• Healthcare Informatics Research
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• 제24권4호
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• pp.346-358
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• 2018

Objectives: The association between obstructive sleep apnea (OSA) and mortality or serious cardiovascular events over a long period of time is not clearly understood. The aim of this observational study was to estimate the clinical effectiveness of continuous positive airway pressure (CPAP) treatment on an outcome variable combining mortality, acute myocardial infarction (AMI), and cerebrovascular insult (CVI) during a follow-up period of 15.5 years ($186{\pm}58$ months). Methods: The data set consisted of 978 patients with an apnea-hypopnea index (AHI) ${\geq}5.0$. One-third had used CPAP treatment. For the first time, a data-driven causal Bayesian network (DDBN) and a hypothesis-driven causal Bayesian network (HDBN) were used to investigate the effectiveness of CPAP. Results: In the DDBN, coronary heart disease (CHD), congestive heart failure (CHF), and diuretic use were directly associated with the outcome variable. Sleep apnea parameters and CPAP treatment had no direct association with the outcome variable. In the HDBN, CPAP treatment showed an average improvement of 5.3 percentage points in the outcome. The greatest improvement was seen in patients aged ${\leq}55$ years. The effect of CPAP treatment was weaker in older patients (>55 years) and in patients with CHD. In CHF patients, CPAP treatment was associated with an increased risk of mortality, AMI, or CVI. Conclusions: The effectiveness of CPAP is modest in younger patients. Long-term effectiveness is limited in older patients and in patients with heart disease (CHD or CHF).

• Yonsei Medical Journal
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• 제59권9호
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• pp.1057-1063
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• 2018

Purpose: Coronary artery spasm (CAS) and diabetes mellitus (DM) are implicated in endothelial dysfunction, and insulin resistance (IR) is a major etiological cause of type 2 DM. However, the association between CAS and IR in non-diabetic individuals has not been elucidated. The aim of the present study was to evaluate the impact of IR on CAS in patients without DM. Materials and Methods: A total of 330 eligible patients without DM and coronary artery disease who underwent acetylcholine (Ach) provocation test were enrolled in this study. Inclusion criteria included both hemoglobin A1c <6.0% and fasting glucose level <110 mg/dL without type 2 DM. Patients were divided into quartile groups according the level of homeostasis model assessment of insulin resistance (HOMA-IR): 1Q (n=82; HOMA-IR<1.35), 2Q (n=82; $1.35{\leq}HOMA-IR<1.93$), 3Q (n=83; $1.93{\leq}HOMA-IR<2.73$), and 4Q (n=83; $HOMA-IR{\geq}2.73$). Results: In the present study, the higher HOMA-IR group (3Q and 4Q) was older and had higher body mass index, fasting blood glucose, serum insulin, hemoglobin A1c, total cholesterol, and triglyceride levels than the lower HOMA-IR group (1Q). Also, poor IR (3Q and 4Q) was considerably associated with frequent CAS. Compared with Q1, the hazard ratios for Q3 and Q4 were 3.55 (95% CI: 1.79-7.03, p<0.001) and 2.12 (95% CI: 1.07-4.21, p=0.031), respectively, after adjustment of baseline risk confounders. Also, diffuse spasm and accompanying chest pain during Ach test were more strongly associated with IR patients with CAS. Conclusion: HOMA-IR was significantly negatively correlated with reference diameter measured after nitroglycerin and significantly positively correlated with diffuse spasm and chest pain.

• 한국의학물리학회지:의학물리
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• 제31권3호
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• pp.111-123
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• 2020

Deep learning (DL) is a subset of machine learning and artificial intelligence that has a deep neural network with a structure similar to the human neural system and has been trained using big data. DL narrows the gap between data acquisition and meaningful interpretation without explicit programming. It has so far outperformed most classification and regression methods and can automatically learn data representations for specific tasks. The application areas of DL in radiation oncology include classification, semantic segmentation, object detection, image translation and generation, and image captioning. This article tries to understand what is the potential role of DL and what can be more achieved by utilizing it in radiation oncology. With the advances in DL, various studies contributing to the development of radiation oncology were investigated comprehensively. In this article, the radiation treatment process was divided into six consecutive stages as follows: patient assessment, simulation, target and organs-at-risk segmentation, treatment planning, quality assurance, and beam delivery in terms of workflow. Studies using DL were classified and organized according to each radiation treatment process. State-of-the-art studies were identified, and the clinical utilities of those researches were examined. The DL model could provide faster and more accurate solutions to problems faced by oncologists. While the effect of a data-driven approach on improving the quality of care for cancer patients is evidently clear, implementing these methods will require cultural changes at both the professional and institutional levels. We believe this paper will serve as a guide for both clinicians and medical physicists on issues that need to be addressed in time.

• 대한치과교정학회지
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• 제52권3호
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• pp.182-200
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• 2022

Objective: This study aims to examine the effectiveness of miniscrew assisted rapid palatal expansion (MARPE) treatment in late adolescents and adult patients using cone-beam computed tomography (CBCT). Methods: Literature search was conducted in five electronic databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) based on the PICOS keyword design focusing on MARPE. Out of the 18 CBCT screened outcomes, only nine parameters were sufficient for the quantitative meta-analysis. The parameters were classified into three main groups: 1) skeletal changes, 2) alveolar change, and 3) dental changes. Heterogeneity test, estimation of pooled means, publication bias, sensitivity analysis and risk of bias assessment were also performed. Results: Upon database searching, only 14 full-text articles were qualified from the 364 obtained results. Heterogeneity test indicated the use of the random-effects model. The pooled mean estimate were as follows: 1) Skeletal expansion: zygomatic width, 2.39 mm; nasal width, 2.68 mm; jugular width, 3.12 mm; and midpalatal suture at the posterior nasal spine and anterior nasal spine, 3.34 mm and 4.56 mm, respectively; 2) Alveolar molar width expansion, 4.80 mm; and 3) Dental expansion: inter-canine width, 3.96 mm; inter-premolar width, 4.99 mm and inter-molar width, 5.99 mm. The percentage of expansion demonstrated a skeletal expansion (PNS) of 55.76%, alveolar molar width expansion of 24.37% and dental expansion of 19.87%. Conclusions: In the coronal view, the skeletal and dental expansion created by MARPE was of the pyramidal pattern. MARPE could successfully expand the constricted maxilla in late adolescents and adult patients.

• 지질공학
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• 제31권4호
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• pp.533-540
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• 2021

비탈면 안전성과 밀접한 관련이 있는 내부 상태를 평가하는 방법으로 복합지구물리탐사와 지반의 밀도모델링을 수행하였다. 완전부게이상 분포로부터 풍화대의 규모와 신선한 기반암의 분포 위치를 확인할 수 있었다. 오일러 디콘볼루션 역산법으로 비탈면 중앙부의 신선한 기반암은 주변에 비해 10 m 정도 깊은 30 m 깊이에 분포하고 저밀도의 풍화대 두께가 증가한다. 이러한 경향은 전기비저항 분포에서 관찰되는 저비저항과 고비저항대의 깊이와 일치한다. 비탈면 지반의 밀도 모델은 암반의 차별풍화대의 분도와 유사하게 나타났으며 이러한 결과로부터 중력장 해석을 이용한 밀도 모델링이 비탈면의 내적인 상태변화와 안전성 해석에 활용될 수 있고 노출된 암반에서 풍화대의 형상을 파악하는 방법으로써 적합함을 시사한다.

• 대한통합의학회지
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• 제10권3호
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• pp.37-52
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• 2022

Purpose : The purpose of this meta-analysis was to evaluate the effects of electrical stimulation on patients with non-specific low back pain. Methods : Domestic databases were gathered from studies that conducted clinical trials associated with electrical stimulation and its impact on pain of non-specific low back patients. A total of 681 studies were identified, with 12 studies satisfying the inclusion data. The studies consisted of patient, intervention, comparison, outcome, and study design (PICO-SD). The search outcomes were items associated with low back pain. Cochrane risk of bias 2 (RoB 2) was used to evaluate the quality of 12 randomized controlled trials. Effect sizes (Hedges's g) in this study were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger's regression and 'trim-and-fill' tests were carried out to analyze the publication bias. Cumulative meta-analysis and sensitivity analysis were conducted to analyze the effect according to the sample size and the consistency of the effect size. Results : The following factors had a large overall effect size (Hedges's g=1.28, 95 % CI=.20~2.36) involving electrical stimulation on non-specific low back pain. The subgroup analysis all showed a statistical difference in the types of study design, electrical stimulation, and assessment tool. No statistically significant difference was found in the meta-regression analysis. Publican bias was found in the data. Conclusion : The findings in this study indicate that electrical stimulation interventions have a positive effect on patients with non-specific low back pain. However, due to the low quality of studies and publication bias, the results of our study should be interpreted cautiously.

• 한국환경성돌연변이발암원학회지
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• 제23권2호
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• pp.56-62
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• 2003

The liver progenitor cells could form a potential target cell population fore both tumor-initiating and -promoting chemicals. Induction of drug-metabolizing and antioxidant enzymes, including AhR-dependent CYP1A1, NQO-1 and AKR1C9, was detected in the rat liver epithelial WB-F344 "stem-like" cells. Additionally, WB-F344 cells express a functional, wild-type form of p53 protein, a biomarker of genotoxic events, and connexin 43, a basic structural unit of gap junctions forming an important type of intercellular communication. In this cellular model, two complementary assays have been established for detection of the modes of action associated with tumor promotion: inhibition of gap junctional intercellular communication (GJIC) and proliferative activity in confluent cells. We found that the PAHs and PCBs, which are AhR agonists, released WB-F344 cells from contact inhibition, increasing both DNA synthesis and cell numbers. Genotoxic effects of some PAHs that lead to apoptosis and cell cycle delay might interfere with the proliferative activity of PAHs. Contrary to that, the nongenotoxic low-molecular-weight PAHs and non-dioxin-like PCB congeners, abundant in the environment, did not significantly affect cell cycle and cell proliferation; however both groups of compounds inhibited GJIC in WB-F344 cells. The release from contact inhibiton by a mechanism that possibly involves the AhR activation, inhibition of GJIC and genotoxic events induced by environmental contaminants are three important modes of action that could play an important role in carcinogenic effects of toxic compounds. The relative potencies to inhibit GJIC, to induce AhR-mediated activity, and to release cells from contact inhibition were determined for a large series of PAHs and PCBs and their metabolites. In vitro bioassays based on detection of events on cellular level (deregulation of GJIC and/or proliferation) or determination of receptor-mediated activities in both ?$stem-like^{\circ}{\times}$ and hepatocyte-like liver cellular models are valuable tools for detection of modes of action of polyaromatic hydrocarbons. They may serve, together with concentration data, as a first step in their risk assessment.

• 근관절건강학회지
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• 제16권1호
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• pp.5-12
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• 2009

Purpose: The purpose of this study was to investigate bone mineral density(BMD) and fear of falling and falls efficacy in the middle and old aged women over 50 years. Methods: The subjects consisted of 409 women. One-way ANOVA, Pearson's correlations and multiple regression were used to test the BMD, fear of falling and falls efficacy scale by using SPSSWIN 12.0. The BMD of the calcaneus were measured with peripheral dual energy x-ray absorptiometry(DEXA). Results: The average age was 63 years old and the average T-score was -3.21 in patient with osteoporosis, -1.72 with osteopenia, and .13 with normal. There were significant differences in the status of the BMD according to age(p=.000), height(p=.000), weight(p=.000), married status(p=.000), age of menarche(p=.002), and menopause(p=.002). The fear of falling was related with falls efficacy(r=-.247, p=.01), BMD(r=-.337, p=.01). Falls efficacy($\beta$=-.21, p=.000)and BMD($\beta$=-.26, p=.000) were predicting variables of fear of falling. The model explained 13% of the variance in fear of falling(F=27.38, p=.000). Conclusion: Fear of falling and falls efficacy were related with the bone mineral density. Falls efficacy and BMD may be useful for the predicting fear of falling for women in middle and old age. Further studies with assessment of fall-related risk-factors and a longitudinal study are necessary to assess with falls efficacy, and BMD with age.

• International Journal of Computer Science & Network Security
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• 제23권5호
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• pp.148-162
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• 2023

Classification systems can significantly assist the medical sector by allowing for the precise and quick diagnosis of diseases. As a result, both doctors and patients will save time. A possible way for identifying risk variables is to use machine learning algorithms. Non-surgical technologies, such as machine learning, are trustworthy and effective in categorizing healthy and heart-disease patients, and they save time and effort. The goal of this study is to create a medical intelligent decision support system based on machine learning for the diagnosis of heart disease. We have used a mixed feature creation (MFC) technique to generate new features from the UCI Cleveland Cardiology dataset. We select the most suitable features by using Least Absolute Shrinkage and Selection Operator (LASSO), Recursive Feature Elimination with Random Forest feature selection (RFE-RF) and the best features of both LASSO RFE-RF (BLR) techniques. Cross-validated and grid-search methods are used to optimize the parameters of the estimator used in applying these algorithms. and classifier performance assessment metrics including classification accuracy, specificity, sensitivity, precision, and F1-Score, of each classification model, along with execution time and RMSE the results are presented independently for comparison. Our proposed work finds the best potential outcome across all available prediction models and improves the system's performance, allowing physicians to diagnose heart patients more accurately.

• 한국미생물·생명공학회지
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• 제51권2호
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• pp.191-202
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• 2023

Elevated serum cholesterol is a main risk factor for heart disorders. Most probiotic products administered to lower cholesterol are dairy products which are not suitable for lactose-intolerant individuals. In this study, we assessed the cholesterol-lowering efficacy of LAB isolated from traditionally fermented drinks in diet-induced rats and determine their efficacy in the production of non-dairy, probiotic formulations using papaya juice. LAB were isolated from palm wine and corn beer on MRS agar using a pour-plate technique. Identification was carried out using 16S rRNA gene sequencing. A hypercholesterolemia model in which diet-induced Wistar albino rats were assigned into four groups was established. Oral gavage was carried out for 30 days. On the 31^st day, the rats were dissected and the serum lipid profile was analyzed using biochemical kits. A 10⁶ cfu/ml of a 24-h-old culture of selected lactobacilli was used to inoculate papaya juice and incubated at 37℃. Microbial and chemical changes were assessed during papaya fermentation and after four weeks of cold storage. Two selected isolates (Pw1 and Cb4) had in vitro cholesterol reduction of > 80%. These two isolates lowered lipid profile (triglyceride, total cholesterol, LDL-c) significantly, and increased HDL-c levels (p < 0.5) in the rat sera. Phylogenetic analysis showed that Pw1 was 98.86% similar to Limosilactobacillus fermentum, while Cb4 was 99.54% similar to Enteroccocus faecium. Both strains fermented papaya juice with cell viability reaching 8.92 × 10⁸ cfu/ml and 25.3 × 10⁸ cfu/ml respectively, and were still viable after 4 weeks of cold storage.