• Title/Summary/Keyword: 3P analysis

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Prediction of Cognitive Progression in Individuals with Mild Cognitive Impairment Using Radiomics as an Improvement of the ATN System: A Five-Year Follow-Up Study

  • Rao Song;Xiaojia Wu;Huan Liu;Dajing Guo;Lin Tang;Wei Zhang;Junbang Feng;Chuanming Li
    • Korean Journal of Radiology
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    • v.23 no.1
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    • pp.89-100
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    • 2022
  • Objective: To improve the N biomarker in the amyloid/tau/neurodegeneration system by radiomics and study its value for predicting cognitive progression in individuals with mild cognitive impairment (MCI). Materials and Methods: A group of 147 healthy controls (HCs) (72 male; mean age ± standard deviation, 73.7 ± 6.3 years), 197 patients with MCI (114 male; 72.2 ± 7.1 years), and 128 patients with Alzheimer's disease (AD) (74 male; 73.7 ± 8.4 years) were included. Optimal A, T, and N biomarkers for discriminating HC and AD were selected using receiver operating characteristic (ROC) curve analysis. A radiomics model containing comprehensive information of the whole cerebral cortex and deep nuclei was established to create a new N biomarker. Cerebrospinal fluid (CSF) biomarkers were evaluated to determine the optimal A or T biomarkers. All MCI patients were followed up until AD conversion or for at least 60 months. The predictive value of A, T, and the radiomics-based N biomarker for cognitive progression of MCI to AD were analyzed using Kaplan-Meier estimates and the log-rank test. Results: The radiomics-based N biomarker showed an ROC curve area of 0.998 for discriminating between AD and HC. CSF Aβ42 and p-tau proteins were identified as the optimal A and T biomarkers, respectively. For MCI patients on the Alzheimer's continuum, isolated A+ was an indicator of cognitive stability, while abnormalities of T and N, separately or simultaneously, indicated a high risk of progression. For MCI patients with suspected non-Alzheimer's disease pathophysiology, isolated T+ indicated cognitive stability, while the appearance of the radiomics-based N+ indicated a high risk of progression to AD. Conclusion: We proposed a new radiomics-based improved N biomarker that could help identify patients with MCI who are at a higher risk for cognitive progression. In addition, we clarified the value of a single A/T/N biomarker for predicting the cognitive progression of MCI.

Angioembolization performed by trauma surgeons for trauma patients: is it feasible in Korea? A retrospective study

  • Soonseong Kwon;Kyounghwan Kim;Soon Tak Jeong;Joongsuck Kim;Kwanghee Yeo;Ohsang Kwon;Sung Jin Park;Jihun Gwak;Wu Seong Kang
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.28-36
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    • 2024
  • Purpose: Recent advancements in interventional radiology have made angioembolization an invaluable modality in trauma care. Angioembolization is typically performed by interventional radiologists. In this study, we aimed to investigate the safety and efficacy of emergency angioembolization performed by trauma surgeons. Methods: We identified trauma patients who underwent emergency angiography due to significant trauma-related hemorrhage between January 2020 and June 2023 at Jeju Regional Trauma Center. Until May 2022, two dedicated interventional radiologists performed emergency angiography at our center. However, since June 2022, a trauma surgeon with a background and experience in vascular surgery has performed emergency angiography for trauma-related bleeding. The indications for trauma surgeon-performed angiography included significant hemorrhage from liver injury, pelvic injury, splenic injury, or kidney injury. We assessed the angiography results according to the operator of the initial angiographic procedure. The term "failure of the first angioembolization" was defined as rebleeding from any cause, encompassing patients who underwent either re-embolization due to rebleeding or surgery due to rebleeding. Results: No significant differences were found between the interventional radiologists and the trauma surgeon in terms of re-embolization due to rebleeding, surgery due to rebleeding, or the overall failure rate of the first angioembolization. Mortality and morbidity rates were also similar between the two groups. In a multivariable logistic regression analysis evaluating failure after the first angioembolization, pelvic embolization emerged as the sole significant risk factor (adjusted odds ratio, 3.29; 95% confidence interval, 1.05-10.33; P=0.041). Trauma surgeon-performed angioembolization was not deemed a significant risk factor in the multivariable logistic regression model. Conclusions: Trauma surgeons, when equipped with the necessary endovascular skills and experience, can safely perform angioembolization. To further improve quality control, an enhanced training curriculum for trauma surgeons is warranted.

Surgical outcome and risk scoring to predict survival after hepatic resection for hepatocellular carcinoma with portal vein tumor thrombosis

  • Tae-Seok Kim;Kwangho Yang;Gi Hong Choi;Hye Yeon Yang;Dong-Sik Kim;Hye-Sung Jo;Gyu-Seong Choi;Kwan Woo Kim;Young Chul Yoon;Jaryung Han;Doo Jin Kim;Shin Hwang;Koo Jeong Kang
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.2
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    • pp.134-143
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    • 2024
  • Backgrounds/Aims: The hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is classified as the advanced stage (BCLC stage C) with extremely poor prognosis, and in current guidelines is recommended for systemic therapy. This study aimed to evaluate the surgical outcomes and long-term prognosis after hepatic resection (HR) for patients who have HCC combined with PVTT. Methods: We retrospectively analyzed 332 patients who underwent HR for HCC with PVTT at ten tertiary referral hospitals in South Korea. Results: The median overall and recurrence-free survival after HR were 32.4 and 8.6 months, while the 1-, 3-, and 5-year overall survival rates were 75%, 48%, and 39%, respectively. In multivariate analysis, tumor number, tumor size, AFP, PIVKA-II, neutrophil-to-lymphocyte ratio, and albumin-bilirubin (ALBI) grade were significant prognostic factors. The risk scoring was developed using these seven factors-tumor, inflammation and hepatic function (TIF), to predict patient prognosis. The prognosis of the patients was well stratified according to the scores (log-rank test, p < 0.001). Conclusions: HR for patients who have HCC combined with PVTT provided favorable survival outcomes. The risk scoring was useful in predicting prognosis, and determining the appropriate treatment strategy for those patients who have HCC with PVTT.

Homocysteine levels are associated with diabetes mellitus in Chinese with H-type hypertension

  • Dejian Fu;Wanbao Gong;Xiaomin Bao;Bo Yang;Feng Wang;Yubing Qiao;Yuanjiang Wu;Guangzhen Chen;Weixun Sun;Qiongzhi Xiao;Wenbo Zou;Ning Fang
    • Nutrition Research and Practice
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    • v.18 no.4
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    • pp.511-522
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    • 2024
  • BACKGROUND/OBJECTIVES: The study examined the association between homocysteine and diabetes mellitus in patients with H-type hypertension and assessed the possible effect modifiers. SUBJECTS/METHODS: This cross-sectional study included 1,255 eligible participants in the 'H-type Hypertension Management and Stroke Prevention Strategic International Science and Technology Innovation Cooperation Project' among rural Chinese people with H-type hypertension. A multivariate logistic regression model was used to evaluate the relationship between homocysteine and diabetes mellitus. RESULTS: The mean level of total homocysteine (tHcy) in the diabetes mellitus population was 19.37 μmol/L, which was significantly higher than the non-diabetic patients (18.18 μmol/L). When tHcy was analyzed as a continuous variable, the odds ratio (OR) of diabetes was 1.17 (95% confidence interval [CI], 1.01-1.35; per interquartile range). When tHcy was stratified according to the quintile, the ORs for diabetes were 2.86 (95% CI, 1.22-6.69) in the highest quintile (tHcy ≥ 20.60 μmol/L) compared to the reference group (tHcy < 12.04 μmol/L). When tHcy was grouped by 15 μmol/L and 20 μmol/L, patients with tHcy ≥ 20 μmol/L had a significantly (P = 0.037) higher risk of diabetes (OR, 2.03; 95% CI, 1.04-3.96) than in those with tHcy < 15 μmol/L. Subgroup analysis showed that the tHcy-diabetes association was unaffected by other variables. CONCLUSION: In this study of rural Chinese people with H-type hypertension, the tHcy levels showed a positive association with diabetes mellitus. This independent association is unaffected by other potential risk factors.

Fresh and hardened properties of expansive concrete utilizing waste aluminum lathe

  • Yasin Onuralp Ozkilic;Ozer Zeybek;Ali Ihsan Celik;Essam Althaqafi;Md Azree Othuman Mydin;Anmar Dulaimi;Memduh Karalar;P. Jagadesh
    • Steel and Composite Structures
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    • v.50 no.5
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    • pp.595-608
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    • 2024
  • In this study, aluminum lathe waste was used by replacing aggregates in certain proportions in order to obtain expansive concrete using recycled materials. For this reason, five different aluminum wastes of 1%, 2%, 3%, 4% and 5% were selected and also reference without aluminum waste was produced. Based on the mechanical tests conducted, which included slump, compression, splitting tensile, and flexural tests, it was evident that the workability of the material declined dramatically once the volume ratio of aluminum exceeded 2%. As determined by the compressive strength test (CST), the CS of concrete (1% aluminum lathe wastes replaced with aggregate) was 11% reducer than that of reference concrete. It was noted that the reference concrete's CS values, which did not include aluminum waste, were greater than those of the concrete that contained 5% aluminum. When comparing for splitting tensile strength (STS), it was observed that the results of STS generally follow the parallel inclination as the CS. The reduction in these strengths when 1% aluminum is utilized is less than 10%. These ratios modified 18% when flexural strength (FS) is considered. Therefore, 1% of aluminum waste is recommended to obtain expansive concrete with recycled materials considering minimum loss of strength. Moreover, Scanning Electron Microscope (SEM) analysis was performed and the results also confirm that there was expansion in the aluminum added concrete. The presence of pores throughout the concrete leads to the formation of gaps, resulting in its expansion. Additionally, for practical applications, basic equations were developed to forecast the CS, STS, and FS of the concrete with aluminum lathe waste using the data already available in the literature and the findings of the current study. In conclusion, this study establishes that aluminum lathe wastes are suitable, readily available in significant quantities, locally sourced eco-materials, cost-effective, and might be selected for construction using concrete, striking a balance among financially and ecological considerations.

Ischemic Burden Assessment Using Single Photon Emission Computed Tomography in Single Vessel Chronic Total Occlusion of Coronary Artery

  • Yong-Hoon Yoon;Sangwon Han;Osung Kwon;Kyusup Lee;Ju Hyeon Kim;Junghoon Lee;Tae oh Kim;Jae-Hyung Roh;Pil Hyung Lee;Soo-Jin Kang;Jae-Hwan Lee;Young-Hak Kim;Cheol Whan Lee;Dae Hyuk Moon;Seung-Whan Lee
    • Korean Circulation Journal
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    • v.52 no.2
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    • pp.150-161
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    • 2022
  • Background and Objectives: Studies evaluating the nature of ischemic burden of chronic total occlusion (CTO) vessels are still lacking. Methods: A total of 165 patients with single vessel CTO >2.5 mm in an epicardial coronary artery who underwent single photon emission computed tomography (SPECT) were enrolled in the study. Ischemic burden was calculated with the use of semi-quantitative SPECT analysis, and was defined as the summed difference score (SDS) divided by the maximal limit of the score (=SDS/68). Results: The mean age of the participants was 59.5 years and the CTO of the left anterior descending coronary artery (LAD), left circumplex coronary artery (LCX), and right coronary artery (RCA) accounted for 93 (56.4%), 18 (10.9%), and 54 (32.7%) patients, respectively. The median ischemic burden of the total population was 8.8%, and it was highest in the LAD CTO (10.3%) compared with the LCX (5.9%) and RCA CTO (5.9%, p<0.001). High-ischemic burden (ischemic burden >10%) was observed in 66 patients (40.0%), and in 47 patients (50.5%) of the LAD CTO. Ischemic burden was different according to the CTO location only in LAD CTO. The statistically significant predictors for high-ischemic burden were hypertension, baseline ejection fraction >45%, LAD CTO, proximal CTO location, and de novo CTO. Japanese-CTO score and Rentrop scale collateral grade were not associated with high-ischemic burden. Conclusions: Only 40% of patients with single vessel CTO had ischemic burden >10%. For CTO vessels, measurement of ischemic burden using SPECT prior to revascularization may be helpful in identifying beneficial subjects.

Study on the Limitation of AVO Responses Shown in the Seismic Data from East-sea Gas Reservoir (동해 가스전 탄성파 자료에서 나타나는 AVO 반응의 한계점에 대한 고찰)

  • Shin, Seung-Il;Byun, Joong-Moo;Choi, Hyung-Wook;Kim, Kun-Deuk;Ko, Seung-Won;Seo, Young-Tak;Cha, Young-Ho
    • Geophysics and Geophysical Exploration
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    • v.11 no.3
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    • pp.242-249
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    • 2008
  • Recently, AVO analysis has been widely used in oil exploration with seismic subsurface section as a direct indicator of the existence of the gas. In the case of the deep reservoirs like the gas reservoirs in the East-sea, it is often difficult to observe AVO responses in CMP gathers even though the bright spots are shown in the stacked section. Because the reservoir becomes more consolidated as its depth deepens, P-wave velocity does not decrease significantly when the pore fluid is replaced by the gas. Thus the difference in Poisson's ratio, which is a key factor for AVO response, between the reservoir and the layer above it does not increase significantly. In this study, we analyzed the effects of Poisson's ratio difference on AVO response with a variety of Poisson's ratios for the upper and lower layers. The results show that, as the difference in Poisson's ratio between the upper and lower layers decreases, the change in the reflection amplitude with incidence angle decreases and AVO responses become insignificant. To consider the limitation of AVO responses shown in the gas reservoir in East-sea, the velocity model was made by simulation Gorae V structure with seismic data and well logs. The results of comparing AVO responses observed from the synthetic data with theoretical AVO responses calculated by using material properties show that the amount of the change in reflection amplitude with increasing incident angle is very small when the difference in Poisson's ratio between the upper and lower layers is small. In addition, the characteristics of AVO responses were concealed by noise or amplitude distortion arisen during preprocessing. To overcome such limitations of AVO analysis of the data from deep reservoirs, we need to acquire precisely reflection amplltudes In data acquisition stage and use processing tools which preserve reflection amplitude in data processing stage.

Analysis of First Flushing Effects and EMCs of Non-point Pollutants from Impervious Area during Rainfall (강우시 불투수성 지역의 비점오염물질 EMCs 산정 및 초기세척효과 분석)

  • Ahn, Tae-Woong;Kim, Tae-Hoon;Oh, Jong-Min
    • Korean Journal of Ecology and Environment
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    • v.45 no.4
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    • pp.459-473
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    • 2012
  • This study evaluated the rainfall-runoff characteristics of Non-point Pollution Source (NPS) of the impervious area through on-site monitoring. In this study, trend analysis was performed by various runoff analysis method of non-point pollution source. The characteristics of rainfall at impervious area appeared to be influenced by rainfall strength. It is judged that the measure is required to be prepared against that now that concentration difference of non-point pollution source appeared to be big by precedent number of days of no rainfall. However, it appeared that Rainfall Sustaining Time (RST) has nothing to do with effluent concentration of non-point pollution source, however, the rising tendency that effluent concentration did not appear because the tendency that concentration of non-point pollution source reduces more than 50% within initial 60 min due to first flushing effects and rainfall sustaining time is long. If looking into the outflow tendency of non-point pollution source at the impervious area, it showed the tendency that the concentration lowers gradually as time goes by after initial concentration appeared very high. However, it could be recognized that the concentration of non-point pollution source appeared to be high as the pollutants integrated on the surface of the road during dry season. The Event Mean Concentrations (EMCs) in impervious area were ranged $9.2{\sim}199.3mg{\cdot}L^{-1}$ for TSS, $8.1{\sim}24.2mg{\cdot}L^{-1}$ for $COD_{Mn}$, $0.070{\sim}1.860mg{\cdot}L^{-1}$ for T-N. Based on such runoff characteristics of non-point pollution source, it is judged that it would be desirable to process initial rain efficiently as the measure against initial rain phenomenon at the impervious area.

A Neurobehavioral Performance Assessment in Lacunar Infarction Case-control Study (열공성 뇌경색 환자-대조군에서 신경행동검사의 수행 평가)

  • Kim, Ham-Gyum;Park, Sue-Kyung;Lee, Kun-Sei;Kim, Hyeoug-Su;Kim, Wha-Sun;Chang, Soung-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.3
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    • pp.255-262
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    • 2003
  • Objectives : We carried out tests for neurobehavior by using WHO-NCTB (neurobehavioral core test battery) and Perdue pegboard score test to identify differences between lacunar infarction cases and controls. Methods : Among the subjects who underwent MRI between February 2001 and March 2002 in a university hospital located in Seoul and who were diagnosed only as lacunar infarction without any intracranial disease, 46 patients were selected as cases (male: 21, female: 25). Controls were selected who had no cerebrovascular disease on MRI by matching age (5 years), gender, and education (2 years) in a ratio of 1:1 , Among WHO-NCTB, the following 5 tests and Perdue pegboard score test were used to categorize the study subjects: digit and symbol matching, simple reaction time, Benton visual retention, digit span, and Pursuit aiming test, Results : Among the above 6 tests of neurobehavior, lacunar infarction cases showed lower score than controls except for the simple reaction time test. As the controlling variables of multivariate analysis in the stepwise regression analysis, the followings were selected due to their significant association: age, education, BMI, gender, drinking, exercise, add systolic blood pressure. From multivariate regression analysis, there was significant difference (p<0.05) between lacunar infarction cases and controls in digit and symbol matching, Benton visual retention, digit span, pursuit aiming, and Perdue pegboard score test, but not in the score of simple reaction time test. Conclusions : We suggest that the above 5 tests for neurobehavior, with the exception of the simple reaction time test, might be used as the basis for recommendation of further treatment and other neurological tests by the earlier defection for neurological abnormality in lacunar infarction.

The Factors Related to Musculoskeletal Symptoms of Family Care-Givers who Have a Patient with Brain Damage (뇌손상 가족 간병인의 근골격계 자각증상과 관련요인)

  • Jeon, Eun-Mi;Lee, Seong-A;Gu, Jung-Whan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.1
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    • pp.336-344
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    • 2017
  • This study was conducted to identify factors related to the musculoskeletal symptoms of 340 family caregivers who have a patient with brain damage based on self-administered questionnaires. The questionnaires included general characteristics, characteristics of care activities and caregivers' musculoskeletal symptoms. Data were collected from many long-term care hospitals and rehabilitation centers during March 17 to March 21, 2014. The results indicated that complaint rates of work-related musculoskeletal systems of the body sites differed. Factor analysis revealed that neck complaints were related to education (under mid), while shoulder complaints were related to sex (female), age (50-59), education (mid) and duration of care (< 2 years). Arm/elbow complaints were related to age (40-49), education (high) and duration of care (12-24). Complaints regarding the hand/wrist/finger were related to age (50-59) and duration of care (12-24), while those associated with the legs/feet were related to age (50-59) and duration of care (< 6[ED highlight - years? Please specify.]). Back problems were related to education (under mid, mid stage, high) and gait. The complaint rate regarding musculoskeletal symptoms during daily life was not statistically significant. Logistic regression analysis of significant factors related to subjective musculoskeletal symptoms identified ambulation and gait as having the greatest influence and complaint factor among family caregivers. The complaint rate of family caregivers differed among body parts. Being a caregiver for less than one year was found to have a significant impact on pain. Overall, long term family caregivers could be faced with risk factors for musculoskeletal problems, but there are many different factors that affect musculoskeletal symptoms with regards to their activities. Accordingly, comprehensive and systematic prevention plans for family caregivers who have patients with brain damage should be developed.