1.Inhibitory effect of carvacrol on lipopolysaccharide-induced memory impairment in rats
Bombi LEE ; Mijung YEOM ; Insop SHIM ; Hyejung LEE ; Dae hyun HAHM
The Korean Journal of Physiology and Pharmacology 2020;24(1):27-37
Neuroinflammation is an important process underlying a wide variety of neurodegenerative diseases. Carvacrol (CAR) is a phenolic monoterpene commonly used as a food additive due to its antibacterial properties, but it has also been shown to exhibit strong antioxidative, anti-inflammatory, and neuroprotective effects. Here, we sought to investigate the effects of CAR on inflammation in the hippocampus and prefrontal cortex, as well as the molecular mechanisms underlying these effects. In our study, lipopolysaccharide was injected into the lateral ventricle of rats to induce memory impairment and neuroinflammation. Daily administration of CAR (25, 50, and 100 mg/kg) for 21 days improved recognition, discrimination, and memory impairments relative to untreated controls. CAR administration significantly attenuated expression of several inflammatory factors in the brain, including interleukin-1β, tumor necrosis factor-α, and cyclooxygenase-2. In addition, CAR significantly increased expression of brain-derived neurotrophic factor (BDNF) mRNA, and decreased expression of Toll-like receptor 4 (TLR4) mRNA. Taken together, these results show that CAR can improve memory impairment caused by neuroinflammation. This cognitive enhancement is due to the anti-inflammatory effects of CAR medicated by its regulation of BDNF and TLR4. Thus, CAR has significant potential as an inhibitor of memory degeneration in neurodegenerative diseases.
Animals
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Brain
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Brain-Derived Neurotrophic Factor
;
Cyclooxygenase 2
;
Cytokines
;
Discrimination (Psychology)
;
Food Additives
;
Hippocampus
;
Inflammation
;
Lateral Ventricles
;
Lipopolysaccharides
;
Memory
;
Necrosis
;
Neurodegenerative Diseases
;
Neuroprotective Agents
;
Phenol
;
Prefrontal Cortex
;
Rats
;
RNA, Messenger
;
Toll-Like Receptor 4
2.Prediction Model for Massive Transfusion in Placenta Previa during Cesarean Section
Jieun KANG ; Hye Sim KIM ; Eun Bi LEE ; Young UH ; Kyoung Hee HAN ; Eun Young PARK ; Hyang Ah LEE ; Dae Ryong KANG ; In Bai CHUNG ; Seong Jin CHOI
Yonsei Medical Journal 2020;61(2):154-160
0.05). The area under the receiver operating characteristics curve (AUC) was 0.922 [95% confidence interval (CI) 0.89–0.95]. In external validation, the discrimination was good, with an AUC value of 0.833 (95% CI 0.70–0.92) for this model. Nomogram calibration plots indicated good agreement between the predicted and observed outcomes, exhibiting close approximation between the predicted and observed probability.CONCLUSION: We constructed a scoring model for predicting massive transfusion during cesarean section in women with placenta previa. This model may help in determining the need to prepare an appropriate amount of blood products and the optimal timing of blood transfusion.]]>
Area Under Curve
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Blood Transfusion
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Calibration
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Cesarean Section
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Cohort Studies
;
Discrimination (Psychology)
;
Early Intervention (Education)
;
Erythrocytes
;
Female
;
Humans
;
Logistic Models
;
Maternal Age
;
Nomograms
;
Placenta Previa
;
Placenta
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Placentation
;
Postpartum Hemorrhage
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Pregnancy
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ROC Curve
;
Ultrasonography
3.Clinical significance of cell-free DNA as a prognostic biomarker in patients with diffuse large B-cell lymphoma
Mahsa ESKANDARI ; Saba MANOOCHEHRABADI ; Hossein PASHAIEFAR ; Mohammad Ali ZAIMY ; Mohammad AHMADVAND
Blood Research 2019;54(2):114-119
BACKGROUND: Cell-free DNA (cfDNA) has the potential to serve as a non-invasive prognostic biomarker in some types of neoplasia. The investigation of plasma concentration of cfDNA may reveal its use as a valuable biomarker for risk stratification of diffuse large B-cell lymphoma (DLBCL). The present prognostic value of plasma cfDNA has not been widely confirmed in DLBCL subjects. Here, we evaluated cfDNA plasma concentration and assessed its potential prognostic value as an early DLBCL diagnostic tool. METHODS: cfDNA concentrations in plasma samples from 40 patients with DLBCL during diagnosis and of 38 normal controls were determined with quantitative polymerase chain reaction (qPCR) for the multi-locus L1PA2 gene. RESULTS: Statistically significant elevation in plasma cfDNA concentrations was observed in patients with DLBCL as compared to that in normal controls (P<0.05). A cutoff point of 2.071 ng/mL provided 82.5% sensitivity and 62.8% specificity and allowed successful discrimination of patients with DLBCL from normal controls (area under the curve=0.777; P=0.00003). Furthermore, patients with DLBCL showing higher concentrations of cfDNA had shorter overall survival (median, 9 mo; P=0.022) than those with lower cfDNA levels. In addition, elevated cfDNA concentration was significantly associated with age, B-symptoms, International Prognostic Index (IPI) score, and different stages of disease (all P<0.05). CONCLUSION: Quantification of cfDNA with qPCR at the time of diagnosis may allow identification of patients with high cfDNA concentration, which correlates with aggressive clinical outcomes and adverse prognosis.
B-Lymphocytes
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Diagnosis
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Discrimination (Psychology)
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DNA
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Humans
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Lymphoma, B-Cell
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Plasma
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Polymerase Chain Reaction
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Prognosis
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Sensitivity and Specificity
4.Validation of the 8th AJCC Cancer Staging System for Pancreas Neuroendocrine Tumors Using Korean Nationwide Surgery Database
Yunghun YOU ; Jin Young JANG ; Song Cheol KIM ; Yoo Seok YOON ; Joon Seong PARK ; Chol Kyoon CHO ; Sang Jae PARK ; Jae Do YANG ; Woo Jung LEE ; Tae Ho HONG ; Keun Soo AHN ; Chi Young JEONG ; Hyeon Kook LEE ; Seung Eun LEE ; Young Hoon ROH ; Hee Joon KIM ; Hongbeom KIM ; In Woong HAN
Cancer Research and Treatment 2019;51(4):1639-1652
PURPOSE: The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for pancreatic neuroendocrine tumor (PNET) included several significant changes. We aim to evaluate this staging system compared to the 7th edition AJCC staging system and European Neuroendocrine Tumors Society (ENETS) system. MATERIALS AND METHODS: We used Korean nationwide surgery database (2000-2014). Of 972 patients who had undergone surgery for PNET, excluding patients diagnosed with ENETS/World Health Organization 2010 grade 3 (G3), only 472 patients with accurate stage were included. RESULTS: Poor discrimination in overall survival rate (OSR) was noted between AJCC 8th stage III and IV (p=0.180). The disease-free survival (DFS) curves of 8th AJCC classification were well separated between all stages. Compared with stage I, the hazard ratio of II, III, and IV was 3.808, 13.928, and 30.618, respectively (p=0.007, p < 0.001, and p < 0.001). The curves of OSR and DFS of certain prognostic group in AJCC 7th and ENETS overlapped. In ENETS staging system, no significant difference in DFS between stage IIB versus IIIA (p=0.909) and IIIA versus IIIB (p=0.291). In multivariable analysis, lymphovascular invasion (p=0.002), perineural invasion (p=0.003), and grade (p < 0.001) were identified as independent prognostic factors for DFS. CONCLUSION: This is the first large-scale validation of the AJCC 8th edition staging system for PNET. The revised 8th system provides better discrimination compared to that of the 7th edition and ENETS TNM system. This supports the clinical use of the system.
Classification
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Discrimination (Psychology)
;
Disease-Free Survival
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Humans
;
Joints
;
Neoplasm Staging
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Neuroectodermal Tumors, Primitive
;
Neuroendocrine Tumors
;
Pancreas
;
Survival Rate
5.Novel Prognostic Nomograms Based on Inflammation-Related Markers for Patients with Hepatocellular Carcinoma Underwent Hepatectomy
Yifei WANG ; Kaiyu SUN ; Jingxian SHEN ; Bin LI ; Ming KUANG ; Qinghua CAO ; Sui PENG
Cancer Research and Treatment 2019;51(4):1464-1478
PURPOSE: Hepatocellular carcinoma (HCC) is an aggressive disease with high recurrence rate. However, current staging systems were lack of predictive capacity for HCC recurrence. We aimed to develop prognostic nomograms based on inflammation-related markers for HCC patients underwent hepatectomy. MATERIALS AND METHODS: We recruited 889 surgically treated patients from two medical centers. Independent prognostic factors were identified by cox regression analyses. Nomograms for recurrence-free survival (RFS) and overall survival (OS) were established, and validated internally and externally. The performance, discrimination, and calibration of nomograms were assessed, and compared with existed staging systems. RESULTS: Neutrophil to lymphocyte ratio (NLR) and gamma-glutamyl transpeptidase to platelet ratio (GPR) were the two inflammation-related factor that independently correlated with survival. NLR, GPR, international normalized ratio (INR), microvascular invasion, satellite lesions, tumour number, tumour diameter, and macrovascular invasion were used to construct nomogram for RFS while GPR, total bilirubin, INR, α-fetoprotein, microvascular invasion, satellite lesions, tumour diameter, and macrovascular invasion were for OS. In the training cohort, the C-index of nomogram was 0.701 (95% confidence interval [CI], 0.669 to 0.732) for RFS and 0.761 (95% CI, 0.728 to 0.795) for OS. These results received both internal and external validation with C-index of 0.701 (95% CI, 0.647 to 0.755) and 0.707 (95% CI, 0.657 to 0.756) for RFS, and 0.706 (95% CI, 0.640 to 0.772) and 0.708 (95% CI, 0.646 to 0.771) for OS, respectively. The nomograms showed superior accuracy to conventional staging systems (p<0.001). CONCLUSION: The nomograms based on inflammation-related markers are of high efficacy in predicting survival of HCC patients after hepatectomy, which will be valuable in guiding postoperative interventions and follow-ups.
Bilirubin
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Blood Platelets
;
Calibration
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Carcinoma, Hepatocellular
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Cohort Studies
;
Discrimination (Psychology)
;
Follow-Up Studies
;
gamma-Glutamyltransferase
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Hepatectomy
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Humans
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Inflammation
;
International Normalized Ratio
;
Lymphocytes
;
Neutrophils
;
Nomograms
;
Recurrence
6.Nomogram Development and External Validation for Predicting the Risk of Lymph Node Metastasis in T1 Colorectal Cancer
Jung Ryul OH ; Boram PARK ; Seongdae LEE ; Kyung Su HAN ; Eui Gon YOUK ; Doo Han LEE ; Do Sun KIM ; Doo Seok LEE ; Chang Won HONG ; Byung Chang KIM ; Bun KIM ; Min Jung KIM ; Sung Chan PARK ; Dae Kyung SOHN ; Hee Jin CHANG ; Jae Hwan OH
Cancer Research and Treatment 2019;51(4):1275-1284
PURPOSE: Predicting lymph node metastasis (LNM) risk is crucial in determining further treatment strategies following endoscopic resection of T1 colorectal cancer (CRC). This study aimed to establish a new prediction model for the risk of LNM in T1 CRC patients. MATERIALS AND METHODS: The development set included 833 patients with T1 CRC who had undergone endoscopic (n=154) or surgical (n=679) resection at the National Cancer Center. The validation set included 722 T1 CRC patients who had undergone endoscopic (n=249) or surgical (n=473) resection at Daehang Hospital. A logistic regression model was used to construct the prediction model. To assess the performance of prediction model, discrimination was evaluated using the receiver operating characteristic (ROC) curves with area under the ROC curve (AUC), and calibration was assessed using the Hosmer-Lemeshow (HL) goodness-of-fit test. RESULTS: Five independent risk factors were determined in the multivariable model, including vascular invasion, high-grade histology, submucosal invasion, budding, and background adenoma. In final prediction model, the performance of the model was good that the AUC was 0.812 (95% confidence interval [CI], 0.770 to 0.855) and the HL chi-squared test statistic was 1.266 (p=0.737). In external validation, the performance was still good that the AUC was 0.771 (95% CI, 0.708 to 0.834) and the p-value of the HL chi-squared test was 0.040. We constructed the nomogram with the final prediction model. CONCLUSION: We presented an externally validated new prediction model for LNM risk in T1 CRC patients, guiding decision making in determining whether additional surgery is required after endoscopic resection of T1 CRC.
Adenoma
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Area Under Curve
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Calibration
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Colorectal Neoplasms
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Decision Making
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Discrimination (Psychology)
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Humans
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Logistic Models
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Lymph Nodes
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Neoplasm Metastasis
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Nomograms
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Risk Factors
;
ROC Curve
7.External Validation of 3 Risk Scores in Adults with Congenital Heart Disease
Bunty K RAMCHANDANI ; Luz POLO ; Raúl SÁNCHEZ ; Juvenal REY ; Alvaro GONZÁLEZ ; Jesús DÍEZ ; Angel AROCA
Korean Circulation Journal 2019;49(9):856-863
BACKGROUND AND OBJECTIVES: Adults with congenital heart disease (CHD) are an increasing group of patients thanks to the survival of over 85% of children with CHD. 20% of these patients shall warrant a surgical procedure during their life span. However, currently there is no one risk score that assess correctly the mortality of these procedures. Thus, we analyse the risk scores used at our institution. METHODS: From May 1991 till June 2017, 608 procedures in adults with CHD were performed. The 3 risk scores (risk adjustment for congenital heart surgery [RACHS-1], Aristotle, and Euroscore I) of each procedure were analysed. We used area under the receiver operating characteristic curve (c-index) to measure model discrimination, and Hosmer-Lemeshow (H-L) statistic along with calibration plots to measure calibration. RESULTS: There was no statistical difference between the area under the curve for the 3 scores (χ²=0.58 with 2 df, p=0.750). There was no evidence of lack of fit for RACHS-1 (H-L, χ²=2.61; p=0.271) and Aristotle score (H-L, χ²=5.69; p=0.459). However, there was evidence in lack of calibration in the Euroscore I scoring system (H-L, χ²=33.69; p<0.001). The calibration slope for RACHS-1 was 0.912, for Aristotle (stratified in risk groups) was −0.14 and for Euroscore 1 (stratified in risk groups) was 0.46. CONCLUSIONS: RACHS-1 seems to be best risk scoring system for calculating mortality applied to surgery in adults with CHD.
Adult
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Calibration
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Child
;
Discrimination (Psychology)
;
Heart Defects, Congenital
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Humans
;
Mortality
;
ROC Curve
;
Thoracic Surgery
8.Classification of Common Relationships Based on Short Tandem Repeat Profiles Using Data Mining
Su Jin JEONG ; Hyo Jung LEE ; Soong Deok LEE ; Seung Hwan LEE ; Su Jeong PARK ; Jong Sik KIM ; Jae Won LEE
Korean Journal of Legal Medicine 2019;43(3):97-105
We reviewed past studies on the identification of familial relationships using 22 short tandem repeat markers. As a result, we can obtain a high discrimination power and a relatively accurate cut-off value in parent-child and full sibling relationships. However, in the case of pairs of uncle-nephew or cousin, we found a limit of low discrimination power of the likelihood ratio (LR) method. Therefore, we compare the LR ranking method and data mining techniques (e.g., logistic regression, linear discriminant analysis, diagonal linear discriminant analysis, diagonal quadratic discriminant analysis, K-nearest neighbor, classification and regression trees, support vector machines, random forest [RF], and penalized multivariate analysis) that can be applied to identify familial relationships, and provide a guideline for choosing the most appropriate model under a given situation. RF, one of the data mining techniques, was found to be more accurate than other methods. The accuracy of RF is 99.99% for parent-child, 99.44% for full siblings, 90.34% for uncle-nephew, and 79.69% for first cousins.
Classification
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Data Mining
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Discrimination (Psychology)
;
Forests
;
Humans
;
Logistic Models
;
Methods
;
Microsatellite Repeats
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Siblings
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Support Vector Machine
;
Trees
9.Social Perceptions of Quack in Qing Dynasty and Its Transformation in the Late Qing Period
Korean Journal of Medical History 2019;28(1):191-238
“Yong-yi” means “quack” in English, which generally refers to a doctor who does not have good medical skills. In the Ming and Qing dynasties in China, various criticism about “Yong-yi” became popularized, and by the late Qing period, “quacks” had become a serious social issue. The theory of traditional Chinese medicine was developed during the Ming and Qing dynasties, and local medical resources also increased. Moreover, the prevalence of medical book publishing led to the openness and generalization of medical knowledge. As a result, not only the number of doctors increased, but also the number of doctors who lack medical knowledge and clinical experience increased. However, at the outset, “Yong-yi” did not only mean doctors with poor medical skills. “Yong-yi” also reflected conflicts and contradictions between doctors. Doctors consistently criticized quacks in an attempt to maintain their identity as a “good” doctor or a Confucian doctor. In this sense, “Yong-yi” was used among physicians as an expression of discrimination and exclusion. The concept of “quackery” was also determined by the relationship between patients and doctors. In general, itinerant doctors, midwives and shaman doctors were regarded as “Yong-yi”; however, they served the medical needs of various patients. Thus, to some extent, “Yong-yi” were also useful medical resources. On the contrary, in certain situations, “shiyi,” physicians who serviced a family for generations and were generally believed to be reliable and as trustworthy doctors, were also labelled as quacks, especially when the patient did not trust them or was not satisfied with the treatment. Therefore, doctors' thoughts about “Yong-yi” did not always coincide with patients' thoughts about “Yong-yi.” However, by the late Qing period, the description of quacks in media reports found a singular connotation, and the divergent social image of quacks disappeared. By this time, quacks were uniformly described as ignorant and irresponsible Chinese medicine practitioners. Specifically, in one murder case in which a “Yong-yi” was accused as the murderer, the report unilaterally reported the patient's claims. Consequently, Chinese medicine practitioners who failed in their treatment of patients became labeled as “quack” doctors. In newspaper reports, “Yong-yi” no longer simply referred to individual cases of “quacks” but had come to represent the entirety of the Chinese medicine practitioner community. On the contrary, Western medical doctors who replaced the status of traditional doctors were positively portrayed. Pictorials also had similar perspectives with newspapers, supporting the narrative of the news with ironic drawings and articles. Overall, media reports regarding “Yong-yi” did not focus on reporting facts, but they had the purpose of making quacks a serious social problem.
Asian Continental Ancestry Group
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China
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Discrimination (Psychology)
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Family Characteristics
;
Generalization (Psychology)
;
Homicide
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Humans
;
Iron
;
Medicine, Chinese Traditional
;
Midwifery
;
Periodicals
;
Prevalence
;
Social Perception
;
Social Problems
10.Life and Ideas of LEE Kap-Soo: Focusing on the Ideas and Activities Related to Eugenics
Young jeon SHIN ; Ilyeong JEONG
Korean Journal of Medical History 2019;28(1):43-88
Lee Kap-Soo (April 23, 1889–December 5, 1973) graduated from Gyeongseong Medical College in 1920, went to Germany to study, and returned to Korea after graduating from Berlin University in 1924. On September 14, 1933, he played a leading role in the founding of the Joseon Eugenics Society, and he contributed eugenic ideas through written publications and lectures. He was a leading eugenicist who continued his activities related to eugenics, such as re-establishing the Korean National Eugenics Society and making efforts to enact the Eugenics Act after Korea's liberation from Japanese occupation. His ideas on eugenics were then a rapid acceptance of the world's times and science, and his ideas were an expanded eugenics that emphasized the nation. He actively carried out the campaign for eugenics and maintained a consistent stance before and after liberation. His eugenic ideas and activities show that Korean society was not free from the influence of eugenics that was gaining popularity around the world. His eugenic ideas were related to enlightenment, but the basis of eugenics was the logic of discrimination and exclusion. In particular, his eugenic ideas and activities have caused pain to Hansen's patients through forced isolation and discontinuation. In addition, his doctrine of eugenics still holds sway in Korean society. The history of Lee Kap-Soo's life and eugenics-related activities shows the important points and characteristics of the history of eugenics in Korean society before and after the liberation from Japan, and furthermore provides an important clue in understanding and explaining the colonial vestige in Korean society, economic growth first ideology, enthusiasm for scientific development, and competitive social culture.
Asian Continental Ancestry Group
;
Berlin
;
Discrimination (Psychology)
;
Economic Development
;
Eugenics
;
Germany
;
Humans
;
Japan
;
Korea
;
Lectures
;
Leprosy
;
Logic
;
Occupations

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