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Yoon GW, Joo S. Classification feasibility test on multi-lead electrocardiography signals generated from single-lead electrocardiography signals. Sci Rep 2024; 14:1888. [PMID: 38253719 PMCID: PMC10803292 DOI: 10.1038/s41598-024-52216-y] [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: 09/06/2023] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
Nowadays, Electrocardiogram (ECG) signals can be measured using wearable devices, such as smart watches. Most wearable devices provide only a few details; however, they have the advantage of recording data in real time. In this study, 12-lead ECG signals were generated from lead I and their feasibility was tested to obtain more details. The 12-lead ECG signals were generated using a U-net-based generative adversarial network (GAN) that was trained on ECG data obtained from the Asan Medical Center. Subsequently, unseen PTB-XL PhysioNet data were used to produce real 12-lead ECG signals for classification. The generated and real 12-lead ECG signals were then compared using a ResNet classification model; and the normal, atrial fibrillation (A-fib), left bundle branch block (LBBB), right bundle branch block (RBBB), left ventricular hypertrophy (LVH), and right ventricular hypertrophy (RVH) were classified. The mean precision, recall, and f1-score for the real 12-lead ECG signals are 0.70, 0.72, and 0.70, and that for the generated 12-lead ECG signals are 0.82, 0.80, and 0.81, respectively. In our study, according to the result generated 12-lead ECG signals performed better than real 12-lead ECG.
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Affiliation(s)
- Gi-Won Yoon
- Department of Biomedical Engineering, Asan Medical Center, Asan Medical Institute of Convergence Science and Technology, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Segyeong Joo
- Department of Biomedical Engineering, Asan Medical Center, Asan Medical Institute of Convergence Science and Technology, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Choi S, Choi K, Yun HK, Kim SH, Choi HH, Park YS, Joo S. Diagnosis of atrial fibrillation based on AI-detected anomalies of ECG segments. Heliyon 2024; 10:e23597. [PMID: 38187293 PMCID: PMC10770559 DOI: 10.1016/j.heliyon.2023.e23597] [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] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
Early detection of atrial fibrillation (AF) is crucial for its effective management and prevention. Various methods for detecting AF using deep learning (DL) based on supervised learning with a large labeled dataset have a remarkable performance. However, supervised learning has several problems, as it is time-consuming for labeling and has a data dependency problem. Moreover, most of the DL methods do not provide any clinical evidence to physicians regarding the analysis of electrocardiography (ECG) for classification or detection of AF. To address these limitations, in this study, we proposed a novel AF diagnosis system using unsupervised learning for anomaly detection with three segments, PreQ, QRS, and PostS, based on the normal ECG. Two independent datasets, PTB-XL and China, were used in three experiments. We used a long short-term memory (LSTM)-based autoencoder to train the segments of the normal ECG. Based on the threshold of anomaly scores using mean squared error (MSE), it distinguished between normal and AF segments. In Experiment A, the best score was that of PreQ, which detected AF with an AUROC score of 0.96. In Experiment B and C for cross validation of each dataset, the best scores were also of PreQ, with AUROC scores of 0.9 and 0.95, respectively. To verify the significance of the anomaly score in distinguishing between AF and normal segments, we utilized an XG-Boosted model after generating anomaly scores in the three segments. The XG-Boosted model achieved an AUROC score of 0.98 and an F1 score of 0.94. AF detection using DL has been controversial among many physicians. However, our study differentiates itself from previous studies in that we can demonstrate evidence that distinguishes AF from normal segments based on the anomaly score.
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Affiliation(s)
- Sanghoon Choi
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, Seoul, Republic of Korea
| | - Kyungmin Choi
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, Seoul, Republic of Korea
| | - Hong Kyun Yun
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, Seoul, Republic of Korea
| | - Su Hyeon Kim
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, Seoul, Republic of Korea
| | - Hyeon-Hwa Choi
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, Seoul, Republic of Korea
| | - Yi-Seul Park
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, Seoul, Republic of Korea
| | - Segyeong Joo
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, Seoul, Republic of Korea
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Kim SH, Seo HC, Choi S, Joo S. Tele-monitoring system for intensive care ventilators in isolation rooms. Sci Rep 2023; 13:15207. [PMID: 37709819 PMCID: PMC10502084 DOI: 10.1038/s41598-023-42229-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/07/2023] [Indexed: 09/16/2023] Open
Abstract
The COVID-19 pandemic and discovery of new mutant strains have a devastating impact worldwide. Patients with severe COVID-19 require various equipment, such as ventilators, infusion pumps, and patient monitors, and a dedicated medical team to operate and monitor the equipment in isolated intensive care units (ICUs). Medical staff must wear personal protective equipment to reduce the risk of infection. This study proposes a tele-monitoring system for isolation ICUs to assist in the monitoring of COVID-19 patients. The tele-monitoring system consists of three parts: medical-device panel image processing, transmission, and tele-monitoring. This system can monitor the ventilator screen with obstacles, receive and store data, and provide real-time monitoring and data analysis. The proposed tele-monitoring system is compared with previous studies, and the image combination algorithm for reconstruction is evaluated using structural similarity index (SSIM) and peak signal-to-noise ratio (PSNR). The system achieves an SSIM score of 0.948 in the left side and a PSNR of 23.414 dB in the right side with no obstacles. It also reduces blind spots, with an SSIM score of 0.901 and a PSNR score of 18.13 dB. The proposed tele-monitoring system is compatible with both wired and wireless communication, making it accessible in various situations. It uses camera and performs live data monitoring, and the two monitoring systems complement each other. The system also includes a comprehensive database and an analysis tool, allowing medical staff to collect and analyze data on ventilator use, providing them a quick, at-a-glance view of the patient's condition. With the implementation of this system, patient outcomes may be improved and the burden on medical professionals may be reduced during the COVID-19 pandemic-like situations.
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Affiliation(s)
- Su Hyeon Kim
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyo-Chang Seo
- Digital Therapeutics Research Center, Smart Healthcare Research Institute, Samsung Medical Center, Seoul, South Korea
| | - Sanghoon Choi
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Segyeong Joo
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Cha B, Choi K, Jung KW, Kim HJ, Kim GH, Na HK, Ahn JY, Lee JH, Choi KD, Kim DH, Song HJ, Lee GH, Jung HY, Joo S. High-resolution impedance manometry for comparing bolus transit between patients with non-obstructive dysphagia and asymptomatic controls. Neurogastroenterol Motil 2023; 35:e14452. [PMID: 35998271 DOI: 10.1111/nmo.14452] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 07/07/2022] [Accepted: 08/04/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Currently, there are no high-resolution impedance manometry (HRIM)-based diagnostic criteria for non-obstructive dysphagia (NOD). New impedance parameters, such as the esophageal impedance integral (EII) and volume of inverted impedance (VII) ratios, have shown strong correlations with bolus transit. This study compared the EII and VII ratios as diagnostic tools for NOD. METHODS We analyzed 36 participants (12 patients with achalasia, 12 patients with NOD [7 with normal motility and 5 with ineffective esophageal motility], and 12 asymptomatic controls) who underwent HRIM with a maximum of 5 swallows per participant. The EII and VII ratios were calculated as Z2 (post-swallow)/Z1 (pre-swallow). Bolus transit was retrospectively evaluated using transluminal impedance analysis. KEY RESULTS Both EII and VII ratios could effectively distinguish the achalasia group from the non-achalasia groups (area under the receiver operating characteristic curve [AUROC]: 0.83 for VII vs. 0.80 for EII; p = 0.73). However, the VII ratio was significantly better in discriminating asymptomatic controls from patients with dysphagia (NOD + achalasia) (AUROC: 0.81 vs. 0.68; p = 0.01). Moreover, the VII ratio was better in discriminating asymptomatic controls from patients with NOD (AUROC: 0.68 vs. 0.51; p = 0.06). In repeated swallows, the VII ratio was consistently the lowest in controls and the highest in patients with achalasia, whereas the EII ratio did not show a consistent pattern. CONCLUSIONS & INFERENCES The VII ratio was more reliable than the EII ratio for describing bolus transit and distinguishing patients with NOD from asymptomatic controls, even during repeated measures of subsequent swallows.
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Affiliation(s)
- Boram Cha
- Department of Internal Medicine, Digestive Disease Center, Inha University School of Medicine, Incheon, South Korea
| | - Kyungmin Choi
- Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kee Wook Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hwa Jung Kim
- Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Ga Hee Kim
- Department of Internal Medicine, Chung-Ang University, College of Medicine, Seoul, South Korea
| | - Hee Kyong Na
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ji Yong Ahn
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jeong Hoon Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kee Don Choi
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Do Hoon Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ho June Song
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Gin Hyug Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hwoon-Yong Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Segyeong Joo
- Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Cho MS, Seo HC, Yoon GW, Lee JS, Joo S, Nam GB. Temporal change in repolarization parameters after surgical correction of valvular heart diseases. J Electrocardiol 2023; 79:46-52. [PMID: 36934492 DOI: 10.1016/j.jelectrocard.2023.02.004] [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: 10/06/2022] [Revised: 02/06/2023] [Accepted: 02/12/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Ventricular tachyarrhythmia is a potentially fatal outcome of cardiac surgery. Abrupt changes in the hemodynamics after surgical correction of valvular heart disease (VHD) can lead to alterations in ventricular repolarization. We compared the difference between temporal changes in repolarization parameters after correction of left-sided VHD. METHODS We retrospectively analyzed the electrograms of patients who underwent surgical correction of isolated VHD between 2006 and 2015 at Asan Medical Center, including mitral stenosis (MS), mitral regurgitation (MR), aortic stenosis (AS), and aortic regurgitation (AR). Ventricular repolarization parameters were measured at pre-specified time intervals after index surgery using a custom-made ECG analysis program. We compared repolarization parameters, including QT and corrected QT intervals, T peak-to-end interval, and corrected T peak-to-end interval. RESULTS Analysis of 8265 ECGs from 2110 patients (266 MS, 1059 MR, 421 AS, and 364 AR) was performed. Patients with AS were characterized by older age and more comorbidities than other VHDs. The corrected QT interval showed a peak value immediately after surgery and decreased thereafter in the AS groups. However, a gradual increase over 1 month after surgery in AR, MS, and MR groups was observed. The corrected T peak-to-end interval increased in the MS and MR groups and was unchanged in the AS and AR groups. CONCLUSIONS The repolarization parameters of surgery changed dynamically after left-sided valvular surgery. Understanding differential temporal change of repolarization parameters according to the type of VHD would help clinicians avoid fatal arrhythmias related to the repolarization changes.
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Affiliation(s)
- Min Soo Cho
- Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyo-Chang Seo
- Digital Therapeutics Research Center, Smart Healthcare Research Institute, Samsung Medical Center, Seoul, South Korea
| | - Gi-Won Yoon
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji-Sung Lee
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Segyeong Joo
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Gi-Byoung Nam
- Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Seo M, Yoon J, Jung KW, Joo S, Lee J, Choi KM, Lee HJ, Yoon IJ, Noh W, Seo SY, Kim DY, Hwang SW, Park SH, Yang DH, Ye BD, Byeon JS, Yang SK, Myung SJ. Predicting Responsiveness to Biofeedback Therapy Using High-resolution Anorectal Manometry With Integrated Pressurized Volume. J Neurogastroenterol Motil 2022; 28:608-617. [PMID: 36250368 DOI: 10.5056/jnm21137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/25/2021] [Accepted: 03/13/2022] [Indexed: 11/20/2022] Open
Abstract
Background/Aims Biofeedback therapy is widely used to treat patients with chronic constipation, especially those with dyssynergic defecation. Yet, the utility of high-resolution manometry with novel parameters in the prediction of biofeedback response has not been reported. Thus, we constructed a model for predicting biofeedback therapy responders by applying the concept of integrated pressurized volume in patients undergoing high-resolution anorectal manometry. Methods Seventy-one female patients (age: 48-68 years) with dyssynergic defecation who underwent initial high-resolution anorectal manometry and subsequent biofeedback therapy were enrolled. The manometry profiles were used to calculate the 3-dimensional integrated pressurized volumes by multiplying the distance, time, and amplitude during simulated evacuation. Partial least squares regression was performed to generate a predictive model for responders to biofeedback therapy by using the integrated pressurized volume parameters. Results Fifty-five (77.5%) patients responded to biofeedback therapy. The responders and non-responders did not show significant differences in the conventional manometric parameters. The partial least squares regression model used a linear combination of eight integrated pressurized volume parameters and generated an area under the curve of 0.84 (95% confidence interval: 0.76-0.95, P < 0.01), with 85.5% sensitivity and 62.1% specificity. Conclusions Integrated pressurized volume parameters were better than conventional parameters in predicting the responsiveness to biofeedback therapy, and the combination of these parameters and partial least squares regression was particularly promising. Integrated pressurized volume parameters can more effectively explain the physiology of the anorectal canal compared with conventional parameters.
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Affiliation(s)
- Myeongsook Seo
- Department of Gastroenterology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Gangwon-do, Korea
| | - Jiyoung Yoon
- Department of Gastroenterology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeoungbu, Gyeonggi-do, Korea
| | - Kee Wook Jung
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Segyeong Joo
- Departments of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jungbok Lee
- Departments of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung Min Choi
- Departments of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyo Jeong Lee
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - In Ja Yoon
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woojoo Noh
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - So Young Seo
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Do Yeon Kim
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Wook Hwang
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Hyoung Park
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong-Hoon Yang
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Byong Duk Ye
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong-Sik Byeon
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Suk-Kyun Yang
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Jae Myung
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Hsing LC, Choi K, Jung KW, Joo S, Kim N, Kim GH, Na HK, Ahn JY, Lee J, Kim DH, Choi KD, Song HJ, Lee GH, Jung HY. The Predictive Value of Intraoperative Esophageal Functional Luminal Imaging Probe Panometry in Patients With Achalasia Undergoing Peroral Endoscopic Myotomy: A Single-center Experience. J Neurogastroenterol Motil 2022; 28:474-482. [PMID: 35799241 PMCID: PMC9274461 DOI: 10.5056/jnm21186] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 03/05/2022] [Accepted: 04/25/2022] [Indexed: 11/20/2022] Open
Abstract
Background/Aims We evaluated the clinical significance and prognostic power of functional luminal imaging probe (FLIP) panometry in patients with achalasia treated with peroral endoscopic myotomy (POEM), and examined the clinical parameters associated with symptomatic improvement and the presence of contractility (POC) following POEM. Methods We reviewed the electronic medical records of patients with achalasia treated with FLIP panometry and POEM at a tertiary teaching hospital in Seoul, Republic of Korea. Follow-up examination was composed of esophageal manometry and questionnaires on symptoms. We analyzed the FLIP data by interpolating using the cubic spline method in MATLAB. Results We retrospectively analyzed 33 men and 35 women (mean age 52 ± 17 years), of whom 14, 39, and 15 patients were diagnosed with achalasia types I, II, and III, respectively. The FLIP panometry diagnoses were reduced esophagogastric junction opening (REO) with a retrograde contractile response (n = 43); REO with an absent contractile response (n = 5); REO with a normal contractile response (n = 11); and a retrograde contractile response (n = 9). Overall, the patients showed improvements in Eckardt scores following POEM from 6.48 ± 2.20 to 1.16 ± 1.15 (P < 0.01). Post-POEM symptomatic improvement was not significantly associated with any of the clinical parameters, including panometry diagnosis. Conversely, post-POEM POC was significantly associated with the presence of repetitive antegrade contractions and achalasia subtypes (both P < 0.01). Conclusion While FLIP panometry was not significantly associated with the clinical course of achalasia, FLIP panometry was associated with POC following POEM and may complement manometry in the functional evaluation of esophageal motility disorders.
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Affiliation(s)
- Li-Chang Hsing
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - KyungMin Choi
- Departments of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kee Wook Jung
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Segyeong Joo
- Departments of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Nayoung Kim
- Departments of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ga Hee Kim
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea (Current address)
| | - Hee Kyong Na
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yong Ahn
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - JeongHoon Lee
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Do Hoon Kim
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kee Don Choi
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ho June Song
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gin Hyug Lee
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hwoon-Yong Jung
- Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Seo HC, Yoon GW, Joo S, Nam GB. Multiple electrocardiogram generator with single-lead electrocardiogram. Comput Methods Programs Biomed 2022; 221:106858. [PMID: 35605516 DOI: 10.1016/j.cmpb.2022.106858] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/18/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Electrocardiogram (ECG) is measured in various ways. The three main ECG measurement methods include resting ECG, Holter monitoring, and treadmill method. In standard ECG measurement methods, multiple electrodes are attached to the limb and chest. Limb and chest leads measure the frontal and sagittal planes of the heart, respectively. In this case, ECG signals are measured briefly up to 10 seconds. To measure ECG signals based on a single lead, wearable devices have been developed that could measure long-term ECG signals daily. ECG signals are vectors in the heart, which is a three-dimensional structure. Therefore, a single-lead measurement lacks detailed information. The objective of this study was to synthesize multiple ECGs from a single-lead ECG using a generative adversarial network (GAN). METHODS We trained our model with two independent datasets and one combined dataset. For experiment 1, the PTB-XL dataset was used as the training set, and the China dataset was used as the test set. For experiment 2, the China dataset was used as the training set, and the PTB-XL was used as the test set. Optimized GAN models were obtained for each experiment and evaluated. RESULTS The Fréchet distance (FD) score and mean squared error (MSE) were used for evaluation. The FD and MSE scores for experiments 1 and 2 were 7.237 and 0.024, and 8.055 and 0.011, respectively. CONCLUSION We proposed a method to overcome the limitations of modern ECG measurement methods. Low FD and MSE scores not only indicate the possibility but also the similarity between synthesized ECG and reference ECG when compared in ECG paper format. This indicates that the proposed method can be applied to wearable devices that measure single-lead ECG.
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Affiliation(s)
- Hyo-Chang Seo
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul, South Korea; Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, Seoul, South Korea
| | - Gi-Won Yoon
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul, South Korea; Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, Seoul, South Korea
| | - Segyeong Joo
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul, South Korea; Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, Seoul, South Korea.
| | - Gi-Byoung Nam
- Heart Institute, University of Ulsan College of Medicine Asan Medical Center, Seoul, South Korea
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Dhaygude K, Suominen T, Krebs R, Joo S, Holmström E, Syrjälä S, Nykänen A, Lemström K. Donor Metabolic Risk Score Predicts Graft-Related Outcome After Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.062] [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] Open
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Joo S, Dhaygude K, Puhka M, Krebs R, Rouvinen E, Suoranta A, Mattila P, Syrjälä S, Nykänen A, Lemström K. Donor Extracellular Vesicle Transcriptomic Profile Predicts the Risk for Acute Rejection After Lung Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.368] [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: 11/28/2022] Open
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Seo SY, Kim SJ, Oh JS, Chung J, Kim SY, Oh SJ, Joo S, Kim JS. Unified Deep Learning-Based Mouse Brain MR Segmentation: Template-Based Individual Brain Positron Emission Tomography Volumes-of-Interest Generation Without Spatial Normalization in Mouse Alzheimer Model. Front Aging Neurosci 2022; 14:807903. [PMID: 35309883 PMCID: PMC8931825 DOI: 10.3389/fnagi.2022.807903] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/17/2022] [Indexed: 02/03/2023] Open
Abstract
Although skull-stripping and brain region segmentation are essential for precise quantitative analysis of positron emission tomography (PET) of mouse brains, deep learning (DL)-based unified solutions, particularly for spatial normalization (SN), have posed a challenging problem in DL-based image processing. In this study, we propose an approach based on DL to resolve these issues. We generated both skull-stripping masks and individual brain-specific volumes-of-interest (VOIs—cortex, hippocampus, striatum, thalamus, and cerebellum) based on inverse spatial normalization (iSN) and deep convolutional neural network (deep CNN) models. We applied the proposed methods to mutated amyloid precursor protein and presenilin-1 mouse model of Alzheimer’s disease. Eighteen mice underwent T2-weighted MRI and 18F FDG PET scans two times, before and after the administration of human immunoglobulin or antibody-based treatments. For training the CNN, manually traced brain masks and iSN-based target VOIs were used as the label. We compared our CNN-based VOIs with conventional (template-based) VOIs in terms of the correlation of standardized uptake value ratio (SUVR) by both methods and two-sample t-tests of SUVR % changes in target VOIs before and after treatment. Our deep CNN-based method successfully generated brain parenchyma mask and target VOIs, which shows no significant difference from conventional VOI methods in SUVR correlation analysis, thus establishing methods of template-based VOI without SN.
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Affiliation(s)
- Seung Yeon Seo
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, South Korea
- Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, South Korea
| | - Soo-Jong Kim
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, South Korea
- Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, South Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Songpa-gu, South Korea
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon-si, South Korea
| | - Jungsu S. Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, South Korea
- *Correspondence: Jungsu S. Oh, ;
| | - Jinwha Chung
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, South Korea
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, South Korea
| | - Seog-Young Kim
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, South Korea
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, South Korea
| | - Seung Jun Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, South Korea
| | - Segyeong Joo
- Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, South Korea
| | - Jae Seung Kim
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, South Korea
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Joo S, Lee J, Kim S, Beom J, Boo K, Choi J, Jeong M. Association of beta-blockers or inhibitors of renin-angiotensin system with clinical outcomes in patients with mid-range left ventricular ejection fraction after acute myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1215] [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: 11/14/2022] Open
Abstract
Abstract
Background
In the era of the initial optimal interventional and medical therapy for acute myocardial infarction (AMI), a number of patients with mid-range left ventricular ejection fraction (EF) (>40%, <50%) becomes increasing.
Purpose
This observational study aimed to investigate the association between oral beta-blockers or inhibitors of renin-angiotensin system (RAS) and 2-year clinical outcomes in patients with mid-range EF after AMI.
Methods
Among 13,624 patients enrolled in the Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH), propensity-score matched patients who survived the initial attack and had mid-range EF were selected according to beta-blocker or RAS inhibitor therapy at discharge.
Results
Beta-blocker therapy at discharge was associated with lower 2-year major adverse cardiac events (MACE) of cardiac death, MI, revascularization or re-hospitalization due to heart failure (8.7 vs. 12.8/100 person-year; hazard ratio [HR] 0.68; 95% confidence interval [CI] 0.50–0.93; P=0.015), and no significant interaction between EF ≤45% and >45% was observed (P for interaction=0.354). This association was mainly driven by lower MI in patients with beta-blockers (1.6 vs. 3.1/100 person-year; HR 0.50; 95% CI 0.26–0.95; P=0.035). Inhibitors of RAS at discharge were not associated with lower 2-year MACE, but with lower re-hospitalization due to heart failure (1.8 vs. 3.5/100 person-year; HR 0.53; 95% CI 0.33–0.86; P=0.010) without significant interaction between EF ≤45% and >45% (P for interaction=0.333).
Conclusions
Beta-blockers or RAS inhibitors at discharge were associated with better 2-year clinical outcomes without significant interaction between ≤45% and >45% in patients with mid-range EF after AMI.</ef<50%)>
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Korea Centers for Disease Control and Prevention. 2-year clinical outcomes
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Affiliation(s)
- S Joo
- Jeju National University Hospital, Cardiology, Jeju, Korea (Republic of)
| | - J Lee
- Jeju National University Hospital, Cardiology, Jeju, Korea (Republic of)
| | - S Kim
- Jeju National University Hospital, Cardiology, Jeju, Korea (Republic of)
| | - J Beom
- Jeju National University Hospital, Cardiology, Jeju, Korea (Republic of)
| | - K Boo
- Jeju National University Hospital, Cardiology, Jeju, Korea (Republic of)
| | - J Choi
- Jeju National University Hospital, Cardiology, Jeju, Korea (Republic of)
| | - M Jeong
- Chonnam National University Hospital, Cardilogy, Gwangju, Korea (Republic of)
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Blakely C, Urisman A, Kerr D, Wu W, Bacaltos B, Rotow J, Gubens M, Jones K, Bivona T, Joo S, Riess J, Aisner D, Doebele R, Patil T, Schenk E, Kratz J, Jablons D. P26.02 A Phase II Trial of Neoadjuvant Osimertinib for Surgically Resectable EGFR-Mutant Non-Small Cell Lung Cancer: Updated Results. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.383] [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: 10/20/2022]
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14
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Seo HC, Lee Y, Joo S. A simple apparatus for safety assessment of magnetically induced torque on active implantable medical devices (AIMDs) under 1.5 T and 3.0 T MRI. MAGMA 2021; 34:767-774. [PMID: 33763763 DOI: 10.1007/s10334-021-00921-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Our goal is to design and validate a simple apparatus for the safety assessments of magnetically induced torques by four active implantable medical devices (AIMDs) in 1.5 T and 3.0 T magnetic resonance imaging (MRI) environments. MATERIALS AND METHODS A simple apparatus was designed to measure the magnetically induced torque. Before testing the apparatus, its effectiveness was first evaluated with a commercially available weights. The torque values of the four AIMDs, namely implantable cardioverter defibrillator (ICD), pacemaker, bone conduction implant, and cochlear implant, under 1.5 T and 3.0 T MRI environments were measured and compared with established international standard. RESULTS The ICD, pacemaker, bone conduction implant, and cochlear implant had average torques of 1.405, 0.255, 9.460, and 5.490 N·cm under 1.5 T MRI and 2.950, 0.668, 14.618, and 11.484 N·cm under 3.0 T MRI, respectively. DISCUSSION The apparatus developed in this study was verified to be feasible for measuring magnetically induced torques, with tests on four types of AIMDs under 1.5 T and 3.0 T MRI environments. Although the designed structure is simple, the apparatus was shown to measure torque values of AIMDs under MRI accurately.
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Affiliation(s)
- Hyo-Chang Seo
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Yongkwan Lee
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Segyeong Joo
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea.
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15
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Seo HC, Oh S, Kim H, Joo S. ECG data dependency for atrial fibrillation detection based on residual networks. Sci Rep 2021; 11:18256. [PMID: 34521892 PMCID: PMC8440762 DOI: 10.1038/s41598-021-97308-1] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/09/2021] [Indexed: 12/05/2022] Open
Abstract
Atrial fibrillation (AF) is an arrhythmia that can cause blood clot and may lead to stroke and heart failure. To detect AF, deep learning-based detection algorithms have recently been developed. However, deep learning models were often trained with limited datasets and were evaluated within the same datasets, which makes their performance generally drops on the external datasets, known as data dependency. For this study, three different databases from PhysioNet were used to investigate the data dependency of deep learning-based AF detection algorithm using the residual neural network (Resnet). Resnet 18, 34, 50 and 152 model were trained with raw electrocardiogram (ECG) signal extracted from independent database. The highest accuracy was about 98–99% which is evaluation results of test dataset from the own database. On the other hand, the lowest accuracy was about 53–92% which was evaluation results of the external dataset extracted from different source. There are data dependency according to the train dataset and the test dataset. However, the data dependency decreased as a large amount of train data.
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Affiliation(s)
- Hyo-Chang Seo
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seok Oh
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyunbin Kim
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Segyeong Joo
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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16
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Adeboyeje G, Sierra M, Bartels A, Field M, Jhamb S, Buikema A, Joo S. 1471P Overall survival by BRCA and ATM mutation status in patients with metastatic pancreatic cancer: Findings from the PRIOR-2 study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Kindler H, Yoo H, McGuinness D, Cui K, Joo S, Locker G, Golan T. P-105 POLO: Patient-centred outcomes with maintenance olaparib in patients with a germline BRCA mutation and metastatic pancreatic cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.160] [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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18
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Joo S, Dhaygude K, Puhka M, Krebs R, Rouvinen E, Suoranta A, Mattila P, Syrjälä S, Lemström K. Brain-Dead Donor-Derived Plasma Extracellular Vesicles May Induce Systemic Inflammation and Microvascular Dysfunction. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.393] [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: 11/29/2022] Open
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19
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Gong EJ, Choi K, Jung KW, Pandolfino JE, Kim DY, Yoon IJ, Seo SY, Koo HS, Na HK, Ahn JY, Lee JH, Choi KD, Kim DH, Song HJ, Lee GH, Jung HY, Myung SJ, Kim N, Joo S. New parameter for quantifying bolus transit with high-resolution impedance manometry: A comparison with simultaneous esophagogram. Neurogastroenterol Motil 2020; 32:e13847. [PMID: 32299145 DOI: 10.1111/nmo.13847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 02/19/2020] [Accepted: 03/18/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Esophageal bolus transit can be assessed using esophagogram or high-resolution impedance manometry (HRIM). The three-dimensional volume of inverted impedance (VII) has been developed to quantify the residual bolus between each swallow through spatiotemporal analysis. However, this novel metric has not been validated against simultaneous esophagogram. METHODS A total of nine healthy volunteers (Seven males, aged 19-45 years) were prospectively evaluated with HRIM and barium esophagogram. In addition, 21 symptomatic patients (12 males, aged 20-85 years) without major motility disorder were also included. The VII was estimated from HRIM data using MATLAB program and was compared with residual bolus volume in the esophagus estimated from simultaneous esophagogram. KEY RESULTS A total of 80 swallows (24 in controls and 56 in patients) were analyzed. Results from the VII method were concordant with the bolus transit pattern estimated from the esophagogram in 91.3% (73/80) of swallows. The correlation between quantitative data from VII and the volume of residual bolus estimated from esophagogram was strong in both groups with a Pearson's correlation coefficient of 0.805 for healthy volunteers and 0.730 for symptomatic patients. The intraclass correlation coefficient of VII between the three swallows within a subject was 0.901 in healthy subjects and 0.705 in patients, indicating a modest reliability of this method. CONCLUSIONS AND INFERENCES The newly developed VII method is a reliable method in assessing residual bolus volume in the esophagus based on comparison with bolus volume estimated from simultaneous esophagogram.
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Affiliation(s)
- Eun Jeong Gong
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Kyungmin Choi
- Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kee Wook Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - John E Pandolfino
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Do Yeon Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - In Ja Yoon
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - So Young Seo
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun Sook Koo
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee Kyong Na
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yong Ahn
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong Hoon Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kee Don Choi
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Do Hoon Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ho June Song
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gin Hyug Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hwoon-Yong Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Jae Myung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Nayoung Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea
| | - Segyeong Joo
- Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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20
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Chirovsky D, Liu Z, Baxi S, Chandwani S, Joo S, Ramakrishnan K. Real World Treatment Patterns and Time On Treatment in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma (R/M HNSCC) Previously Treated with Platinum-Containing Chemotherapy in United States (US). Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.150] [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: 11/24/2022]
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21
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Hammel P, Kindler HL, Reni M, Van Cutsem E, Macarulla T, Hall MJ, Park JO, Hochhauser D, Arnold D, Oh DY, Reinacher-Schick A, Tortora G, Algül H, O'Reilly EM, McGuinness D, Cui KY, Joo S, Yoo HK, Patel N, Golan T. Health-related quality of life in patients with a germline BRCA mutation and metastatic pancreatic cancer receiving maintenance olaparib. Ann Oncol 2019; 30:1959-1968. [PMID: 31562758 PMCID: PMC6938600 DOI: 10.1093/annonc/mdz406] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Patients with metastatic pancreatic cancer often have a detriment in health-related quality of life (HRQoL). In the randomized, double-blind, phase III POLO trial progression-free survival was significantly longer with maintenance olaparib, a poly(ADP-ribose) polymerase inhibitor, than placebo in patients with a germline BRCA1 and/or BRCA2 mutation (gBRCAm) and metastatic pancreatic cancer whose disease had not progressed during first-line platinum-based chemotherapy. The prespecified HRQoL evaluation is reported here. PATIENTS AND METHODS Patients were randomized to receive maintenance olaparib (300 mg b.i.d.; tablets) or placebo. HRQoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item module at baseline, every 4 weeks until disease progression, at discontinuation, and 30 days after last dose. Scores ranged from 0 to 100; a ≥10-point change or difference between arms was considered clinically meaningful. Adjusted mean change from baseline was analysed using a mixed model for repeated measures. Time to sustained clinically meaningful deterioration (TSCMD) was analysed using a log-rank test. RESULTS Of 154 randomized patients, 89 of 92 olaparib-arm and 58 of 62 placebo-arm patients were included in HRQoL analyses. The adjusted mean change in Global Health Status (GHS) score from baseline was <10 points in both arms and there was no significant between-group difference [-2.47; 95% confidence interval (CI) -7.27, 2.33; P = 0.31]. Analysis of physical functioning scores showed a significant between-group difference (-4.45 points; 95% CI -8.75, -0.16; P = 0.04). There was no difference in TSCMD for olaparib versus placebo for GHS [P = 0.25; hazard ratio (HR) 0.72; 95% CI 0.41, 1.27] or physical functioning (P = 0.32; HR 1.38; 95% CI 0.73, 2.63). CONCLUSIONS HRQoL was preserved with maintenance olaparib treatment with no clinically meaningful difference compared with placebo. These results support the observed efficacy benefit of maintenance olaparib in patients with a gBRCAm and metastatic pancreatic cancer. CLINCALTRIALS.GOV NUMBER NCT02184195.
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Affiliation(s)
- P Hammel
- Department of Digestive Oncology, Hôpital Beaujon (AP-HP), Clichy, and University Paris VII, Paris, France.
| | - H L Kindler
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, USA
| | - M Reni
- Department of Oncology, IRCCS Ospedale San Raffaele Scientific Institute, Milan, Italy
| | - E Van Cutsem
- Division of Digestive Oncology, University Hospitals Gasthuisberg and KU Leuven, Leuven, Belgium
| | - T Macarulla
- Department of Medical Oncology, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - M J Hall
- Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, USA
| | - J O Park
- Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - D Hochhauser
- Department of Oncology, University College London Cancer Institute, London, UK
| | - D Arnold
- Department of Oncology, Asklepios Tumorzentrum Hamburg Asklepios Klinik Altona, Hamburg, Germany
| | - D-Y Oh
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - A Reinacher-Schick
- Department of Hematology, Oncology and Palliative Care, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany
| | - G Tortora
- Department of Medicine, Section of Medical Oncology, Azienda Ospedaliera Universitaria Integrata Verona, Verona and Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy
| | - H Algül
- Second Department of Internal Medicine, Klinikum rechts der Isar, Comprehensive Cancer Center Munich-TUM and Department of Internal Medicine II, Technische Universität München, Munich, Germany
| | - E M O'Reilly
- Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | | | - K Y Cui
- AstraZeneca, Gaithersburg, USA
| | - S Joo
- Merck & Co., Inc., Kenilworth, USA
| | | | - N Patel
- AstraZeneca, Gaithersburg, USA
| | - T Golan
- The Oncology Institute, Sheba Medical Center, Tel Aviv, Israel
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Ahn MJ, Chirovsky D, Kuyas H, Auclair V, Abounit S, Joo S, Shah R, Yang MH. Global longitudinal assessment of treatment outcomes in nasopharyngeal carcinoma (GLANCE-NPC) study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz428.011] [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: 11/14/2022] Open
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23
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Hammel P, Kindler H, Reni M, Van Cutsem E, Macarulla Mercade T, Hall M, Park J, Hochhauser D, Arnold D, Oh DY, Reinacher-Schick A, Tortora G, Algül H, O’Reilly E, McGuinness D, Cui K, Joo S, Yoo H, Patel N, Golan T. POLO: Health-related quality of life (HRQoL) of olaparib maintenance treatment versus placebo in patients with a germline BRCA mutation and metastatic pancreatic cancer (mPC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.003] [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: 11/13/2022] Open
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Kim HH, Kim B, Joo S, Shin SY, Cha HS, Park YR. Why Do Data Users Say Health Care Data Are Difficult to Use? A Cross-Sectional Survey Study. J Med Internet Res 2019; 21:e14126. [PMID: 31389335 PMCID: PMC6701164 DOI: 10.2196/14126] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/27/2019] [Accepted: 06/29/2019] [Indexed: 12/27/2022] Open
Abstract
Background There has been significant effort in attempting to use health care data. However, laws that protect patients’ privacy have restricted data use because health care data contain sensitive information. Thus, discussions on privacy laws now focus on the active use of health care data beyond protection. However, current literature does not clarify the obstacles that make data usage and deidentification processes difficult or elaborate on users’ needs for data linking from practical perspectives. Objective The objective of this study is to investigate (1) the current status of data use in each medical area, (2) institutional efforts and difficulties in deidentification processes, and (3) users’ data linking needs. Methods We conducted a cross-sectional online survey. To recruit people who have used health care data, we publicized the promotion campaign and sent official documents to an academic society encouraging participation in the online survey. Results In total, 128 participants responded to the online survey; 10 participants were excluded for either inconsistent responses or lack of demand for health care data. Finally, 118 participants’ responses were analyzed. The majority of participants worked in general hospitals or universities (62/118, 52.5% and 51/118, 43.2%, respectively, multiple-choice answers). More than half of participants responded that they have a need for clinical data (82/118, 69.5%) and public data (76/118, 64.4%). Furthermore, 85.6% (101/118) of respondents conducted deidentification measures when using data, and they considered rigid social culture as an obstacle for deidentification (28/101, 27.7%). In addition, they required data linking (98/118, 83.1%), and they noted deregulation and data standardization to allow access to health care data linking (33/98, 33.7% and 38/98, 38.8%, respectively). There were no significant differences in the proportion of responded data needs and linking in groups that used health care data for either public purposes or commercial purposes. Conclusions This study provides a cross-sectional view from a practical, user-oriented perspective on the kinds of data users want to utilize, efforts and difficulties in deidentification processes, and the needs for data linking. Most users want to use clinical and public data, and most participants conduct deidentification processes and express a desire to conduct data linking. Our study confirmed that they noted regulation as a primary obstacle whether their purpose is commercial or public. A legal system based on both data utilization and data protection needs is required.
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Affiliation(s)
- Ho Heon Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bora Kim
- Emphasis Information Technology Inc, Seoul, Republic of Korea
| | - Segyeong Joo
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Soo-Yong Shin
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, SungKyunKwan University, Seoul, Republic of Korea.,Big Data Research Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyo Soung Cha
- Cancer Big Data Center, National Cancer Center, Gyeonggi-do, Republic of Korea
| | - Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
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Kim SH, Kwon J, Kim YJ, Lee HJ, Seo HC, Lim SB, Joo S, Seo DW, Kim WY, Hong SB. Impact of a custom-made 3D printed ergonomic grip for direct laryngoscopy on novice intubation performance in a simulated easy and difficult airway scenario-A manikin study. PLoS One 2018; 13:e0207445. [PMID: 30458013 PMCID: PMC6245686 DOI: 10.1371/journal.pone.0207445] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 10/31/2018] [Indexed: 11/29/2022] Open
Abstract
Direct laryngoscopy using a Macintosh laryngoscope is the most widely used approach; however, this skill is not easy for novices and trainees. We evaluated the performance of novices using a laryngoscope with a three-dimensional (3D)-printed ergonomic grip on an airway manikin. Forty second-year medical students were enrolled. Endotracheal intubation was attempted using a conventional Macintosh laryngoscope with or without a 3D-printed ergonomic support grip. Primary outcomes were intubation time and overall success rate. Secondary outcomes were number of unsuccessful attempts, first-attempt success rate, airway Cormack-Lehane (CL) grade, and difficulty score. In the easy airway scenario, intubation time, and the overall success rate were similar between two group. CL grade and ease-of-use scores were significantly better for those using the ergonomic support grip (P < 0.05). In the difficult airway scenario, intubation time (49.7±37.5 vs. 35.5±29.2, P = 0.013), the first-attempt success rate (67.5% vs. 90%, P = 0.029), number of attempts (1.4±0.6 vs. 1.1±0.4, P = 0.006), CL grade (2 [2, 2] vs. 2 [1, 1], P = 0.012), and ease-of-use scores (3.5 [2, 4] vs. 4 [3, 5], P = 0.008) were significantly better for those using the ergonomic support grip. Linear mixed model analysis showed that the ergonomic support grip had a favorable effect on CL grade (P<0.001), ease-of-use scores (P<0.001), intubation time (P = 0.015), and number of intubation attempts (P = 0.029). Our custom 3D-printed ergonomic laryngoscope support grip improved several indicators related to the successful endotracheal intubation in the easy and difficult scenario simulated on an airway manikin. This grip may be useful for intubation training and practice.
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Affiliation(s)
- Sung-Hoon Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jeonghoon Kwon
- Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Youn-Jung Kim
- Department of Emergent Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hyung-Joo Lee
- Department of Emergent Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hyo-Chang Seo
- Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seung Bok Lim
- Emergency Nursing Department, Asan Medical Center, Seoul, Korea
| | - Segyeong Joo
- Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- * E-mail: (SJ);(DWS)
| | - Dong-Woo Seo
- Department of Emergent Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Department of Biomedical Informatics, University of California San Diego, School of Medicine, San Diego, United States of America
- * E-mail: (SJ);(DWS)
| | - Won-Young Kim
- Department of Emergent Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sang-Bum Hong
- Department of Pulmonology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Abstract
PURPOSE OF REVIEW To review recently published diagnostic methods that use high-resolution (HR-) or high-definition- (HD-) anorectal manometry (ARM) techniques. RECENT FINDINGS The integrated pressurized volume (IPV) is a new measure based on spatiotemporal plots obtained from HR-ARM. The IPV may be clinically useful for improving the prediction of abnormal balloon expulsion test in patients with constipation and for discriminating patients with anorectal disorders from asymptomatic controls. Combination of IPV parameters was superior to conventional manometric parameters in predicting the responsiveness to biofeedback therapy. Moreover, several novel parameters including the HR-ARM resting integral, HR-ARM squeeze profile, and anorectal asymmetry index may each be useful as predictive factors for identifying patients with fecal incontinence. HR- and HD-ARM are increasingly performed worldwide for evaluation of anorectal function. Here, we describe new metrics whose clinical significance has not been fully established. Further standardization and validation of these metrics could provide clinically important new information and could help improve our understanding of the pathophysiology of anorectal disorders.
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Affiliation(s)
- Myeongsook Seo
- Department of Internal Medicine, Konkuk University Chungju Hospital, Chungju, South Korea
| | - Segyeong Joo
- Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kee Wook Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
| | - Eun Mi Song
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Satish S C Rao
- Division of Gastroenterology and Hepatology, Department of Medicine, Augusta University, Augusta, GA, USA
| | - Seung-Jae Myung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
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Almeida DM, Chai HW, Joo S, Sin N, Charles ST. LIVING A STRESSOR-FREE DAILY LIFE: PREVALENCE AND PSYCHOSOCIAL CORRELATES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2188] [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: 11/13/2022] Open
Affiliation(s)
- D M Almeida
- Pennsylvania State University, University Park, Pennsylvania, United States
| | - H Won Chai
- The Pennsylvania State University, University Park, PA, USA
| | - S Joo
- Yonsei University, Seoul, South Korea; Center for Healthy Aging at the Pennsylvania State University, University Park, PA, USA
| | - N Sin
- University of British Columbia, Vancouver, BC, Canada
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Song S, Jun H, Joo S. THE MODERATING EFFECT OF SELF-RATED HEALTH IN BETWEEN GRANDPARENTING AND DEPRESSIVE SYMPTOMS AMONG GRANDPARENTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1091] [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: 11/13/2022] Open
Affiliation(s)
| | - H Jun
- Yonsei University, Seoul, Republic of Korea
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29
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Joo S, Won Chai H, Jung Jun H, Almeida DM. DAILY STRESS FACILITATES ENGAGEMENT IN EMOTIONAL SUPPORT EXCHANGE THROUGHOUT ADULTHOOD. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2190] [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: 11/13/2022] Open
Affiliation(s)
- S Joo
- Yonsei University, Seoul, Seoul-t’ukpyolsi, Republic of Korea
| | - H Won Chai
- The Pennsylvania State University, University Park, PA, USA
| | | | - D M Almeida
- The Pennsylvania State University, University Park, PA, USA
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Park H, Jun H, Joo S. THE EFFECT OF SIMILARITY IN GENDER ROLE ATTITUDE ON MARITAL SATISFACTION AMONG MIDDLE-AGED COUPLES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1042] [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: 11/14/2022] Open
Affiliation(s)
| | - H Jun
- Yonsei University, Seoul, Republic of Korea
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31
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Lee S, Jun H, Joo S, Chai H, Sin N, Almeida D. THE INTERPLAY BETWEEN DAILY POSITIVE EVENTS AND DAILY STRESS SEVERITY ON INFLAMMATION IN ADULTHOOD. Innov Aging 2018. [DOI: 10.1093/geroni/igy031.3709] [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: 11/13/2022] Open
Affiliation(s)
| | - H Jun
- . Yonsei University, Seoul, Republic of Korea
| | | | - H Chai
- The Pennsylvania State University
| | - N Sin
- University of British Columbia
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Lee K, Jun H, Joo S. THE EFFECTS OF MONETARY REWARDS FOR GRANDCHILD CARE ON THE MENTAL HEALTH OF GRANDPARENTS IN DIFFERENT INCOME CONTEXTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1090] [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: 11/13/2022] Open
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33
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Park H, Jun H, Joo S. THE EFFECT OF GRANDCHILD CARE ON SPOUSAL RELATIONSHIP SATISFACTION OF GRANDPARENTS: A COARSENED EXACT MATCHING. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1089] [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: 11/15/2022] Open
Affiliation(s)
| | - H Jun
- Yonsei University, Seoul, Republic of Korea
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34
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Seo M, Joo S, Jung KW, Lee J, Lee HJ, Soh JS, Yoon IJ, Koo HS, Seo SY, Kim D, Hwang SW, Park SH, Yang DH, Ye BD, Byeon JS, Jung HY, Yang SK, Rao SS, Myung SJ. A high-resolution anorectal manometry parameter based on integrated pressurized volume: A study based on 204 male patients with constipation and 26 controls. Neurogastroenterol Motil 2018; 30:e13376. [PMID: 29797379 DOI: 10.1111/nmo.13376] [Citation(s) in RCA: 15] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 04/12/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Conventional anorectal manometric parameters based on linear waves cannot properly predict balloon expulsion (BE) time. We aimed to determine the correlation between integrated pressurized volume (IPV) parameters during simulated evacuation (SE) and BE time in healthy individuals and constipated patients and to assess the correlation between each parameter and symptoms. METHODS A total of 230 male participants (including 26 healthy volunteers and 204 chronically constipated patients) underwent high-resolution anorectal manometry (HRAM) and BE tests. The IPV was calculated by multiplying the amplitude, distance, and time from the HRAM profile. Receiver operating characteristic curve (ROC) analysis and partial least square regression (PLSR) were performed. KEY RESULTS ROC analysis indicated that the IPV ratio between the upper 1 cm and lower 4 cm of the anal canal was more effective for predicting BE time (area under the curve [AUC]: 0.74, 95% confidence interval [CI]: 0.67-0.80, P < .01) than the conventional anorectal parameters, including defecation index and rectoanal gradient (AUC: 0.60, 95% CI: 0.52-0.67, P = .01). PLSR analysis of a linear combination of IPV parameters yielded an AUC of 0.79. Moreover, the IPV ratio showed a greater clinical correlation with patient symptoms than conventional parameters. CONCLUSIONS AND INFERENCES The IPV parameters and the combination of IPV parameters via PLSR were more significantly correlated with BE time than the conventional parameters. Thus, this study presents a useful diagnostic tool for the evaluation of pathophysiologic abnormalities in dyssynergic defecation using IPV and BE time.
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Affiliation(s)
- M Seo
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S Joo
- Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - K W Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J Lee
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H J Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J S Soh
- Department of Internal Medicine, University of Hallym College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - I J Yoon
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H S Koo
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S Y Seo
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - D Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S W Hwang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S H Park
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - D-H Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - B D Ye
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J-S Byeon
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H-Y Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S-K Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S S Rao
- Department of Medicine, Division of Gastroenterology and Hepatology, Augusta University, Augusta, GA, USA
| | - S-J Myung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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35
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Hye Lim S, Jun H, Joo S, Kim S. AN EMPIRICAL TEST OF ROLE THEORY IN THE RELATIONSHIP BETWEEN WIDOWHOOD AND LIFE SATISFACTION. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1241] [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: 11/14/2022] Open
Affiliation(s)
- S. Hye Lim
- Yonsei University, Seoul, Korea (the Republic of)
| | - H. Jun
- Yonsei University, Seoul, Korea (the Republic of)
| | - S. Joo
- Yonsei University, Seoul, Korea (the Republic of)
| | - S. Kim
- Yonsei University, Seoul, Korea (the Republic of)
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36
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Park H, Jun H, Joo S. THE PATTERN OF GENDER ROLE ATTITUDE AND MARITAL QUALITY AMONG MIDDLE-AGED KOREANS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2018] [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: 11/14/2022] Open
Affiliation(s)
- H. Park
- Child and Family Studies, Yonsei University, Seoul, Korea (the Republic of)
| | - H. Jun
- Child and Family Studies, Yonsei University, Seoul, Korea (the Republic of)
| | - S. Joo
- Child and Family Studies, Yonsei University, Seoul, Korea (the Republic of)
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Chai H, Joo S. TIES WITH ADULT CHILDREN AND LONGITUDINAL PARENT-CHILD RELATIONSHIP SATISFACTION OF KOREAN RETIREES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1376] [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: 11/14/2022] Open
Affiliation(s)
- H. Chai
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania,
| | - S. Joo
- Yonsei University, Seoul, Korea (the Republic of)
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Joo S, Jun H, Bomi C. THE EFFECTS OF PHYSICAL LIMIT AND NEIGHBORHOOD COMPOSITION ON DEPRESSIVE SYMPTOMS IN LATER LIFE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3099] [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: 11/14/2022] Open
Affiliation(s)
- S. Joo
- Dept. of Child and Family Studies, Yonsei, Seoul, Korea (the Republic of)
| | - H. Jun
- Dept. of Child and Family Studies, Yonsei, Seoul, Korea (the Republic of)
| | - C. Bomi
- Dept. of Child and Family Studies, Yonsei, Seoul, Korea (the Republic of)
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Lee H, Shin SY, Seo M, Nam GB, Joo S. Prediction of Ventricular Tachycardia One Hour before Occurrence Using Artificial Neural Networks. Sci Rep 2016; 6:32390. [PMID: 27561321 PMCID: PMC4999952 DOI: 10.1038/srep32390] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/03/2016] [Indexed: 12/21/2022] Open
Abstract
Ventricular tachycardia (VT) is a potentially fatal tachyarrhythmia, which causes a rapid heartbeat as a result of improper electrical activity of the heart. This is a potentially life-threatening arrhythmia because it can cause low blood pressure and may lead to ventricular fibrillation, asystole, and sudden cardiac death. To prevent VT, we developed an early prediction model that can predict this event one hour before its onset using an artificial neural network (ANN) generated using 14 parameters obtained from heart rate variability (HRV) and respiratory rate variability (RRV) analysis. De-identified raw data from the monitors of patients admitted to the cardiovascular intensive care unit at Asan Medical Center between September 2013 and April 2015 were collected. The dataset consisted of 52 recordings obtained one hour prior to VT events and 52 control recordings. Two-thirds of the extracted parameters were used to train the ANN, and the remaining third was used to evaluate performance of the learned ANN. The developed VT prediction model proved its performance by achieving a sensitivity of 0.88, specificity of 0.82, and AUC of 0.93.
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Affiliation(s)
- Hyojeong Lee
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Soo-Yong Shin
- Department of Biomedical Informatics, Asan Medical Center, Seoul, Republic of Korea
| | - Myeongsook Seo
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Gi-Byoung Nam
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Segyeong Joo
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Department of Biomedical Engineering, Asan Medical Center, Seoul, Republic of Korea
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40
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Kim T, Joo S, Hong S. Health related quality of life in Korean patients with narcolepsy. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.135] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lee Y, Shin SY, Kim JY, Kim JH, Seo DW, Joo S, Park JY, Kim WS, Lee JH, Bates DW. Evaluation of Mobile Health Applications Developed by a Tertiary Hospital as a Tool for Quality Improvement Breakthrough. Healthc Inform Res 2015; 21:299-306. [PMID: 26618037 PMCID: PMC4659888 DOI: 10.4258/hir.2015.21.4.299] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 09/07/2015] [Accepted: 09/07/2015] [Indexed: 11/23/2022] Open
Abstract
Objectives To evaluate the mobile health applications (apps) developed by a single tertiary hospital in Korea with a particular focus on quality and patient safety. Methods Twenty-three mobile health apps developed by Asan Medical Center were selected for analysis after exclusion of the apps without any relationship with healthcare or clinical workflow, the apps for individual usage, and the mobile Web apps. Two clinical informaticians independently evaluated the apps with respect to the six aims for quality improvement suggested by the United States Institute of Medicine. All discrepancies were resolved after discussion by the two reviewers. The six aims observed in the apps were reviewed and compared by target users. Results Eleven apps targeted patients, the other 12 were designed for healthcare providers. Among the apps for patients, one app also had functions for healthcare providers. 'My cancer diary' and 'My chart in my hand' apps matched all the six aims. Of the six aims, Timeliness was the most frequently observed (20 apps), and Equity was the least observed (6 apps). Timeliness (10/11 vs. 10/12) and Patient safety (10/11 vs. 9/12) were frequently observed in both groups. In the apps for patients, Patient-centeredness (10/11 vs. 2/12) and Equity (6/11 vs. 0/12) were more frequent but Efficiency (5/11 vs. 10/12) was less frequent. Conclusions Most of the six aims were observed in the apps, but the extent of coverage varied. Further studies, evaluating the extent to which they improve quality are needed.
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Affiliation(s)
- Yura Lee
- Department of Biomedical Informatics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Department of Breast and Endocrine Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soo-Yong Shin
- Department of Biomedical Informatics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Ubiquitous Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Medical Information Office, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji-Young Kim
- Ubiquitous Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Medical Information Office, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong Hun Kim
- Ubiquitous Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Medical Information Office, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong-Woo Seo
- Medical Information Office, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Segyeong Joo
- Ubiquitous Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Department of Biomedical Engineering, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joong-Yeol Park
- Ubiquitous Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Department of Endocrinology/Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Sung Kim
- Department of Biomedical Informatics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Medical Information Office, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Ho Lee
- Department of Biomedical Informatics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Ubiquitous Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - David W Bates
- Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
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Alemao E, Joo S, Frits M, Iannaccone C, Shadick N, Weinblatt M. AB0448 Baseline Characteristics and Changes in Disease Activity at 12 Months in Patients Treated with Abatacept Versus Other Biologic Disease-Modifying Antirheumatic Drugs in Clinical Practice Setting – Results from the Brass Registry. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1665] [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: 11/04/2022]
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44
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Alemao E, Joo S, Frits M, Iannaccone C, Shadick N, Weinblatt M. SAT0340 Evaluation of Resource Utilization in Ra Patients with and Without Infections in a Clinical Practice Setting. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1666] [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: 11/04/2022]
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Jang D, Shin SY, Seo DW, Joo S, Huh SJ. A smartphone-based system for the automated management of point-of-care test results in hospitals. Telemed J E Health 2015; 21:301-5. [PMID: 25654664 DOI: 10.1089/tmj.2014.0083] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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: 11/12/2022] Open
Abstract
OBJECTIVE Managing test results is an important issue in hospitals because of the increasing use of point-of-care testing (POCT). Here, we propose a smartphone-based system for automatically managing POCT test results. MATERIALS AND METHODS We developed the system to provide convenience to the medical staffs. The system recognizes the patient identification or prescription number of the test by reading barcodes and provides a countdown to indicate when the results will be ready. When the countdown in finished, a picture of the test result is transferred to the electronic medical record server using the Health Level 7 protocol. Human immunodeficiency virus (HIV) kits were selected in this research because HIV is a life-threatening infectious virus, especially for the medical staff who treat undiagnosed patients. The performance of the system was verified from a survey of the users. RESULTS The performance of the system was tested at the emergency room (ER) for 10 months using commercially available POCT kits for detecting HIV. The survey showed that, in total, 80% and 0% of users reported positive or negative feedback, respectively. The staff also reported that the system reduced total processing time by approximately 32 min, in addition to reducing workload. CONCLUSIONS The developed automated management system was successfully tested at an ER for 10 months. The survey results show that the system is effective and that medical staff members who used the system are satisfied with using the system at the ER.
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Affiliation(s)
- Dasom Jang
- 1 Department of Biomedical Engineering, University of Ulsan College of Medicine , Seoul, Republic of Korea
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Choi J, Yoo J, Lee M, Kim EG, Lee JS, Lee S, Joo S, Song SH, Kim EC, Lee JC, Kim HC, Jung YG, Kwon S. A rapid antimicrobial susceptibility test based on single-cell morphological analysis. Sci Transl Med 2014; 6:267ra174. [DOI: 10.1126/scitranslmed.3009650] [Citation(s) in RCA: 201] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Jung KW, Joo S, Yang DH, Yoon IJ, Seo SY, Kim SO, Lee J, Lee HJ, Kim KJ, Ye BD, Byeon JS, Jung HY, Yang SK, Kim JH, Myung SJ. A novel high-resolution anorectal manometry parameter based on a three-dimensional integrated pressurized volume of a spatiotemporal plot, for predicting balloon expulsion in asymptomatic normal individuals. Neurogastroenterol Motil 2014; 26:937-49. [PMID: 24758370 DOI: 10.1111/nmo.12347] [Citation(s) in RCA: 20] [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: 09/28/2013] [Accepted: 03/25/2014] [Indexed: 01/17/2023]
Abstract
BACKGROUND Anorectal manometry with simulated evacuation (SE) has limited applicability in predicting balloon expulsion (BE) test results. The newly developed high-resolution anorectal manometry (HRAM) technique can yield spatiotemporal plots with three-dimensional pressurization. We aimed to define new parameters based on three-dimensional integrated pressurized volume (IPV) for predicting the BE test results in asymptomatic normal individuals. METHODS Fifty-four asymptomatic healthy individuals were prospectively enrolled. BE tests were performed using 50 mL of water, and a requirement of more than 1 min was considered as delayed BE. HRAM profiles were converted into ASCII files and analyzed using a MATLAB program. A three-dimensional IPV was plotted after transforming the data to a cubic spline interpolation followed by resampling the manometry position at 0.1-cm intervals. KEY RESULTS Eight of the 54 (15%) individuals demonstrated delayed BE. Conventional manometric profiles did not differ significantly between cases of early and delayed BE. Receiver-operator characteristic curve analysis revealed that the ratio of the IPVs of the upper 1 cm to the lower 4 cm of the anorectal canal with balloon distension was more predictable of the BE results (area under curve, 0.73: 95% confidence interval, 0.53-0.92; p = 0.04) than the other IPVs or their ratios. CONCLUSIONS & INFERENCES The newly developed IPV methods could predict delayed BE tests during SE better than the conventional parameters defined on the basis of linear waves. Well-designed prospective trials on a large number of subjects are warranted to validate the clinical application of this novel parameter.
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Affiliation(s)
- Kee Wook Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Alemao E, Joo S, Allison P, Al M, Rutten-van Molken M, L'Italien G, Iannaccone C, Frits M, Shadick N, Weinblatt M, Liao K. SAT0039 Development and Validation of A Prognostic Clinical Model for RAPID Radiographic Progression in Patients with RA. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Alemao E, Joo S, Banerjee S, Emery P, Weinblatt M, L'Italien G. AB0423 Impact of Anti-IL-6 Monoclonal Antibody, Clazakizumab, on Patient-Reported Outcomes in Patients with Rheumatoid Arthritis and an Inadequate Response to Methotrexate in A Phase Iib Study. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1515] [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: 11/04/2022]
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Alemao E, Joo S, Kawabata H, Al M, Allison P, Rutten-van Molken M, Frits M, Iannaccone C, Shadick N, Weinblatt M. THU0246 Differences (OR Variations) in Physical Functioning in RA by Disease Activity Levels Defined by Das, CDai, and SDAI in Clinical Practice. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1519] [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: 11/03/2022]
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