• Nutrition Research and Practice
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• 제17권6호
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• pp.1099-1112
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• 2023

BACKGROUND/OBJECTIVES: Dyslipidemia causes metabolic disorders such as atherosclerosis and fatty liver syndrome due to abnormally high blood lipids. Purple perilla frutescens extract (PPE) possesses various bioactive compounds such as α-asarone, chlorogenic acid and rosmarinic acid. This study examined whether PPE and α-asarone improved dyslipidemia-associated inflammation and inhibited atheroma formation in apolipoprotein E (apoE)-deficient mice, an experimental animal model of atherosclerosis. MATERIALS/METHODS: ApoE-deficient mice were fed on high cholesterol-diet (Paigen's diet) and orally administrated with 10-20 mg/kg PPE and α-asarone for 10 wk. RESULTS: The Paigen's diet reduced body weight gain in apoE-deficient mice, which was not restored by PPE or α-asarone. PPE or α-asarone improved the plasma lipid profiles in Paigen's diet-fed apoE-deficient mice, and despite a small increase in high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein (LDL)-cholesterol, and very LDL were significantly reduced. Paigen's diet-induced systemic inflammation was reduced in PPE or α-asarone-treated apoE-deficient mice. Supplying PPE or α-asarone to mice lacking apoE suppressed aorta atherogenesis induced by atherogenic diet. PPE or α-asarone diminished aorta accumulation of CD68- and/or F4/80-positive macrophages induced by atherogenic diet in apoE-deficient mice. Treatment of apoE-deficient mice with PPE and α-asarone resulted in a significant decrease in plasma cholesteryl ester transfer protein level and an increase in lecithin:cholesterol acyltransferase reduced by supply of Paigen's diet. Supplementation of PPE and α-asarone enhanced the transcription of hepatic apoA1 and SR-B1 reduced by Paigen's diet in apoE-deficient mice. CONCLUSIONS: α-Asarone in PPE inhibited inflammation-associated atheroma formation and promoted hepatic HDL-C trafficking in dyslipidemic mice.

• 경영정보학연구
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• 제24권1호
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• pp.21-37
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• 2022

신약을 개발하는 한 가지 방법의 하나인 신약 재창출(Drug Repositioning)은 이미 사람들에게 사용할 수 있도록 승인된 약물들이 다른 용도로 사용되도록 하여 새로운 적응증을 발견하는 유용한 방법이다. 최근에는 머신러닝 기술의 발달로 방대한 생물학적 정보를 분석하여 신약 개발에 활용하는 경우가 증가하고 있다. 신약 재창출에 머신러닝 기술을 활용하면 효과적인 치료법을 신속하게 찾아내는 데 도움을 줄 것이다. 현재 심각한 급성 호흡기 증후군인 코로나바이러스(COVID-19)에 의한 신종 질병으로 전 세계가 힘든 시간을 보내고 있다. 이미 임상적으로 승인된 약물의 용도를 변경하는 신약 재창출은 COVID-19 환자를 치료하기 위한 치료제의 대안이 될 수 있다. 본 연구는 머신러닝 기법을 활용하여 신약 재창출 분야에 대한 연구 동향을 살펴보고자 한다. Pub Med에서 웹 스크래핑 기법을 사용하여 'Drug Repositioning'이라는 키워드로 총 4,821건의 논문을 수집하였다. 데이터 전처리 후, 4,419건의 논문을 대상으로 빈도분석, LDA 기반 토픽모델링, Random Forest 분류 분석 및 예측 성능평가를 수행하였다. Word2vec 모델을 기반으로 연관어를 분석하였고, PCA 차원 축소 후 K-Means 군집화하여 레이블을 생성한 후, t-SNE 알고리즘을 이용하여 논문이 형성하고 있는 그룹을 시각화하고, LDA 결과에 계층적 군집화를 적용하여 히트맵으로 시각화하였다. 본 연구는 신약 재창출과 관련된 연구 주제가 무엇인지를 파악하고, 머신러닝 알고리즘을 사용하여 대량의 문헌에서 의미 있는 주제를 도출하고 시각화하는 방법을 제시하였다. 향후 신약 재창출 분야의 연구나 개발 전략을 수립하기 위한 기초자료로 활용되는 데 도움을 줄 것이라고 기대한다.

• Korean Journal of Radiology
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• 제22권6호
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• pp.994-1004
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• 2021

Objective: To extract pulmonary and cardiovascular metrics from chest CTs of patients with coronavirus disease 2019 (COVID-19) using a fully automated deep learning-based approach and assess their potential to predict patient management. Materials and Methods: All initial chest CTs of patients who tested positive for severe acute respiratory syndrome coronavirus 2 at our emergency department between March 25 and April 25, 2020, were identified (n = 120). Three patient management groups were defined: group 1 (outpatient), group 2 (general ward), and group 3 (intensive care unit [ICU]). Multiple pulmonary and cardiovascular metrics were extracted from the chest CT images using deep learning. Additionally, six laboratory findings indicating inflammation and cellular damage were considered. Differences in CT metrics, laboratory findings, and demographics between the patient management groups were assessed. The potential of these parameters to predict patients' needs for intensive care (yes/no) was analyzed using logistic regression and receiver operating characteristic curves. Internal and external validity were assessed using 109 independent chest CT scans. Results: While demographic parameters alone (sex and age) were not sufficient to predict ICU management status, both CT metrics alone (including both pulmonary and cardiovascular metrics; area under the curve [AUC] = 0.88; 95% confidence interval [CI] = 0.79-0.97) and laboratory findings alone (C-reactive protein, lactate dehydrogenase, white blood cell count, and albumin; AUC = 0.86; 95% CI = 0.77-0.94) were good classifiers. Excellent performance was achieved by a combination of demographic parameters, CT metrics, and laboratory findings (AUC = 0.91; 95% CI = 0.85-0.98). Application of a model that combined both pulmonary CT metrics and demographic parameters on a dataset from another hospital indicated its external validity (AUC = 0.77; 95% CI = 0.66-0.88). Conclusion: Chest CT of patients with COVID-19 contains valuable information that can be accessed using automated image analysis. These metrics are useful for the prediction of patient management.

• Journal of Korean Neurosurgical Society
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• 제67권2호
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• pp.237-248
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• 2024

Objective : Postoperative data on Cushing's disease (CD) are equivocal in the literature. These discrepancies may be attributed to different series with different criteria for remission and variable follow-up durations. Additional data from experienced centers may address these discrepancies. In this study, we present the results obtained from 96 endoscopic transsphenoidal surgeries (ETSSs) for CD conducted in a well-experienced center. Methods : Pre- and postoperative data of 96 ETSS in 87 patients with CD were included. All cases were handled by the same neurosurgical team between 2014 and 2022. We obtained data on remission status 3-6 months postoperatively (medium-term) and during the latest follow-up (long-term). Additionally, magnetic resonance imaging (MRI) and pathology results were obtained for each case. Results : The mean follow-up duration was 39.5±3.2 months. Medium and long-term remission rates were 77% and 82%, respectively. When only first-time operations were considered, the medium- and long-term remission rates were 78% and 82%, respectively. The recurrence rate in this series was 2.5%. Patients who showed remission between 3-6 months had higher long-term remission rates than did those without initial remission. Tumors >2 cm and extended tumor invasion of the cavernous sinus (Knosp 4) were associated with lower postoperative remission rates. Conclusion : Adenoma size and the presence/absence of cavernous sinus invasion on preopera-tive MRI may predict long-term postoperative remission. A tumor size of 2 cm may be a supporting criterion for predicting remission in Knosp 4 tumors. Further studies with larger patient populations are necessary to support this finding.

• Journal of Chest Surgery
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• 제57권2호
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• pp.160-168
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• 2024

Background: Data on perioperative outcomes of emergent versus elective resection in esophageal cancer patients requiring esophagectomy are lacking. We investigated whether emergent resection was associated with increased risks of morbidity and mortality. Methods: Data on patients with esophageal malignancy who underwent esophagectomy from 2005 to 2020 were retrospectively analyzed from the American College of Surgeons National Surgical Quality Improvement Program database. Thirty-day complication and mortality rates were compared between emergent esophagectomy (EE) and non-emergent esophagectomy. Logistic regression assessed factors associated with complications and mortality. Results: Of 10,067 patients with malignancy who underwent esophagectomy, 181 (1.8%) had EE, 64% had preoperative systemic inflammatory response syndrome, sepsis, or septic shock, and 44% had bleeding requiring transfusion. The EE group had higher American Society of Anesthesiologists (ASA) class and functional dependency. More transhiatal esophagectomies and diversions were performed in the EE group. After EE, the rates of 30-day mortality (6.1% vs. 2.8%), overall complications (65.2% vs. 44.2%), bleeding, pneumonia, prolonged intubation, and positive margin (17.7% vs. 7.4%) were higher, while that of anastomotic leak was similar. On adjusted logistic regression, older age, lower albumin, higher ASA class, and fragility were associated with increased complications and mortality. McKeown esophagectomy and esophageal diversion were associated with a higher risk of postoperative complications. EE was associated with 30-day postoperative complications (odds ratio, 2.39; 95% confidence interval, 1.66-3.43; p<0.0001). Conclusion: EE was associated with a more than 2-fold increase in complications compared to elective procedures, but no independent increase in short-term mortality. These findings may help guide data-driven critical decision-making for surgery in select cases of complicated esophageal malignancy.

• 대한치위생과학회지
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• 제1권2호
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• pp.41-52
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• 2018

The purpose of this study was to examine the state of oral prophylaxis practice among dental hygiene students and their awareness of musculoskeletal diseases in an effort to provide some information on how to strengthen education on treatment posture to manage musculoskeletal diseases and how to raise awareness of musculoskeletal diseases. From November 2 to 13, 2016, a self-administered survey was conducted on 653 sophomores, juniors and seniors with an experience of oral prophylaxis practice. SPSS version 20.0 for Windows was employed to analyze the collected data. The findings of the study were as follows: 1. The largest group that accounted for 37.4% responded that the total number of students undergoing oral prophylaxis practice during a semester was four to six. The biggest group that represented 65.4% answered that the required practice time per student was one to fewer than three hours. 76.0% continued to be in the repeated same posture. 2. As for the posture of patients, supine position was most common for the maxillary sinus, which accounted for 82.2%. And semi-upright position was most common for the mandibular sinus, which represented 49.6%. 3. In regard to the burden of oral prophylaxis practice, 33.9% considered the required for the practice appropriate. 42.3% took the repeated long-lasting posture, and 53.5% were under physical pressure. 55.4% suffered from mental pressure and stress. 4. The most dominant musculoskeletal area that they experienced pain after oral prophylaxis practice was neck with 52.5%; waist with 48.2, shoulders/wrists/hands with 45.5, back with 10.3, buttocks with 4.1, elbows with 2.3, legs with 2.1, ankles/feet with 0.8 and knees with 0.6%. 5. Concerning the maintenance of repeated treatment postures and pain experience, the students who continued to be in the repeated same position underwent more pain than the others who didn't on the shoulders(2.92±1.05), in the waist(3.02±1.01), buttocks(1.75±0.92), elbows(1.55±0.79) and ankles/foot(2.52±1.25). The differences were statistically significant(p<.05, p<.01). 6. As to educational experience on treatment posture and musculoskeletal diseases, 88.8% received education on treatment posture; 87.9%, on what position should be taken in times of cooperation; 46.9%, on musculoskeletal diseases; 51.9%, on carpal tunnel syndrome; 42.3%, on varicose vein. The students who replied education on occupational diseases was necessary accounted for 89.6%. 7. The students who experienced treatment posture education were better aware of the causes of musculoskeletal diseases(3.23±3.00), ways for preventing the diseases(3.33±.834) and how to stretch the body(3.63±.858). The differences were statistically significant(p<.05, p<.001). 8. The students who experienced education on occupational diseases heard more about musculoskeletal diseases(3.27±.965), were better cognizant of the causes of the diseases(3.45±.847), were better aware of how to prevent them(3.55±.805) and found themselves to know how to stretch to prevent the diseases (3.73±.826). The differences were statistically significant(p<.001).

• IMMUNE NETWORK
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• 제23권6호
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• pp.43.1-43.10
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• 2023

The continuous emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants has provided insights for updating current coronavirus disease 2019 (COVID-19) vaccines. We examined the neutralizing activity of Abs induced by a BA.4/5-containing bivalent mRNA vaccine against Omicron subvariants BN.1 and XBB.1.5. We recruited 40 individuals who had received a monovalent COVID-19 booster dose after a primary series of COVID-19 vaccinations and will be vaccinated with a BA.4/5-containing bivalent vaccine. Sera were collected before vaccination, one month after, and three months after a bivalent booster. Neutralizing Ab (nAb) titers were measured against ancestral SARS-CoV-2 and Omicron subvariants BA.5, BN.1, and XBB.1.5. BA.4/5-containing bivalent vaccination significantly boosted nAb levels against both ancestral SARS-CoV-2 and Omicron subvariants. Participants with a history of SARS-CoV-2 infection had higher nAb titers against all examined strains than the infection-naïve group. NAb titers against BN.1 and XBB.1.5 were lower than those against the ancestral SARS-CoV-2 and BA.5 strains. These results suggest that COVID-19 vaccinations specifically targeting emerging Omicron subvariants, such as XBB.1.5, may be required to ensure better protection against SARS-CoV-2 infection, especially in high-risk groups.

• IMMUNE NETWORK
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• 제23권4호
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• pp.33.1-33.13
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• 2023

Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been acknowledged as an effective mean of preventing infection and hospitalization. However, the emergence of highly transmissible SARS-CoV-2 variants of concern (VOCs) has led to substantial increase in infections among children and adolescents. Vaccine-induced immunity and longevity have not been well defined in this population. Therefore, we aimed to analyze humoral and cellular immune responses against ancestral and SARS-CoV-2 variants after two shots of the BNT162b2 vaccine in healthy adolescents. Although vaccination induced a robust increase of spike-specific binding Abs and neutralizing Abs against the ancestral and SARS-CoV-2 variants, the neutralizing activity against the Omicron variant was significantly low. On the contrary, vaccine-induced memory CD4⁺ T cells exhibited substantial responses against both ancestral and Omicron spike proteins. Notably, CD4⁺ T cell responses against both ancestral and Omicron strains were preserved at 3 months after two shots of the BNT162b2 vaccine without waning. Polyfunctionality of vaccine-induced memory T cells was also preserved in response to Omicron spike protein. The present findings characterize the protective immunity of vaccination for adolescents in the era of continuous emergence of variants/subvariants.

• Journal of Korean Neurosurgical Society
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• 제67권4호
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• pp.442-450
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• 2024

Objective : Cerebral hyperperfusion syndrome (CHS) manifests as a collection of symptoms brought on by heightened focal cerebral blood flow (CBF), afflicting nearly 30% of patients who have undergone superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis. The aim of this study was to investigate whether the amalgamation of magnetic resonance imaging (MRI) fluid-attenuated inversion recovery (FLAIR) and apparent diffusion coefficient (ADC) imaging via MRI can discern cerebral hyperemia after STA-MCA anastomosis surgery. Methods : A retrospective study was performed of patients who underwent STA-MCA anastomosis due to Moyamoya disease or atherosclerotic steno-occlusive disease. A protocol aimed at preventing CHS was instituted, leveraging the use of MRI FLAIR. Patients underwent MRI diffusion with FLAIR imaging 24 hours after STA-MCA anastomosis. A high signal on FLAIR images signified the presence of hyperemia at the bypass site, triggering a protocol of hyperemia care. All patients underwent hemodynamic evaluations, including perfusion MRI, single-photon emission computed tomography (SPECT), and digital subtraction angiography, both before and after the surgery. If a high signal intensity is observed on MRI FLAIR within 24 hours of the surgery, a repeat MRI is performed to confirm the presence of hyperemia. Patients with confirmed hyperemia are managed according to a protocol aimed at preventing further progression. Results : Out of a total of 162 patients, 24 individuals (comprising 16 women and 8 men) exhibited hyperemia on their MRI FLAIR scans following the procedure. SPECT was conducted on 23 patients, and 11 of them yielded positive results. All 24 patients underwent perfusion MRI, but nine of them showed no significant findings. Among the patients, 10 displayed elevations in both CBF and cerebral blood volume (CBV), three only showed elevation in CBF, and two only showed elevation in CBV. Follow-up MRI FLAIR scans conducted 6 months later on these patients revealed complete normalization of the previously observed high signal intensity, with no evidence of ischemic injury. Conclusion : The study determined that the use of MRI FLAIR and ADC mapping is a competent means of early detection of hyperemia after STA-MCA anastomosis surgery. The protocol established can be adopted by other neurosurgical institutions to enhance patient outcomes and mitigate the hazard of permanent cerebral injury caused by cerebral hyperemia.

• 정신신체의학
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• 제32권1호
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• pp.1-9
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• 2024

노쇠는 스트레스 요인에 대한 취약성이 증가하여 생리적인 예비능력이 감소되고 항상성을 유지하는 능력이 저하되는 증후군으로 입원, 장애 및 사망의 위험을 증가시킨다. 노쇠는 다양한 원인에 의해 발생하며 다차원적인 접근이 필요하고 조기에 발견해서 관리하는 것이 중요하다. 노쇠는 통증이나 우울증과 같은 신경정신과적 문제와도 깊은 관련이 있다. 노쇠를 평가하는데 있어서 질병, 영양, 움직임, 감각기능 등의 신체적 영역뿐만 아니라 심리사회적인 영역까지 포괄적으로 고려하는 것이 바람직하며, 대표적인 척도로 Fried의 신체적 노쇠 기준과 Rockwood의 노쇠 척도를 들 수 있다. 노쇠 관리를 위해서는 신체적 활동과 적절한 단백질 섭취가 중요하며, 부적절한 약물 사용을 줄이고 구강관리, 인지기능, 낙상에도 유의해야한다. 노쇠와 통증은 서로 영향을 미칠 수 있으며 통증이 노쇠를 촉진시킬 수 있다. 노쇠와 통증 연구 분야에서 호르몬과 단백질의 이상, 면역체계 활성과 염증반응, 그리고 후성 유전학의 기전이 공통적으로 작용하고 있다는 증거들이 발표되고 있다. 향후 좀 더 광범위하고 수준 높은 연구가 이루어져야 할 것이며, 그 결과를 노쇠와 통증의 억제와 치료에 적용한다면 삶의 질이 높아질 것이다.