• Journal of Korean Neurosurgical Society
• /
• v.62 no.2
• /
• pp.256-262
• /
• 2019

Objective : Pituitary adenomas (PAs) are often detected as incidental findings. However, the natural history remains unclear. The objective of this study was to evaluate the natural history and growth pattern of untreated PAs. Methods : Between 2003 and 2014, 59 PAs were managed with clinico-radiological follow up for longer than 12 months without any kind of therapeutic intervention. Tumor volumes were calculated at initial and last follow-up visit, and tumor growth during the observation period was determined. Data were analyzed according to clinical and imaging characteristics. Results : The mean initial and last tumor volume and diameter were $1.83{\pm}2.97mL$ and $13.77{\pm}6.45mm$, $2.85{\pm}4.47mL$ and $15.75{\pm}8.08mm$, respectively. The mean annual tumor growth rate was $0.33{\pm}0.68mL/year$ during a mean observation period of $46.8{\pm}32.1months$. Sixteen (27%) PAs showed tumor growth. The initial tumor size (HR, 1.140; 95% confidence interval, 1.003-1.295; p=0.045) was the independent predictive factor that determined the tumor growth. Six patients (11%) of 56 conservatively managed non-symptomatic PAs underwent resection for aggravating visual symptoms with mean interval of 34.5 months from diagnosis. By Cox regression analysis, PAs of last longest diameter over 21.75 mm were a significant prognostic factor for eventual treatment. Conclusion : The initial tumor size of PAs was independently associated with the tumor growth. Six patients (11%) of conservatively managed PAs were likely to be treated eventually. PAs of last follow-up longest diameter over 21.75 mm were a significant prognostic factor for treatment. Further studies with a large series are required to determine treatment strategy.

• Nutrition Research and Practice
• /
• v.13 no.3
• /
• pp.247-255
• /
• 2019

BACKGROUND/OBJECTIVES: Accurate, early identification of acutely malnourished children has the potential to reduce related child morbidity and mortality. The current World Health Organisation (WHO) guidelines classify non-oedematous acute malnutrition among children under five using Mid-Upper Arm Circumference (MUAC) or Weight-for-Height Z-score (WHZ). However, there is ongoing debate regarding the use of current MUAC cut-offs. This study investigates the diagnostic performance of MUAC to identify children aged 6-24 months with global (GAM) or severe acute malnutrition (SAM). SUBJECTS/METHODS: Cross-sectional, secondary data from a community sample of children aged 6-24 months in Niger were used for this study. Children with complete weight, height and MUAC data and without clinical oedema were included. Using WHO guidelines for GAM (WHZ < -2, MUAC < 12.5 cm) and SAM (WHZ < -3, MUAC < 11.5 cm), the sensitivity (Se), specificity (Sp), predictive values, Youden Index and Receiver Operating Characteristic (ROC) curves were calculated for MUAC when compared with the WHZ reference criterion. RESULTS: Of 1161 children, 23.3% were diagnosed with GAM using WHZ, and 4.4% with SAM. Using current WHO cut-offs, the Se of MUAC to identify GAM was greater than for SAM (79 vs. 57%), yet the Sp was lower (84 vs. 97%). From inspection of the ROC curve and Youden Index, Se and Sp were maximised for MUAC < 12.5 cm to identify GAM (Se 79%, Sp 84%), and MUAC < 12.0 cm to identify SAM (Se 88%, Sp 81%). CONCLUSIONS: The current MUAC cut-off to identify GAM should continue to be used, but when screening for SAM, a higher cut-off could improve case identification. Community screening for SAM could use MUAC < 12.0 cm followed by appropriate treatment based on either MUAC < 11.5 cm or WHZ < -3, as in current practice. While the practicalities of implementation must be considered, the higher SAM MUAC cut-off would maximise early case-finding of high-risk acutely malnourished children.

• Parasites, Hosts and Diseases
• /
• v.58 no.5
• /
• pp.513-525
• /
• 2020

Clonorchis sinensis is a food-borne trematode that infects more than 15 million people. The liver fluke causes clonorchiasis and chronical cholangitis, and promotes cholangiocarcinoma. The underlying molecular pathogenesis occurring in the bile duct by the infection is little known. In this study, transcriptome profile in the bile ducts infected with C. sinensis were analyzed using microarray methods. Differentially expressed genes (DEGs) were 1,563 and 1,457 at 2 and 4 weeks after infection. Majority of the DEGs were temporally dysregulated at 2 weeks, but 519 DEGs showed monotonically changing expression patterns that formed seven distinct expression profiles. Protein-protein interaction (PPI) analysis of the DEG products revealed 5 sub-networks and 10 key hub proteins while weighted co-expression network analysis (WGCNA)-derived gene-gene interaction exhibited 16 co-expression modules and 13 key hub genes. The DEGs were significantly enriched in 16 Kyoto Encyclopedia of Genes and Genomes pathways, which were related to original systems, cellular process, environmental information processing, and human diseases. This study uncovered a global picture of gene expression profiles in the bile ducts infected with C. sinensis, and provided a set of potent predictive biomarkers for early diagnosis of clonorchiasis.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.25 no.1
• /
• pp.70-78
• /
• 2022

Purpose: Cholestasis resulting from cytomegalovirus (CMV)-induced hepatitis manifests in 40% of patients with a CMV infection. Ganciclovir treatment in children with CMV infections has proven to be highly effective. Until now, there are very few studies have identified predictive factors for liver biochemistry improvement after ganciclovir therapy. This study aimed to identify the predictors of liver biochemistry improvement in patients with CMV cholestasis after ganciclovir treatment. Methods: A retrospective cohort study was conducted using medical records from Dr. Sardjito General Hospital Yogyakarta, Indonesia from 2013 to 2018. CMV cholestasis was confirmed based on serum CMV IgG and IgM positivity and/or blood and urine CMV antigenemia positivity. Incomplete medical records and other etiologies for cholestasis, such as biliary atresia, choledochal cyst, metabolic diseases, and Alagille syndrome, were excluded. Patient age at cholestasis diagnosis and ganciclovir treatment, duration of CMV cholestasis, history of prematurity, central nervous system involvement, and nutritional status were analyzed and presented as an odds ratio (OR) with a 95% confidence interval (95% CI). Results: CMV cholestasis with ganciclovir therapy was found in 41 of 54 patients. Multivariate analysis showed that a shorter duration of CMV cholestasis (OR: 4.6, 95% CI: 1.00-21.07, p=0.04) was statistically significant for liver biochemistry improvement after 1 month of ganciclovir treatment. The remaining factors that were analyzed were not significant predictors of liver biochemistry improvement in patients with CMV cholestasis after ganciclovir treatment. Conclusion: A shorter duration of CMV cholestasis is the predictor of liver biochemistry improvement after 1 month gancyclovir treatment.

• The Journal of the Institute of Internet, Broadcasting and Communication
• /
• v.22 no.6
• /
• pp.83-89
• /
• 2022

Internet of Things technology is rapidly developing due to the recent development of information and communication technology. IoT technology utilizes various sensors to generate unique data from each sensor, enabling diagnosis of system status. However, the equipment management system currently in effect is a post-preservation concept in which administrators must deal with the problem after the problem occurs, which could mean system reliability and availability problems due to system errors, and could result in economic losses due to negative productivity disruptions. Therefore, this study confirmed that edge controller control decision algorithms for more efficient operation of rectifiers in the factory by applying intelligent IoT (AIoT) technology and domain knowledge-based modeling for each sensor data collected based on this, outputting appropriate status messages for each scenario.

• Journal of the Korea Institute of Information and Communication Engineering
• /
• v.26 no.12
• /
• pp.1826-1831
• /
• 2022

Rapid Aging Society demands the transformation of medical paradigm of diagnosis and treatment towards prevention and management. This paper explores the norm and development of digital health care, focusing on Busan Metropolitan City. Digital health care which combines new ICT technology and medical technology is predictive, preventive, personalized and participatory; and suggests alternative to solve the problem of demographic changes and increasing social cost of medical welfare. Community Health Center in Busan is unique one based in the minimum community of collecting data from self-leading health management. Digital transformation using basic health data and social information can build preventive care system in the community. Easy access leads community center to test bed of developing new technology, as a living lab. In order to use the newly developed goods and service effectively, user-participatory test is nicessary. Finally community nurse and activists can specify health-welfare converged service through digital transformation empowerment training.

• Journal of the Society of Naval Architects of Korea
• /
• v.60 no.2
• /
• pp.95-109
• /
• 2023

In the 4th industrial revolution, changes in the technological paradigm have had a direct impact on the maintenance system of ships. The 2-stroke low speed engine system integrates with the core equipment required for propulsive power. The Condition Based Management (CBM) is defined as a technology that predictive maintenance methods in existing calender-based or running time based maintenance systems by monitoring the condition of machinery and diagnosis/prognosis failures. In this study, we have established a framework for CBM technology development on our own, and are engaged in engineering-based failure analysis, data development and management, data feature analysis and pre-processing, and verified the reliability of failure mode DB using LSTM algorithms. We developed various simulated failure mode scenarios for 2-stroke low speed engine and researched to produce data on onshore basis test_beds. The analysis and pre-processing of normal and abnormal status data acquired through failure mode simulation experiment used various Exploratory Data Analysis (EDA) techniques to feature extract not only data on the performance and efficiency of 2-stroke low speed engine but also key feature data using multivariate statistical analysis. In addition, by developing an LSTM classification algorithm, we tried to verify the reliability of various failure mode data with time-series characteristics.

• The Journal of the Institute of Internet, Broadcasting and Communication
• /
• v.23 no.4
• /
• pp.127-135
• /
• 2023

Nowadays, the number of patients committing suicide due to depression and stress is rapidly increasing. In addition, if stress and depression last for a long time, they are dangerous factors that can cause heart disease, brain disease, and high blood pressure. However, no matter how modern medicine has developed, it is a very difficult situation for patients with depression and heart disease without special drugs or treatments. Therefore, in many countries around the world, studies are being actively conducted to determine patients at risk of depression and patients at risk of suicide at an early stage using electrocardiogram, oxygen saturation, and brain wave analysis functions. In this paper, in order to analyze these problems, a computer simulation was performed to determine heart disease risk patients by establishing heart disease hypothesis data. In particular, in order to improve the predictive rate of heart disease by more than 10%, a simulation using fuzzy inference was performed.

• Journal of Korean Biological Nursing Science
• /
• v.25 no.2
• /
• pp.131-142
• /
• 2023

Purpose: The aim of this study was to assess lipid levels and to identify groups with poor lipid control group among patients with dyslipidemia. Methods: Data from 1,399 Korean patients with dyslipidemia older than 20 years were extracted from the Korea National Health and Nutrition Examination Survey. Complex sample analysis and decision-tree analysis were conducted with using SPSS for Windows version 27.0. Results: The mean levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein cholesterol were 211.38±1.15 mg/dL, 306.61±1.15 mg/dL, 118.48±1.08 mg/dL, and 42.39±1.15 mg/dL, respectively. About 61% of participants showed abnormal lipid control. Poor glycemic control groups (TC ≥ 200 mg/dL or TG ≥ 150 mg/dL or LDL-C ≥ 130 mg/dL) were identified through seven different pathways via decision-tree analysis. Poor lipid control groups were categorized based on patients' characteristics such as gender, age, education, dyslipidemia medication adherence, perception of dyslipidemia, diagnosis of myocardial infarction or angina, diabetes mellitus, perceived health status, relative hand grip strength, hemoglobin A1c, aerobic exercise per week, and walking days per week. Dyslipidemia medication adherence was the most significant predictor of poor lipid control. Conclusion: The findings demonstrated characteristics that are predictive of poor lipid control and can be used to detect poor lipid control in patients with dyslipidemia.

• Annals of Hepato-Biliary-Pancreatic Surgery
• /
• v.27 no.2
• /
• pp.189-194
• /
• 2023

Backgrounds/Aims: Postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) is a source of major morbidity and mortality. Early diagnosis and treatment of POPF is mandatory to improve patient outcomes and clinical risk scores may be ombined with postoperative drain fluid amylase (DFA) values to stratify patients. The aim of this pilot study was to etermine if intraoperative fluid amylase (IFA) values correlate with DFA1 and POPF. Methods: In patients undergoing PD from February to November 2020, intraoperative samples of intra-abdominal fluid adjacent to the pancreatic anastomosis were taken and sent for fluid amylase measurement prior to abdominal closure. Data regarding patient demographics, postoperative DFA values, complications, and mortality were prospectively collected. Results: Data were obtained for 52 patients with a median alternative Fistula Risk Score (aFRS) of 9.9. Postoperative complications occurred in 20 (38.5%) patients (five Clavien grade ≥ 3). There were eight POPFs and two patients died (pneumonia/sepsis). There was a significant correlation between IFA and DFA1 (R² = 0.713; p < 0.001) and DFA3 (p < 0.001), and the median IFA was higher in patients with POPF than patients without (1,232.5 vs. 122; p = 0.0003). IFA > 260 U/L predicted POPF with sensitivity, specificity, positive and negative predictive values of 88.0%, 75.0%, 39.0%, and 97.0%, respectively. The incidence of POPF was 43.0% in high-risk (high aFRS/IFA) and 0% in lowrisk patients (low aFRS/IFA). Conclusions: IFA correlated with POPF and may be a useful adjunct to clinical risk scores to stratify patients during PD. Larger, prospective studies are needed to determine whether IFA has clinical utility.