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Allajbeu I, Morris K, Nanaa M, Payne N, Charnley K, Moyle PL, Taylor K, Sharma N, Lim Y, Gilbert FJ. Introduction of automated breast ultrasound as an additional screening tool for dense breasts in the UK: a practical approach from the BRAID trial. Clin Radiol 2024; 79:e641-e650. [PMID: 38413353 DOI: 10.1016/j.crad.2023.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 02/29/2024]
Affiliation(s)
- I Allajbeu
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrookes' Hospital, Hills Road, Cambridge CB2 0QQ, UK; Western Balkans University, 1001, Tirana, Albania; Department of Radiology, University of Cambridge, School of Clinical Medicine, Box 218, Level 5, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - K Morris
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrookes' Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - M Nanaa
- Department of Radiology, University of Cambridge, School of Clinical Medicine, Box 218, Level 5, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - N Payne
- Department of Radiology, University of Cambridge, School of Clinical Medicine, Box 218, Level 5, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - K Charnley
- Department of Radiology, University of Cambridge, School of Clinical Medicine, Box 218, Level 5, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - P L Moyle
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrookes' Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - K Taylor
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrookes' Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - N Sharma
- Breast Unit, Level 1 Chancellor Wing, St James Hospital, Beckett Street, Leeds LS9 7TF, UK
| | - Y Lim
- University Hospital of South Manchester, NHS Foundation Trust, Oxford Road, Manchester M13 9WL, UK
| | - F J Gilbert
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrookes' Hospital, Hills Road, Cambridge CB2 0QQ, UK; Department of Radiology, University of Cambridge, School of Clinical Medicine, Box 218, Level 5, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.
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Kim CH, Chang JS, Lim Y, Lim D, Kim JW. Safety of urgent surgery for the patients with proximal femur fracture treated with platelet aggregation inhibitors: a propensity-score matching analysis. Eur J Trauma Emerg Surg 2024; 50:347-358. [PMID: 37768385 DOI: 10.1007/s00068-023-02368-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION To compare the various perioperative outcomes in an urgent surgery setting among patients with proximal femur fracture (PFF) who received platelet aggregation inhibitors (PAIs) and those who did not. METHODS We retrospectively reviewed the data of 1,838 patients who underwent surgery for PFF between January 2011 and January 2021. We conducted 1:1 propensity-score matching and compared the perioperative outcomes, including operation time, postoperative complications, hospital stay, mortality, and variables related to bleeding risk (e.g., number of transfusion profiles, hemoglobin levels, and laboratory data, including coagulation battery). RESULTS Of the 492 patients who were treated with PAIs, 484 were 1:1 matched to the untreated control group. The PAI group showed shorter operation time than the matched control group (72.3 min for PAI vs. 77.7 min for control; P = 0.041), and the control group showed more pulmonary thromboembolism (0.2% for PAI vs 1.7% for control; P = 0.046) than the PAI group. The other complications and length of hospital stay, mortality rate, transfusion profile, and the laboratory test (except preoperative international normalized ratio, INR) showed no significant difference between the groups. Subgroup analyses of the patients treated with only aspirin (aspirin: 306, matched control: 306), only clopidogrel (clopidogrel: 100, matched control: 100), and others who were treated with dual anticoagulation (dual anticoagulation: 78, matched control: 78) showed no significant differences in perioperative outcomes among the groups. CONCLUSION The patients who were treated with PAI could undergo PFF surgery safely without delay, which led to no significant difference in operation time, postoperative complication risk, perioperative blood transfusion, and variables related to bleeding risk. Therefore, we believe that it is unnecessary to delay surgery for patients with PFF who receive PAI.
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Affiliation(s)
- Chul-Ho Kim
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, Republic of Korea
| | - Jae Suk Chang
- Department of Orthopedic Surgery, National Police Hospital, Seoul, Republic of Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
| | - Dongkyung Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
| | - Ji Wan Kim
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, Republic of Korea.
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Park EJ, Kim H, Lim Y, Lee SY, Lee WY. Effect of motivated physicians and elderly patients with hypertension or type 2 diabetes mellitus in prepared communities on health behaviours and outcomes: A population-based PS matched retrospective cohort study during five-year follow-up period. PLoS One 2024; 19:e0296834. [PMID: 38349922 PMCID: PMC10863870 DOI: 10.1371/journal.pone.0296834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 12/18/2023] [Indexed: 02/15/2024] Open
Abstract
Effective chronic disease management requires the active participation of patients, communities, and physicians. The objective of this study was to estimate the effectiveness of the Community-based Registration and Management for elderly patients with Hypertension or Type 2 Diabetes mellitus Project (CRMHDP) by using motivated primary care physicians and patients supported by prepared communities, to utilise healthcare and health outcomes in four cities in South Korea. We conducted a propensity score-matched retrospective cohort study using 2010-2011 as the baseline years, alongside a follow-up period until 2015/2016, based on the Korean National Health Insurance database. Both a CRMHDP group (n = 46,865) and a control group (n = 93,730) were applied against healthcare utilisation and difference-in-differences estimations were performed. For the health outcome analysis, the intervention group (n = 27,242) and control group (n = 54,484) were analysed using the Kaplan-Meier method and Cox proportional hazard regression. Results: The difference-in-differences estimation of the average annual clinic visits per person and the average annual days covered were 1.26 (95% confidence interval, 1.13-1.39) and 22.97 (95% CI, 20.91-25.03), respectively, between the intervention and control groups. The adjusted hazard ratio for death in the intervention group, compared to the control group, was 0.90 (95% CI, 0.86-0.93). For stroke and chronic renal failure, the adjusted hazard ratios for the intervention group compared to the control group were 0.94 (95% CI, 0.88-0.99) and 0.80 (95% CI 0.73-0.89), respectively. Our study suggests that for effective chronic disease management both elderly patients and physicians need to be motivated by community support.
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Affiliation(s)
- Eun Jee Park
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Hyunsung Kim
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
| | - Soon Young Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon-si, Korea
| | - Weon-Young Lee
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
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Park JY, Choe YJ, Lim Y, Kim H, Kim J. Association between the incidence of type 1 diabetes mellitus and tuberculosis or bacillus Calmette-Guérin immunization in children and adolescents. Ann Pediatr Endocrinol Metab 2023; 28:251-257. [PMID: 38173381 PMCID: PMC10765028 DOI: 10.6065/apem.2244254.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/20/2023] [Accepted: 07/07/2023] [Indexed: 01/05/2024] Open
Abstract
PURPOSE The correlation between the incidence of type 1 diabetes mellitus (T1DM) and tuberculosis or bacillus Calmette-Guérin (BCG) vaccination rate in individuals aged <15 years was investigated using worldwide data. METHODS The incidence of T1DM, rate of BCG vaccination, and incidence of tuberculosis were obtained from the Diabetes Atlas 9th edition of the International Diabetes Federation and the Global Health Observatory data repository of the World Health Organization. Gross domestic product (GDP) per capita and population data by country were obtained from the World Bank and United Nations, respectively. RESULTS GDP per capita negatively correlated with the incidence of tuberculosis and positively correlated with the incidence of T1DM (coefficient=-0.630 and 0.596, respectively; all P<0.001). The incidence of T1DM and tuberculosis was significantly associated with the Organisation for Economic Cooperation and Development (OECD) status (P<0.001). After adjusting for GDP per capita, regional grouping, and OECD status, the incidence of T1DM negatively correlated with that of tuberculosis (R2 =0.729, P=0.009). However, there was no association between the BCG vaccination rate and incidence of T1DM (P=0.890). CONCLUSION There was a negative correlation between the incidence of tuberculosis and T1DM in children and adolescents aged <15 years at the country level.
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Affiliation(s)
- Ji Young Park
- Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea
| | - Young June Choe
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Korea
| | - Hyunsung Kim
- Department of Applied Statistics, Chung-Ang University, Seoul, Korea
| | - Jaehyun Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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Kim H, Lim Y. Functional clustering on a sphere via Riemannian functional principal components. Stat (Int Stat Inst) 2023. [DOI: 10.1002/sta4.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Affiliation(s)
- Hyunsung Kim
- Department of Statistics Chung‐Ang University Seoul 06974 Korea
| | - Yaeji Lim
- Department of Statistics Chung‐Ang University Seoul 06974 Korea
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Lim Y, Dahapute A, Clarke A, Hutton M, Selbi W. Delayed tension pneumocephalus and pneumorrhacis after routine cervical spine surgery treated successfully without burr holes. Ann R Coll Surg Engl 2023. [PMID: 37381753 DOI: 10.1308/rcsann.2023.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023] Open
Abstract
Tension pneumocephalus (TP) after spinal surgery is very rare with only a few cases reported in the English literature. Most cases of TP occur rapidly after spinal surgery. Traditionally, TP is managed using burr holes to relieve intracranial pressure. However, our case highlights a rare delayed presentation of TP and pneumorrhacis 1 month after routine cervical spine surgery. It is to our knowledge the first case of TP after spinal surgery to be treated using dural repair and supportive care. A 75-year-old woman presented with TP after having routine cervical decompression and stabilisation for cervical myelopathy. She re-presented 1 month after her initial operation with a leaking wound and altered mental status, which deteriorated rapidly shortly after admission. This, in combination with her radiographic features, influenced the decision to explore her surgical wound emergently. She made a full recovery and was discharged after 2 weeks in hospital. We hope to emphasise the need for a high index of suspicion for cerebrospinal fluid leaks and the low threshold to return to theatre to repair a potential dural defect, as well as illustrate that TP after spinal surgery can be treated successfully without burr holes.
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Affiliation(s)
- Y Lim
- Royal Devon and Exeter NHS Foundation Trust, UK
| | - A Dahapute
- Royal Devon and Exeter NHS Foundation Trust, UK
| | - A Clarke
- Royal Devon and Exeter NHS Foundation Trust, UK
| | - M Hutton
- Royal Devon and Exeter NHS Foundation Trust, UK
| | - W Selbi
- Royal Devon and Exeter NHS Foundation Trust, UK
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Kim M, Oh HS, Lim Y. Zero-Inflated Time Series Clustering Via Ensemble Thick-Pen Transform. J Classif 2023; 40:1-25. [PMID: 37359508 PMCID: PMC10258486 DOI: 10.1007/s00357-023-09437-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 06/28/2023]
Abstract
This study develops a new clustering method for high-dimensional zero-inflated time series data. The proposed method is based on thick-pen transform (TPT), in which the basic idea is to draw along the data with a pen of a given thickness. Since TPT is a multi-scale visualization technique, it provides some information on the temporal tendency of neighborhood values. We introduce a modified TPT, termed 'ensemble TPT (e-TPT)', to enhance the temporal resolution of zero-inflated time series data that is crucial for clustering them efficiently. Furthermore, this study defines a modified similarity measure for zero-inflated time series data considering e-TPT and proposes an efficient iterative clustering algorithm suitable for the proposed measure. Finally, the effectiveness of the proposed method is demonstrated by simulation experiments and two real datasets: step count data and newly confirmed COVID-19 case data.
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Affiliation(s)
- Minji Kim
- Department of Statistics and Operations Research, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Hee-Seok Oh
- Department of Statistics, Seoul National University, 08826 Seoul, Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, 48513 Seoul, Korea
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Choi SH, Park JY, Kweon OJ, Park JH, Kim MC, Lim Y, Chung JW. Immune Responses After Vaccination With Primary 2-Dose ChAdOx1 Plus a Booster of BNT162b2 or Vaccination With Primary 2-Dose BNT162b2 Plus a Booster of BNT162b2 and the Occurrence of Omicron Breakthrough Infection. J Korean Med Sci 2023; 38:e155. [PMID: 37218354 DOI: 10.3346/jkms.2023.38.e155] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/05/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Before the omicron era, health care workers were usually vaccinated with either the primary 2-dose ChAdOx1 nCoV-19 (Oxford-AstraZeneca) series plus a booster dose of BNT162b2 (Pfizer-BioNTech) (CCB group) or the primary 2-dose BNT162b2 series plus a booster dose of BNT162b2 (BBB group) in Korea. METHODS The two groups were compared using quantification of the surrogate virus neutralization test for wild type severe acute respiratory syndrome coronavirus 2 (SVNT-WT), the omicron variant (SVNT-O), spike-specific IgG, and interferon-gamma (IFN-γ), as well as the omicron breakthrough infection cases. RESULTS There were 113 participants enrolled in the CCB group and 51 enrolled in the BBB group. Before and after booster vaccination, the median SVNT-WT and SVNT-O values were lower in the CCB (SVNT-WT [before-after]: 72.02-97.61%, SVNT-O: 15.18-42.29%) group than in the BBB group (SVNT-WT: 89.19-98.11%, SVNT-O: 23.58-68.56%; all P < 0.001). Although the median IgG concentrations were different between the CCB and BBB groups after the primary series (2.677 vs. 4.700 AU/mL, respectively, P < 0.001), they were not different between the two groups after the booster vaccination (7.246 vs. 7.979 AU/mL, respectively, P = 0.108). In addition, the median IFN-γ concentration was higher in the BBB group than in the CCB group (550.5 and 387.5 mIU/mL, respectively, P = 0.014). There was also a difference in the cumulative incidence curves over time (CCB group 50.0% vs. BBB group 41.8%; P = 0.045), indicating that breakthrough infection occurred faster in the CCB group. CONCLUSION The cellular and humoral immune responses were low in the CCB group so that the breakthrough infection occurred faster in the CCB group than in the BBB group.
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Affiliation(s)
- Seong-Ho Choi
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Ji Young Park
- Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea
| | - Oh Joo Kweon
- Department of Laboratory Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
| | - Joung Ha Park
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
| | - Min-Chul Kim
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Korea
| | - Jin-Won Chung
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea.
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Kim Y, Lee ES, Park HJ, Park SB, Kuehn B, Sung JK, Lim Y, Kim C. Comparison between Conventional Breath-hold and Respiratory-triggered Magnetic Resonance Cholangiopancreatography with and without Compressed Sensing: Cross-sectional Study. Curr Med Imaging 2023:CMIR-EPUB-130388. [PMID: 37018526 DOI: 10.2174/1573405620666230328093206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/17/2023] [Accepted: 02/01/2023] [Indexed: 04/07/2023]
Abstract
AIM The application of compressed sensing (CS) has enabled breath-hold 3D-MRCP with a shorter acquisition time in clinical practice. INTRODUCTION To compare the image quality of breath-hold (BH) and respiratory-triggered (RT) 3D-MRCP with or without CS application in the same study population. METHODS In this retrospective study, from February to July 2020, a total of 98 consecutive patients underwent four different acquisition types of 3D-MRCP.; 1) BH MRCP with the generalized autocalibrating partially parallel acquisition (GRAPPA) (BH-GRAPPA), 2) RT-GRAPPA-MRCP, 3) RT-CS-MRCP and 4) BH-CS-MRCP. Relative contrast of common bile duct, 5-scale visibility score of biliary pancreatic ducts, 3-scale artifact score and 5-scale overall image quality score were evaluated by two abdominal radiologists. RESULTS Relative contrast value was significantly higher in BH-CS or RT-CS than in RT-GRAPPA (0.90 ± 0.057 and 0.89 ± 0.079, respectively, vs. 0.82 ± 0.071, p < 0.01) or BH-GRAPPA (vs. 0.77 ± 0.080, p < 0.01). The area affected by artifact was significantly lower in BH-CS among 4 MRCPs (p < 0.08). Overall image quality score in BH-CS was significantly higher than BH-GRAPPA (3.40 vs. 2.71, p < 0.01). There were no significant differences between RT-GRAPPA and BH-CS (vs. 3.13, p = 0.67) in overall image quality. CONCLUSION In this study, our results revealed BH-CS had higher relative contrast and comparable or superior image quality among four MRCP sequences.
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Affiliation(s)
- Younguk Kim
- Department of Radiology, Chung-Ang University Hospital, 102, Heukseok-ro, Dongjak-gu, Seoul 06973, Republic of Korea
| | - Eun Sun Lee
- Department of Radiology, Chung-Ang University Hospital, 102, Heukseok-ro, Dongjak-gu, Seoul 06973, Republic of Korea
| | - Hyun Jeong Park
- Department of Radiology, Chung-Ang University Hospital, 102, Heukseok-ro, Dongjak-gu, Seoul 06973, Republic of Korea
| | - Sung Bin Park
- Department of Radiology, Chung-Ang University Hospital, 102, Heukseok-ro, Dongjak-gu, Seoul 06973, Republic of Korea
| | - Bernd Kuehn
- Siemens Healthcare GmbH, Henkestr. 127, Erlangen 91052, Germany
| | - Jae Kon Sung
- Siemens Healthineers Ltd, 23, Chungjeong-ro, Seodaemun-gu, Seoul 03737, Republic of Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, 102, Heukseok-ro, Dongjak-gu, Seoul 06973, Republic of Korea
| | - Changwoo Kim
- Department of Applied Statistics, Chung-Ang University, 102, Heukseok-ro, Dongjak-gu, Seoul 06973, Republic of Korea
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Teo YN, Basker G, Teoh SE, Tan EWX, Teo YH, Chai P, Wong RCC, Yip JWL, Kuntjoro I, Lim Y, Poh KK, Yeo TC, Kong WKF, Sia CH. Natural history of functional mitral regurgitation: a systematic review and individual patient data meta-analysis. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Ching-Hui Sia was supported by the National University of Singapore Yong Loo Lin School of Medicine's Junior Academic Fellowship Scheme.
Background
Functional mitral regurgitation (FMR) precipitates a vicious cycle of left ventricular volume overload and remodelling, leading to perpetual worsening of FMR and left ventricular dysfunction, with a resultant poor prognosis. However, there is a lack of conclusive data on the natural progression of FMR in patients who do not undergo valvular intervention.
Purpose
We performed a one-stage meta-analysis on reconstructed individual patient data (IPD) to elucidate the natural history of FMR.
Methods
Four databases (PubMed, Embase, Scopus, Cochrane) were searched for randomised controlled trials or cohorts, published from inception to March 13, 2022, reporting clinical outcomes in patients with FMR not receiving valvular intervention. IPD meta-analysis, as the gold standard approach for evidence synthesis, was performed with reconstructed IPD obtained from the survival curves reported in the included studies. Pooled survival estimates were derived. Quality assessment of included studies was conducted using the Cochrane risk-of-bias tool and Newcastle Ottawa Scale. This study was registered on the International Prospective Register of Systematic Reviews.
Results
A total of five studies were included, comprising a total cohort of 691 patients with FMR who did not undergo valvular intervention. The mean age of the cohort was 72.4 years (95% CI 67.6 to 77.1) and the proportion of males was 61.1% (95% CI 43.8 to 76.0). All-cause mortality was analysed over a follow-up duration of five years, while hospitalisation for heart failure, cardiovascular death, and the composite of all-cause mortality and hospitalisation for heart failure were analysed over a follow-up duration of three years. The probability of survival of patients with FMR without intervention was 79.4% (95% CI 76.2 to 82.3), 50.9% (95% CI 46.6 to 55.1), and 39.6% (95% CI 33.1 to 46.0) at one, three, and five years respectively. The probability of survival free from the composite of all-cause mortality and hospitalisation for heart failure was 51.3% (95% CI 46.8 to 55.6) and 12.0% (95% CI 8.9 to 15.7) at one year and three years respectively. The probability of survival free from hospitalisation for heart failure was 58.3% (95% CI 54.0 to 62.3) and 19.7% (95% CI 16.0 to 23.7) at one and three years respectively. The probability of survival free from cardiovascular death was 75.4% (95% CI 68.9 to 80.8) and 45.6% (95% CI 29.1 to 60.7) at one and three years respectively. All included studies were of low to moderate risk of bias.
Conclusion
FMR in the absence of valvular intervention is associated with poor survival and cardiovascular outcomes. Further research should focus on the role of interventions to mitigate its poor prognosis.
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Affiliation(s)
- Y N Teo
- National University of Singapore, Yong Loo Lin School of Medicine , Singapore , Singapore
| | - G Basker
- National University of Singapore, Yong Loo Lin School of Medicine , Singapore , Singapore
| | - S E Teoh
- National University of Singapore, Yong Loo Lin School of Medicine , Singapore , Singapore
| | - E W X Tan
- National University of Singapore, Yong Loo Lin School of Medicine , Singapore , Singapore
| | - Y H Teo
- National University of Singapore, Department of Medicine , Singapore , Singapore
| | - P Chai
- National University Heart Centre, Department of Cardiology , Singapore , Singapore
| | - R C C Wong
- National University Heart Centre, Department of Cardiology , Singapore , Singapore
| | - J W L Yip
- National University Heart Centre, Department of Cardiology , Singapore , Singapore
| | - I Kuntjoro
- National University Heart Centre, Department of Cardiology , Singapore , Singapore
| | - Y Lim
- National University Heart Centre, Department of Cardiology , Singapore , Singapore
| | - K K Poh
- National University Heart Centre, Department of Cardiology , Singapore , Singapore
| | - T C Yeo
- National University Heart Centre, Department of Cardiology , Singapore , Singapore
| | - W K F Kong
- National University Heart Centre, Department of Cardiology , Singapore , Singapore
| | - C H Sia
- National University Heart Centre, Department of Cardiology , Singapore , Singapore
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Baek MS, Choi SH, Kim WY, Kim MC, Joo EJ, Lee MS, Kim HA, Jung SI, Nae YS, Kim B, Lim Y, Chung JW. A study on changes in lung function, neutralizing antibodies, and symptoms of adult patients hospitalized with COVID-19. Korean J Intern Med 2023; 38:101-112. [PMID: 36281537 PMCID: PMC9816687 DOI: 10.3904/kjim.2022.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/18/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND/AIMS To identify changes in symptoms and pulmonary sequelae in patients with coronavirus disease 2019 (COVID-19). METHODS Patients with COVID-19 hospitalized at seven university hospitals in Korea between February 2020 and February 2021 were enrolled, provided they had ≥ 1 outpatient follow-up visit. Between January 11 and March 9, 2021 (study period), residual symptom investigations, chest computed tomography (CT) scans, pulmonary function tests (PFT), and neutralizing antibody tests (NAb) were performed at the outpatient visit (cross-sectional design). Additionally, data from patients who already had follow-up outpatient visits before the study period were collected retrospectively. RESULTS Investigation of residual symptoms, chest CT scans, PFT, and NAb were performed in 84, 35, 31, and 27 patients, respectively. After 6 months, chest discomfort and dyspnea persisted in 26.7% (4/15) and 33.3% (5/15) patients, respectively, and 40.0% (6/15) and 26.7% (4/15) patients experienced financial loss and emotional distress, respectively. When the ratio of later CT score to previous ones was calculated for each patient between three different time intervals (1-14, 15-60, and 61-365 days), the median values were 0.65 (the second interval to the first), 0.39 (the third to the second), and 0.20 (the third to the first), indicating that CT score decreases with time. In the high-severity group, the ratio was lower than in the low-severity group. CONCLUSION In COVID-19 survivors, chest CT score recovers over time, but recovery is slower in severely ill patients. Subjects complained of various ongoing symptoms and socioeconomic problems for several months after recovery.
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Affiliation(s)
- Moon Seong Baek
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Seong-Ho Choi
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Won-Young Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Min-Chul Kim
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Eun-Jeong Joo
- Division of Infectious Diseases, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Mi Suk Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul,
Korea
| | - Hyun Ah Kim
- Department of Infectious Diseases, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu,
Korea
| | - Sook In Jung
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju,
Korea
| | - Yu Shi Nae
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan,
Korea
| | - Bongyoung Kim
- Division of Infectious Diseases, Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine, Seoul,
Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul,
Korea
| | - Jin-Won Chung
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul,
Korea
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Kim HM, Hwang I, Yoon YE, Park J, Lee S, Kim H, Kim Y, Lim Y, Cho G. Prediction of Deterioration of Left Ventricular Function Using 3-Dimensional Speckle-Tracking Echocardiography in Patients With Left Bundle-Branch Block. J Am Heart Assoc 2022; 12:e026194. [PMID: 36583438 PMCID: PMC9973573 DOI: 10.1161/jaha.122.026194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Previous studies have demonstrated that 2-dimensional (2D) global longitudinal strain (GLS) is associated with cardiovascular outcomes in patients with left bundle-branch block. However, the predictive value of 3-dimensional (3D) speckle-tracking echocardiography has not yet been investigated in these patients. Methods and Results The authors retrospectively identified 290 patients with left bundle-branch block who underwent echocardiography more than twice. Using speckle-tracking echocardiography, 2D-GLS, 3D-GLS, 3D-global circumferential strain, 3D global radial strain, and 3D global area strain were acquired. The association between 2D and 3D strains and the follow-up left ventricular (LV) ejection fraction (LVEF) was analyzed. The study population was divided into 2 sets: a group with preserved LVEF (baseline LVEF ≥40%) and a group with reduced LVEF (baseline LVEF <40%). After a median follow-up of 29.1 months (interquartile range, 13.1-53.0 months), 14.9% of patients progressed to LV dysfunction in the group with preserved LVEF, and 51.0% of patients showed improved LV function in the group with reduced LVEF. Multivariable analysis of 2D and 3D strains revealed that higher 2D-GLS (odds ratio [OR], 0.65 [95% CI, 0.54-0.78], P<0.001) was highly associated with maintaining LVEF in patients with preserved LVEF. However, a lower 3D-global circumferential strain (OR, 0.61 [95% CI, 0.47-0.78], P<0.001) showed a strong association with persistently reduced LVEF in patients with reduced LVEF. Conclusions Although 2D-GLS showed a powerful predictive value for the deterioration of LV function in the preserved LVEF group, 3D strain, especially 3D-global circumferential strain, can be helpful to predict consistent LV dysfunction in patients with left bundle-branch block who have reduced LVEF.
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Affiliation(s)
- Hyue Mee Kim
- Division of CardiologyDepartment of Internal MedicineChung‐Ang University HospitalChung‐Ang University College of MedicineSeoulSouth Korea
| | - In‐Chang Hwang
- Cardiovascular Center & Department of Internal MedicineCollege of MedicineSeoul National UniversitySeoul National University Bundang HospitalSeongnamGyeonggiSouth Korea
| | - Yeonyee Elizabeth Yoon
- Cardiovascular Center & Department of Internal MedicineCollege of MedicineSeoul National UniversitySeoul National University Bundang HospitalSeongnamGyeonggiSouth Korea
| | - Jun‐Bean Park
- Cardiovascular Center, Department of Internal MedicineCollege of Medicine, Seoul National UniversitySeoul National University HospitalSeoulSouth Korea
| | - Seung‐Pyo Lee
- Cardiovascular Center, Department of Internal MedicineCollege of Medicine, Seoul National UniversitySeoul National University HospitalSeoulSouth Korea
| | - Hyung‐Kwan Kim
- Cardiovascular Center, Department of Internal MedicineCollege of Medicine, Seoul National UniversitySeoul National University HospitalSeoulSouth Korea
| | - Yong‐Jin Kim
- Cardiovascular Center, Department of Internal MedicineCollege of Medicine, Seoul National UniversitySeoul National University HospitalSeoulSouth Korea
| | - Yaeji Lim
- Department of Applied StatisticsChung‐Ang UniversitySeoulSouth Korea
| | - Goo‐Yeong Cho
- Cardiovascular Center & Department of Internal MedicineCollege of MedicineSeoul National UniversitySeoul National University Bundang HospitalSeongnamGyeonggiSouth Korea
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Baek MS, Kim JH, Lim Y, Kwon YS. Neuromuscular blockade in mechanically ventilated pneumonia patients with moderate to severe hypoxemia: A multicenter retrospective study. PLoS One 2022; 17:e0277503. [PMID: 36520923 PMCID: PMC9754162 DOI: 10.1371/journal.pone.0277503] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 10/28/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND/PURPOSE The benefit of neuromuscular blockades (NMBs) in critically ill patients receiving mechanical ventilation remains uncertain. Therefore, we aimed to investigate whether NMB use is associated with improved survival of mechanically ventilated pneumonia patients with moderate to severe hypoxemia. METHODS This retrospective multicenter study was conducted at five university-affiliated hospitals. Data of pneumonia patients aged 18 years and older who received mechanical ventilation between January 1, 2011, and December 31, 2020, were analyzed. RESULTS In a total of 1,130 patients, the mean patient age was 73.1 years (SD±12.6), and the overall mortality rate at 30 d was 29.5% (n = 333). NMB users had a higher 30 d mortality rate than NMB nonusers (33.9% vs. 26.8%, P = 0.014). After PS matching, the 30 d mortality rate was not significantly different between NMB users and nonusers (33.4% vs. 27.8%, p = 0.089). However, 90 d mortality rate was significantly increased in NMB users (39.7% vs. 31.9%, p = 0.021). Univariable Cox proportional hazard regression analyses showed that NMB use ≥ 3 d was significant risk factor for the 90 d mortality than those with < 3 d use (90 d mortality HR 1.39 [95% CI: 1.01-1.91], P = 0.045). CONCLUSIONS NMB use was not associated with lower 30 d mortality among mechanically ventilated pneumonia patients with moderate to severe hypoxemia. Rather, NMB users had higher 90 d mortality, furthermore, and NMB use ≥ 3 d was associated with a higher risk of long-term mortality compared to NMB use < 3 d. Therefore, care should be taken to avoid extended use of NMB in critically ill pneumonia patients during mechanical ventilation.
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Affiliation(s)
- Moon Seong Baek
- Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Jong Ho Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University, Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea
- Institute of New Frontier Research Team, Hallym University, Chuncheon, South Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
| | - Young Suk Kwon
- Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University, Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea
- Institute of New Frontier Research Team, Hallym University, Chuncheon, South Korea
- * E-mail:
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Lim Y, Kang S, Jeong S, Kim H. 455 Spatial transcriptomic analysis of tumor-infiltrating immune cells in melanoma reveals distinct immune profiles depending on tumor progression. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Park JH, Cha MJ, Choi H, Kim MC, Chung JW, Lee KS, Jeong DG, Baek MS, Kim WY, Lim Y, Yoon SW, Choi SH. Relationship between SARS-CoV-2 antibody titer and the severity of COVID-19. J Microbiol Immunol Infect 2022; 55:1094-1100. [PMID: 35570185 PMCID: PMC9069977 DOI: 10.1016/j.jmii.2022.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/14/2022] [Accepted: 04/01/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND It remains unclear whether high titers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies aggravate clinical manifestations in patients or whether severe clinical manifestations result in high antibody titers. Thus, we investigated the cause-effect relationship between SARS-CoV-2 antibody titers and disease severity. METHODS We prospectively enrolled patients admitted with the diagnosis of coronavirus disease-19 (COVID-19) from February 2020 to August 2020. We measured SARS-CoV-2 antibody titers, namely anti-receptor-binding domain (RBD) antibody and neutralizing antibody (NAb), from blood samples and calculated the chest radiograph (CXR) scores of the patients to evaluate the severity of COVID-19. RESULTS Overall, 40 patients with COVID-19 were enrolled. Pneumonia was observed in more than half of the patients (25/40, 60%). SARS-CoV-2 antibody titers were higher in patients who were aged >60 years (anti-RBD antibodies, P = 0.003 and NAb, P = 0.009), presented with pneumonia (P = 0.006 and 0.007, respectively), and required oxygen therapy (P = 0.003 and 0.004, respectively) than in those who were not. CXR scores peaked (at 15-21 days after the onset of symptoms) statistically significantly earlier than SARS-CoV-2 antibody titers (at 22-30 days for NAb and at 31-70 days for anti-RBD antibody). There was a close correlation between the maximum CXR score and the maximum SAR-CoV-2 antibody titer. CONCLUSIONS Based on the comparison of the peak time of SARS-CoV-2 antibody titers with the CXR score after symptom onset, we suggest that severe clinical manifestations result in high titers of SARS-CoV-2 antibodies.
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Affiliation(s)
- Joung Ha Park
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, South Korea
| | - Min Jae Cha
- Department of Radiology, Chung-Ang University Hospital, Seoul, South Korea
| | - Hyewon Choi
- Department of Radiology, Chung-Ang University Hospital, Seoul, South Korea
| | - Min-Chul Kim
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, South Korea
| | - Jin-Won Chung
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea
| | - Kyu-Sun Lee
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea
| | - Dae Gwin Jeong
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea
| | - Moon Seong Baek
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea
| | - Won-Young Kim
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, South Korea
| | - Sun Woo Yoon
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea,Corresponding author. Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea
| | - Seong-Ho Choi
- Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea,Corresponding author. Fax: +82 2 6299 2064
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Cho S, Lim Y, Cho S, Kim S, Park G, Song S, Song H, Park S, Ma M, Jung W, Paeng K, Ock CY, Cho E, Song S. 155P Artificial Intelligence (AI) - powered human epidermal growth factor receptor-2 (HER2) and tumor-infiltrating lymphocytes (TIL) analysis for HER2-positive early breast cancer patients treated with HER2-targeted neoadjuvant chemotherapy (NAC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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17
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Shin S, Kwon HJ, Kim H, Min N, Lim Y, Joo T, Lee K, Jeong MS, Kim H, Um SW, An C, Lee S. 23P MRE-seq based cancer screening for lung and colorectal cancer by deep learning analysis of cfDNA methylation pattern cancer screening. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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18
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Lim Y, Kang S, Kim H, Mun J, Roh M, Gulati N, Yang H, Moon J, Won C, Park C. 631 Determining intra-tumoral heterogeneity and immune escape mechanisms in melanoma using spatial transcriptomics. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Ha J, Kim J, Jeong C, Lim Y, Kim MK, Kwon HS, Song KH, Kang MI, Baek KH. Effect of follow-up raloxifene therapy after denosumab discontinuation in postmenopausal women. Osteoporos Int 2022; 33:1591-1599. [PMID: 35376989 PMCID: PMC8978765 DOI: 10.1007/s00198-022-06388-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/25/2022] [Indexed: 12/31/2022]
Abstract
UNLABELLED Follow-up raloxifene therapy after denosumab discontinuation resulted in a decrease in bone mass to the pre-denosumab levels and a rebound increase of bone turnover markers. The decrease in lumbar bone mineral density was particularly evident when the body mass index was low, there were previous vertebral fractures, or lumbar bone mineral density before denosumab administration was low. INTRODUCTION Selective estrogen receptor modulators may be an alternative to bisphosphonates for treating rebound resorption after discontinuing denosumab. This study aimed to investigate the effects of follow-up raloxifene therapy after denosumab discontinuation in postmenopausal women. METHODS This retrospective observational study included 61 patients who received 12-month follow-up raloxifene therapy after denosumab discontinuation. The primary endpoint was the bone mineral density change. The secondary endpoints were the changes in bone turnover markers and the incidence of new vertebral fractures. RESULTS Raloxifene administration for 12 months after denosumab discontinuation resulted in a significantly lower bone mineral density at all sites compared to the level at 6 months after the last denosumab treatment (lumbar spine, - 5.48%; femoral neck, - 2.95%; total hip, - 3.52%; all, p < 0.001). The decrease in lumbar bone mineral density was particularly evident when the body mass index was low, there were previous vertebral fractures, or lumbar bone mineral density before denosumab administration was low. Marked increases in the bone turnover markers from baseline were noted after switching to raloxifene. However, no new vertebral fractures occurred during raloxifene treatment. CONCLUSIONS Follow-up raloxifene therapy after denosumab discontinuation resulted in a decrease in bone mass to the pre-denosumab levels and a rebound increase of bone turnover markers. Therefore, raloxifene administered sequentially after denosumab discontinuation was not effective in preventing rebound phenomenon.
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Affiliation(s)
- J Ha
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J Kim
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - C Jeong
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Republic of Korea
| | - Y Lim
- Department of Internal Medicine, Division of General Internal Medicine, National University Bundang Hospital, Seongnam, Republic of Korea
| | - M K Kim
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H-S Kwon
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K-H Song
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - M I Kang
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K-H Baek
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Lim Y, Cicuttini F, Wluka A, Jones G, Hill C, Forbes A, Tonkin A, Berezovskaya S, Tan L, Ding C, Wang Y. AB0978 Effect of atorvastatin on skeletal muscles of patients with knee osteoarthritis: post-hoc analysis of a randomised controlled trial. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundStatins are often discontinued due to muscle-related side effects. The effect of statin on skeletal muscles in populations with osteoarthritis is unknown.ObjectivesThis study aims to examine the effect of atorvastatin on skeletal muscle biochemistry, strength, size and symptoms in patients with symptomatic knee osteoarthritis.MethodsThis is a post-hoc analysis of a multicentre randomised, double-blind, placebo-controlled trial over 2 years in which participants with knee osteoarthritis who met the American College of Rheumatology clinical criteria received atorvastatin 40mg daily (n=151) or placebo (n=153). Outcomes included levels of creatinine kinase (CK), aspartate transaminases (AST) and alanine transaminases (ALT) at baseline, 4 weeks, 6, 12 and 24 months; muscle strength measured by dynamometry at baseline, 12 and 24 months; vastus medialis cross-sectional area (CSA) on magnetic resonance imaging at baseline and 24 months; and self-reported myalgia during the trial.Results304 participants [mean age 55.7 (SD 7.6) years, 55.6% female] were randomised. There were no significant differences in CK and AST levels between atorvastatin and placebo groups at 4 weeks (CK median 107 vs 110, p=0.76; AST 22 vs 21, p=0.14), 6 (CK 109 vs 101.5, p=0.37; AST 21 vs 20, p=0.45), 12 (CK 103 vs 103, p=0.93; AST 22 vs 21, p=0.99), and 24 (CK 103 vs 93.5, p=0.17; AST 22 vs 21, p=0.34) months. The atorvastatin group had higher ALT levels than the placebo group at 4 weeks [26 vs 21, p=0.0004] and 6 months [25 vs 22, p=0.007] but no between-group differences at 12 [24 vs 21, p=0.08] and 24 [24 vs 21, p=0.053] months. Muscle strength significantly increased in the atorvastatin group but not the placebo group over 24 months with no between-group differences [mean 8.5 (95% CI 2.6,14.4) vs 5.6 (-0.3,11.5), p=0.50]. Change in vastus medialis CSA over 24 months showed between-group differences favouring the atorvastatin group [+0.12 (-0.09,0.34) vs -0.24 (-0.48,0.01), p=0.03] but of uncertain clinical significance. There was a trend for more myalgia in the atorvastatin group over 2 years (8/151 vs 2/153, p=0.06), mostly occurring within 6 months (7/151 vs 1/153, p=0.04). Of the 10 participants with myalgia, there was no relationship between the incidence of myalgia and CK levels.ConclusionIn those with symptomatic knee osteoarthritis, despite a trend for more myalgia, there was no clear evidence of an adverse effect of atorvastatin on skeletal muscles, including those most relevant to knee joint health.Disclosure of InterestsYuan Lim: None declared, Flavia Cicuttini: None declared, Anita Wluka: None declared, Graeme Jones Speakers bureau: GJ received honoraria for talks from BMS, Roche, AbbVie, Amgen, Lilly, Novartis, and Janssen, Grant/research support from: GJ received grant for a clinical trial from Covance, Catherine Hill: None declared, Andrew Forbes: None declared, Andrew Tonkin Speakers bureau: AT received honoraria for lectures from Pfizer; honoraria for lectures and advisory board participation from Amgen, Consultant of: AT received honoraria for lectures and advisory board participation from Amgen, honoraria for data and safety monitoring board participation from Merck, and honoraria for data and safety monitoring board participation from Novartis, Sofia Berezovskaya: None declared, Lynn Tan: None declared, Changhai Ding: None declared, Yuanyuan Wang: None declared
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Lim Y, Wong J, Hussain SM, Estee M, Zolio L, Page M, Harrison C, Wluka A, Wang Y, Cicuttini F. AB0979 Recommendations for weight management in osteoarthritis: a systematic review of clinical practice guidelines. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundWeight loss interventions are often recommended to target overweight and obesity in the clinical practice guidelines (CPGs) for the management of osteoarthritis. This is despite evidence from meta-analyses of clinical trials that significant weight loss results in modest improvements in symptoms and minimal effects on disease progression1,2. There is evidence that weight gain is associated with increase in knee pain3,4. In countries such as USA, adults gain on average 0.5 to 1 kilogram per year from early to middle adulthood Preventing weight gain is easier to achieve and sustain than losing weight.ObjectivesGiven that weight loss is accepted as fundamental to osteoarthritis management, we systematically reviewed the recommendations and approaches for weight management in all current osteoarthritis CPGs.MethodsNine databases were searched (1st January 2010 to 30th September 2021) to identify guidelines informing the non-pharmacological management of osteoarthritis. Three reviewers appraised guidelines according to the AGREE II instrument, and independently extracted data on their characteristics. One author extracted and summarised guideline recommendations on weight management. This systematic review is registered on PROSPERO (CRD42021274195).ResultsFifteen CPGs from developed and developing countries were included. Weight loss was recommended for knee (12 of 13 guidelines) and hip (10 of 11 guidelines) but not hand osteoarthritis (0 of 4 guidelines). Combination approaches of diet and/or exercise were recommended for overweight or obese individuals (knee: 8 of 12; hip: 4 of 10), with 2 guidelines specifying ≥5% weight loss for knee and hip osteoarthritis. One of 15 guidelines specified strategies for weight loss and maintenance of lost weight. Two of 15 guidelines recommended controlling body weight for osteoarthritis, regardless of obesity status.ConclusionMost CPGs for knee and hip osteoarthritis include recommendations for weight loss in those with overweight or obesity as key to managing osteoarthritis, despite evidence of modest at best effect of weight loss on symptoms and no effect on joint structure1,2. Given obesity is a major risk factors for osteoarthritis, the prevention of weight gain may be more effective and practical in improving clinical outcomes for osteoarthritis, and hence should be considered as part of the key management in osteoarthritis.References[1]Chu IJH, Lim AYT, Ng CLW. Effects of meaningful weight loss beyond symptomatic relief in adults with knee osteoarthritis and obesity: a systematic review and meta-analysis. Obes Rev. 2018;19(11):1597-1607.[2]Daugaard CL, Hangaard S, Bartels EM, Gudbergsen H, Christensen R, Bliddal H, et al. The effects of weight loss on imaging outcomes in osteoarthritis of the hip or knee in people who are overweight or obese: a systematic review. Osteoarthritis Cartilage. 2020;28(1):10-21.[3]Tanamas SK, Wluka AE, Davies-Tuck M, Wang Y, Strauss BJ, Proietto J, et al. Association of weight gain with incident knee pain, stiffness, and functional difficulties: a longitudinal study. Arthritis Care Res (Hoboken). 2013;65(1):34-43.[4]Teichtahl AJ, Wluka AE, Tanamas SK, Wang Y, Strauss BJ, Proietto J, et al. Weight change and change in tibial cartilage volume and symptoms in obese adults. Annals of the rheumatic diseases. 2015;74(6):1024-1029.[5]Zheng Y, Manson JE, Yuan C, Liang MH, Grodstein F, Stampfer MJ, et al. Associations of Weight Gain From Early to Middle Adulthood With Major Health Outcomes Later in Life. JAMA. 2017;318(3):255-269.Disclosure of InterestsNone declared
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Lim Y, Wang Y, Estee M, Abidi J, Udaya Kumar M, Hussain SM, Wluka A, Little C, Cicuttini F. POS1118 METFORMIN AS A POTENTIAL DISEASE-MODIFYING DRUG IN OSTEOARTHRITIS: A SYSTEMATIC REVIEW OF PRE-CLINICAL AND HUMAN STUDIES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundOsteoarthritis causes significant pain and disability with no approved disease-modifying drugs. There is evidence emerging from pre-clinical and human studies suggesting metformin may have disease-modifying properties in osteoarthritis1-5. Given its pleiotropic effects and safety profile, metformin has the potential to be a novel therapy for osteoarthritis.ObjectivesWe systematically reviewed the evidence from both pre-clinical and human studies for the potential disease-modifying effect of metformin in osteoarthritis.MethodsOvid Medline, Embase and CINAHL were searched between inception and June 2021 using MeSH terms and key words to identify studies examining the association between metformin use and outcome measures related to osteoarthritis. Two reviewers performed the risk of bias assessment and 3 reviewers extracted data independently. Qualitative evidence synthesis was performed. This systematic review is registered on PROSPERO (CRD42021261052 and CRD42021261060).ResultsFifteen (10 pre-clinical and 5 human) studies were included. Most studies (10 pre-clinical and 3 human) assessed the effect of metformin using knee osteoarthritis models. In pre-clinical studies, metformin was assessed for the effect on structural outcomes (n=10); immunomodulation (n=5); pain (n=4); and molecular pathways of its effect in osteoarthritis (n=7). For human studies, metformin was evaluated for the effect on structural progression (n=3); pain (n=1); and immunomodulation (n=1). Overall, pre-clinical studies consistently showed metformin having a chondroprotective, immunomodulatory and analgesic effect in osteoarthritis, predominantly mediated by adenosine monophosphate-activated protein kinase activation. Evidence from human studies, although limited, was consistent with findings in pre-clinical studies.ConclusionWe found consistent evidence across pre-clinical and human studies to support a favourable effect of metformin on chondroprotection, immunomodulation and pain reduction in knee osteoarthritis. Further high-quality clinical trials are needed to confirm these findings as metformin could be a novel therapeutic drug for the treatment of osteoarthritis.References[1]Li H, Ding X, Terkeltaub R, Lin H, Zhang Y, Zhou B, et al. Exploration of metformin as novel therapy for osteoarthritis: preventing cartilage degeneration and reducing pain behavior. Arthritis Res Ther. 2020;22(1):34.[2]Li J, Zhang B, Liu WX, Lu K, Pan H, Wang T, et al. Metformin limits osteoarthritis development and progression through activation of AMPK signalling. Ann Rheum Dis. 2020;79(5):635-645.[3]Na HS, Kwon JY, Lee SY, Lee SH, Lee AR, Woo JS, et al. Metformin Attenuates Monosodium-Iodoacetate-Induced Osteoarthritis via Regulation of Pain Mediators and the Autophagy-Lysosomal Pathway. Cells. 2021;10(3).[4]Lu CH, Chung CH, Lee CH, Hsieh CH, Hung YJ, Lin FH, et al. Combination COX-2 inhibitor and metformin attenuate rate of joint replacement in osteoarthritis with diabetes: A nationwide, retrospective, matched-cohort study in Taiwan. PLoS ONE [Electronic Resource]. 2018;13(1):e0191242.[5]Wang Y, Hussain SM, Wluka AE, Lim YZ, Abram F, Pelletier JP, et al. Association between metformin use and disease progression in obese people with knee osteoarthritis: data from the Osteoarthritis Initiative-a prospective cohort study. Arthritis research & therapy. 2019;21(1):127.Disclosure of InterestsYuan Lim: None declared, Yuanyuan Wang: None declared, Mahnuma Estee: None declared, Jawad Abidi: None declared, Maushmi Udaya Kumar: None declared, Sultana Monira Hussain: None declared, Anita Wluka: None declared, Christopher Little Grant/research support from: CBL receives research funding from pharmaceutical companies (Fidia Farmaceutici, Cynata Therapeutics, Ceva Animal Health Pty Ltd and Regeneus Pty Ltd) to investigate efficacy of novel osteoarthritis therapeutics in pre-clinical models, through specific services/testing-contract research agreements between and managed by The University of Sydney or the Northern Sydney Local Health District, Flavia Cicuttini: None declared
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Kim MJ, Shin JH, Hahn SY, Oh YL, Kim SW, Kim TH, Lim Y, Lee S. Ultrasonographic characteristics of Hurthle cell: prediction of malignancy. Ultrasonography 2022; 41:689-697. [PMID: 36031766 PMCID: PMC9532204 DOI: 10.14366/usg.21264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/14/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose This study investigated the ultrasound (US) features of malignancy in patients with Hürthle cell neoplasms (HCNs) of the thyroid gland. Methods The present study included 139 HCNs that had undergone surgical excision at a single institution from 1996 to 2020 and had preoperative US images. The sonographic characteristics of HCNs were correlated with their pathological results. The US findings associated with malignancy were explored using logistic regression analysis, and the diagnostic performance and cutoff were assessed using receiver operating characteristic analysis. Results The most common US findings of HCNs were a solid content (76.3%), oval to round shape (100%), hypoechogenicity (70.5%), a smooth margin (95.0%), the halo sign (90.6%), and no calcifications (93.5%). HCNs were commonly smaller in pathologic measurements than in US measurements (smaller, same, and greater than US measurements in 60.4%, 21.6%, and 18.0% of HCNs, respectively; P<0.001). On US, malignant nodules were significantly larger than benign nodules (3.4±1.6 cm vs. 2.2±1.2 cm, P<0.001). Multiple logistic regression showed that the US tumor size was an independent predictor of malignancy (P=0.001; odds ratio, 1.730 for a 1-cm increase [95% confidence interval, 1.258 to 2.375]). The best cutoff US tumor size for predicting malignancy was 3.35 cm (sensitivity, 53.1%; specificity, 87.9%). Conclusion The US tumor size was found to be an independent predictor of malignancy in HCNs, and a US tumor size >3.35 cm might be used as a criterion to suggest malignancy. The size of HCNs often showed discrepancies between US and pathologic measurements.
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Affiliation(s)
- Min Je Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Hee Shin
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Correspondence to: Jung Hee Shin, MD, PhD, Department of Radiology and Center for Imaging Science, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea Tel. +82-2-3410-2518 Fax. +82-2-3410-2559 E-mail:
| | - Soo Yeon Hahn
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Lyun Oh
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Korea
| | - Sanghyuk Lee
- Department of Applied Statistics, Chung-Ang University, Seoul, Korea
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Mustafah AM, Khairunniza-Bejo S, Lim Y. The development of an automatic rubber seed sowing system with machine vision assistance. J RUBBER RES 2022. [DOI: 10.1007/s42464-022-00153-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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25
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Darmawan CC, Ohn J, Mun J, Kim S, Lim Y, Jo SJ, Kim Y, Kim B, Seong M, Kim BJ, Lee C, Kwak Y, Chung HJ, Virós A, Lee D. Diagnosis and treatment of nail melanoma: A review of the clinicopathologic, dermoscopic, and genetic characteristics. J Eur Acad Dermatol Venereol 2022; 36:651-660. [DOI: 10.1111/jdv.17975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/20/2021] [Accepted: 01/07/2022] [Indexed: 12/01/2022]
Affiliation(s)
- C. C. Darmawan
- Department of Dermatology Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Institute of Human‐Environment Interface Biology Seoul National University 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - J. Ohn
- Department of Dermatology Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Institute of Human‐Environment Interface Biology Seoul National University 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - J.‐H. Mun
- Department of Dermatology Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Institute of Human‐Environment Interface Biology Seoul National University 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Department of Dermatology Seoul National University Hospital 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Skin Cancer/Chemotherapy Skin Care Center Seoul National University Cancer Hospital 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - S. Kim
- Department of Dermatology Seoul National University Hospital 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - Y. Lim
- Department of Dermatology Seoul National University Hospital 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Skin Cancer/Chemotherapy Skin Care Center Seoul National University Cancer Hospital 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - S. J. Jo
- Department of Dermatology Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Institute of Human‐Environment Interface Biology Seoul National University 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Department of Dermatology Seoul National University Hospital 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
- Skin Cancer/Chemotherapy Skin Care Center Seoul National University Cancer Hospital 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - Y.‐g. Kim
- Department of Laboratory Medicine Green Cross Genomic Laboratories 107 Ihyeonro 30beon‐gil Giheng‐gu Yongin‐Si Gyeonggi‐do 16924 Korea
| | - B. Kim
- Department of Laboratory Medicine Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - M.‐W. Seong
- Department of Laboratory Medicine Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - B. J. Kim
- Department of Plastic and Reconstructive Surgery Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - C. Lee
- Department of Pathology Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - Y. Kwak
- Department of Pathology Seoul National University College of Medicine 101 Daehak‐ro, Jongno‐gu Seoul 03080 Korea
| | - H. J. Chung
- Department of Dermatology Harvard Medical School Boston Massachusetts 02215 USA
| | - A. Virós
- Skin Cancer and Ageing Lab Cancer Research UK Manchester Institute The University of Manchester Manchester SK10 4TG UK
| | - D.Y. Lee
- Department of Dermatology Samsung Medical Center Sungkyunkwan University 81 Irwon‐Ro, Gangnam‐gu Seoul 06351 Korea
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26
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Ha J, Jeong C, Han KD, Lim Y, Kim MK, Kwon HS, Song KH, Kang MI, Baek KH. Comparison of fracture risk between type 1 and type 2 diabetes: a comprehensive real-world data. Osteoporos Int 2021; 32:2543-2553. [PMID: 34333678 DOI: 10.1007/s00198-021-06032-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/11/2021] [Indexed: 12/24/2022]
Abstract
UNLABELLED Population-based cohort study of 6,548,784 Korean subjects demonstrates that the risk of fracture was higher in patients with diabetes than in nondiabetic subjects. Furthermore, patients with type 1 diabetes were associated with a higher risk of fracture than patients with type 2 diabetes for all measurement sites. INTRODUCTION Diabetes mellitus is associated with increased fracture risk. Although the pathophysiologic effect on bone metabolism differs according to the type of diabetes, a higher risk of fracture in patients with diabetes than in nondiabetic patients has been consistently demonstrated. Considering the ever-increasing number of patients with diabetes, we aimed to provide updated information on whether this phenomenon remains valid in real-world settings by using large-scale population datasets. METHODS We conducted a retrospective longitudinal study using data from the Korean National Health Insurance Service dataset of preventive health check-ups between January 2009 and December 2016. The hazard ratios were calculated for any fracture, vertebral fracture, and hip fracture and were analyzed according to the presence and type of diabetes. Among 10,585,818 subjects, 6,548,784 were eligible for the analysis (2418 patients with type 1 diabetes mellitus [T1DM] and 506,208 patients with type 2 diabetes mellitus [T2DM]). RESULTS The mean follow-up duration (in years) was 7.0 ± 1.3 for subjects without diabetes, 6.4 ± 2.0 for those with T1DM, and 6.7 ± 1.7 for T2DM. Patients with T1DM had a higher incidence rate for all types of fractures per 1000 person-years. The fully adjusted hazard ratios (HRs) for any fracture, vertebral fracture, and hip fracture were higher in T1DM than in T2DM (1.37 [95% confidence interval (CI): 1.23-1.52] for any fracture, 1.33 [95% CI: 1.09-1.63] for vertebral fracture, and 1.99 [95% CI: 1.56-2.53] for hip fracture). CONCLUSIONS In this large-scale population analysis, diabetes was associated with a higher risk of all types of fractures. Patients with T1DM had a higher risk of fracture than those with T2DM for all measurement sites, and hip fractures had the highest risk. Therefore, fracture prevention training for patients with diabetes is advisable.
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Affiliation(s)
- J Ha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - C Jeong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K-D Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Y Lim
- Division of General Internal Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - M K Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H-S Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K-H Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - M I Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K-H Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Whitehead TR, Lim Y, Holt JW. Global Microscopic Description of Nucleon-Nucleus Scattering with Quantified Uncertainties. Phys Rev Lett 2021; 127:182502. [PMID: 34767381 DOI: 10.1103/physrevlett.127.182502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 08/25/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
We develop for the first time a microscopic global nucleon-nucleus optical potential with quantified uncertainties suitable for analyzing nuclear reaction experiments at next-generation rare-isotope beam facilities. Within the improved local density approximation and without any adjustable parameters, we begin by computing proton-nucleus and neutron-nucleus optical potentials from a set of five nuclear forces from chiral effective field theory for 1800 target nuclei in the mass range 12≤A≤242 for energies between 0 MeV<E≲150 MeV. We then parameterize a global optical potential for each chiral force that depends smoothly on the projectile energy as well as the target nucleus mass number and isospin asymmetry. Uncertainty bands for elastic scattering observables are generated from a full covariance analysis of the parameters entering in the description of our global optical potential and benchmarked against existing experimental data for stable target nuclei. Since our approach is purely microscopic, we anticipate a similar quality of the model for nucleon scattering on unstable isotopes.
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Affiliation(s)
- T R Whitehead
- Cyclotron Institute, Texas A&M University, College Station, Texas 77843, USA
- Department of Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
- Facility for Rare Isotope Beams, Michigan State University, Michigan 48824, USA
| | - Y Lim
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
- Department of Science Education, Ewha Womans University, Seoul 120-750, Korea
| | - J W Holt
- Cyclotron Institute, Texas A&M University, College Station, Texas 77843, USA
- Department of Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
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28
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Kang SJ, Lim Y. Ensemble mapper. Stat (Int Stat Inst) 2021. [DOI: 10.1002/sta4.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Sung Jin Kang
- Department of Statistics Chung‐Ang University Seoul Korea
| | - Yaeji Lim
- Department of Statistics Chung‐Ang University Seoul Korea
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Kim H, Lim Y. Bootstrap aggregated classification for sparse functional data. J Appl Stat 2021; 49:2052-2063. [DOI: 10.1080/02664763.2021.1889997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Hyunsung Kim
- Department of Applied Statistics, Chung-Ang University, Seoul, Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Korea
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Lee J, Kang DH, Park S, Kim JE, Kang E, Kim Y, Lee S, Kim YC, Kim YS, Lim Y, Lee H. The impact of new-onset diabetes after transplantation on survival and major cardiovascular events in Korean kidney transplantation recipients. Korean Journal of Transplantation 2020. [DOI: 10.4285/atw2020.po-1138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Jangwook Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Dong Hyun Kang
- Department of Applied Statistics, Chung-Ang University, Seoul, Korea
| | - Sehoon Park
- Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Ji Eun Kim
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Eunjeong Kang
- Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Yaerim Kim
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Sua Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yon Su Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Korea
| | - Hajeong Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
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Abstract
The role of histogram based on ultrasound (US) images for thyroid nodules found in fluorine-18 fluorodeoxyglucose (18F-FDG) Positron Emission Tomography/Computed Tomography (PET-CT) is unknown. We aimed to assess whether histogram analysis using gray scale US could differentiate thyroid nodules detected by PET-CT.In this study, 71 thyroid nodules ≥1 cm were identified in 71 patients by conducting 18F-FDG PET-CT, from January 2010 to June 2013. Subsequently, either grayscale US-guided fine needle aspirations or core needle biopsies were performed on each patient. Each grayscale US feature was categorized according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS). Histogram parameters (skewness, kurtosis, intensity, uniformity, and entropy) were extracted from the grayscale US images followed by statistical analysis using the Chi-Squared or Mann-Whitney U tests.The 71 nodules comprised 30 (42.3%) benign nodules, 30 (42.3%) primary thyroid malignancies, and 11 (15.4%) metastatic lesions. Tumor size, US findings, and histogram parameters were significantly different between the benign and malignant thyroid nodules (P = .011, P = .000, and P < .02, respectively). A comparison showed that parallel orientation and an absence of calcifications were found more frequently in metastatic thyroid nodules than in primary thyroid malignancies (P = .04, P < .000, respectively). However, histogram parameters and K-TIRADS were not significantly different between primary thyroid malignancies and metastatic lesions.There is a limit to replacing cytopathological confirmation with texture analysis for the differentiation of thyroid nodules detected by PET-CT. Therefore, cytopathological confirmation of nodules appearing malignant on US images cannot be avoided for an ultimate diagnosis of metastasis.
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Affiliation(s)
- Ko Woon Park
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Jung Hee Shin
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Soo Yeon Hahn
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Jae-Hun Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, 221, Heukseok-dong, Dongjak-gu
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
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Choi Y, Sung K, Dong K, Kim H, Lee Y, Lim Y. PO-1309: Dosimetric Impact of Respiratory Motion in IMRT for breast cancer: 3D-Printed Dynamic Phantom Study. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01327-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hornick N, Wang A, Lim Y, Gehlhausen J, Siegel J, Wang J, Foss F, Lim I, Zubek A, Milstone L, Galan A, King B, Damsky W. Development or worsening of sarcoidosis associated with IL-17 blockade for psoriasis. J Eur Acad Dermatol Venereol 2020; 34:e583-e585. [PMID: 32277505 DOI: 10.1111/jdv.16451] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- N Hornick
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - A Wang
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Y Lim
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - J Gehlhausen
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - J Siegel
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - J Wang
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - F Foss
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA.,Department of Medicine, Section of Hematology, Yale School of Medicine, New Haven, CT, USA
| | - I Lim
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - A Zubek
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - L Milstone
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - A Galan
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA.,Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - B King
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - W Damsky
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
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Abstract
This paper presents a new model-based generalized functional clustering method for discrete longitudinal data, such as multivariate binomial and Poisson distributed data. For this purpose, we propose a multivariate functional principal component analysis (MFPCA)-based clustering procedure for a latent multivariate Gaussian process instead of the original functional data directly. The main contribution of this study is two-fold: modeling of discrete longitudinal data with the latent multivariate Gaussian process and developing of a clustering algorithm based on MFPCA coupled with the latent multivariate Gaussian process. Numerical experiments, including real data analysis and a simulation study, demonstrate the promising empirical properties of the proposed approach.
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Affiliation(s)
- Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
| | | | - Hee-Seok Oh
- Department of Statistics, Seoul National University, Seoul, Republic of Korea
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35
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Wang A, Hornick N, Lim Y, Gehlhausen J, Siegel J, Wang J, Foss F, Lim I, Zubek A, Milstone L, Galan A, King B, Damsky W. Interleukin-17 blockade downregulates NOD2 in skin and may promote paradoxical sarcoidosis. J Eur Acad Dermatol Venereol 2020; 34:e497-e499. [PMID: 32249470 DOI: 10.1111/jdv.16416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 03/24/2020] [Indexed: 11/30/2022]
Affiliation(s)
- A Wang
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - N Hornick
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Y Lim
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - J Gehlhausen
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - J Siegel
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - J Wang
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - F Foss
- Department of Medicine, Section of Hematology, Yale School of Medicine, New Haven, CT, USA
| | - I Lim
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - A Zubek
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - L Milstone
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - A Galan
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA.,Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - B King
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - W Damsky
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
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Jang JY, Oh HS, Lim Y, Cheung YK. Ensemble clustering for step data via binning. Biometrics 2020; 77:293-304. [PMID: 32150282 DOI: 10.1111/biom.13258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 11/29/2022]
Abstract
This paper considers the clustering problem of physical step count data recorded on wearable devices. Clustering step data give an insight into an individual's activity status and further provide the groundwork for health-related policies. However, classical methods, such as K-means clustering and hierarchical clustering, are not suitable for step count data that are typically high-dimensional and zero-inflated. This paper presents a new clustering method for step data based on a novel combination of ensemble clustering and binning. We first construct multiple sets of binned data by changing the size and starting position of the bin, and then merge the clustering results from the binned data using a voting method. The advantage of binning, as a critical component, is that it substantially reduces the dimension of the original data while preserving the essential characteristics of the data. As a result, combining clustering results from multiple binned data can provide an improved clustering result that reflects both local and global structures of the data. Simulation studies and real data analysis were carried out to evaluate the empirical performance of the proposed method and demonstrate its general utility.
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Affiliation(s)
- Ja-Yoon Jang
- Department of Statistics, Stanford University, Stanford, California
| | - Hee-Seok Oh
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Korea
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Hahn SY, Shin JH, Oh YL, Park KW, Lim Y. Comparison Between Fine Needle Aspiration and Core Needle Biopsy for the Diagnosis of Thyroid Nodules: Effective Indications According to US Findings. Sci Rep 2020; 10:4969. [PMID: 32188891 PMCID: PMC7080804 DOI: 10.1038/s41598-020-60872-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 02/13/2020] [Indexed: 01/25/2023] Open
Abstract
Thyroid nodules are initially handled by fine needle aspiration (FNA). However, the stance of thyroid core needle biopsy (CNB) still is a challenge. This study aimed to compare the diagnostic performances and conclusive rates of FNA and CNB for the diagnosis of thyroid nodules and to define effective indications of CNB. This retrospective study enrolled 1,060 consecutive thyroid nodules in 1,037 patients who underwent FNA from January 2008 to May 2008, and 462 consecutive nodules in 453 patients who underwent CNB from January 2014 to December 2015 at our institution. Ultrasound (US) features were classified according to the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) and Korean TIRADS (K-TIRADS). We compared diagnostic performances and conclusive rates between FNA and CNB groups. Propensity score matching was conducted to match FNA patients with CNB patients. After matching, the diagnostic performances for selecting surgical candidates and predicting malignancy were comparable between the two biopsy groups. Based on US findings, conclusive results were obtained significantly more in CNB than in FNA when thyroid nodules were classified as ACR TI-RADS or K-TIRADS category 4 and measured larger than 2 cm. Diagnostic performances between FNA and CNB were comparable. Superiority of CNB to FNA was found for thyroid nodules larger than 2 cm and classified as ACR TI-RADS or K-TIRADS category 4.
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Affiliation(s)
- Soo Yeon Hahn
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jung Hee Shin
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
| | - Young Lyun Oh
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Ko Woon Park
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, 84, Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea
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Yang SY, Shin JH, Hahn SY, Lim Y, Hwang SY, Kim TH, Kim JS. Comparison of ultrasonography and CT for preoperative nodal assessment of patients with papillary thyroid cancer: diagnostic performance according to primary tumor size. Acta Radiol 2020; 61:21-27. [PMID: 31084186 DOI: 10.1177/0284185119847677] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Indications for computed tomography (CT) in preoperative patients with thyroid cancer are still controversial. Purpose To determine the value of CT and ultrasonography (US) in preoperative lymph node assessment of patients with papillary thyroid carcinoma (PTC) according to primary tumor size. Material and Methods A total 453 patients with surgically proven PTC who underwent US and CT for preoperative evaluation in 2010 at our tertiary referral center were included. The diagnostic sensitivity, specificity, and accuracy of US, CT, and the combination of US and CT (US/CT) in the preoperative nodal assessment were compared. We performed subgroup analysis to compare the findings according to primary tumor size. Results In overall tumors, adding CT to US had greater sensitivity, lower specificity, and greater accuracy in predicting central lymph node metastasis (LNM) but lower accuracy in prediction of lateral LNM. In smaller cancers (≤1 cm), US alone had greater specificity and accuracy than CT alone or US/CT in predicting lateral LNM. In larger cancers (>1 cm), CT had greater sensitivity and accuracy than US in predicting central LNM, while US had greater specificity and accuracy than CT in predicting lateral LNM. There were no patients with smaller tumors who showed retropharyngeal and superior mediastinal LNM diagnosed by CT alone. Conclusion CT is superior to US for detecting central LNM in preoperative patients with PTCs > 1 cm. However, there are no benefits to adding CT to US to predict lateral LNM in small cancers (≤1 cm).
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Affiliation(s)
- So Yeon Yang
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Hee Shin
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Soo Yeon Hahn
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
| | - Seok Young Hwang
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jee Soo Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Affiliation(s)
- Junhyeon Kwon
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Hee-Seok Oh
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Korea
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Kim Y, Kim D, Lee K, Lim Y, Nam D. Preclinical in vivo screening to predict responder patients depend on EGFR status. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz268.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lee E, Lee J, Hur M, Park HY, Yum H, Nam H, Oh MY, Choi H, Kim J, Cho B, Lim Y, Won J. MG1124, a novel CEACAM1-targeted monoclonal antibody, has therapeutic potential as a combination partner of PD-1 inhibitors in NSCLC patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lim Y. A GEE approach to estimating accuracy and its confidence intervals for correlated data. Pharm Stat 2019; 19:59-70. [PMID: 31448536 DOI: 10.1002/pst.1970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 11/11/2022]
Abstract
In this paper, we provide a method for constructing confidence interval for accuracy in correlated observations, where one sample of patients is being rated by two or more diagnostic tests. Confidence intervals for other measures of diagnostic tests, such as sensitivity, specificity, positive predictive value, and negative predictive value, have already been developed for clustered or correlated observations using the generalized estimating equations (GEE) method. Here, we use the GEE and delta-method to construct confidence intervals for accuracy, the proportion of patients who are correctly classified. Simulation results verify that the estimated confidence intervals exhibit consistent/appropriate coverage rates.
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Affiliation(s)
- Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
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Nam KJ, Park H, Ko ES, Lim Y, Cho HH, Lee JE. Radiomics signature on 3T dynamic contrast-enhanced magnetic resonance imaging for estrogen receptor-positive invasive breast cancers: Preliminary results for correlation with Oncotype DX recurrence scores. Medicine (Baltimore) 2019; 98:e15871. [PMID: 31169691 PMCID: PMC6571434 DOI: 10.1097/md.0000000000015871] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
To evaluate the ability of a radiomics signature based on 3T dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) to distinguish between low and non-low Oncotype DX (OD) risk groups in estrogen receptor (ER)-positive invasive breast cancers.Between May 2011 and March 2016, 67 women with ER-positive invasive breast cancer who performed preoperative 3T MRI and OD assay were included. We divided the patients into low (OD recurrence score [RS] <18) and non-low risk (RS ≥18) groups. Extracted radiomics features included 8 morphological, 76 histogram-based, and 72 higher-order texture features. A radiomics signature (Rad-score) was generated using the least absolute shrinkage and selection operator (LASSO). Univariate and multivariate logistic regression analyses were performed to investigate the association between clinicopathologic factors, MRI findings, and the Rad-score with OD risk groups, and the areas under the receiver operating characteristic curves (AUC) were used to assess classification performance of the Rad-score.The Rad-score was constructed for each tumor by extracting 10 (6.3%) from 158 radiomics features. A higher Rad-score (odds ratio [OR], 65.209; P <.001), Ki-67 expression (OR, 17.462; P = .007), and high p53 (OR = 8.449; P = .077) were associated with non-low OD risk. The Rad-score classified low and non-low OD risk with an AUC of 0.759.The Rad-score showed the potential for discrimination between low and non-low OD risk groups in patients with ER-positive invasive breast cancers.
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Affiliation(s)
- Kyung Jin Nam
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam-do
| | - Hyunjin Park
- School of Electronic and Electrical Engineering
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Sungkyunkwan University, Jangan-gu, Suwon
| | - Eun Sook Ko
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Dongjak-gu, Seoul
| | - Hwan-Ho Cho
- Department of Electronic and Computer Engineering, Sungkyunkwan University, Jangan-gu, Suwon
| | - Jeong Eon Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea
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Kim I, Park J, Lee J, Kim D, Lim Y. OC-0151 Radiation and PI3K-αδ inhibitor enhanced anti-tumor effect of PD-1 blockade in syngeneic tumor model. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30571-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kim H, Shin JH, Hahn SY, Oh YL, Kim SW, Park KW, Lim Y. Prediction of follicular thyroid carcinoma associated with distant metastasis in the preoperative and postoperative model. Head Neck 2019; 41:2507-2513. [PMID: 30891875 DOI: 10.1002/hed.25721] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 01/21/2019] [Accepted: 02/07/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Only clinicopathological findings are reported for predicting follicular thyroid carcinoma (FTC) associated with distant metastasis, and preoperative ultrasound (US) findings are unknown. METHODS Associations between distant metastases of FTC and predicting factors were evaluated by using logistic regression analysis in the preoperative and postoperative models. RESULTS Distant metastasis was present in 37 (11.5%) of the 321 patients with FTC. In the preoperative model, independent predictors of distant metastasis were age, marked hypoechogenicity, nodule-in-nodule appearance, and rim calcification on US. Postoperative predictors were marked hypoechogenicity, rim calcification, and widely invasive histology. Sensitivities, specificities, and the area under the curves for predicting distant metastasis were 86.5%, 80.3%, and 0.889 on preoperative status and 86.5%, 78.5%, and 0.908 on postoperative status. Although not statistically significant, all four patients with gross extrathyroidal extension had metastasis. CONCLUSION Age, ultrasound features, and widely invasive histology allow preoperative and postoperative prediction of FTC associated with distant metastasis.
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Affiliation(s)
- Hankyul Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Hee Shin
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Soo Yeon Hahn
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Lyun Oh
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ko Woon Park
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yaeji Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
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Lim Y, Goel S, Brimacombe JR. The ProSeal™ Laryngeal Mask Airway is an Effective Alternative to Laryngoscope-Guided Tracheal Intubation for Gynaecological Laparoscopy. Anaesth Intensive Care 2019; 35:52-6. [PMID: 17323666 DOI: 10.1177/0310057x0703500106] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We tested the hypothesis that the ProSeal™ laryngeal mask airway is superior to laryngoscope-guided tracheal intubation for gynaecological laparoscopy. One-hundred and eighty consecutive patients (ASA grade 1-2, aged 18-80y) were divided into two equal-sized groups for airway management with the ProSeal™ laryngeal mask airway or tracheal tube. Induction was with fentanyl/propofol, maintenance with sevoflurane and muscle relaxation with atracurium. The following primary variables were tested: time to achieve an effective airway, ventilatory capability, peak airway pressure before and after pneumoperitoneum, duration of surgery and pneumoperitoneum and haemodynamic responses. Data about gastric size, airway trauma and sore throat were collected. The number of attempts for successful insertion were similar, but effective airway time was shorter for the ProSeal™ laryngeal mask airway (20±2s vs 37±3s, P<0.001). All devices were successfully inserted within three attempts. There was no episode of failed ventilation or hypoxia. The haemodynamic stress responses to insertion and removal were greater for the tracheal tube than the ProSeal™ laryngeal mask airway. The duration of surgery, duration of pneumoperitoneum and intraabdominal pressures were similar. Gastric size was similar at the start and end of surgery. There were no differences in the frequency of complications or sore throat. We conclude that the ProSeal™ laryngeal mask airway is a similarly effective airway device to conventional laryngoscope-guided tracheal intubation for gynaecological laparoscopy, but is more rapidly inserted and associated with an attenuated haemodynamic response to insertion and removal.
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Affiliation(s)
- Y Lim
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore
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47
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Sng BL, Sia ATH, Lim Y, Woo D, Ocampo C. Comparison of Computer-integrated Patient-controlled Epidural Analgesia and Patient-controlled Epidural Analgesia with a Basal Infusion for Labour and Delivery. Anaesth Intensive Care 2019; 37:46-53. [DOI: 10.1177/0310057x0903700119] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- B. L. Sng
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore
| | - A. T. H. Sia
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore
| | - Y. Lim
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore
| | - D. Woo
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore
| | - C. Ocampo
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore
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Ng SY, Teoh WHL, Lim Y, Cheong VG. Comparison of the AMBU® Laryngeal Mask and the LMA Classic in Anaesthetised, Spontaneously Breathing Patients. Anaesth Intensive Care 2019; 35:57-61. [PMID: 17323667 DOI: 10.1177/0310057x0703500107] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There may be a role for single-use laryngeal mask airways with concerns about inability to adequately sterilise laryngeal mask airways to eradicate prion proteins. A single-blinded prospective randomised controlled trial was conducted to compare the clinical performance of the single-use AMBU®LMA with the reuseable LMA Classic. There was no difference in time to insertion, successful insertion at first attempt, oropharyngeal leak pressure, haemodynamic response to insertion or complications of placement. The AMBU®LMA was easier to insert. There was a suggestion of reduced postoperative sore throat and pharyngeal trauma for the AMBU® LMA group. The AMBU®LMA is a viable alternative to the LMA Classic for airway management in spontaneously breathing patients.
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Affiliation(s)
- S Y Ng
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore
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Lim Y, Yeo SW. A Comparison of the GlideScope® with the Macintosh Laryngoscope for Tracheal Intubation in Patients with Simulated Difficult Airway. Anaesth Intensive Care 2019; 33:243-7. [PMID: 15960409 DOI: 10.1177/0310057x0503300215] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We compared the use of the GlideScope® and the conventional Macintosh laryngoscope in a simulated difficult airway. The primary hypothesis was that time to intubation would be shorter using the GlideScope® than using the Macintosh laryngoscope. After obtaining approval from the ethics committee and written informed consent, we recruited 60 ASA 1 and 2 patients to our randomized controlled trial. Group G (n=30) had tracheal intubation performed using the GlideScope® and Group M (n=30) were intubated using a Macintosh laryngoscope. We simulated a difficult airway in each patient by having an experienced assistant provide in-line manual stabilization of the head and neck. We recorded the best laryngeal view; difficulty of the tracheal intubation; time taken for successful tracheal intubation; manoeuvre needed to aid tracheal intubation and complications associated with the tracheal intubation. The median Cormack and Lehane grade was significantly better in Group G than Group M. Group G had a significantly shorter intubation time than group M (mean 41.8s±SD 20.2 vs mean 56.2s±26.6, P<0.05). The GlideScope® improved the laryngeal view and decreased time for tracheal intubation time when compared with the Macintosh laryngoscope in patients with simulated difficult airway. The GlideScope® may be a good alternative for managing the difficult airway but clinical trials evaluating its use on patients with an actual difficult airway are needed.
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Affiliation(s)
- Y Lim
- Department of Anaesthesia, KK Women's and Children's Hospital, Singapore
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50
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Kim K, Kang S, Kim W, Park C, Lee D, Cho H, Kang W, Park S, Kim G, Lim H, Lee H, Park J, Jeon D, Lim Y, Woo T, Oh J. A new software scheme for scatter correction based on a simple radiographic scattering model. Med Biol Eng Comput 2018; 57:489-503. [PMID: 30232700 DOI: 10.1007/s11517-018-1893-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 09/03/2018] [Indexed: 11/29/2022]
Abstract
In common radiography, image contrast is often limited due mainly to scattered x-rays and noise, decreasing the quantitative usefulness of x-ray images. Several scatter reduction methods based on software correction schemes have been extensively investigated in an attempt to overcome these difficulties, most of which are based on measurement, mathematical-physical modeling, or a combination of both. However, those methods require special equipment, system geometry, and extra manual work to measure scatter characteristics. In this study, we investigated a new software scheme for scatter correction based on a simple radiographic scattering model where the intensity of the scattered x-rays was directly estimated from a single x-ray image using a weighted l1-norm contextual regularization framework. We implemented the proposed algorithm and performed a systematic simulation and experiment to demonstrate its viability. We also conducted some clinical image studies using patient's image data of breast and L-spine to verify the clinical effectiveness of the proposed scheme. Our results indicate that the degradation of image characteristics by scattered x-rays and noise was effectively recovered by using the proposed software scheme, thus improving radiographic visibility considerably. Graphical abstract The schematic illustrations of scatter suppression methods by using a an antiscatter grid and b a scatter estimation algorithm.
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Affiliation(s)
- K Kim
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, South Korea
| | - S Kang
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, South Korea
| | - W Kim
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, South Korea
| | - C Park
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, South Korea
| | - D Lee
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, South Korea
| | - H Cho
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, South Korea.
| | - W Kang
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, South Korea
| | - S Park
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, South Korea
| | - G Kim
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, South Korea
| | - H Lim
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, South Korea
| | - H Lee
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, South Korea
| | - J Park
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, South Korea
| | - D Jeon
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, South Korea
| | - Y Lim
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, South Korea
| | - T Woo
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, South Korea
| | - J Oh
- Division of Convergence Technology, National Cancer Center, Goyang, 10408, South Korea
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