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Intracranial stenting compared to medical treatment alone for intracranial atherosclerosis patients: An updated meta-analysis

  • Adam A. Dmytriw;Jerry Ku;Ahmed Y. Azzam;Osman Elamin;Nicole Cancelliere;Anish Kapadia;James D. Rabinov;Christopher J. Stapleton;Robert W. Regenhardt;Vitor Mendes Pereira;Aman B. Patel;Victor X.D. Yang
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.26 no.2
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    • pp.152-162
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    • 2024
  • Objective: Stroke is the second-leading cause of death globally. Intracranial atherosclerotic stenosis (ICAS) represents 10-15% of ischemic strokes in Western countries and up to 47% in Asian countries. Patients with ICAS have an especially high risk of stroke recurrence. The aim of this meta-analysis is to reassess recurrent stroke, transient ischemic attack (TIA), and other outcomes with stenting versus best medical management for symptomatic ICAS. Methods: The search protocol was developed a priori according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The OVID Medline, Embase, Web of Science, and Cochrane Library databases were searched from inception to August 14th, 2022. Results: This meta-analysis included four randomized controlled trials (RCTs), with a total number of 991 patients. The mean age of participants was 57 years. The total number of intracranial stenting patients was 495, and the number of medical treatment patients was 496. The included studies were published between 2011 and 2022. Two studies were conducted in the USA, and the other two in China. All included studies compared intracranial stenting to medical treatment for ICAS. Conclusions: In patients with ischemic stroke due to symptomatic severe intracranial atherosclerosis, the rate of 30-day ischemic stroke, 30-day intracerebral hemorrhage, one-year stroke in territory or mortality favored the medical treatment alone without intracranial stenting. The risk of same-territory stroke at last follow-up, disabling stroke at last follow-up, and mortality did not significantly favor either group. Intracranial stenting for atherosclerosis did not result in significant benefit over medical treatment.

A Study on Home Visiting Hospice Care of the Terminally Ill Patients (가정 호스피스케어환자 방문간호 조사분석)

  • Lee, So-Woo;Lee, Eun-Ok;Park, Hyun-Ae;Oh, Hyo-Sook;Ahn, Hyo-Seop;Huh, Dae-Suk;Yun, Young-Ho;Kim, Dal-Sook;Rho, Yoo-Ja
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.39-46
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    • 1998
  • Purpose : Hospice Care is considered as one of the most perfect solutions for the problems brought up as the number of chronically ill patients are increasing rapidly and most of social welfare oriented countries are seeking the quality of life. Our former studies(1996, 1997) were to find out the current status of the hospice care in Korea by surveying terminally ill patients and their family members as well as medical professionals. The former study was also to conduct the operation research by developing an information service system for training of hospice care teams and volunteers, and hospice patients management. The purpose of this study was that hospice information service system was tested by home visiting hospice care through visiting nurses. Methods : From October 1, 1997 to March 31, 1998, Twenty six terminal cancer patients were included in this study from Seoul National University Hospital and other hospital. Databases and homepage, hospice information service system were designed and developed for the information needed for the hospice care before this study by our research team and this services were available through the internet. Visiting nurses were trained about this system and they visited the patients with PC notebook and provided them hospice care with hospice information system. They collected physical, psychiatric, social data of the subjects at the first visit and during hospice care at home. Results : Sixteen subjects(61.5%) died during the study and the mean survival was 20.7 days. Anorexia(96.2%), immobility(88.5%) and pain(84.6%) were the major symptom in the 26 subjects, Altered nutrition(26.1%) and pain(12.4%) were the most frequent diagnoses in 226 nursing diagnoses of the subjects. Families understood and demanded the hospice care more than patients. And most patients and families didn't demand spiritual or social care. Conclusion : Through this demonstration study, it was found that we have to provide the information of pain management and nutritional support for patients by the nurses and visiting hospice nurse. The information service system needs to be upgraded with information and manpower of spiritual and social care according to the findings.

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Branching Path Query Processing for XML Documents using the Prefix Match Join (프리픽스 매취 조인을 이용한 XML 문서에 대한 분기 경로 질의 처리)

  • Park Young-Ho;Han Wook-Shin;Whang Kyu-Young
    • Journal of KIISE:Databases
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    • v.32 no.4
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    • pp.452-472
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    • 2005
  • We propose XIR-Branching, a novel method for processing partial match queries on heterogeneous XML documents using information retrieval(IR) techniques and novel instance join techniques. A partial match query is defined as the one having the descendent-or-self axis '//' in its path expression. In its general form, a partial match query has branch predicates forming branching paths. The objective of XIR-Branching is to efficiently support this type of queries for large-scale documents of heterogeneous schemas. XIR-Branching has its basis on the conventional schema-level methods using relational tables(e.g., XRel, XParent, XIR-Linear[21]) and significantly improves their efficiency and scalability using two techniques: an inverted index technique and a novel prefix match join. The former supports linear path expressions as the method used in XIR-Linear[21]. The latter supports branching path expressions, and allows for finding the result nodes more efficiently than containment joins used in the conventional methods. XIR-Linear shows the efficiency for linear path expressions, but does not handle branching path expressions. However, we have to handle branching path expressions for querying more in detail and general. The paper presents a novel method for handling branching path expressions. XIR-Branching reduces a candidate set for a query as a schema-level method and then, efficiently finds a final result set by using a novel prefix match join as an instance-level method. We compare the efficiency and scalability of XIR-Branching with those of XRel and XParent using XML documents crawled from the Internet. The results show that XIR-Branching is more efficient than both XRel and XParent by several orders of magnitude for linear path expressions, and by several factors for branching path expressions.

Adaptive Row Major Order: a Performance Optimization Method of the Transform-space View Join (적응형 행 기준 순서: 변환공간 뷰 조인의 성능 최적화 방법)

  • Lee Min-Jae;Han Wook-Shin;Whang Kyu-Young
    • Journal of KIISE:Databases
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    • v.32 no.4
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    • pp.345-361
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    • 2005
  • A transform-space index indexes objects represented as points in the transform space An advantage of a transform-space index is that optimization of join algorithms using these indexes becomes relatively simple. However, the disadvantage is that these algorithms cannot be applied to original-space indexes such as the R-tree. As a way of overcoming this disadvantages, the authors earlier proposed the transform-space view join algorithm that joins two original- space indexes in the transform space through the notion of the transform-space view. A transform-space view is a virtual transform-space index that allows us to perform join in the transform space using original-space indexes. In a transform-space view join algorithm, the order of accessing disk pages -for which various space filling curves could be used -makes a significant impact on the performance of joins. In this paper, we Propose a new space filling curve called the adaptive row major order (ARM order). The ARM order adaptively controls the order of accessing pages and significantly reduces the one-pass buffer size (the minimum buffer size required for guaranteeing one disk access per page) and the number of disk accesses for a given buffer size. Through analysis and experiments, we verify the excellence of the ARM order when used with the transform-space view join. The transform-space view join with the ARM order always outperforms existing ones in terms of both measures used: the one-pass buffer size and the number of disk accesses for a given buffer size. Compared to other conventional space filling curves used with the transform-space view join, it reduces the one-pass buffer size by up to 21.3 times and the number of disk accesses by up to $74.6\%$. In addition, compared to existing spatial join algorithms that use R-trees in the original space, it reduces the one-pass buffer size by up to 15.7 times and the number of disk accesses by up to $65.3\%$.

Evolutionary Explanation for Beauveria bassiana Being a Potent Biological Control Agent Against Agricultural Pests

  • Han, Jae-Gu
    • 한국균학회소식:학술대회논문집
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    • 2014.05a
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    • pp.27-28
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    • 2014
  • Beauveria bassiana (Cordycipitaceae, Hypocreales, Ascomycota) is an anamorphic fungus having a potential to be used as a biological control agent because it parasitizes a wide range of arthropod hosts including termites, aphids, beetles and many other insects. A number of bioactive secondary metabolites (SMs) have been isolated from B. bassiana and functionally verified. Among them, beauvericin and bassianolide are cyclic depsipeptides with antibiotic and insecticidal effects belonging to the enniatin family. Non-ribosomal peptide synthetases (NRPSs) play a crucial role in the synthesis of these secondary metabolites. NRPSs are modularly organized multienzyme complexes in which each module is responsible for the elongation of proteinogenic and non-protein amino acids, as well as carboxyl and hydroxyacids. A minimum of three domains are necessary for one NRPS elongation module: an adenylation (A) domain for substrate recognition and activation; a tholation (T) domain that tethers the growing peptide chain and the incoming aminoacyl unit; and a condensation (C) domain to catalyze peptide bond formation. Some of the optional domains include epimerization (E), heterocyclization (Cy) and oxidation (Ox) domains, which may modify the enzyme-bound precursors or intermediates. In the present study, we analyzed genomes of B. bassiana and its allied species in Hypocreales to verify the distribution of NRPS-encoding genes involving biosynthesis of beauvericin and bassianolide, and to unveil the evolutionary processes of the gene clusters. Initially, we retrieved completely or partially assembled genomic sequences of fungal species belonging to Hypocreales from public databases. SM biosynthesizing genes were predicted from the selected genomes using antiSMASH program. Adenylation (A) domains were extracted from the predicted NRPS, NRPS-like and NRPS-PKS hybrid genes, and used them to construct a phylogenetic tree. Based on the preliminary results of SM biosynthetic gene prediction in B. bassiana, we analyzed the conserved gene orders of beauvericin and bassianolide biosynthetic gene clusters among the hypocrealean fungi. Reciprocal best blast hit (RBH) approach was performed to identify the regions orthologous to the biosynthetic gene cluster in the selected fungal genomes. A clear recombination pattern was recognized in the inferred A-domain tree in which A-domains in the 1st and 2nd modules of beauvericin and bassianolide synthetases were grouped in CYCLO and EAS clades, respectively, suggesting that two modules of each synthetase have evolved independently. In addition, inferred topologies were congruent with the species phylogeny of Cordycipitaceae, indicating that the gene fusion event have occurred before the species divergence. Beauvericin and bassianolide synthetases turned out to possess identical domain organization as C-A-T-C-A-NM-T-T-C. We also predicted precursors of beauvericin and bassianolide synthetases based on the extracted signature residues in A-domain core motifs. The result showed that the A-domains in the 1st module of both synthetases select D-2-hydroxyisovalerate (D-Hiv), while A-domains in the 2nd modules specifically activate L-phenylalanine (Phe) in beauvericin synthetase and leucine (Leu) in bassianolide synthetase. antiSMASH ver. 2.0 predicted 15 genes in the beauvericin biosynthetic gene cluster of the B. bassiana genome dispersed across a total length of approximately 50kb. The beauvericin biosynthetic gene cluster contains beauvericin synthetase as well as kivr gene encoding NADPH-dependent ketoisovalerate reductase which is necessary to convert 2-ketoisovalarate to D-Hiv and a gene encoding a putative Gal4-like transcriptional regulator. Our syntenic comparison showed that species in Cordycipitaceae have almost conserved beauvericin biosynthetic gene cluster although the gene order and direction were sometimes variable. It is intriguing that there is no region orthologous to beauvericin synthetase gene in Cordyceps militaris genome. It is likely that beauvericin synthetase was present in common ancestor of Cordycipitaceae but selective gene loss has occurred in several species including C. militaris. Putative bassianolide biosynthetic gene cluster consisted of 16 genes including bassianolide synthetase, cytochrome P450 monooxygenase, and putative Gal4-like transcriptional regulator genes. Our synteny analysis found that only B. bassiana possessed a bassianolide synthetase gene among the studied fungi. This result is consistent with the groupings in A-domain tree in which bassianolide synthetase gene found in B. bassiana was not grouped with NRPS genes predicted in other species. We hypothesized that bassianolide biosynthesizing cluster genes in B. bassiana are possibly acquired by horizontal gene transfer (HGT) from distantly related fungi. The present study showed that B. bassiana is the only species capable of producing both beauvericin and bassianolide. This property led to B. bassiana infect multiple hosts and to be a potential biological control agent against agricultural pests.

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A Comparative Study on the Effective Deep Learning for Fingerprint Recognition with Scar and Wrinkle (상처와 주름이 있는 지문 판별에 효율적인 심층 학습 비교연구)

  • Kim, JunSeob;Rim, BeanBonyka;Sung, Nak-Jun;Hong, Min
    • Journal of Internet Computing and Services
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    • v.21 no.4
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    • pp.17-23
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    • 2020
  • Biometric information indicating measurement items related to human characteristics has attracted great attention as security technology with high reliability since there is no fear of theft or loss. Among these biometric information, fingerprints are mainly used in fields such as identity verification and identification. If there is a problem such as a wound, wrinkle, or moisture that is difficult to authenticate to the fingerprint image when identifying the identity, the fingerprint expert can identify the problem with the fingerprint directly through the preprocessing step, and apply the image processing algorithm appropriate to the problem. Solve the problem. In this case, by implementing artificial intelligence software that distinguishes fingerprint images with cuts and wrinkles on the fingerprint, it is easy to check whether there are cuts or wrinkles, and by selecting an appropriate algorithm, the fingerprint image can be easily improved. In this study, we developed a total of 17,080 fingerprint databases by acquiring all finger prints of 1,010 students from the Royal University of Cambodia, 600 Sokoto open data sets, and 98 Korean students. In order to determine if there are any injuries or wrinkles in the built database, criteria were established, and the data were validated by experts. The training and test datasets consisted of Cambodian data and Sokoto data, and the ratio was set to 8: 2. The data of 98 Korean students were set up as a validation data set. Using the constructed data set, five CNN-based architectures such as Classic CNN, AlexNet, VGG-16, Resnet50, and Yolo v3 were implemented. A study was conducted to find the model that performed best on the readings. Among the five architectures, ResNet50 showed the best performance with 81.51%.

Effects of Methyl Ethyl Ketone and Methanol on the Survival and Reproduction of Paronychiurus kimi (Collembola: Onychiuridae) (메틸에틸케톤과 메탄올이 김어리톡토기의 사망 및 번식에 미치는 영향)

  • Wee, June;Lee, Yun-Sik;Son, Jino;Kim, Yongeun;Mo, Hyoung-ho;Cho, Kijong
    • Korean Journal of Environmental Biology
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    • v.35 no.2
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    • pp.169-174
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    • 2017
  • Acute and chronic toxicities of methyl ethyl ketone and methanol were investigated on Paronychiurus kimi (Collembola), for evaluating the potential effects of accidental exposures of these chemical substances on the terrestrial environments. This study was undertaken to establish a toxicity database for these chemical substances, which was required for the preparation of the response compensation and liability act for agricultural production and environmental damage. The 7-d acute toxicity and 28-d chronic toxicity were conducted using the OECD artificial soil spiked with varying, serially diluted concentrations of methyl ethyl ketone and methanol. Mortality was recorded after 7-d and 28-d of exposures, and the number of juveniles were determined after 28-d of exposure in the chronic toxicity test. In both assessments, methanol was more toxic than methyl ethyl ketone in terms of mortality ($LC_{50}$) and reproduction ($EC_{50}$). The 7-d $LC_{50}$ of methyl ethyl ketone and methanol were 762 and $2378mg\;kg^{-1}$ soil dry wt., respectively, and the 28-d $LC_{50}s$ were 6063 and $1857mg\;kg^{-1}$ soil dry wt., respectively. The 28-d $EC_{50}$ of methyl ethyl ketone and methanol were 265 and $602mg\;kg^{-1}$ soil dry wt., respectively. Comparison of results obtained in this study with literature data revealed that P. kimi was more sensitive to methanol than other soil invertebrates. However, given the high volatility of the chemicals tested in this study, further studies are necessary to improve the current test guideline, or to develop new test guidelines for an accurate assessment of chemicals that require toxicity databases for chemical accidents.

The Efficacy of Aspirin in Preventing the Recurrence of Colorectal Adenoma: a Renewed Meta-Analysis of Randomized Trials

  • Zhao, Tai-Yun;Tu, Jing;Wang, Yin;Cheng, Da-Wei;Gao, Xian-Kui;Luo, Hao;Yan, Bi-Chun;Xu, Xiao-Li;Zhang, Hong-Ling;Lu, Xing-Jun;Wang, Yao-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2711-2717
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    • 2016
  • Background: Through search the possible randomized control trials, we make a renewed meta-analysis in order to assess the impact of aspirin in preventing the recurrence of colorectal adenoma. Materials and Methods: The Medicine/PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Chinese biomedical literature service system (SinoMed) databases were searched for the related randomized controlled trials until to the April 2016. Three different authors respectively evaluated the quality of studies and extracted data, and we used the STATA software to analyze, investigate heterogeneity between the data, using the fixed-effects model to calculate and merge data. Results: 7 papers were included the renewed meta-analysis, among these studies, two pairs were identified as representing the same study population, with the only difference being the duration of follow-up. Thus there were only five papers included our meta-analysis, and one Chinese paper were also included the work. Results were categorized by the length of follow-up, different kinds of people, varied dose of oral aspirin. The relative of adenoma in patients taking aspirin vs placebo were 0.73 (95% CI 0.55-0.98, P=0.039) with 1 year follow up; 0.84 (95% CI 0.72-0.98, P=0.484) with greater than 1 year follow up; for the advanced adenoma, the RR 0.68 (95% CI 0.49-0.94, P=0.582),for one year; RR=0.75 (95% CI 0.52-1.07, P=0.552) for greater one year. Furthermore the white population could divided into two subgroups according to the different length of follow-up time. When the length of follow-up time less than 3-year, The RR of two subgroups respective were RR=0.86 (95% CI 0.76-0.98, P=0.332), $I^2=0%$, RR=0.68 (95% CI 0.47-0.98, P=0.552), $I^2=64.6%$, But with the extension of follow-up time greater than 2-year, with the white, oral aspirin without considering dose had no efficacy on preventing the recurrence of any adenoma, the RR was 0.86 (95% CI 0.71-1.05, P=0.302), $I^2=16.4%$. Conclusions: This meta-analysis indicated that oral aspirin is associated with a remarkable decrease in the recurrence of any adenoma and advanced adenomas in patients follow-up for 1 year without concerning the dose of aspirin, but with the extension of follow-up time for greater than 1 year, oral aspirin can be effective on preventing the recurrence of any adenoma, but for the advanced adenoma, the result indicated that oral aspirin had no efficacy, According to the inclusion of ethnic groups, we also divided relevant papers into two subgroups as the yellow and white group. Then the follow-up time was less than 3 years, oral aspirin without considering the dose, had an significant efficacy on preventing the recurrence of any adenoma. But with the follow-up greater than 2 years, oral aspirin had no effect in the white.

Recent Trends of Immunologic Studies of Herbal Medicine on Rheumatoid Arthritis (류마티스 관절염에 대한 한약의 면역학적 연구동향)

  • Choi, Do-young;Lee, Jae-dong;Back, Yong-hyeon;Lee, Song-shil;Yoo, Myung-chul;Han, Chung-soo;Yang, Hyung-in;Park, Sang-do;Ryu, Mi-hyun;Park, Eun-kyung;Park, Dong-seok
    • Journal of Acupuncture Research
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    • v.21 no.4
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    • pp.177-196
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    • 2004
  • Objective : Rheumatoid arthritis is an autoimmune disease that pathogenesis is not fully understood and one of the most intractable musculoskeletal diseases. The concern in the immunopathogenesis of rheumatoid arthritis has been increased since 1980's and many immunotherapeutic agents including disease-modifying antirheumatic drugs (DMARDs) were developed and became the mainstay of treatment of rheumatoid arthritis. However, the cure of the disease has hardly been achieved. In oriental medicine, rheumatoid arthritis is related to Bi-Zheng(痺證), that presents pain, swelling, andlor loss of joint function as major clinical manifestations, and also known to be deeply involved in suppression of immune function related to weakness of Jung-Ki(正氣). The herbal medicine, empirically used, could be a potential resource of development of new immunotherapeutic agents for rheumatoid arthritis. Methods : We developed a search strategy using terms to include "rheumatoid arthritis and herbal medicine" combined with "Chinese medicine" and/or "Oriental medicine". The search was focused on experimental studies of herbal medicine (January 1999 to May 2004), which is known to have effects on immune function of patients with rheumatoid arthritis. Computerized search used Internet databases including KISS and RISS4U (Korea), CNKI (China), MOMJ (Main Oriental Medicine Journal, Japan), and PubMed. The articles were selected from journals of universities or major research institutes. Results : The literature search for experimental studies on effects of herbal medicine on immunity of rheumatoid arthritis retrieved a total of 21 articles (Korea; 8, China ; 12, Japan ; 1). Of 21 articles, 10 were related to single-drug formula, 2 to drug interaction, and 9 to multi-drug formula. Single-drug formula was mainly used for aqua-acupuncture and researches on active components. Studies of drug interaction emphasized harmony of Ki-Hyul(氣血) and balance of Han-Yeul(寒熱). Multi-drug regimen was mainly found among formulas for Bo-Ki-Hyul(補氣血) and Bo-Sin(補腎). Conclusion : Studies on rheumatoid arthritis were performed both in vitro and in vivo in vitro study, LPS-stimulated splenocytes and synoviocytes were treated with herbal medicine, resulting in proliferation and activation of immune cells and suppression of cytokine activities in vivo study CIA animal model demonstrated that herbal medicine decreased antibody production and improved function of immune cells. In cellular and molecular study herbal medicine showed profound effects on the level of mRNA expression of certain cytokines related to immune function. This study revealed that herbal medicine has significant immune modulatory action and could be used for recovery of immune dysfunction of rheumatoid arthritis patients.

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A Review of the Systemic Analysis Method on Dental Sedation for Children (소아 치과환자에 대한 진정법의 체계적 분석 방법 고찰)

  • An, Soyoun;Lee, Jewoo;Kim, Seungoh;Kim, Jongbin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.4
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    • pp.331-339
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    • 2015
  • The first priority of sedation for incorporative children in pediatric dentistry is a safety. Therefore, evidence-based practices in health care are needed for preventing medical accidents. In accordance with the rise of the evidence based medicine, the interest in Evidence-Based Dentistry is increasing in the field of dentistry. However, systematic research about Evidence-Based sedation in Korea has rarely been done. As such, the purpose of this systematic review is to critically analyze the available scientific literature regarding dental sedation and to seek the next developmental strategies about evidence based pediatric dental sedation. A broad search of the 5 databases of the systematic reviews manual of the National Evidence-based Healthcare Collaborating Agency in Korea were referenced: 1) Core search database- KMbase, KISS; 2) Academic information and portal; 3) the National Assembly Library; 4) DBpia, and 5) RISS. Of a total 470 themes limited to the search term of "dental sedation", in accordance with the PRISMA statement for reporting systematic reviews of health sciences interventions, a literature selection process, which includes the removal of overlapping down the flow chart, was performed. Of the remaining 31 articles, two authors read through articles independently and added or removed articles using the exclusion criteria. Finally, twenty published papers of acceptable quality were identified and reviewed. This systemic review of Korean pediatric dental sedation practices for the last twenty-five years was based on the objective criteria defined in the GRADE process and identified consistent evidence. The results were evidence of moderate quality. Therefore, more systemically well-designed clinical studies are needed about the safe use of a sedative medicines (drugs).