Publications by authors named "Jae Young Choi"

493 Publications

Mid-term outcomes of the Pulsta transcatheter pulmonary valve for the native right ventricular outflow tract.

Catheter Cardiovasc Interv 2021 Jul 6. Epub 2021 Jul 6.

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

Objectives: The aim of this study is to present the mid-term outcomes of Pulsta valve.

Background: The Pulsta valve is a Self-expandable knitted nitinol-wire stent mounted with a treated tri-leaflet α-Gal-free porcine pericardial valve for percutaneous pulmonary valve implantation (PPVI) in patients with native right ventricular outflow tract (RVOT) lesions.

Methods: A multi-center clinical trial using Pulsta valve® was designed for patients with severe pulmonary regurgitation (PR) in the native RVOT in multiple centers in South Korea and 25 patients were enrolled. Before PPVI, severe PR (mean PR fraction: 45.5 ± 6.9%) and enlarged RV volume (mean indexed RV end-diastolic volume; 169.7 ± 13.0 ml/m ) was present. The mean age was 21.6 ± 6.6 years old.

Results: All patients were successfully implanted with 26, 28, or 32 mm diameter of Pulsta valve loaded on the 18 or 20 French delivery catheters. At 6 months follow up, indexed RV end-diastolic volume was decreased to 126.9 ± 16.9 ml/m . At mean 33.1 ± 14.3 months follow-up, the mean value of mean pressure gradient in Pulsta valve was 6.5 ± 3.0 mmhg without significant PR. There was no serious device-related adverse event.

Conclusions: A multi-center clinical trial was completed successfully with planned Pulsta valve implantation and demonstrated good mid-term effectiveness without device-related serious adverse events.
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http://dx.doi.org/10.1002/ccd.29865DOI Listing
July 2021

Multi-Scale Squeeze U-SegNet with Multi Global Attention for Brain MRI Segmentation.

Sensors (Basel) 2021 May 12;21(10). Epub 2021 May 12.

Department of Information and Communications Engineering, Chosun University, Gwangju 61452, Korea.

In this paper, we propose a multi-scale feature extraction with novel attention-based convolutional learning using the U-SegNet architecture to achieve segmentation of brain tissue from a magnetic resonance image (MRI). Although convolutional neural networks (CNNs) show enormous growth in medical image segmentation, there are some drawbacks with the conventional CNN models. In particular, the conventional use of encoder-decoder approaches leads to the extraction of similar low-level features multiple times, causing redundant use of information. Moreover, due to inefficient modeling of long-range dependencies, each semantic class is likely to be associated with non-accurate discriminative feature representations, resulting in low accuracy of segmentation. The proposed global attention module refines the feature extraction and improves the representational power of the convolutional neural network. Moreover, the attention-based multi-scale fusion strategy can integrate local features with their corresponding global dependencies. The integration of fire modules in both the encoder and decoder paths can significantly reduce the computational complexity owing to fewer model parameters. The proposed method was evaluated on publicly accessible datasets for brain tissue segmentation. The experimental results show that our proposed model achieves segmentation accuracies of 94.81% for cerebrospinal fluid (CSF), 95.54% for gray matter (GM), and 96.33% for white matter (WM) with a noticeably reduced number of learnable parameters. Our study shows better segmentation performance, improving the prediction accuracy by 2.5% in terms of dice similarity index while achieving a 4.5 times reduction in the number of learnable parameters compared to previously developed U-SegNet based segmentation approaches. This demonstrates that the proposed approach can achieve reliable and precise automatic segmentation of brain MRI images.
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http://dx.doi.org/10.3390/s21103363DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8151599PMC
May 2021

Improved efficiency of coding systems with health information technology.

Sci Rep 2021 May 13;11(1):10294. Epub 2021 May 13.

Department of Business Administration, Hallym University College of Business, 1 Hallymdaehak-gil, Chuncheon, Gangwon-do, 200-702, Republic of Korea.

This study aimed to investigate the impact of health information technology (IT) on the Case Mix Index (CMI). This study was a retrospective cohort study using hospital financial data from the Office of Statewide Health Planning and Development (OSHPD) in California. A total of 309 unique hospitals were included in the study for 7 years, from 2009 to 2015, resulting in 2,135 hospital observations. The effects of health information technology (IT) on the Case Mix Index (CMI) was evaluated using dynamic panel data analysis to control endogeneity issues. This study found that more health IT adoption could lead to a lower CMI by improving coding systems. Policy makers, researchers, and healthcare providers must be cautious when interpreting the effect of health IT on the CMI. To encourage the adoption of health IT, the cost savings and reimbursement reductions resulting from health IT adoption should be compared. If any profit loss occurs (i.e., the cost savings is less than reimbursement reduction), more incentives should be provided to healthcare providers.
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http://dx.doi.org/10.1038/s41598-021-89869-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119452PMC
May 2021

Results of the Active Middle Ear Implantation in Patients With Mixed Hearing Loss After the Middle Ear Surgery: Prospective Multicenter Study (ROMEO Study).

Clin Exp Otorhinolaryngol 2021 Apr 9. Epub 2021 Apr 9.

Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

Objectives: To evaluate the user satisfaction, efficacy, and safety of round window (RW) vibroplasty using the Vibrant Soundbridge (VSB) in patients with persistent mixed hearing loss after mastoidectomy.

Methods: The study included twenty-seven patients (mean age, 58.7 years; age range, 28-76 years; 11 men and 16 women) with mixed hearing loss after mastoidectomy surgery from 15 tertiary referral centers in Korea. The VSB was implanted at the RW. The Korean translation of the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire and the Korean version of the International Outcome Inventory for Hearing Aids (K-IOI-HA) questionnaire were used to evaluate user satisfaction as the primary outcome. Secondary outcome measures were audiological test results and complication rates.

Results: The mean scores on the Ease of Communication (61.3% → 29.7% → 30.2%), Reverberation (62.1% → 43.1% → 37.4%), and Background Noise (63.3% → 37.7% → 34.3%) subscales of the APHAB questionnaire were significantly reduced after VSB surgery. Mean K-IOI-HA scores at 3 and 6 months after surgery were significantly higher than the mean preoperative score (18.6 → 26.8 → 28.0). Postoperative VSB-aided thresholds were significantly lower than preoperative unaided and hearing aid (HA)-aided thresholds. There was no significant difference between preoperative unaided, preoperative HA-aided, and postoperative VSB-aided maximum phonetically balanced word-recognition scores. None of the 27 patients experienced a change in postoperative bone conduction pure tone average (PTA). One patient developed temporary facial palsy and two developed surgical wound infections.

Conclusion: RW vibroplasty resulted in improved satisfaction and audiological test results in patients with mixed hearing loss after mastoidectomy surgery, and the complication rate was tolerable.
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http://dx.doi.org/10.21053/ceo.2020.01851DOI Listing
April 2021

Activation of KCNQ4 as a Therapeutic Strategy to Treat Hearing Loss.

Int J Mol Sci 2021 Mar 2;22(5). Epub 2021 Mar 2.

Department of Pharmacology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul 03722, Korea.

Potassium voltage-gated channel subfamily q member 4 (KCNQ4) is a voltage-gated potassium channel that plays essential roles in maintaining ion homeostasis and regulating hair cell membrane potential. Reduction of the activity of the KCNQ4 channel owing to genetic mutations is responsible for nonsyndromic hearing loss, a typically late-onset, initially high-frequency loss progressing over time. In addition, variants of KCNQ4 have also been associated with noise-induced hearing loss and age-related hearing loss. Therefore, the discovery of small compounds activating or potentiating KCNQ4 is an important strategy for the curative treatment of hearing loss. In this review, we updated the current concept of the physiological role of KCNQ4 in the inner ear and the pathologic mechanism underlying the role of KCNQ4 variants with regard to hearing loss. Finally, we focused on currently developed KCNQ4 activators and their pros and cons, paving the way for the future development of specific KCNQ4 activators as a remedy for hearing loss.
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http://dx.doi.org/10.3390/ijms22052510DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7958948PMC
March 2021

Heterogeneity of MYO15A variants significantly determine the feasibility of acoustic stimulation with hearing aid and cochlear implant.

Hear Res 2021 May 19;404:108227. Epub 2021 Mar 19.

Department of Otorhinolaryngology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seoul, Seodaemun-gu 03722, Republic of Korea.

Autosomal recessive nonsyndromic hearing loss 3 (DFNB3) mainly leads to congenital and severe-to-profound hearing impairment, which is caused by variants in MYO15A. However, audiological heterogeneity in patients with DFNB3 hinders precision medicine in hearing rehabilitation. Here, we aimed to elucidate the heterogeneity of the auditory phenotypes of MYO15A variants according to the affected domain and the feasibilities for acoustic stimulation. We conducted whole-exome sequencing for 10 unrelated individuals from seven multiplex families with DFNB3; 11 MYO15A variants, including the novel frameshift c.900delT (p.Pro301Argfs*143) and nonsense c.4879G > T (p.Glu1627*) variants, were identified. In seven probands, residual hearing at low frequencies was significantly higher in the groups with one or two N-terminal frameshift variants in trans conformation compared to that in the group without these variants. This is consistent with the 56 individuals from the previously published reports that carried a varying number of N-terminal truncating variants in MYO15A. In addition, patients with missense variants in the second FERM domain had better hearing at low frequencies than patients without these variants. Subsequently, acoustic stimulation provided by devices such as hearing aids or cochlear implants was feasible in patients with one or two N-terminal truncating variants or a second FERM missense variant. In conclusion, N-terminal or second FERM variants in MYO15A allow the practical use of acoustic stimulation through hearing aids or electroacoustic stimulation for aural rehabilitation.
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http://dx.doi.org/10.1016/j.heares.2021.108227DOI Listing
May 2021

Effects of CROS hearing aids on audiologic and school performance in school-age children with unilateral hearing loss.

Clin Exp Otorhinolaryngol 2021 Feb 26. Epub 2021 Feb 26.

Department of Otorhinolaryngology, Yonsei University College of Medicine, Brain Korea 21 PLUS Project for Medical Sciences, Seoul, Republic of Korea.

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http://dx.doi.org/10.21053/ceo.2020.02523DOI Listing
February 2021

Bone healing on serial plain radiographs occurs slowly but adequately after medial opening wedge high tibial osteotomy without bone graft.

Knee Surg Sports Traumatol Arthrosc 2021 Feb 28. Epub 2021 Feb 28.

Department of Orthopaedic Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7 Keunjaebong-gil, Hwaseong, Gyeonggi-do, 18450, Republic of Korea.

Purpose: The purpose of this study was to prospectively investigate osteotomy gap filling rates on serial plain radiographs, and to evaluate whether alignment correction is maintained after medial opening wedge high tibial osteotomy (MOWHTO) using a locking plate without bone graft.

Methods: Between March 2014 and June 2017, MOWHTO was performed without bone graft regardless of gap size. Radiographs were taken preoperatively, postoperatively, at 1, 3, 6, 12, 18, and 24 months after surgery. Radiographic examinations included a weight bearing long-standing anteroposterior (AP) view of the whole lower extremity, as well as, the AP, lateral, and both oblique views of the knee. Bone healing was measured on the medial oblique view of the knee. The postoperative alignment correction and its maintenance were assessed using the three radiologic parameters of the weight-bearing line (WBL) ratio, the hip-knee-ankle angle (HKAA), and the medial proximal tibial angle (MPTA) on the weight-bearing long-standing AP view of the lower extremity.

Results: Fifty-two consecutive patients underwent MOWHTO, but three patients failed to follow-up for more than 24 months. A total of 49 patients were assessed in this study. The median opening gap height was 10.0 mm (IQR, 8.0-12.0; range, 7-20). On immediate post-operative radiographs, the mean gap filling was 31.4 ± 3.6%. After 1, 3, 6, 12, 18, and 24 months, the mean gap filling rates increased to 38.7 ± 4.4%, 51.4 ± 6.6%, 66.5 ± 5.1%, 84.8 ± 7.0%, 92.4 ± 5.6%, and 97.8 ± 2.3%, respectively. Statistical differences were observed between all the follow-up evaluations (P < 0.001). Statistical differences in the WBL ratio, HKAA, and MPTA were observed between preoperatively and 1 month after surgery (P < 0.001). The mean PTSA increased significantly from preoperatively to postoperatively (P < 0.001). However, no statistical differences were found between the post-operative follow-up radiographs performed for these four values.

Conclusion: MOWHTO using a locking plate without bone graft achieved at least 90% bone healing and had no loss in correction at 2 years postoperatively.

Level Of Evidence: III.
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http://dx.doi.org/10.1007/s00167-021-06506-xDOI Listing
February 2021

Natural variation in plant telomere length is associated with flowering time.

Plant Cell 2021 May;33(4):1118-1134

Department of Biology, Center for Genomics and Systems Biology, New York University, New York 10003, NY, USA.

Telomeres are highly repetitive DNA sequences found at the ends of chromosomes that protect the chromosomes from deterioration duringcell division. Here, using whole-genome re-sequencing and terminal restriction fragment assays, we found substantial natural intraspecific variation in telomere length in Arabidopsis thaliana, rice (Oryza sativa), and maize (Zea mays). Genome-wide association study (GWAS) mapping in A. thaliana identified 13 regions with GWAS-significant associations underlying telomere length variation, including a region that harbors the telomerase reverse transcriptase (TERT) gene. Population genomic analysis provided evidence for a selective sweep at the TERT region associated with longer telomeres. We found that telomere length is negatively correlated with flowering time variation not only in A. thaliana, but also in maize and rice, indicating a link between life-history traits and chromosome integrity. Our results point to several possible reasons for this correlation, including the possibility that longer telomeres may be more adaptive in plants that have faster developmental rates (and therefore flower earlier). Our work suggests that chromosomal structure itself might be an adaptive trait associated with plant life-history strategies.
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http://dx.doi.org/10.1093/plcell/koab022DOI Listing
May 2021

One-stage cochlear implantation in patients with chronic otitis media using canal wall up mastoidectomy.

Acta Otolaryngol 2021 Apr 3;141(4):354-358. Epub 2021 Feb 3.

Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

Background: Cochlear implantation (CI) with subtotal petrosectomy was recommended to avoid the complications for patients with chronic otitis media (COM).

Objectives: To evaluate the surgical outcomes of CI in patients with COM using a one-stage operation with canal wall up mastoidectomy (CWUM).

Methods: Thirty-five patients with COM who underwent CI with CWUM as a one-stage between 2009 and 2017 were participated. They divided into those with inactive COM and active COM. The anatomical success rate, postoperative complication, and hearing outcomes were analyzed.

Results: Twenty-four patients had inactive COM and seven with active COM. Three of the 31 patients (9.7%) had otorrhea from the ear undergone surgery. Two of these three patients had myringitis after CI and their symptoms improved after conservative management. Although infection of the tympanic membrane in the third patient was controlled after conservative management, a perforation was left. Postoperative otorrhea occurred in two patients (8.3%) in the inactive COM group and one patient (14.3%) in the active COM group.

Conclusion: This study indicates that infection control and successful implantation can be achieved through a one-stage CI operation with CWUM in selected patients with COM.HIGHLIGHTSAlthough COM was once considered a contraindication to CI, CI in patients with COM has been made feasible by STP before CI or simultaneously with CI.Simultaneous CI with CWUM was performed for 31 patients with COM.Three patients (9.7%) had minor complications after the surgery and only one patient experienced device explantation which was due to device failure.
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http://dx.doi.org/10.1080/00016489.2021.1877812DOI Listing
April 2021

Analysis of early failure rate and its risk factor with 2157 total ankle replacements.

Sci Rep 2021 Jan 21;11(1):1901. Epub 2021 Jan 21.

Department of Orthopaedic Surgery, Hallym University Dongtan Sacred Heart Hospital, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 18450, Republic of Korea.

The failure rate of TAA is still higher than that of other joint replacement procedures. This study aimed to calculate the early failure rate and identify associated patient factors. Data from the Korean Health Insurance Review and Assessment Service database from 2009 to 2017 were collected. We evaluated patients who had TAA as a primary surgical procedure. Early failure was defined as conversion to revision TAA or arthrodesis after primary TAA within five years. Patients with early failure after primary TAA were designated as the "Failure group". Patients without early failure and who were followed up unremarkably for at least five years after primary TAA were designated as the "No failure group". Overall, 2157 TAA participants were included. During the study period, 197 patients developed failure within five years postoperatively, for an overall failure rate of 9.1%. Significant risk factors for early failure were history of chronic pulmonary disease, diabetes, peripheral vascular disease, hyperlipidemia, dementia, and alcohol abuse. A significant increase of odds ratio was found in patients with a history of dementia, chronic pulmonary disease, and diabetes. Surgical indications and preoperative patient counseling should consider these factors.
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http://dx.doi.org/10.1038/s41598-021-81576-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7820457PMC
January 2021

Neutrophils infiltrate into the spiral ligament but not the stria vascularis in the cochlea during lipopolysaccharide-induced inflammation.

Theranostics 2021 1;11(6):2522-2533. Epub 2021 Jan 1.

Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea.

It has been challenging to apply intravital imaging for monitoring the inner ear, as the anatomical location and intricate structure hamper the access of imaging instruments to the inner ear of live mice. By employing intravital imaging of the cochlea in live mice with two-photon microscopy, we investigated neutrophil infiltration into the cochlea tissue and its characteristics under a lipopolysaccharide (LPS)-induced inflammatory state. Cochlea inflammation was induced by LPS injection to the middle ear. Using two-photon intravital microscopy with specifically designed surgical exteriorization of the cochlea in live mice, we investigated the dynamic features of neutrophils in the lateral wall of the cochlea. The molecular expression pattern of the cochlea lateral wall was also investigated during the LPS-induce inflammation. Despite the contention of whether neutrophils are recruited to the spiral ligament (SL) during inflammation, we observed that LPS-induced inflammation of the middle ear, which mimics acute otitis media, triggered neutrophil migration to the SL in the lateral wall. Notably, massive neutrophil infiltration to the SL occurred 2 days after LPS inoculation, but there was no neutrophil infiltration into the stria vascularis (SV) region. At 1 day after LPS-induced cochlear inflammation, increased mRNA expression of interleukin-1β, interleukin-6 were identified in both the SL and SV, while the mRNA expression increased only in the SL. The differential reactivity of ICAM-1 is likely responsible for the different neutrophil recruitment pattern in the cochlea. Intravital imaging of the cochlea revealed that neutrophil recruitment and infiltration during inflammation are spatially controlled and exclusively observed in the SL but not in the SV and organ of Corti.
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http://dx.doi.org/10.7150/thno.49121DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7806478PMC
July 2021

A study on the bio-applicability of aqueous-dispersed van der Waals 1-D material NbSe using poloxamer.

Sci Rep 2021 01 8;11(1):176. Epub 2021 Jan 8.

School of Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon, 16419, Republic of Korea.

In this research, dispersion of a new type of one-dimensional inorganic material NbSe, composed of van der Waals bonds, in aqueous solution for bio-application study were studied. To disperse NbSe, which exhibits hydrophobic properties in water, experiments were carried out using a block copolymer (poloxamer) as a dispersant. It was confirmed that PPO, the hydrophobic portion of Poloxamer, was adsorbed onto the surface of NbSe, and PEO, the hydrophilic portion, induced steric hinderance to disperse NbSe to a size of 10 nm or less. To confirm the adaptability of muscle cells C2C12 to the dispersed NbSe using poloxamer 188 as dispersant, a MTT assay and a live/dead assay were performed, demonstrating improvement in the viability and proliferation of C2C12 cells.
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http://dx.doi.org/10.1038/s41598-020-80730-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794490PMC
January 2021

The Effects of Preoperative Audiovisual Speech Perception on the Audiologic Outcomes of Cochlear Implantation in Patients with Postlingual Deafness.

Audiol Neurootol 2021 22;26(3):149-156. Epub 2020 Dec 22.

Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea,

Introduction: Patients with postlingual deafness usually depend on visual information for communication, and their lipreading ability could influence cochlear implantation (CI) outcomes. However, it is unclear whether preoperative visual dependency in postlingual deafness positively or negatively affects auditory rehabilitation after CI. Herein, we investigated the influence of preoperative audiovisual per-ception on CI outcomes.

Method: In this retrospective case-comparison study, 118 patients with postlingual deafness who underwent unilateral CI were enrolled. Evaluation of speech perception was performed under both audiovisual (AV) and audio-only (AO) conditions before and after CI. Before CI, the speech perception test was performed under hearing aid (HA)-assisted conditions. After CI, the speech perception test was performed under the CI-only condition. Only patients with a 10% or less preoperative AO speech perception score were included.

Results: Multivariable regression analysis showed that age, gender, residual hearing, operation side, education level, and HA usage were not correlated with either postoperative AV (pAV) or AO (pAO) speech perception. However, duration of deafness showed a significant negative correlation with both pAO (p = 0.003) and pAV (p = 0.015) speech perceptions. Notably, the preoperative AV speech perception score was not correlated with pAO speech perception (R2 = 0.00134, p = 0.693) but was positively associated with pAV speech perception (R2 = 0.0731, p = 0.003).

Conclusion: Preoperative dependency on audiovisual information may positively influence pAV speech perception in patients with postlingual deafness.
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http://dx.doi.org/10.1159/000509969DOI Listing
July 2021

Tuning the electronic properties of highly anisotropic 2D dangling-bond-free sheets from 1D VSe chain structures.

Nanotechnology 2020 Dec 8;32(9):095203. Epub 2020 Dec 8.

Department of Chemistry, Sungkyunkwan University, Suwon 16419, Republic of Korea.

True one-dimensional (1D) van der Waals materials can form two-dimensional (2D) dangling-bond-free anisotropic surfaces. Dangling bonds on surfaces act as defects for transporting charge carriers. In this study, we consider true 1D materials to be VSe chains, and then the electronic structures of 2D sheets composed of true 1D VSe chains are calculated. The (010) plane has indirect bandgap with 0.757 eV (1.768 eV), while the (111̅) plane shows a nearly direct bandgap of 1.047 eV (2.118 eV) for DFT-D3 (HSE06) correction, respectively. The (111̅) plane of VSe is expected to be used in optoelectronic devices because it contains a nearly direct bandgap. Partial charge analysis indicates that the (010) plane exhibits interchain interaction is stronger than the (111̅) plane. To investigate the strain effect, we increased the interchain distance of planes until an indirect-to-direct bandgap transition occurred. The (010) plane then demonstrated a direct bandgap when interchain distance increased by 30%, while the (111̅) plane demonstrated a direct bandgap when the interchain distance increased by 10%. In mechanical sensors, this change in the bandgap was induced by the interchain distance.
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http://dx.doi.org/10.1088/1361-6528/abc6deDOI Listing
December 2020

Comparison of the Change in Diastolic Dysfunction after Transcatheter Atrial Septal Defect Closure between Asymptomatic Younger and Older Age Groups.

J Clin Med 2020 Nov 12;9(11). Epub 2020 Nov 12.

Division of Pediatric Cardiology, Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea.

Transcatheter device closure of a secundum atrial septal defect (ASD) is followed by a noticeable change in the left atrium (LA) and left ventricle (LV) over a long-term follow-up. This study aimed to assess the remodeling of the atrial and ventricular myocardium with respect to diastolic function in adult ASD patients. Around 38 asymptomatic patients (age: 48.6 ± 17.1 years, range: 23-69 years) diagnosed with ASD during routine health check-up and who underwent ASD device closure with the Amplatzer septal occluder were included in this retrospective study, and their medical records (containing echocardiographic data) were reviewed. The defect size was 21.77 + 6.79 mm, while the balloon measurement of the defect was 24.29 ± 6.64 mm. The patients were divided into two groups, namely, Group I (with 18 patients aged <50 years [mean: 33.06 ± 9.43 years] and Group II (with 20 patients aged ≥50 years [mean: 62.55 ± 7.54 years]). Comparison of echocardiographic data collected before closure and at a follow-up 2 years later revealed significant differences between pre-closure and post-closure states in the left ventricular end-diastolic dimension (40.76 ± 3.28 vs. 43.39 ± 3.52), left ventricular mass (99.64 ± 28.81 vs. 116.57 ± 32.03), and right ventricular pressure (36.88 ± 12.20 vs. 31.81 ± 11.11). Tissue Doppler measurements were significantly decreased 2 years after closure, while the post-closure E/E' was higher than the pre-closure E/E' (11.58 ± 4.80 vs. 8.79 + 3.19, < 0.005). In both groups, mitral A and tissue Doppler E', A', and S' values decreased post-closure, while the E/E' was higher in Group II than in Group I at both pre-closure and long-term follow-up measurements (pre-closure: 9.60 ± 5.15 vs. 7.41 ± 1.42, < 0.003; post-closure: 13.03 + 4.05 vs. 10.49 ± 3.95, < 0.02). The LA size and LV function exhibited recognizable remodeling after transcatheter ASD closure. Because the LV preload elevation (i.e., E/E') after ASD closure can be pronounced in older patients, caution should be provided more in older patients than in younger patients. Hence, it may be beneficial to close the ASD at an earlier age in adults even after a late diagnosis; a relatively younger age may be more suited for adaptation to the remodeling process to protect the myocardial function. Careful consideration should be given to the previous underloaded left heart after long-term closure.
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http://dx.doi.org/10.3390/jcm9113637DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7696672PMC
November 2020

Hearing Rehabilitation with Combined Electroacoustic Stimulation and Ossiculoplasty.

J Audiol Otol 2021 Apr 16;25(2):110-114. Epub 2020 Nov 16.

Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.

We report a case of hearing rehabilitation following combined cochlear implantation and ossiculoplasty. A 71-year-old patient visited the clinic for right-sided mixed hearing loss. We targeted neural and conductive components, performing two different operations simultaneously. At two months post-operative, the patient showed satisfactory results with respect to hearing threshold and speech comprehension. Our experience suggests that careful evaluation of patients and consideration of the diverse array of available treatment strategies can be used to provide personalized rehabilitation with maximal effectiveness. To the best of our knowledge, this is the first report to take such an integrated approach to treat hearing impairment and is thus likely to have clinical importance for otologists.
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http://dx.doi.org/10.7874/jao.2020.00136DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8062243PMC
April 2021

Synergistic effect of smoking on age-related hearing loss in patients with diabetes.

Sci Rep 2020 11 3;10(1):18893. Epub 2020 Nov 3.

Department of Otorhinolaryngology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.

This study investigated the synergistic effects of risk factors on age-related hearing loss (ARHL) using nationwide cross-sectional data of 33,552 individuals from the 2010‒2013 Korea National Health and Nutrition Examination Survey. Patients with ARHL were selected based on their pure-tone audiometry results. Previously reported risk factors for ARHL were analyzed using logistic regression and propensity score-matching, and synergistic effects between risk factors were analyzed using propensity score-matching. Of the 12,570 individuals aged 40-79 years, 2002 (15.9%) met the criteria for ARHL. Male sex, exposure to occupational noise, and diabetes showed a significant relationship with ARHL (p < 0.05) in both the logistic regression and propensity score-matching analyses. Smoking and diabetes showed the strongest significant synergistic effect on ARHL (odds ratio [OR] 1.963, 95% confidence interval [CI] 1.285‒2.998; p = 0.002). In the subgroup analysis based on smoking status, current smokers with diabetes had a significant relationship with ARHL (OR 1.883, CI 1.191‒2.975; p = 0.009), whereas ex-smokers with diabetes did not (OR 1.250; CI 0.880‒1.775; p = 0.246). This implies that current smokers with diabetes may benefit from the cessation of smoking. In conclusion, patients with diabetes should strictly avoid or cease smoking to prevent the progression of ARHL.
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http://dx.doi.org/10.1038/s41598-020-75880-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7641162PMC
November 2020

Tuning the electronic properties of highly anisotropic 2D dangling-bond-free sheets from 1D VSechain structures.

Nanotechnology 2020 Nov 2. Epub 2020 Nov 2.

Chemistry, Sungkyunkwan University Department of Chemistry, Suwon, 16419, Korea (the Republic of).

True one-dimensional (1D) van der Waals materials can form two-dimensional (2D) dangling-bond-free anisotropic surfaces. Dangling bonds on surfaces act as defects for transporting charge carriers. In this study, we consider true 1D materials to be VSechains, and then the electronic structures of 2D sheets composed of true 1D VSechains are calculated. The (010) plane has indirect bandgap with 0.757 eV (1.768 eV), while the (11-1) plane shows a nearly direct bandgap of 1.047 eV (2.118 eV) for DFT-D3 (HSE06) correction, respectively. The (11-1) plane of VSeis expected to be used in optoelectronic devices because it contains a nearly direct bandgap. Partial charge analysis indicates that the (010) plane exhibits interchain interaction is stronger than the (11-1) plane. To investigate the strain effect, we increased the interchain distance of planes until an indirect-to-direct bandgap transition occurred. The (010) plane then demonstrated a direct bandgap when interchain distance increased by 30%, while the (11-1) plane demonstrated a direct bandgap when the interchain distance increased by 10%. In mechanical sensors, this change in the bandgap was induced by the interchain distance.
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http://dx.doi.org/10.1088/1361-6528/abc6deDOI Listing
November 2020

Inhibition of Pendrin by a small molecule reduces Lipopolysaccharide-induced acute Lung Injury.

Theranostics 2020 7;10(22):9913-9922. Epub 2020 Aug 7.

Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea.

Pendrin is encoded by and its mutation leads to congenital hearing loss. Additionally, pendrin is up-regulated in inflammatory airway diseases such as chronic obstructive pulmonary disease, allergic rhinitis, and asthma. In this study, the effects of a novel pendrin inhibitor, YS-01, were investigated in an LPS-induced acute lung injury (ALI) mice model, and the mechanism underlying the effect of YS-01 was examined. Lipopolysaccharide (LPS, 10 mg/kg) was intranasally instilled in wild type (WT) and pendrin-null mice. YS-01 (10 mg/kg) was administered intra-peritoneally before or after LPS inhalation. Lung injury parameters were assessed in the lung tissue and bronchoalveolar lavage fluid (BALF). Pendrin levels in the BALF of 41 patients with acute respiratory distress syndrome (ARDS) due to pneumonia and 25 control (solitary pulmonary nodule) patients were also measured. LPS instillation induced lung injury in WT mice but not in pendrin-null mice. Pendrin expression was increased by LPS stimulation both and . YS-01 treatment dramatically attenuated lung injury and reduced BALF cell counts and protein concentration after LPS instillation in WT mice. Proinflammatory cytokines and NFB activation were suppressed by YS-01 treatment in LPS-induced ALI mice. In BALF of patients whose ARDS was caused by pneumonia, pendrin expression was up-regulated compared to that in controls (mean, 24.86 vs. 6.83 ng/mL, 0.001). A novel pendrin inhibitor, YS-01, suppressed lung injury in LPS-induced ALI mice and our data provide a new strategy for the treatment of inflammatory airway diseases including sepsis-induced ALI.
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http://dx.doi.org/10.7150/thno.46417DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7481407PMC
May 2021

Effect of Cochlear Implantation on Hearing Fluctuation in Patients with Biallelic SLC26A4 Variants.

Audiol Neurootol 2021 2;26(2):111-120. Epub 2020 Sep 2.

Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.

Introduction: Fluctuating hearing loss is a distinctive feature caused by SLC26A4 variants. We investigated whether cochlear implantation had protective or deleterious effect on hearing fluctuation in patients with biallelic SLC26A4 variants.

Methods: Patients with biallelic SLC26A4 variants (N = 16; age = 10.24 ± 9.20 years) who had unilateral cochlear implantation and consecutive postsurgical, bilateral pure-tone audiograms more than 3 times were selected. We retrospectively reviewed the patients' medical records from 2008 to 2019 obtained from a tertiary medical center and used the auditory threshold change (Shift) over time as a marker of hearing fluctuation. Fluctuation events were counted, and the Shift of the implanted and contralateral ears was compared using logistic regression with a generalized estimating equation and linear mixed model. A total of 178 values were included.

Results: The odds of fluctuating hearing frequency were 11.185-fold higher in the unimplanted ears than in the implanted ears postoperatively (p = 0.001). The extent of fluctuation at 250 and 500 Hz was also significantly lower in the implanted ears than in the unimplanted ears after adjusting for every other effect (p = 0.003 and p < 0.001, respectively). Notably, higher residual hearing was rather associated with lesser fluctuation in frequency and the extent of fluctuation at 500 Hz, indicating residual hearing function is not the positive predictor for hearing fluctuation.

Conclusion: In patients with biallelic SLC26A4 variants, cochlear implantation may reduce the frequency and extent of hearing fluctuations.
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http://dx.doi.org/10.1159/000508858DOI Listing
June 2021

Early Outcomes of Percutaneous Pulmonary Valve Implantation with Pulsta and Melody Valves: The First Report from Korea.

J Clin Med 2020 Aug 26;9(9). Epub 2020 Aug 26.

Division of Pediatric Cardiology, Center for Congenital Heart Disease, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea.

Percutaneous pulmonary valve implantation (PPVI) is used to treat pulmonary stenosis (PS) or pulmonary regurgitation (PR). We described our experience with PPVI, specifically valve-in-valve transcatheter pulmonary valve replacement using the Melody valve and novel self-expandable systems using the Pulsta valve. We reviewed data from 42 patients undergoing PPVI. Twenty-nine patients had Melody valves in mostly bioprosthetic valves, valved conduits, and homografts in the pulmonary position. Following Melody valve implantation, the peak right ventricle-to-pulmonary artery gradient decreased from 51.3 ± 11.5 to 16.7 ± 3.3 mmHg and right ventricular systolic pressure fell from 70.0 ± 16.8 to 41.3 ± 17.8 mmHg. Thirteen patients with native right ventricular outflow tract (RVOT) lesions and homograft underwent PPVI with the new self-expandable Pulsta valve-a nitinol wire stent mounted with a trileaflet porcine pericardial valve. Following Pulsta valve implantation, cardiac magnetic resonance imaging showed a decreased PR fraction and that the right ventricular end-diastolic volume index decreased from 166.1 ± 11.9 to 123.6 ± 12.4 mL/m. There were no mortality, severe procedural morbidity, or valve-related complications. At the mean 14.2 month (4-57 months) follow-up, no patients had more than mild PR. PPVI using Melody and Pulsta valves was first shown to provide excellent early outcomes without serious adverse event in most patients with RVOT dysfunction in Korea.
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http://dx.doi.org/10.3390/jcm9092769DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7565703PMC
August 2020

Functional Evaluation of Upper Urinary Tract with Diuretic Mercaptoacetyltriglycine Renal Scans in Patients with Benign Prostatic Obstruction before and after Surgical Intervention: A Pilot Study.

Biomed Res Int 2020 10;2020:4605683. Epub 2020 Aug 10.

Department of Urology, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Republic of Korea.

Introduction: We investigated which benign prostatic hyperplasia-related lower urinary parameters are related to upper urinary tract obstruction and whether transurethral prostatectomy could improve upper urinary tract obstruction.

Materials And Methods: Patients with prostate size over 30 g and urodynamically proven bladder outlet obstruction were enrolled in this prospective observational study. Bladder wall thickness and prostate size were measured by ultrasonography. A urodynamic study with laboratory tests including serum creatinine, prostate-specific antigen, and urinalysis was performed. Finally, a diuretic scintigraphy using mercaptoacetyltriglycine was performed. Tests except the urodynamic evaluation were repeated after transurethral prostatectomy.

Results: In total, 24 patients were enrolled, and 19 patients completed the present study. The mean values of age (yrs), prostate size (mL), bladder thickness (mm), bladder compliance (mL/pr), and the bladder outlet obstruction index were 68.42 ± 8.25, 72.29 ± 32.78, 4.42 ± 1.14, 50.17 ± 32.15, and 82.11 ± 34.68, respectively. The mean T (min) was 17.51 ± 16.34 on the left side and 15.30 ± 11.96 on the right side. Statistical analysis showed that bladder compliance and bladder thickness were preoperatively related to upper urinary tract obstruction ( = 0.001 and = 0.007, respectively). Diuretic mercaptoacetyltriglycine scan in 19 patients showed improvement 6 months after prostate surgery. Clinically significant proteinuria was associated with upper urinary tract obstruction, and proteinuria was also improved after prostate surgery.

Conclusion: Storage-phase bladder dysfunction could be a reliable urodynamic factor for the indication of upper urinary tract obstruction in patients with benign prostatic hyperplasia, and upper urinary tract obstruction with subsequent kidney damage could be improved by surgical decompression of benign prostatic obstruction.
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http://dx.doi.org/10.1155/2020/4605683DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436344PMC
April 2021

Plasticized Polystyrene by Addition of -Diene Based Molecules for Defect-Less CVD Graphene Transfer.

Polymers (Basel) 2020 Aug 17;12(8). Epub 2020 Aug 17.

SKKU Advanced Institute of Nanotechnology (SAINT), Sungkyunkwan University, Suwon 16419, Korea.

Chemical vapor deposition of graphene on transition metals is the most favored method to get large scale homogenous graphene films to date. However, this method involves a very critical step of transferring as grown graphene to desired substrates. A sacrificial polymer film is used to provide mechanical and structural support to graphene, as it is detached from underlying metal substrate, but, the residue and cracks of the polymer film after the transfer process affects the properties of the graphene. Herein, a simple mixture of polystyrene and low weight plasticizing molecules is reported as a suitable candidate to be used as polymer support layer for transfer of graphene synthesized by chemical vapor deposition (CVD). This combination primarily improves the flexibility of the polystyrene to prevent cracking during the transfer process. In addition, the polymer removal solvent can easily penetrate between the softener molecules, so that the polymer film can be easily dissolved after transfer of graphene, thereby leaving no residue. This facile method can be used freely for the large-scale transfer of 2D materials.
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http://dx.doi.org/10.3390/polym12081839DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465162PMC
August 2020

Automatic segmentation of brain MRI using a novel patch-wise U-net deep architecture.

PLoS One 2020 3;15(8):e0236493. Epub 2020 Aug 3.

Division of Computer & Electronic Systems Engineering, Hankuk University of Foreign Studies, Yongin-si, Republic of Korea.

Accurate segmentation of brain magnetic resonance imaging (MRI) is an essential step in quantifying the changes in brain structure. Deep learning in recent years has been extensively used for brain image segmentation with highly promising performance. In particular, the U-net architecture has been widely used for segmentation in various biomedical related fields. In this paper, we propose a patch-wise U-net architecture for the automatic segmentation of brain structures in structural MRI. In the proposed brain segmentation method, the non-overlapping patch-wise U-net is used to overcome the drawbacks of conventional U-net with more retention of local information. In our proposed method, the slices from an MRI scan are divided into non-overlapping patches that are fed into the U-net model along with their corresponding patches of ground truth so as to train the network. The experimental results show that the proposed patch-wise U-net model achieves a Dice similarity coefficient (DSC) score of 0.93 in average and outperforms the conventional U-net and the SegNet-based methods by 3% and 10%, respectively, for on Open Access Series of Imaging Studies (OASIS) and Internet Brain Segmentation Repository (IBSR) dataset.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0236493PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7398543PMC
September 2020

Three-Dimensional Distribution of Cochlear Macrophages in the Lateral Wall of Cleared Cochlea.

Clin Exp Otorhinolaryngol 2021 May 24;14(2):179-184. Epub 2020 Jul 24.

Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.

Objectives: Resident macrophages are well known to be present in the cochlea, but the exact patterns thereof in spiral ligaments have not been discussed in previous studies. We sought to document the distribution of macrophages in intact cochleae using three-dimensional imaging.

Methods: Cochleae were obtained from C-X3-C motif chemokine receptor 1+/GFP mice, and organ clearing was performed. Three-dimensional images of cleared intact cochleae were reconstructed using two-photon microscopy. The locations of individual macrophages were investigated using 100-μm stacked images to reduce bias. Cochlear inflammation was then induced by lipopolysaccharide (LPS) inoculation into the middle ear through the tympanic membrane. Four days after inoculation, three-dimensional images were obtained.

Results: Macrophages were scarce in areas adjacent to the stria vascularis, particularly the area just beneath it even though many have suspected macrophages to be abundant in this area. This finding remained consistent upon LPS-induced cochlear inflammation, despite a significant increase in the number of macrophages, compared to non-treated cochlea.

Conclusion: Resident macrophages in spiral ligaments are scarce in areas adjacent to the stria vascularis.
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http://dx.doi.org/10.21053/ceo.2020.00395DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111389PMC
May 2021

Double-edged sword: The evolutionary consequences of the epigenetic silencing of transposable elements.

PLoS Genet 2020 07 16;16(7):e1008872. Epub 2020 Jul 16.

Department of Ecology and Evolutionary Biology, University of California, Irvine, California, United States of America.

Transposable elements (TEs) are genomic parasites that selfishly replicate at the expense of host fitness. Fifty years of evolutionary studies of TEs have concentrated on the deleterious genetic effects of TEs, such as their effects on disrupting genes and regulatory sequences. However, a flurry of recent work suggests that there is another important source of TEs' harmful effects-epigenetic silencing. Host genomes typically silence TEs by the deposition of repressive epigenetic marks. While this silencing reduces the selfish replication of TEs and should benefit hosts, a picture is emerging that the epigenetic silencing of TEs triggers inadvertent spreading of repressive marks to otherwise expressed neighboring genes, ultimately jeopardizing host fitness. In this Review, we provide a long-overdue overview of the recent genome-wide evidence for the presence and prevalence of TEs' epigenetic effects, highlighting both the similarities and differences across mammals, insects, and plants. We lay out the current understanding of the functional and fitness consequences of TEs' epigenetic effects, and propose possible influences of such effects on the evolution of both hosts and TEs themselves. These unique evolutionary consequences indicate that TEs' epigenetic effect is not only a crucial component of TE biology but could also be a significant contributor to genome function and evolution.
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http://dx.doi.org/10.1371/journal.pgen.1008872DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365398PMC
July 2020

Comparison of resilience and quality of life between adolescent blood cancer survivors and those with congenital heart disease: a cross sectional study.

Health Qual Life Outcomes 2020 Jul 14;18(1):231. Epub 2020 Jul 14.

Division of Pediatric Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, South Korea.

Background: The resilience and Quality of Life (QOL) of adolescent cancer survivors was compared with those of children with other diseases to identify the patterns and factors that affect resilience and QOL The purpose of the present study was to compare the resilience and QOL between adolescent blood cancer survivors and adolescents with Congenital Heart Disease (CHD).

Methods: A cross-sectional study was conducted in two hospitals. Ninety-four adolescent blood cancer survivors and 81 adolescents with CHD completed a self-reported questionnaire regarding resilience, QOL, and general characteristics. Independent t-test and ANCOVA were used to compare the resilience and QOL between adolescent blood cancer survivors and adolescents with CHD.

Results: The resilience of adolescent blood cancer survivors was significantly lower than that of adolescents with CHD, and the QOL of adolescent blood cancer survivors was not different from that of adolescents with CHD.

Conclusions: The experiences of adolescent blood cancer survivors were different from those of adolescents with CHD even though they are of the same ages. Adolescents with chronic disease have a different level of illness controllability and self-regulation according to their disease and situation. Therefore, health-providers need to develop the specific programs for improving resilience and QOL of adolescents with chronic illness with focusing their characteristics and situations.
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http://dx.doi.org/10.1186/s12955-020-01487-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7362561PMC
July 2020

Voriconazole-induced Severe Hyperkalemia Precipitated by Multiple Drug Interactions.

Electrolyte Blood Press 2020 Jun 18;18(1):10-15. Epub 2020 Jun 18.

Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea.

Voriconazole, a triazole antifungal agent used to treat serious fungal infections, has a pharmacokinetic characteristic of undergoing hepatic metabolism by the cytochrome P450 system. Few cases of hyperkalemia have been reported, which presented only when the serum voriconazole level was exceptionally elevated by drug-drug interactions. Additionally, azole antifungals may interfere with the biosynthesis of adrenal steroids and therefore can predispose patients to aldosterone deficiency. However, it is unclear whether voriconazole itself can induce hypoaldosteronism or hyperkalemia. Here, we report a case of voriconazole-induced hyperkalemia in a patient administered concurrent medications to treat comorbidities. Voriconazole was orally administered for pulmonary aspergillosis, and three episodes of severe hyperkalemia recurred, which improved with emergency treatment. In the first episode, renin-angiotensin-aldosterone system inhibitors were associated. We found that dronedarone might have increased the voriconazole level in the second episode. At that time, severe hypercalcemia was concurrent, which improved with acute hemodialysis and eliminating dronedarone. Finally, severe hyperkalemia recurred without concurrent medications known to interact with voriconazole. Upon switching from voriconazole to itraconazole, the hyperkalemia was resolved. Drug level monitoring is necessary when voriconazole is used. Genetic susceptibility, such as through CYP2C19 polymorphism, may be investigated for patients with adverse reactions to voriconazole.
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http://dx.doi.org/10.5049/EBP.2020.18.1.10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327389PMC
June 2020
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