• Title/Summary/Keyword: Early outcomes

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Distal Soft Tissue Procedure in Hallux Valgus Deformity: Comparison of Modified Mcbride Procedure and Trans-Articular Approach (무지외반증에서의 원위 연부 조직 유리술: 변형된 맥브라이드 술식과 경관절 접근법의 비교)

  • JunYeop Lee;KwangYeon Kim;Se-Jin Park
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.4
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    • pp.123-130
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    • 2023
  • Purpose: "Hallux valgus" is a common disease encountered in clinical practice and is accompanied by foot deformities. Conservative treatment is commonly used in the early stages of hallux valgus. On the other hand, surgical treatment often becomes necessary as the deformity progresses. Surgical treatments involve various osteotomy methods or joint fusion procedures combined with soft tissue release, and outcomes from these surgical treatments are generally favorable. This study compared two soft tissue release techniques in the hallux region. Materials and Methods: This study conducted a retrospective cohort study on 48 participants who underwent surgical treatment for hallux valgus at a single institution from March 1, 2018, to March 31, 2023. A scarf osteotomy was performed in all cases, and the "Modified Mcbride procedure" or "Trans-articular approach" was done for soft tissue release. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and the degree of subluxation of the lateral sesamoid were measured through simple foot radiographs taken before surgery and one year after surgery. Results: In the Modified Mcbride procedure group, HVA, IMA, and the sesamoid position grade decreased from 34.94° to 9.98°, 15.64° to 5.44°, and 2.47 to 0.44, respectively. In the trans-articular approach group, HVA, IMA, and the sesamoid position grade decreased from 33.42° to 7.34°, 15.06° to 6.03°, and 2.17 to 0.58, respectively. There was no significant difference in these changes between the preoperative and one-year postoperative measurements for both techniques (p-value>0.05). Conclusion: A radiological assessment of soft tissue release through the Modified Mcbride procedure and trans-articular approach in hallux valgus did not show significant differences. Therefore, both surgical techniques can be considered in the distal soft tissue release for a hallux valgus correction.

Machine-learning-based out-of-hospital cardiac arrest (OHCA) detection in emergency calls using speech recognition (119 응급신고에서 수보요원과 신고자의 통화분석을 활용한 머신 러닝 기반의 심정지 탐지 모델)

  • Jong In Kim;Joo Young Lee;Jio Chung;Dae Jin Shin;Dong Hyun Choi;Ki Hong Kim;Ki Jeong Hong;Sunhee Kim;Minhwa Chung
    • Phonetics and Speech Sciences
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    • v.15 no.4
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    • pp.109-118
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    • 2023
  • Cardiac arrest is a critical medical emergency where immediate response is essential for patient survival. This is especially true for Out-of-Hospital Cardiac Arrest (OHCA), for which the actions of emergency medical services in the early stages significantly impact outcomes. However, in Korea, a challenge arises due to a shortage of dispatcher who handle a large volume of emergency calls. In such situations, the implementation of a machine learning-based OHCA detection program can assist responders and improve patient survival rates. In this study, we address this challenge by developing a machine learning-based OHCA detection program. This program analyzes transcripts of conversations between responders and callers to identify instances of cardiac arrest. The proposed model includes an automatic transcription module for these conversations, a text-based cardiac arrest detection model, and the necessary server and client components for program deployment. Importantly, The experimental results demonstrate the model's effectiveness, achieving a performance score of 79.49% based on the F1 metric and reducing the time needed for cardiac arrest detection by 15 seconds compared to dispatcher. Despite working with a limited dataset, this research highlights the potential of a cardiac arrest detection program as a valuable tool for responders, ultimately enhancing cardiac arrest survival rates.

Biomarkers for Canine Mammary Tumors (반려견 유선종양 바이오 마커)

  • Chan-Ho Lee;Young Sun Choi;Suk Jun Lee;Sung-Hak Kim
    • Journal of Life Science
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    • v.34 no.6
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    • pp.434-441
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    • 2024
  • Mammary gland tumors are the most common tumors detected in non-spayed female dogs and pose a significant clinical challenge. Due to the strong similarity between canine mammary tumors (CMT) and human breast cancer (HBC), biomarkers identified in HBC can also be detected in CMT. These biomarkers have been shown to offer valuable insights into early diagnosis, prognosis, and treatment strategies. The purpose of this article is to provide a concise overview of CMT biomarkers based on the current literature. Traditional treatments for CMT in dogs typically begin with surgery, followed by chemotherapy, radiotherapy, or hormonal therapy. However, these treatments alone are not always fully effective. A diagnostic biomarker can detect the presence of a disease or the characteristics of a disease and classify an individual's status. Prognostic biomarkers focus on predicting the expected progression, recurrence, or survival of the disease in patients. By utilizing advances in understanding the mechanism of canine-specific mammary gland tumors, the estimation of biomarkers offers hope for improved outcomes in cancer patients. Novel technologies, such as single-cell RNA sequencing analysis, could provide a valuable resource for deciphering intra- and inter-tumoral heterogeneity. This review paper explores current research on CMT biomarkers and suggests directions for their development.

Trends and Outcomes of Type 2 Myocardial Infarction During the COVID-19 Pandemic in the United States

  • Harshith Thyagaturu;Nicholas Roma;Aakash Angirekula;Sittinun Thangjui;Alex Bolton;Karthik Gonuguntla;Yasar Sattar;Muchi Ditah Chobufo;Abhiram Challa;Neel Patel;Gayatri Bondi;Sameer Raina
    • Korean Circulation Journal
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    • v.53 no.12
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    • pp.829-839
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    • 2023
  • Background and Objectives: There is limited data on the impact of type 2 myocardial infarction (T2MI) during the coronavirus disease 2019 (COVID-19) pandemic. Methods: The National Inpatient Sample (NIS) database from January 2019 to December 2020 was queried to identify T2MI hospitalizations based on the appropriate International Classification of Disease, Tenth Revision-Clinical Modification codes. Monthly trends of COVID-19 and T2MI hospitalizations were evaluated using Joinpoint regression analysis. In addition, the multivariate logistic and linear regression analysis was used to compare inhospital mortality, coronary angiography use, and resource utilization between 2019 and 2020. Results: A total of 743,535 patients hospitalized with a diagnosis of T2MI were identified in the years 2019 (n=331,180) and 2020 (n=412,355). There was an increasing trend in T2MI hospitalizations throughout the study period corresponding to the increase in COVID-19 hospitalizations in 2020. The adjusted odds of in-hospital mortality associated with T2MI hospitalizations were significantly higher in 2020 compared with 2019 (11.1% vs. 8.1%: adjusted odds ratio, 1.19 [1.13-1.26]; p<0.01). In addition, T2MI hospitalizations were associated with lower odds of coronary angiography and higher total hospitalization charges, with no difference in the length of stay in 2020 compared with 2019. Conclusions: We found a significant increase in T2MI hospitalizations with higher in-hospital mortality, total hospitalization costs, and lower coronary angiography use during the early COVID-19 pandemic corresponding to the trends in the rise of COVID-19 hospitalizations. Further research into the factors associated with increased mortality can increase our preparedness for future pandemics.

Clinicopathological characteristics of extrahepatic biliary neuroendocrine neoplasms in the gallbladder, extrahepatic biliary tract, and ampulla of Vater: A single-center cross-sectional study

  • Young Mok Park;Hyung Il Seo;Byeong Gwan Noh;Suk Kim;Seung Baek Hong;Nam Kyung Lee;Dong Uk Kim;Sung Yong Han
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.4
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    • pp.380-387
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    • 2023
  • Backgrounds/Aims: In 2019, the grading and staging system for neuroendocrine neoplasms (NENs) was significantly changed. In this study, we report the clinicopathological characteristics and surgical outcomes of patients with extrahepatic biliary NENs who underwent curative resection with or without adjuvant treatment. Methods: We retrospectively reviewed a database of 16 patients who developed NENs, neuroendocrine carcinoma (NEC), and mixed endocrine non-endocrine neoplasms (MiNENs) after curative resection. Among them, eight patients had ampulla of Vater (AoV) tumors, and eight patients had non-AoV tumors. Results: G1 and G2 were more frequently observed in the AoV group than in the non-AoV group (12.5% and 62.5%, respectively). In contrast, NEC and MiNEN were more common in the non-AoV group (50.0%). High Ki-67 index (> 20%) and perineural invasion (PNI) were more frequently observed in the non-AoV group. Advanced age (> 65 years), mitotic count > 20 per 2 mm2, and Ki-67 index > 20% were strongly correlated with patient survival (p = 0.018, 0.009, and 0.044, respectively). Advanced age (> 65 years) and mitotic count > 20 per 2 mm2 were significantly correlated with disease recurrence (p = 0.033 and 0.010, respectively). Conclusions: AoV and non-AoV tumors had significant differences in the histologic grade, Ki67, and PNI. Patients with non-AoV tumors had an increased risk for survival and recurrence than those in the AoV group. For extrahepatic biliary NENs, early detection of tumors, adequate surgery, and aggressive adjuvant treatment for high-risk patients are important to achieve long-term survival and prevent disease recurrence.

Effect of Mixture of Recombinant Human Bone Morphogenic Protein-2 and Demineralized Bone Matrix in Lateral Lumbar Interbody Fusion

  • Jun Ik Son;Young-Seok Lee;Myeong Jin Ko;Seong-Hyun Wui;Seung Won Park
    • Journal of Korean Neurosurgical Society
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    • v.67 no.3
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    • pp.354-363
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    • 2024
  • Objective : This study aims to determine the optimal dose of recombinant-human bone morphogenic protein-2 (rhBMP-2) for successful bone fusion in minimally invasive lateral lumbar interbody fusion (MIS LLIF). Previous studies show that rhBMP is an effective alternative to autologous iliac crest bone graft, but the optimal dose remains uncertain. The study analyzes the fusion rates associated with different rhBMP doses to provide a recommendation for the optimal dose in MIS LLIF. Methods : Ninety-three patients underwent MIS LLIF using demineralized bone matrix (DBM) or a mixture of rhBMP-2 and DBM as fusion material. The group was divided into the following three groups according to the rhBMP-2 usage : group A, only DBM was used (n=27); group B, 1 mg of rhBMP-2 per 5 mL of DBM paste (n=41); and group C, 2 mg of rhBMP-2 per 5 mL of DBM paste (n=25). Demographic data, clinical outcomes, postoperative complication and fusion were assessed. Results : At 12 months post-surgery, the overall fusion rate was 92.3% according to Bridwell fusion grading system. Groups B and C, who received rhBMP-2, had significantly higher fusion rates than group A, who received only DBM. However, there was no significant increase in fusion rate when the rhBMP-2 dosage was increased from group B to group C. The groups B and C showed significant improvement in back pain and Oswestry disability index compared to the group A. The incidence of screw loosening was decreased in groups B and C, but there was no significant difference in the occurrence of other complications. Conclusion : Usage of rhBMP-2 in LLIF surgery leads to early and increased final fusion rates, which can result in faster pain relief and return to daily activities for patients. The benefits of using rhBMP-2 were not significantly different between the groups that received 1 mg/5 mL and 2 mg/5 mL of rhBMP-2. Therefore, it is recommended to use 1 mg of rhBMP-2 with 5 mL of DBM, taking both economic and clinical aspects into consideration.

Mechanical versus Bioprosthetic Aortic Valve Replacement in Patients Aged 50 to 70 Years

  • Youngkwan Song;Ki Tae Kim;Soo Jin Park;Hong Rae Kim;Jae Suk Yoo;Pil Je Kang;Sung-Ho Jung;Cheol Hyun Chung;Joon Bum Kim;Ho Jin Kim
    • Journal of Chest Surgery
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    • v.57 no.3
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    • pp.242-251
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    • 2024
  • Background: This study compared the outcomes of surgical aortic valve replacement (AVR) in patients aged 50 to 70 years based on the type of prosthetic valve used. Methods: We compared patients who underwent mechanical AVR to those who underwent bioprosthetic AVR at our institution between January 2000 and March 2019. Competing risk analysis and the inverse probability of treatment weighting (IPTW) method based on propensity score were employed for comparisons. Results: A total of 1,580 patients (984 patients with mechanical AVR; 596 patients with bioprosthetic AVR) were enrolled. There was no significant difference in early mortality between the mechanical AVR and bioprosthetic AVR groups (0.9% vs. 1.7%, p=0.177). After IPTW adjustment, the risk of all-cause mortality was significantly higher in the bioprosthetic AVR group than in the mechanical AVR group (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.07-1.80; p=0.014). Competing risk analysis revealed lower risks of stroke (sub-distributional hazard ratio [sHR], 0.44; 95% CI, 0.28-0.67; p<0.001) and anticoagulation-related bleeding (sHR, 0.35; 95% CI, 0.23-0.53; p<0.001) in the bioprosthetic AVR group. Conversely, the risk of aortic valve (AV) reintervention was higher in the bioprosthetic AVR group (sHR, 6.14; 95% CI, 3.17-11.93; p<0.001). Conclusion: Among patients aged 50 to 70 years who underwent surgical AVR, those receiving mechanical valves showed better survival than those with bioprosthetic valves. The mechanical AVR group exhibited a higher risk of stroke and anticoagulation-related bleeding, while the bioprosthetic AVR group showed a higher risk of AV reintervention.

Comparison of Lambertian Model on Multi-Channel Algorithm for Estimating Land Surface Temperature Based on Remote Sensing Imagery

  • A Sediyo Adi Nugraha;Muhammad Kamal;Sigit Heru Murti;Wirastuti Widyatmanti
    • Korean Journal of Remote Sensing
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    • v.40 no.4
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    • pp.397-418
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    • 2024
  • The Land Surface Temperature (LST) is a crucial parameter in identifying drought. It is essential to identify how LST can increase its accuracy, particularly in mountainous and hill areas. Increasing the LST accuracy can be achieved by applying early data processing in the correction phase, specifically in the context of topographic correction on the Lambertian model. Empirical evidence has demonstrated that this particular stage effectively enhances the process of identifying objects, especially within areas that lack direct illumination. Therefore, this research aims to examine the application of the Lambertian model in estimating LST using the Multi-Channel Method (MCM) across various physiographic regions. Lambertian model is a method that utilizes Lambertian reflectance and specifically addresses the radiance value obtained from Sun-Canopy-Sensor(SCS) and Cosine Correction measurements. Applying topographical adjustment to the LST outcome results in a notable augmentation in the dispersion of LST values. Nevertheless, the area physiography is also significant as the plains terrain tends to have an extreme LST value of ≥ 350 K. In mountainous and hilly terrains, the LST value often falls within the range of 310-325 K. The absence of topographic correction in LST results in varying values: 22 K for the plains area, 12-21 K for hilly and mountainous terrain, and 7-9 K for both plains and mountainous terrains. Furthermore, validation results indicate that employing the Lambertian model with SCS and Cosine Correction methods yields superior outcomes compared to processing without the Lambertian model, particularly in hilly and mountainous terrain. Conversely, in plain areas, the Lambertian model's application proves suboptimal. Additionally, the relationship between physiography and LST derived using the Lambertian model shows a high average R2 value of 0.99. The lowest errors(K) and root mean square error values, approximately ±2 K and 0.54, respectively, were achieved using the Lambertian model with the SCS method. Based on the findings, this research concluded that the Lambertian model could increase LST values. These corrected values are often higher than the LST values obtained without the Lambertian model.

Mitral Annular Tissue Velocity Predicts Survival in Patients With Primary Mitral Regurgitation

  • You-Jung Choi;Chan Soon Park;Tae-Min Rhee;Hyun-Jung Lee;Hong-Mi Choi;In-Chang Hwang;Jun-Bean Park;Yeonyee E. Yoon;Jin Oh Na;Hyung-Kwan Kim;Yong-Jin Kim;Goo-Yeong Cho;Dae-Won Sohn;Seung-Pyo Lee
    • Korean Circulation Journal
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    • v.54 no.6
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    • pp.311-322
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    • 2024
  • Background and Objectives: Early diastolic mitral annular tissue (e') velocity is a commonly used marker of left ventricular (LV) diastolic function. This study aimed to investigate the prognostic implications of e' velocity in patients with mitral regurgitation (MR). Methods: This retrospective cohort study included 1,536 consecutive patients aged <65 years with moderate or severe chronic primary MR diagnosed between 2009 and 2018. The primary and secondary outcomes were all-cause and cardiovascular mortality, respectively. According to the current guidelines, the cut-off value of e' velocity was defined as 7 cm/s. Results: A total of 404 individuals were enrolled (median age, 51.0 years; 64.1% male; 47.8% severe MR). During a median 6.0-year follow-up, there were 40 all-cause mortality and 16 cardiovascular deaths. Multivariate analysis revealed a significant association between e' velocity and all-cause death (adjusted hazard ratio [aHR], 0.770; 95% confidence interval [CI], 0.634-0.935; p=0.008) and cardiovascular death (aHR, 0.690; 95% CI, 0.477-0.998; p=0.049). Abnormal e' velocity (≤7 cm/s) independently predicted all-cause death (aHR, 2.467; 95% CI, 1.170-5.200; p=0.018) and cardiovascular death (aHR, 5.021; 95% CI, 1.189-21.211; p=0.028), regardless of symptoms, LV dimension and ejection fraction. Subgroup analysis according to sex, MR severity, mitral valve replacement/repair, and symptoms, showed no significant interactions. Including e' velocity in the 10-year risk score improved reclassification for mortality (net reclassification improvement [NRI], 0.154; 95% CI, 0.308-0.910; p<0.001) and cardiovascular death (NRI, 1.018; 95% CI, 0.680-1.356; p<0.001). Conclusions: In patients aged <65 years with primary MR, e' velocity served as an independent predictor of all-cause and cardiovascular deaths.

The Impact of FinTech Diffusion on Firm Performance: the Case of China (핀테크 확산이 기업의 성과에 미치는 영향: 중국 사례를 중심으로)

  • Jungeun Lee;Dawoon Jung
    • Journal of Korea Society of Industrial Information Systems
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    • v.29 no.5
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    • pp.113-124
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    • 2024
  • FinTech has been credited with generating positive economic outcomes by improving access to financial services through technological innovations. This study examines how FinTech diffusion impacts firm performance using the case of China-one of the world's fastest-growing FinTech markets. Moreover, given China's unique economic landscape-characterized by disparities between the eastern regions and the rest of the country, largely due to early policy decisions that prioritized efficient growth during the Reform and Opening-up period-regional variables (eastern vs. central-western) are incorporated into the model. A random effects model analysis was conducted using panel data collected over six years from listed companies in China. The hypothesis that the level of FinTech diffusion would have a positive impact on firm performance was not supported at the 5% significance level. However, statistical evidence was found for the moderating effect of regional disparities. Specifically, in regions with lower levels of economic development and underdeveloped financial infrastructure-where access to traditional financial services is constrained-the positive impact of FinTech diffusion was more pronounced. These findings suggest that while the economic benefits of FinTech diffusion may not uniformly enhance corporate performance, they can vary depending on contextual factors such as regional disparities.