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Application of Artificial Intelligence in Gastric Cancer (위암에서 인공지능의 응용)

  • Jung In Lee
    • Journal of Digestive Cancer Research
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    • v.11 no.3
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    • pp.130-140
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    • 2023
  • Gastric cancer (GC) is one of the most common malignant tumors worldwide, with a 5-year survival rate of < 40%. The diagnosis and treatment decisions of GC rely on human experts' judgments on medical images; therefore, the accuracy can be hindered by image condition, objective criterion, limited experience, and interobserver discrepancy. In recent years, several applications of artificial intelligence (AI) have emerged in the GC field based on improvement of computational power and deep learning algorithms. AI can support various clinical practices in endoscopic examination, pathologic confirmation, radiologic staging, and prognosis prediction. This review has systematically summarized the current status of AI applications after a comprehensive literature search. Although the current approaches are challenged by data scarcity and poor interpretability, future directions of this field are likely to overcome the risk and enhance their accuracy and applicability in clinical practice.

An Overview of the Herbal Remedies and other Non-conventional Therapies for 2009 Novel Influenza A(H1N1) (2009년 유행 신종인플루엔자 A(H1N1)의 한약 및 기타 비전형적 치료에 대한 고찰)

  • Sun, Seung-Ho;Jang, In-Soo;Baik, You-Sang;Bae, Sun-Jae;Han, Chang-Ho
    • The Journal of Internal Korean Medicine
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    • v.30 no.3
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    • pp.558-570
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    • 2009
  • Background : Since March 2009, when the first patient of novel influenza A (H1N1) was reported, many deaths have occurred in North and Central America. The start of the 2009 influenza pandemic was declared by WHO Director-General Dr. Margaret Chan on 11 June 2009, and the level of influenza pandemic alert raised from phase 5 to phase 6. There was no vaccine yet developed, and many experts worried that the novel H1N1 virus could kill as many or more as did the influenza pandemic in 1918-1919. Objective : To evaluate the possibility of treatment for 2009 novel influenza A (H1N1) using herbal remedies and other non-conventional therapies. Methods : We researched the clinical studies for novel H1N1 influenza virus-related herbal medicine or non-conventional medicine treatment using internet search engines including PubMed and CNKI. In addition, we reviewed many reports and clinical practice guidelines (CPG) for influenza A (H1N1). Results : Two case series were selected after reviewing 701 papers, and two CPG published by the Chinese government and Jilin province identified. They reported that the clinical symptoms were no more significant than seasonal influenza, and the condition of patients more than 45 years old was milder than those less than 45 years old. There are no patients with gastric problems, and oseltamivir has been used at the same time in all patients. Conclusion : The efficacy and effectiveness of herbal medicine and other non-conventional treatments for the novel influenza A (H1N1) is questionable, and more studies are needed to draw a firm conclusion. However, in the severe acute respiratory syndrome (SARS) experience in 2002/2003, it was demonstrated that herbal medicine can relieve all symptoms of SARS patients, promote absorption of lung inflammation, improve the degree of blood oxygen saturation, regulate immunological functions, reduce the required dosage of glucocorticoid and other medicines, and reduce case fatality rate. In light of the current situation that there is no vaccine or conventional treatment yet available, the study of herbal medicine and other non-conventional therapies are also necessary for appropriate evaluation.

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Effects of Yigong-san for the Treatment of Anorexia in Children: A Systematic Review and Meta-Analysis (소아 식욕부진에 대한 이공산(異功散) 치료의 효과 : 체계적 문헌고찰 및 메타분석)

  • Lee, Bo-ram;Ha, Da-jung;Huh, Tae-young;Park, Sang-eun;Lee, Sun-haeng;Chang, Gyu-tae
    • The Journal of Internal Korean Medicine
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    • v.43 no.4
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    • pp.542-558
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    • 2022
  • Objectives: The purpose of this study was to assess the effect of Yigong-san on anorexia in children by conducting a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: Eleven electronic databases were searched on May 30, 2022 to collect relevant studies. All studies published up to the search date were considered. RCTs reporting the effect of Yigong-san on the treatment of anorexia in children were included. The primary outcome was an improvement in clinical anorexia symptoms after treatment. In this meta-analysis, continuous and binary outcomes were assessed, and the data were presented as the mean difference and risk ratio with their 95% confidence intervals. The risk of bias was assessed using the Cochrane Collaboration's risk of bias tool. Results: A total of nine studies were included in this systematic review. The treatment group (Yigong-san only or Yigong-san plus conventional treatment) showed a statistically significant effect compared to the control group (conventional treatment only) in total effective rate (Yigong-san only: RR 1.26, 95% CI 1.17, 1.36, I2=0%; Yigong-san plus conventional treatment: RR 1.32, 95% CI 1.18, 1.47, I2=0%), clinical symptoms, some of the anthropometric outcomes, and biological markers related to appetite and growth in children with anorexia. No serious adverse events related to Yigong-san were reported. Conclusions: Yigong-san showed statistically significant effects as a treatment for anorexia in children. However, the number of studies included in the meta-analysis was insufficient, and the herbs contained in the Yigong-san used in the included studies were not standardized. Future research should focus on the implementation of methodologically robust clinical research.

The Effect of Taeksa-tang for Dyslipidemia: A Systematic Review and Meta-Analysis (이상지질혈증에 대한 택사탕(澤瀉湯)의 효과 : 체계적 문헌 고찰 및 메타 분석)

  • Yeong-seo Lee;Tae-young Huh;Kyoung-min Kim
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.485-505
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    • 2023
  • Objective: The purpose of this study is to assess the effectiveness and safety of using Taeksa-tang for dyslipidemia through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: The search was conducted using keywords such as "dyslipidemia", "hyperlipidemia", "taeksa tang", "zexie tang", and "takusha to" in 12 databases (Pubmed, Cochrane, Embase, ScienceDirect, CNKI, Wanfang, CiNii, RISS, KISS, ScienceON, OASIS, and DBpia) on April 13, 2023. There were no limits on the publication period and language. Cochrane's risk of bias (RoB) was used to evaluate the quality of the studies. A meta-analysis was conducted according to the outcome measurements such as total effective rate (TER), total cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), and adverse effects, using the Review Manager web. Results: A total of 9 RCTs were selected. In evaluating the RoB, 2 studies mentioning the random sequence generation, 1 study conducting double blindness, and 8 studies without missing values were evaluated as low risk, while 1 study without mentioning the random sequence generation was evaluated as high risk. All other parts were evaluated as unclear risk. The treatment group (Taeksa-tang or Taeksa-tang-gagam) showed more statistically significant effects compared to the control group (Western medicine or Chinese patent medicine) in TER (RR : 1.24, 95% CI 1.15 to 1.34, P<0.00001), TC (MD : -1.12, 95% CI -1.68 to -0.56, P<0.0001), TG (MD : -1.08, 95% CI -1.65 to -0.51, P=0.0002), HDL-C (MD : 0.63, 95% CI 0.34 to 0.93, P<0.0001), LDL-C (MD : -0.81, 95% CI -1.10 to -0.53, P<0.00001). In addition, the treatment group showed lower adverse effects compared to the control group (RR : 0.30, 95% CI 0.12 to 0.74, P=0.008). Conclusion: This study suggests that Taeksa-tang is effective and safe to use for treating dyslipidemia. However, due to the low quality of the included studies, more clinical studies need to be conducted in the future to increase the possibility of clinical use.

Effect of Herbal Medicines on Preventing Restenosis After Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis of Randomized Controlled Trials (경피적 관상동맥중재술 후 재협착 예방에 대한 한약의 효과 : 무작위배정 대조군 임상연구에 대한 체계적 문헌고찰 및 메타분석)

  • Nayeon Hur;Subin Ahn;Hongjun Kim;Insoo Jang
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.387-401
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    • 2023
  • Objective: This study was conducted to investigate the preventive effect of herbal medicines on restenosis after percutaneous coronary intervention (PCI) by reviewing randomized controlled trials (RCTs). Methods: RCTs were searched for herbal medicine treatment after PCI using eight online databases (PubMed, CNKI, Wanfang, J-STAGE, OASIS, ScienceON, KTKP, and KISS). Studies that confirmed restenosis through coronary angiography at follow-up were selected according to the inclusion and exclusion criteria. The primary outcome was the restenosis rate, and the secondary outcome was the angina recurrence rate. Data were extracted from the final selected studies according to the research methodology and then analyzed with Review Manager 5.4.1. Study quality was assessed using Cochrane's risk-of-bias (RoB) tool. Results: Of the 252 papers obtained through the primary search, nine studies that met the selection criteria were finally selected. In these nine studies, herbal medicine combined with western medicine was used for the experimental group, and western medicine treatment was used alone for the control group. The meta-analysis result revealed that the restenosis rate and angina recurrence rate were significantly lower in the experimental group than in the control group (RR=0.34, 95% CI: 0.22-0.53, p<0.00001, I2=0% and RR=0.47, 95% CI: 0.29-0.78, p=0.004, I2=0%, respectively). Furthermore, the quality of studies assessed by Cochrane's RoB was low. Conclusions: This study showed that the combined treatment of herbal medicine and western medicine was effective in preventing restenosis and angina after PCI. As the number of papers included in this study was small, a large number of high-quality clinical studies should be considered in the future.

Making Cache-Conscious CCMR-trees for Main Memory Indexing (주기억 데이타베이스 인덱싱을 위한 CCMR-트리)

  • 윤석우;김경창
    • Journal of KIISE:Databases
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    • v.30 no.6
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    • pp.651-665
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    • 2003
  • To reduce cache misses emerges as the most important issue in today's situation of main memory databases, in which CPU speeds have been increasing at 60% per year, and memory speeds at 10% per year. Recent researches have demonstrated that cache-conscious index structure such as the CR-tree outperforms the R-tree variants. Its search performance can be poor than the original R-tree, however, since it uses a lossy compression scheme. In this paper, we propose alternatively a cache-conscious version of the R-tree, which we call MR-tree. The MR-tree propagates node splits upward only if one of the internal nodes on the insertion path has empty room. Thus, the internal nodes of the MR-tree are almost 100% full. In case there is no empty room on the insertion path, a newly-created leaf simply becomes a child of the split leaf. The height of the MR-tree increases according to the sequence of inserting objects. Thus, the HeightBalance algorithm is executed when unbalanced heights of child nodes are detected. Additionally, we also propose the CCMR-tree in order to build a more cache-conscious MR-tree. Our experimental and analytical study shows that the two-dimensional MR-tree performs search up to 2.4times faster than the ordinary R-tree while maintaining slightly better update performance and using similar memory space.

The Effect of Dachaihu Decoction for Hyperlipidemic Acute Pancreatitis: A Systematic Review and Meta-Analysis (고지혈성 급성 췌장염에 대한 대시호탕의 효과 : 체계적 문헌고찰과 메타분석)

  • Kim, Yoon-jung;Jung, Yu-jin;Park, Dong-il
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.306-325
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    • 2020
  • Objectives: The aim of this study is to investigate the effect of a Dachaihu decoction for hyperlipidemic acute pancreatitis (HLAP) by systematic review and meta-analysis of Chinese clinical studies. Methods: China National Knowledge Infrastructure (CNKI) was utilized as the major search engine. The date of the literature search was March 7, 2020. Randomized controlled trials (RCTs) about using a Dachaihu decoction for HLAP were included in this study. Meta-analysis was performed by synthesizing outcome data, including total effective rate, abdomen pain relief time, first bowel movement time, blood amylase recovery time, and triglyceride (TG) levels (mmol/L). The selected literature was assessed using Cochrane's risk of bias (RoB). Results: Twelve of 44 RCTs met the inclusion criteria. Most studies were evaluated with RoB as having unclear risk. The total effective rate of herbal medicine treatment based on the Dachaihu decoction was significantly higher than that of symptomatic supportive treatment in 10 articles (risk ratio=1.15, 95% CI: 1.08 to 1.21, p<0.00001, I2=0%). Herbal medicine treatment based on a Dachaihu decoction was significantly more effective than symptomatic supportive treatment in terms of reducing abdomen pain relief time (in all articles; mean difference=-1.70, 95% CI: -1.91 to -1.41, p<0.00001, I2=45%), first bowel movement time (in 7 articles; mean difference=-1.46, 95% CI: -1.86 to -1.05, p<0.00001, I2=73%), blood amylase recovery time (in 8 articles; mean difference=-1.48, 95% CI: -2.04 to -0.92, p<0.00001, I2=90%), and TG levels (in 8 articles; mean difference=-1.59, 95% CI: -2.28to -0.91, p<0.00001, I2=90%). Only one article reported side effects of treatment among the intervention group and control group, citing pancreatic ulcer and pancreatic pseudocyst formation. Conclusions: This study suggests that herbal medicine treatment based on a Dachaihu decoction could yield higher efficacy for HLAP than symptomatic supportive treatment alone. However, the results might be somewhat biased because of the poor quality and small sample size of the included RCTs. Well-qualified clinical studies are needed to prove the effectiveness of Dachaihu decoction therapy for HLAP.

The Effectiveness of Traditional Korean Medicine for Treating Postoperative Ileus in Gastric Cancer Patients: A Systematic Review and Meta-Analysis (위암 수술 후 장마비에 대한 한의학적 치료의 효과 : 체계적 문헌 고찰 및 메타분석)

  • Bae, Hye-ri;Kim, Eun-ji;Seo, Hyun-sik;Lee, Nam-hun
    • The Journal of Internal Korean Medicine
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    • v.43 no.4
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    • pp.625-642
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    • 2022
  • Objectives: Postoperative ileus (POI) is a common impairment of gastrointestinal motility and causes a delay in postoperative recovery, as well as an increased length of hospital stay, but no single strategy has a significant recuperative effect on POI. Studies of traditional Korean medicine (TKM) have reported improvements in bowel function after surgery. The aim of this systematic review was to assess the effectiveness of TKM on postoperative ileus in gastric cancer patients. Methods: We used six databases to search for studies published from January 1, 2007, until May 11, 2022. The included studies were those reporting gastric cancer patients who received TKM treatment after gastrectomy through indicators related to POI. Results: The search identified 27 RCTs that used herbal medicine (Daegeonjung-tang and Gami-leejoongtang), herbal medicine combined with acupuncture (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, acupuncture and moxibustion, electroacupuncture, warm needling, transcutaneous electroacupuncture (TEA), low-frequency electrical acupoint stimulation (LEAS), moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine as treatments for POI. The time to first flatus was shortened by herbal medicine combined with warm needling (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, electroacupuncture, warm needling, TEA, moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine (p<0.00001). The time to the first defecation decreased significantly in response to the herbal medicine combined with warm needling (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, electroacupuncture, warm needling, TEA, moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine (p<0.00001). No serious adverse events occurred. Conclusions: TKM could be a promising option for preventing and resolving POI in gastric cancer patients after gastrectomy.

Clinical Application of Focused Ultrasound in Korean Medicine (집속초음파 치료의 한의 임상 활용에 대한 고찰)

  • Yoomin Choi;Maeum Lee;Nayeon Hur;Eunhee Lee;Hyugyong Choi;Hyung-Sik Seo;Eui-Hyoung Hwang;Insoo Jang
    • Korean Journal of Acupuncture
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    • v.40 no.3
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    • pp.79-89
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    • 2023
  • Objectives : The purpose of this study is to investigate various application methods of focused ultrasound and apply them to clinical use in Korean medicine. Methods : Search was performed using the search engines of electronic databases, including PubMed, ScienceDirect, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ScienceON, Oriental Medicine Advanced Searching Integrated System (OASIS), China National Knowledge Infrastructure (CNKI), Wanfang Data, Japan Science Technology Information Aggregator, Electronic (J-STAGE) and Citation Information by NII (CiNii), from inception to July 2023 without language limitation. Inclusion criteria were clinical studies including randomized controlled trials (RCTs), and animal experimental studies related with focused ultrasound treatments for acupoints or meridian sinews. Results : Total 17 papers, 7 for RCT, 6 for in vivo animal studies, and other experimental studies, were finally selected. Indications used in studies were shoulder pain, back pain, chronic back pain, and degenerative knee arthritis. In experimental studies, studies on animal models of hypoxic ischemic brain damage and hyperlipidemia were also conducted. As for the acupoints, LR3, LI4, and ST36 were used in clinical studies and, in animal experimental studies, GV20, KI1, and ST36 were used. As for the dose, 4 studies below 3 W/cm2 and 3 studies in the range of 0.625 to 5 W/cm2 in clinical studies, and all studies did not exceed 5 W/cm2. In animal experimental studies, 0.5 W/cm2, 2 W/cm2, 7.5 WW/cm2, 15 W/cm2, 10~20 W/cm2 were used. In all three studies describing the penetration depth during irradiation, it was less than 1 cm. Conclusions : We suggest that focused ultrasound is an appropriate treatment tool for stimulating the acupoints to transfer heat energy. Future studies with rigorous and well-designed RCTs for various diseases will be required to ascertain the focused ultrasound stimulate acupoints or meridian sinews.

A Study on Scale of Participation Motive for Leisure Sports (여가 스포츠 참여동기 척도 분석에 관한 연구)

  • Kim, Ji-Young;Kim, Seung-Hyeon
    • 한국체육학회지인문사회과학편
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    • v.54 no.3
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    • pp.439-452
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    • 2015
  • The purpose of this study is to encourage continuous participation in sports and to provide basic data for the promotion of participation in leisure sports. To achieve the purpose, this study conducted factor scaling analysis on participation motives for leisure sports and subdivided them to analyze psychological reactions of participants. As for study methods, this study collected master and doctor's degree theses and academic journals on motives for sports participation that were conducted from 1997 to 2012 from Korean major search engines. On the search engines, a keyword 'motive' was searched first and then studies on participation motive for leisure sports were collected. Key words that appeared when searching 'motive' were combined with other key words and word spacing between them were checked before conducting a literature analysis. The study results showed that participation motives for leisure sports were divided into a participation motive, an internal motive, an external motive, a leisure motive and other motives. It was identified that there were 23 factors for the participation motive, 17 factors each for the internal motive and the external motive, 8 factors for the leisure motive and 57 factors for other motives. It was found out that 76 factors were used to study a participation motive for leisure sports, excluding the factors that have similar or overlapping meaning based on each factor.