

Problem: Cervical insufficiency (CI) is associated with intra-amniotic infection or inflammation. Antimicrobial peptides (AMPs) in amniotic fluid may protect the fetus against microbial invasion, giving their broad-spectrum microbiocidal properties. We evaluated changes in amniotic fluid AMP expression in women with CI and assessed whether these changes are related to their pregnancy outcomes.

Method Of Study: We evaluated amniotic fluid human neutrophil peptide 3 (HNP-3), human β-defensin-2 (hBD-2), and LL-37 levels in 66 women with CI and 25 normal controls at 16-24 weeks of gestation. The CI group was divided into short cervix and cervical dilation groups, and the cervical dilation group was further divided into preterm and full-term delivery groups according to the pregnancy outcomes, and AMP expression was analyzed in each group.

Results: HNP-3 and hBD-2 levels were higher in women with CI than in normal controls and in the cervical dilation as compared to the short cervix group. Among women with cervical dilation, 22 delivered at full-term, and 23 had spontaneous preterm births. The hBD-2 level in amniotic fluid mid-pregnancy was higher in the full-term delivery than in the preterm delivery groups. However, LL-37 levels in amniotic fluid were low in women with CI and normal controls.

Conclusions: Amniotic fluid HNP-3 and hBD-2 levels increased in women with CI compared with normal controls. Moreover, increased amniotic fluid hBD-2 levels mid-pregnancy were associated with favorable pregnancy outcomes in women with CI. AMPs in the amniotic fluid may participate in host defense against ascending infection in women with CI.
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http://dx.doi.org/10.1111/aji.13577DOI Listing
August 2022

Anti-inflammatory and Anti-bacterial Effects of Allicin-coated Tracheal Tube on Trachea Mucosa.

In Vivo 2022 May-Jun;36(3):1195-1202

Institute of New Frontier Research Team, Hallym University, Hallym Clinical and Translation Science Institute, Chuncheon, Republic of Korea;

Background/aim: Allicin has been known to improve wound healing via antimicrobial and anti-inflammatory properties. The aim of this study was to evaluate whether an allicin-coated tracheal tube can prevent tracheal stenosis through improving wound healing after tracheal injury.

Materials And Methods: Allicin-coated silicone tracheal tube (t-tube) was prepared by the polydopamine-mediated coating method. Tracheal mucosa was injured, and an allicin-coated t-tube was placed into the trachea to evaluate mucosal changes until designated time point. Anti-inflammatory, anti-bacterial and cytotoxic effects of allicin were also investigated in in vitro.

Results: Allicin- coated silicone was not cytotoxic, and it showed anti-inflammatory and anti-bacterial effects in in vitro analysis. The use of allicin-coated t-tube in a rabbit model showed favorable mucosal healing with significant decrease of proinflammatory cytokines compared to the non-coated tube group. The allicin-coated tube showed obvious decreased number of cocci-shaped bacterial attached to the tube surface. From the histological point of view, the allicin- coated tube showed faster regeneration of the normal respiratory epithelial structure compared to the non-coated group.

Conclusion: Allicin-coated t-tube showed anti-inflammatory and anti-bacterial effects on injured tracheal mucosa. We suggest that allicin-coated t-tube can be used for promoting physiological wound healing to prevent laryngotracheal stenosis.
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http://dx.doi.org/10.21873/invivo.12819DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9087065PMC
April 2022

Computer-Aided Diagnosis of Gastrointestinal Protruded Lesions Using Wireless Capsule Endoscopy: A Systematic Review and Diagnostic Test Accuracy Meta-Analysis.

J Pers Med 2022 Apr 17;12(4). Epub 2022 Apr 17.

Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 24253, Korea.

Background: Wireless capsule endoscopy allows the identification of small intestinal protruded lesions, such as polyps, tumors, or venous structures. However, reading wireless capsule endoscopy images or movies is time-consuming, and minute lesions are easy to miss. Computer-aided diagnosis (CAD) has been applied to improve the efficacy of the reading process of wireless capsule endoscopy images or movies. However, there are no studies that systematically determine the performance of CAD models in diagnosing gastrointestinal protruded lesions.

Objective: The aim of this study was to evaluate the diagnostic performance of CAD models for gastrointestinal protruded lesions using wireless capsule endoscopic images.

Methods: Core databases were searched for studies based on CAD models for the diagnosis of gastrointestinal protruded lesions using wireless capsule endoscopy, and data on diagnostic performance were presented. A systematic review and diagnostic test accuracy meta-analysis were performed.

Results: Twelve studies were included. The pooled area under the curve, sensitivity, specificity, and diagnostic odds ratio of CAD models for the diagnosis of protruded lesions were 0.95 (95% confidence interval, 0.93-0.97), 0.89 (0.84-0.92), 0.91 (0.86-0.94), and 74 (43-126), respectively. Subgroup analyses showed robust results. Meta-regression found no source of heterogeneity. Publication bias was not detected.

Conclusion: CAD models showed high performance for the optical diagnosis of gastrointestinal protruded lesions based on wireless capsule endoscopy.
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http://dx.doi.org/10.3390/jpm12040644DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9029411PMC
April 2022

Risk of Burning Mouth Syndrome in Patients with Migraine: A Nationwide Cohort Study.

J Pers Med 2022 Apr 11;12(4). Epub 2022 Apr 11.

Department of Anesthesiology and Pain Medicine, College of Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea.

Migraine is a common neurological disease that causes a variety of symptoms, most notably throbbing, which is described as a pulsing headache on one side of the head. Burning mouth syndrome (BMS) is defined as an intra-oral burning sensation. Currently, no medical or dental cause has been identified for BMS. Interestingly, neuropathic pain is a characteristic feature of BMS; however, it remains unclear whether migraine can cause BMS. We aimed to identify the association of migraine with the risk of developing BMS. We used a representative nationwide cohort sample of approximately 1 million patients from 2002 to 2013 to investigate the prospective association between migraine and BMS. A total of 4157 migraine patients (migraine group) and 16,628 patients without migraine (comparison group) were enrolled after 1:4 propensity score matching. The overall incidence of BMS was significantly higher in the migraine group (0.15 per 1000 person-years) than in the comparison group (0.05 per 1000 person-years). The adjusted HR for patients with migraine who reported BMS events during the 10-year follow-up period was 2.96 (95% confidence interval, 1.02-8.56), after adjusting for other covariates. However, in the subgroup analysis, the adjusted HR for BMS events did not show a significant difference between the migraine and comparison group according to sex, age, and comorbidities. This study suggests that migraine is associated with an increased incidence of BMS. Therefore, clinicians should be attentive to detect BMS at an early stage when treating patients with migraine.
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http://dx.doi.org/10.3390/jpm12040620DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9029595PMC
April 2022

Metagenomic Analysis of Plasma Microbial Extracellular Vesicles in Patients Receiving Mechanical Ventilation: A Pilot Study.

J Pers Med 2022 Apr 2;12(4). Epub 2022 Apr 2.

Institute of New Frontier Research Team, Hallym University College of Medicine, Chuncheon 24253, Korea.

Background: Previous studies reported a significant association between pneumonia outcome and the respiratory microbiome. There is increasing interest in the roles of bacterial extracellular vesicles (EVs) in various diseases. We studied the composition and function of microbiota-derived EVs in the plasma of patients receiving mechanical ventilation to evaluate whether they can be used as a diagnostic marker and to predict clinical outcomes.

Methods: Plasma samples ( = 111) from 59 mechanically ventilated patients (41 in the pneumonia group; 24 in the nursing home and hospital-associated infection [NHAI] group) were prospectively collected on days one and seven. After isolating the bacterial EVs from plasma samples, nucleic acid was extracted for 16S rRNA gene pyrosequencing. The samples were evaluated to determine the α and β diversity, bacterial composition, and predicted functions.

Results: Principal coordinates analysis revealed significantly different clustering of microbial EVs between the pneumonia and non-pneumonia groups. The proportions of , , and were significantly different between the pneumonia and non-pneumonia groups. In addition, the abundances of and were significantly higher in the non-NHAI than the NHAI group. In the analysis of β diversity, the structure of microbial EVs differed significantly different between 28-day survivors and non-survivors (Bray-Curtis distance, = 0.014). Functional profiling revealed significant differences between the pneumonia and non-pneumonia groups. The longitudinal change in predicted functions of microbial EV genes showed a significant difference between 28-day survivors and non-survivors.

Conclusions: Bacterial microbiota-derived EVs in the plasma have potential as diagnostic and prognostic markers for patients receiving mechanical ventilation. Further large prospective studies are needed to determine the clinical utility of plasma microbiota-EVs in intubated patients.
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http://dx.doi.org/10.3390/jpm12040564DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031263PMC
April 2022

Genome-wide polygenic risk impact on intracranial aneurysms and acute ischemic stroke.

PLoS One 2022 15;17(4):e0265581. Epub 2022 Apr 15.

Department of Neurosurgery, Hallym University College of Medicine, Chuncheon, Gangwon-do, Republic of Korea.

Polygenic risk scores (PRSs) have an important relevance to approaches for clinical usage in intracranial aneurysm (IA) patients. Hence, we aimed to develop IA-predicting PRS models including the genetic basis shared with acute ischemic stroke (AIS) in Korean populations. We applied a weighted PRS (wPRS) model based on a previous genome-wide association study (GWAS) of 250 IA patients in a hospital-based multicenter cohort, 222 AIS patients in a validation study, and 296 shared controls. Risk predictability was analyzed by the area under the receiver operating characteristic curve (AUROC). The best-fitting risk models based on wPRSs were stratified into tertiles representing the lowest, middle, and highest risk groups. The weighted PRS, which included 29 GWASs (p < 5×10-8) and two reported genetic variants (p < 0.01), showed a high predictability in IA patients (AUROC = 0.949, 95% CI: 0.933-0.966). This wPRS was significantly validated in AIS patients (AUROC = 0.842, 95% CI: 0.808-0.876; p < 0.001). Two-stage risk models stratified into tertiles showed an increased risk for IA (OR = 691.25, 95% CI: 241.77-1976.35; p = 3.1×10-34; sensitivity/specificity = 0.728/0.963), which was replicated in AIS development (OR = 39.76, 95% CI: 16.91-93.49; p = 3.1×10-17; sensitivity/specificity = 0.284/0.963). A higher wPRS for IA may be associated with an increased risk of AIS in the Korean population. These findings suggest that IA and AIS may have a shared genetic architecture and should be studied further to generate a precision medicine model for use in personalized diagnosis and treatment.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265581PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9012378PMC
April 2022

Effect of Structural Fine-Tuning on Chelate Stability and Liver Uptake of Anionic MRI Contrast Agents.

J Med Chem 2022 04 14;65(8):6313-6324. Epub 2022 Apr 14.

Institute of Biomedical Engineering Research, Kyungpook National University, 41405 Daegu, Korea.

The purpose of this study is to assess the physicochemical properties and MRI diagnostic efficacy of two newly synthesized 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-type Gd chelates, Gd-SucL and Gd-GluL, with an asymmetric α-substituted pendant arm as potential hepatocyte-specific magnetic resonance imaging contrast agents (MRI CAs). Our findings show that fine conformational changes in the chelating arm affect the pharmacokinetic behavior of the MRI CA, and that a six-membered chelating substituent of Gd-SucL is more advantageous in this system to avoid unwanted interactions with endogenous species. Gd-SucL exhibited a general DOTA-like chelate stability trend, indicating that all chelating arms retain coordination bonding. Finally, the diagnostic efficacy of highly stable Gd-SucL as a potential hepatocyte-specific MRI CA was evaluated using -weighted MR imaging on an orthotopic hepatocarcinoma model.
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http://dx.doi.org/10.1021/acs.jmedchem.2c00291DOI Listing
April 2022

An NBD-based fluorescent and colorimetric chemosensor for detecting S: Practical application to zebrafish and water samples.

Spectrochim Acta A Mol Biomol Spectrosc 2022 Aug 31;276:121207. Epub 2022 Mar 31.

Department of Fine Chem. and New and Renewable Energy Convergence, Seoul National Univ. of Sci. and Tech. (SNUT), Seoul 01811, Republic of Korea. Electronic address:

A novel 7-nitro-1,2,3-benzoxadiazole (NBD)-based chemosensor BOP ((5-bromopyridin-2-yl)(4-(7-nitrobenzo[c][1,2,5]oxadiazol-4-yl)piperazin-1-yl)methanone) was synthesized. BOP could detect S through fluorescent quenching and colorimetric change. The detection limit was calculated to be 10.9 µM through fluorescence titration. The reaction mechanism of BOP towards S was estimated to be thiolysis of NBD amine, producing the cleavage products, NBD-S and BP ((5-bromopyridin-2-yl)(piperazin-1-yl)methanone). The thiolysis was demonstrated by H NMR titrations, ESI-mass analysis and theoretical calculations. Importantly, BOP was able to successfully monitor S in zebrafish and water samples. Additionally, test strips coated with BOP were applied to the in-the-field measurements of S.
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http://dx.doi.org/10.1016/j.saa.2022.121207DOI Listing
August 2022

Association of Haptoglobin Phenotype With Neurological and Cognitive Outcomes in Patients With Subarachnoid Hemorrhage.

Front Aging Neurosci 2022 21;14:819628. Epub 2022 Mar 21.

Department of Neurosurgery, Hallym University College of Medicine, Chuncheon, South Korea.

Background: To assess the association of haptoglobin (Hp) phenotype with neurological and cognitive outcomes in a large cohort of patients with subarachnoid hemorrhage (SAH).

Methods: This prospective multicenter study enrolled patients with aneurysmal SAH between May 2015 and September 2020. The Hp phenotype was confirmed Western blots. The relative intensities of α1 in individuals carrying Hp2-1 were compared with those of albumin. Multivariable logistic and Cox proportional-hazard regression analyses were used to identify the risk factors for 6-month and long-term outcomes, respectively.

Results: A total of 336 patients including the phenotypes Hp1-1 ( = 31, 9.2%), Hp2-1 ( = 126, 37.5%), and Hp2-2 ( = 179, 53.3%) were analyzed. The Hp phenotype was closely associated with 6-month outcome ( = 0.001) and cognitive function ( = 0.013), and long-term outcome ( = 0.002) and cognitive function ( < 0.001). Compared with Hp1-1 as the reference value, Hp2-2 significantly increased the risk of 6-month poor outcome (OR: 7.868, 95% CI: 1.764-35.093) and cognitive impairment (OR: 8.056, 95% CI: 1.020-63.616), and long-term poor outcome (HR: 5.802, 95% CI: 1.795-18.754) and cognitive impairment (HR: 7.434, 95% CI: 2.264-24.409). Long-term cognitive impairment based on the Hp phenotype was significantly higher in patients under 65 years of age ( < 0.001) and female gender ( < 0.001). A lower relative α1/albumin intensity (OR: 0.010, 95% CI: 0.000-0.522) was associated with poor outcome at 6 months but not cognitive impairment in patients with SAH expressing Hp2-1.

Conclusion: Hp2-2 increased the risk of poor neurological outcomes and cognitive impairment compared with Hp1-1. For Hp2-1, higher relative α1 intensities were related to 6-month favorable outcomes.
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http://dx.doi.org/10.3389/fnagi.2022.819628DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8978790PMC
March 2022

Risk of Dementia According to Surgery Type: A Nationwide Cohort Study.

J Pers Med 2022 Mar 15;12(3). Epub 2022 Mar 15.

Division of Big Data and Artificial Intelligence, Institute of New Frontier Research, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea.

The relationship between dementia and surgery remains unclear. Research to elucidate the relationship between them is scarce, and conducting epidemiological research is complicated. This study aimed to investigate the incidence and risk of dementia according to the surgery type. We performed a retrospective propensity score-matched cohort study using nationwide representative cohort sample data from the Korean National Health Insurance Service in South Korea between 2003 and 2004. Incidence rates for dementia were obtained by dividing the number of patients with dementia by person-years at risk. To identify the risk of dementia according to the type of surgery, we investigated the hazard ratio by each surgery type. The incidence rates of dementia in control, musculoskeletal, and two or more surgeries groups were 9.66, 13.47, and 13.36 cases per 1000 person-years, respectively. The risk of dementia in the musculoskeletal and two or more surgeries groups was 1.44-fold higher (95% confidence interval (95% CI), 1.22-1.70) and 1.42-fold higher (95% CI, 1.17-1.72) than that in the control group, respectively. Patients who underwent musculoskeletal surgery and two or more surgeries had a higher risk of dementia; however, there was no association with the type of anesthesia administered.
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http://dx.doi.org/10.3390/jpm12030468DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8955036PMC
March 2022

A Bayesian Network Meta-Analysis of First-Line Treatments for Non-Small Cell Lung Cancer with High Programmed Death Ligand-1 Expression.

J Clin Med 2022 Mar 9;11(6). Epub 2022 Mar 9.

Division of Hemato-Oncology, Department of Internal Medicine, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Korea.

We performed a Bayesian network meta-analysis (NMA) to suggest frontline treatments for advanced non-small cell lung cancer (NSCLC) showing high programmed death ligand-1 (PD-L1) expression. A total of 5237 patients from 22 studies were included. In terms of progression-free survival, immune checkpoint inhibitors (ICIs) plus bevacizumab plus chemotherapy had the highest surface under the cumulative ranking curve (SUCRA) value (98.1%), followed by ICI plus chemotherapy (82.9%). In terms of overall survival (OS), dual immunotherapy plus chemotherapy had the highest SUCRA value (79.1%), followed by ICI plus bevacizumab plus chemotherapy (73.4%). However, there was no significant difference in survival outcomes among treatment regimens combined with immunotherapy. Moreover, ICI plus chemotherapy failed to reveal a significant OS superiority to ICI monotherapy (hazard ratio = 0.978, 95% credible internal: 0.771-1.259). In conclusion, this NMA indicates that ICI plus chemotherapy with/without bevacizumab might to be the best options in terms of OS for advanced NSCLC with high PD-L1 expression. However, considering that there was no significant difference in survival outcomes among treatment regimens incorporating immunotherapy and that ICI plus chemotherapy failed to show significant survival benefits over ICI monotherapy, ICI monotherapy may be reasonable as first-line treatment for advanced NSCLC with high PD-L1 expression.
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http://dx.doi.org/10.3390/jcm11061492DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8950568PMC
March 2022

MicroRNA 148a Suppresses Tuberculous Fibrosis by Targeting NOX4 and POLDIP2.

Int J Mol Sci 2022 Mar 10;23(6). Epub 2022 Mar 10.

Institute of New Frontier Research Team, Hallym University College of Medicine, Chuncheon 24253, Korea.

Extracellular matrix production by pleural mesothelial cells in response to contributes to tuberculous fibrosis. NOX4 is involved in the pathogenesis of tuberculous fibrosis. In this study, we evaluated whether gene-targeting microRNAs showed protective effects in tuberculosis fibrosis. TargetScan prediction software was used to identify candidate microRNAs that bind the 3' UTRs of , and microRNA-148a (miR-148a) was selected as the best miRNA candidate. A repressed and forced expression assay in Met5A cells was performed to investigate the causal relationship between miR-148a and NOX4. The role of miR-148a in tuberculous pleural fibrosis was studied using a murine model of bacillus Calmette-Guérin (BCG) pleural infection. Heat-killed (HKMT) induces NOX4 and POLDIP2 expression. We demonstrated the inhibitory effect of miR-148a on NOX4 and POLDIP2 expression. The increased expression of miR-148a suppressed HKMT-induced collagen-1A synthesis in PMC cells. In the BCG pleurisy model, miR-148a significantly reduced fibrogenesis and epithelial mesenchymal transition. High levels of miR-148a in tuberculous pleural effusion can be interpreted as a self-limiting homeostatic response. Our data indicate that miR-148a may protect against tuberculous pleural fibrosis by regulating NOX4 and POLDIP2.
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http://dx.doi.org/10.3390/ijms23062999DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954251PMC
March 2022

Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2019.

Cancer Res Treat 2022 Apr 16;54(2):330-344. Epub 2022 Mar 16.

Korea Central Cancer Registry, National Cancer Center, Goyang, Korea.

Purpose: The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2019.

Materials And Methods: Incidence, survival, and prevalence rates of cancer were calculated using the Korea National Cancer Incidence Database, from 1999 to 2019, with survival follow-up until December 31, 2020. Deaths from cancer were assessed using causes-of-death data obtained from Statistics Korea.

Results: In 2019, newly diagnosed cancer cases and deaths from cancer were reported as 254,718 (ASR, 275.4 per 100,000) and 81,203 (ASR, 72.2 per 100,000), respectively. For the first time, lung cancer (n=29,960) became the most frequent cancer in Korea, excluding thyroid cancer. The overall cancer incidence rates increased by 3.3% annually from 1999 to 2012, and decreased by 5.3% annually from 2012 to 2015, thereafter, followed by nonsignificant changes. The incidence of thyroid cancer increased again from 2016 (annual percentage change, 6.2%). Cancer mortality rates have been decreasing since 2002, with more rapid decline in recent years (annual decrease of 2.7% from 2002 to 2013; 3.3% from 2013 to 2019). The 5-year relative survival between 2015 and 2019 was 70.7%, which contributed to prevalent cases reaching over 2 million in 2019.

Conclusion: Cancer survival rates have improved over the past decades, but the number of newly diagnosed cancers is still increasing, with some cancers showing only marginal improvement in survival outcomes. As the number of cancer survivors increases, a comprehensive cancer control strategy should be implemented in line with the changing aspects of cancer statistics.
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http://dx.doi.org/10.4143/crt.2022.128DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9016309PMC
April 2022

Prognostic value of protein tyrosine kinase 6 overexpression in cancers: a meta-analysis.

Front Biosci (Landmark Ed) 2022 02;27(2):60

Institute of New Frontier Research Team, Hallym University, 24252 Chuncheon, Republic of Korea.

Background: Protein tyrosine kinase 6 (PTK6) plays an important role in cell proliferation and differentiation. However, the functions of PTK6 appear highly context-dependent and differ depending on the cell type, as well as its intracellular localization. High PTK6 expression in tumor has been associated with poor pathological features and prognosis in some studies, but other studies have reported opposite results. Therefore, we performed this meta-analysis to derive more precise estimations of the association of PTK6 expression with prognosis and clinicopathological features in cancer patients.

Methods: We conducted a literature search in PubMed, Ovid MEDLINE, and MEDLINE databases to cover all articles published until June 2021. All 1475 patients from the eight studies were included in the meta-analysis. Because of heterogeneity in PTK6 expression in non-tumor tissues, the included studies were divided into two subgroups according to PTK expression in non-tumor tissues: the low expression subgroup (LESG) or high expression subgroup (HESG).

Results: Patients with high PTK expression showed significantly worse overall survival (OS) in LESG (Hazard Ratio (HR) = 2.53 [95% Confidence Interval (CI), 1.68-3.83], < 0.0001), but significantly better OS in HESG (HR = 0.56 [95% CI, 0.40-0.78], = 0.0006). PTK6 expression also showed different associations with clinicopathological features, such as advanced T classification, stage, and differentiation according to PTK6 expression in non-tumor tissues.

Conclusions: PTK6 expression in tumor was a prognostic factor in patients with various cancers, but the direction of prognosis differs, depending on the degree of PTK6 expression in non-tumor tissues.
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http://dx.doi.org/10.31083/j.fbl2702060DOI Listing
February 2022

The Relationship between Perioperative Blood Transfusion and Postoperative Delirium in Patients Undergoing Spinal Fusion Surgery: Clinical Data Warehouse Analysis.

Medicina (Kaunas) 2022 Feb 11;58(2). Epub 2022 Feb 11.

Department of Orthopedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea.

For preventing postoperative delirium (POD), identifying the risk factors is important. However, the relationship between blood transfusion and POD is still controversial. The aim of this study was to identify the risk factors of POD, to evaluate the impact of blood transfusion in developing POD among people undergoing spinal fusion surgery, and to show the effectiveness of big data analytics using a clinical data warehouse (CDW). The medical data of patients who underwent spinal fusion surgery were obtained from the CDW of the five hospitals of Hallym University Medical Center. Clinical features, laboratory findings, perioperative variables, and medication history were compared between patients without POD and with POD. 234 of 3967 patients (5.9%) developed POD. In multivariate logistic regression analysis, the risk factors of POD were as follows: Parkinson's disease (OR 5.54, 95% CI 2.15-14.27; < 0.001), intensive care unit (OR 3.45 95% CI 2.42-4.91; < 0.001), anti-psychotics drug (OR 3.35 95% CI 1.91-5.89; < 0.001), old age (≥70 years) (OR 3.08, 95% CI 2.14-4.43; < 0.001), depression (OR 2.8 95% CI 1.27-6.2; < 0.001). The intraoperative transfusion (OR 1.1, 95% CI 0.91-1.34; = 0.582), and the postoperative transfusion (OR 0.91, 95% CI 0.74-1.12; = 0.379) had no statistically significant effect on the incidence of POD. There was no relationship between perioperative blood transfusion and the incidence of POD in spinal fusion surgery. Big data analytics using a CDW could be helpful for the comprehensive understanding of the risk factors of POD, and for preventing POD in spinal fusion surgery.
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http://dx.doi.org/10.3390/medicina58020268DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8877007PMC
February 2022

Treatment of Refractory Chylous Ascites with an Innovative Peritoneovenous Shunt: Temporary Usage of a Continuous Renal Replacement System: A Case Report.

J Chest Surg 2022 Feb;55(1):81-84

Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Esophagectomy and esophageal reconstruction are commonly chosen as surgical options for esophageal cancer. However, prolonged untreated chyle leakage is associated with a poor prognosis. We report the case of a patient with refractory chylous ascites. To limit the ongoing fluid loss, we utilized the chylous ascites as an additional fluid source in a renal replacement therapy system. A continuous renal replacement therapy (CRRT) drainage system was modified to drain both the chylous ascites and venous blood. The ascites drainage rate was determined empirically and regulated by a dial-flow extension set. The CRRT mode was set to continuous venovenous hemodiafiltration and maintained for 7 days. After the patient was weaned from CRRT, ascites did not reaccumulate, and the patient's general condition improved dramatically. No infections related to the system occurred. This procedure temporarily alleviates symptoms and provides more time for alternative treatment strategies.
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http://dx.doi.org/10.5090/jcs.21.090DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8824651PMC
February 2022

Association between Late-Onset Ménière's Disease and the Risk of Incident All-Cause Dementia.

J Pers Med 2021 Dec 31;12(1). Epub 2021 Dec 31.

Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24252, Korea.

Studies reported an association between impaired hearing and vestibular function with the risk of dementia. This study investigated the association between Ménière's disease (MD) and the risk of dementia using a nationwide cohort sample of data obtained from the South Korea National Health Insurance Service. The MD group ( = 496) included patients aged over 55 years and diagnosed between 2003 and 2006. The comparison group was selected using propensity score matching ( = 1984). Cox proportional hazards regression models were used to calculate incidence and hazard ratios for dementia events. The incidence of dementia was 14.3 per 1000 person-years in the MD group. After adjustment for certain variables, the incidence of dementia was higher in the MD group than in the comparison group (adjusted hazard ratio (HR) = 1.57, 95% confidence interval = 1.17-2.12). Subgroup analysis showed a significantly increased adjusted HR for developing Alzheimer's disease (1.69, 95% confidence interval = 1.20-2.37) and vascular dementia (1.99, 95% confidence interval = 1.10-3.57) in the MD group. Patients with dementia experienced a higher frequency of MD episodes than those without dementia. Our findings suggest that late-onset MD is associated with an increased incidence of all-cause dementia, and it might be used as a basis for an earlier diagnosis of dementia.
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http://dx.doi.org/10.3390/jpm12010019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8780200PMC
December 2021

Another Look at Obesity Paradox in Acute Ischemic Stroke: Association Rule Mining.

J Pers Med 2021 Dec 29;12(1). Epub 2021 Dec 29.

Institute of New Frontier Research Team, Hallym University College of Medicine, Chuncheon 24252, Korea.

Though obesity is generally associated with the development of cardiovascular disease (CVD) risk factors, previous reports have also reported that obesity has a beneficial effect on CVD outcomes. We aimed to verify the existing obesity paradox through binary logistic regression (BLR) and clarify the paradox via association rule mining (ARM). Patients with acute ischemic stroke (AIS) were assessed for their 3-month functional outcome using the modified Rankin Scale (mRS) score. Predictors for poor outcome (mRS 3-6) were analyzed through BLR, and ARM was performed to find out which combination of risk factors was concurrently associated with good outcomes using maximal support, confidence, and lift values. Among 2580 patients with AIS, being obese (OR [odds ratio], 0.78; 95% CI, 0.62-0.99) had beneficial effects on the outcome at 3 months in BLR analysis. In addition, the ARM algorithm showed obese patients with good outcomes were also associated with an age less than 55 years and mild stroke severity. While BLR analysis showed a beneficial effect of obesity on stroke outcome, in ARM analysis, obese patients had a relatively good combination of risk factor profiles compared to normal BMI patients. These results may partially explain the obesity paradox phenomenon in AIS patients.
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http://dx.doi.org/10.3390/jpm12010016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8781183PMC
December 2021

Diacerein, an inhibitor of IL-1β downstream mediated apoptosis, improves radioimmunotherapy in a mouse model of Burkitt's lymphoma.

Am J Cancer Res 2021 15;11(12):6147-6159. Epub 2021 Dec 15.

Division of RI Application, Korea Institute of Radiological and Medical Sciences Seoul 01812, Republic of Korea.

Lymphoma has the characteristics of a solid tumor. Penetration of monoclonal antibodies is limited in solid tumors during radioimmunotherapy (RIT). Here, we first investigated the use of diacerein (DIA) as a combination drug to improve the penetration and therapeutic efficacy of I-rituximab (RTX) using the Burkitt's lymphoma mouse model. We selected DIA through computational drug repurposing and focused on rheumatoid arthritis (RA) drug interaction genes to minimize side effects. Then, the cytotoxicity of DIA was assessed in vitro using three different lymphoma cell lines. DIA-induced apoptosis was confirmed by Western blotting. After confirming apoptosis, we confirmed the enhanced uptake of I-RTX in Burkitt's lymphoma mouse model using SPECT/CT. Autoradiography of I-RTX confirmed the therapeutic effect of DIA. Finally, the tumor size and survival rate were assessed to measure the enhanced therapeutic efficacy when DIA was used. In addition, we assessed the dose-dependency of DIA in terms of the accumulation of I-RTX in tumor tissue, the tumor size, and the survival rate. The in vitro cytotoxicity was 10.9%. We showed that DIA induced apoptosis which was related to downstream IL-1β signaling by Western blotting. We found increased Annexin V positive apoptosis after DIA administration. Immuno SPECT/CT images demonstrated a higher uptake of I-RTX in tumors in the DIA-administered group than that in the PBS-alone group. However, there were no statistical differences of dose-dependency between 20 mg/kg and 40 mg/kg of DIA. Tumor growth was significantly inhibited in the group treated with the combination of DIA plus I-RTX at 7 days after injection. Our suggested combination of DIA and I-RTX strategies could enhance the efficacy of I-RTX treatment.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8727812PMC
December 2021

Correction: Computer-Aided Diagnosis of Gastrointestinal Ulcer and Hemorrhage Using Wireless Capsule Endoscopy: Systematic Review and Diagnostic Test Accuracy Meta-analysis.

J Med Internet Res 2022 Jan 11;24(1):e36170. Epub 2022 Jan 11.

Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea.

[This corrects the article DOI: 10.2196/33267.].
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http://dx.doi.org/10.2196/36170DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8790694PMC
January 2022

The Effectiveness of Liquid PUD-TiO Photocatalyst on Asphalt Pavement.

Materials (Basel) 2021 Dec 16;14(24). Epub 2021 Dec 16.

Department of Highway & Transportation Research, Korea Institute of Civil Engineering and Building Technology, 283, Goyang-daero, Ilsanseo-gu, Goyang-si 10223, Gyeonggi-do, Korea.

Harmful nitrogen oxides (NO) are produced by vehicles, factories, mines, and power plants. In fact, over one million tons of NO are emitted into the atmosphere every year, making it the most prevalent air pollutant. Approximately 45% of the emitted NO in Korea is associated with the transportation sector. In this paper, the application of a new TiO photocatalyst on the asphalt roads to remove combustion-produced NO was studied. In an effort to overcome the known constructability, adhesion, cost, and dispersion problems associated with TiO photocatalysts, the liquid polyurethane (PUD) was added with TiO to form a mixture later known as liquid PUD-TiO. Laboratory and field tests were conducted to determine the optimum amount of photocatalyst to be used and the performance of asphalt pavement coated with PUD-TiO in terms of indirect tensile strength, water susceptibility, and rutting resistance. Additionally, the performance of PUD-TiO under different humidity, wind speed, and temperature conditions was also evaluated. The results showed that the application of PUD-TiO photocatalyst on the asphalt pavements road reduces the NO available on the surface of the road. The PUD-TiO also was found to have no effects on the performance of asphalt pavement. Meanwhile, under different weather conditions, the reaction between the photocatalyst and NO is mainly affected by the humidity.
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http://dx.doi.org/10.3390/ma14247805DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8703990PMC
December 2021

Risk of Dementia in Patients Who Underwent Surgery under Neuraxial Anesthesia: A Nationwide Cohort Study.

J Pers Med 2021 Dec 20;11(12). Epub 2021 Dec 20.

Institute of New Frontier Research, Division of Big Data and Artificial Intelligence, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea.

The incidence of dementia in patients with surgery under neuraxial anesthesia and the possibility of surgery under neuraxial anesthesia as a risk factor for dementia were investigated. We performed a retrospective matched cohort study with nationwide, representative cohort sample data of the Korean National Health Insurance Service in South Korea between 1 January 2003, and 31 December 2004. The participants were divided into control ( = 4488) and neuraxial groups ( = 1122) using propensity score matching. After 9 years of follow-up, the corresponding incidences of dementia were 11.5 and 14.8 cases per 1000 person-years. The risk of dementia in the surgery under neuraxial group was 1.44-fold higher (95% confidence interval [95%CI], 1.17-1.76) than that in the control group. In the subgroup analysis of dementia, the risk of Alzheimer's disease in those who underwent surgery under neuraxial anesthesia was 1.48-fold higher (95%CI, 1.17-1.87) than that in those who did not undergo surgery under anesthesia. Our findings suggest that patients who underwent surgery under neuraxial anesthesia had a higher risk of dementia and Alzheimer's disease than those who did not undergo surgery under neuraxial anesthesia.
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http://dx.doi.org/10.3390/jpm11121386DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8708516PMC
December 2021

Computer-Aided Diagnosis of Gastrointestinal Ulcer and Hemorrhage Using Wireless Capsule Endoscopy: Systematic Review and Diagnostic Test Accuracy Meta-analysis.

J Med Internet Res 2021 12 14;23(12):e33267. Epub 2021 Dec 14.

Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea.

Background: Interpretation of capsule endoscopy images or movies is operator-dependent and time-consuming. As a result, computer-aided diagnosis (CAD) has been applied to enhance the efficacy and accuracy of the review process. Two previous meta-analyses reported the diagnostic performance of CAD models for gastrointestinal ulcers or hemorrhage in capsule endoscopy. However, insufficient systematic reviews have been conducted, which cannot determine the real diagnostic validity of CAD models.

Objective: To evaluate the diagnostic test accuracy of CAD models for gastrointestinal ulcers or hemorrhage using wireless capsule endoscopic images.

Methods: We conducted core databases searching for studies based on CAD models for the diagnosis of ulcers or hemorrhage using capsule endoscopy and presenting data on diagnostic performance. Systematic review and diagnostic test accuracy meta-analysis were performed.

Results: Overall, 39 studies were included. The pooled area under the curve, sensitivity, specificity, and diagnostic odds ratio of CAD models for the diagnosis of ulcers (or erosions) were .97 (95% confidence interval, .95-.98), .93 (.89-.95), .92 (.89-.94), and 138 (79-243), respectively. The pooled area under the curve, sensitivity, specificity, and diagnostic odds ratio of CAD models for the diagnosis of hemorrhage (or angioectasia) were .99 (.98-.99), .96 (.94-0.97), .97 (.95-.99), and 888 (343-2303), respectively. Subgroup analyses showed robust results. Meta-regression showed that published year, number of training images, and target disease (ulcers vs erosions, hemorrhage vs angioectasia) was found to be the source of heterogeneity. No publication bias was detected.

Conclusions: CAD models showed high performance for the optical diagnosis of gastrointestinal ulcer and hemorrhage in wireless capsule endoscopy.
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http://dx.doi.org/10.2196/33267DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8715364PMC
December 2021

Longitudinal Study of the Association between General Anesthesia and Increased Risk of Developing Dementia.

J Pers Med 2021 Nov 16;11(11). Epub 2021 Nov 16.

Division of Big Data and Artificial Intelligence, Institute of New Frontier Research, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea.

The association between exposure to general anesthesia (GA) and the risk of dementia is still undetermined. To investigate a possible link to the development of dementia in older people who have undergone GA, we analyzed nationwide representative cohort sample data from the Korean National Health Insurance Service. The study cohort comprised patients over 55 years of age who had undergone GA between January 2003 and December 2004 and consisted of 3100 patients who had undergone GA and 12,400 comparison subjects who had not received anesthesia. After the nine-year follow-up period, we found the overall incidence of dementia was higher in the patients who had undergone GA than in the comparison group (10.5 vs. 8.8 per 1000 person-years), with the risk being greater for women (adjusted HR of 1.44; 95% CI, 1.19-1.75) and those with comorbidities (adjusted HR of 1.39; 95% CI, 1.18-1.64). Patients who underwent GA showed higher risks for Alzheimer's disease and vascular dementia (adjusted HR of 1.52; 95% CI, 1.27-1.82 and 1.64; 95% CI, 1.15-2.33, respectively). This longitudinal study using a sample cohort based on a nationwide population sample demonstrated a significant positive association between GA and dementia, including Alzheimer's disease and vascular dementia.
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http://dx.doi.org/10.3390/jpm11111215DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8624274PMC
November 2021
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