1.Risk Assessment Program of Highly Pathogenic Avian Influenza with Deep Learning Algorithm
Hachung YOON ; Ah-Reum JANG ; Chungsik JUNG ; Hunseok KO ; Kwang-Nyeong LEE ; Eunesub LEE
Osong Public Health and Research Perspectives 2020;11(4):239-244
This study presents the development and validation of a risk assessment program of highly pathogenic avian influenza (HPAI). This program was developed by the Korean government (Animal and Plant Quarantine Agency) and a private corporation (Korea Telecom, KT), using a national database (Korean animal health integrated system, KAHIS). Our risk assessment program was developed using the multilayer perceptron method using R Language. HPAI outbreaks on 544 poultry farms (307 with H5N6, and 237 with H5N8) that had available visit records of livestock-related vehicles amongst the 812 HPAI outbreaks that were confirmed between January 2014 and June 2017 were involved in this study. After 140,000 iterations without drop-out, a model with 3 hidden layers and 10 nodes per layer, were selected. The activation function of the model was hyperbolic tangent. Precision and recall of the test gave F1 measures of 0.41, 0.68 and 0.51, respectively, at validation. The predicted risk values were higher for the “outbreak” (average ± SD, 0.20 ± 0.31) than “non-outbreak” (0.18 ± 0.30) farms ( The risk assessment model developed was employed during the epidemics of 2016/2017 (pilot version) and 2017/2018 (complementary version). This risk assessment model enhanced risk management activities by enabling preemptive control measures to prevent the spread of diseases.
2.Surface Landmarks do not Correspond to Exact Levels of the Cervical Spine: References According to the Sex, Age and Height.
Chang Hyun OH ; Gyu Yeul JI ; Seung Hwan YOON ; Dongkeun HYUN ; Chun Gil CHOI ; Hyun Kyoung LIM ; A Reum JANG
Korean Journal of Spine 2014;11(3):178-182
OBJECTIVE: A general orientation along the cervical spine could be estimated by external landmarks, and it was useful, quick and less exposable to radiation, but, sometimes it gave reference confusion of target cervical level. The authors reviewed the corresponding between the neck external landmarks and cervical levels. METHODS: Totally 1,031 cervical lateral radiographs of different patients were reviewed in single university hospital. Its compositions were 534 of males and 497 females; 86 of second decades (10-19 years-old), 169 of third decades, 159 of fourth decades, 209 of fifth decades, 275 of sixth decades, and 133 of more than seventh decades (>60 years-old). Reference external landmarks (mandible, hyoid bone, thyroid cartilage, and cricothyroid membrane) with compounding factors were reviewed. RESULTS: The reference levels of cervical landmarks were C2.13 with mandible angle, C3.54 with hyoid bone, C5.12 with thyroid cartilage, and C6.01 with cricothyroid membrane. The reference levels of cervical landmarks were differently observed by sex, age, and somatometric measurement (height) accordingly mandible angle from C1 to C3, hyoid bone from disc level of C2 and C3 to C5, thyroid cartilage from disc level of C3 and C4 to C7, and cricothyroid membrane from C4 to disc level of C7 and T1. CONCLUSION: Surface landmarks only provide general reference points, but not correspond to exact levels of the cervical spine. Intraoperative fluoroscopy ensures a more precise placement to the targeted cervical level.
Female
;
Fluoroscopy
;
Humans
;
Hyoid Bone
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Male
;
Mandible
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Membranes
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Neck
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Spine*
;
Thyroid Cartilage
3.Delayed Vertebral Artery Dissection after Posterior Cervical Fusion with Traumatic Cervical Instability: A Case Report.
Chang Hyun OH ; Gyu Yeul JI ; Seung Hwan YOON ; Dongkeun HYUN ; Eun Young KIM ; Hyeonseon PARK ; A Reum JANG
Korean Journal of Spine 2015;12(2):79-83
Vascular injury presented immediately after the penetration, but delayed onset of vascular symptom caused by an embolism or vessel dissection after cervical fusion or traumatic event is extremely rare. We present a case of a 56-year-old woman who underwent an operation for cervical fusion for type II Odontoid process fracture. She presented symptoms of seizure with hemiparesis in 6 days after the operation. Multifocal acute infarction due to an embolism from the left VA (V3 segment) dissection was observed without a definite screw breach the transverse foramen. We hereby reported the instructive case report of delayed onset of vertebral artery dissection after posterior cervical fusion with type II odontoid process fracture patient. When a cervical operation performed in the cervical trauma patient, even if no apparent VA injury occurs before and during the operation, the surgeon must take caution not to risk cerebral infarction because of the delayed VA dissection.
Cerebral Infarction
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Embolism
;
Female
;
Humans
;
Infarction
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Middle Aged
;
Odontoid Process
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Paresis
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Seizures
;
Vascular System Injuries
;
Vertebral Artery Dissection*
6.Interleukin 13 on Microglia is Neurotoxic in Lipopolysaccharide-injected Striatum in vivo
Ah Reum HONG ; Jae Geun JANG ; Young Cheul CHUNG ; So-Yoon WON ; Byung Kwan JIN
Experimental Neurobiology 2022;31(1):42-53
To explore the potential function of interleukin-13 (IL-13), lipopolysaccharide (LPS) or PBS as a control was unilaterally microinjected into striatum of rat brain. Seven days after LPS injection, there was a significant loss of neurons and microglial activation in the striatum, visualized by immunohistochemical staining against neuronal nuclei (NeuN) and the OX-42 (complement receptor type 3, CR3), respectively. In parallel, IL-13 immunoreactivity was increased as early as 3 days and sustained up to 7 days post LPS injection, compared to PBS-injected control and detected exclusively within microglia. Moreover, GFAP immunostaining and blood brain barrier (BBB) permeability evaluation showed the loss of astrocytes and disruption of BBB, respectively. By contrast, treatment with IL-13 neutralizing antibody (IL-13NA) protects NeuN + neurons against LPSinduced neurotoxicity in vivo . Accompanying neuroprotection, IL-13NA reduced loss of GFAP + astrocytes and damage of BBB in LPS-injected striatum. Intriguingly, treatment with IL-13NA produced neurotrophic factors (NTFs) on survived astrocytes in LPS-injected rat striatum. Taken together, the present study suggests that LPS induces expression of IL-13 on microglia, which contributes to neurodegeneration via damage on astrocytes and BBB disruption in the striatum in vivo.
7.Colonic Intramucosal Cancer in the Interposed Colon Treated with Endoscopic Mucosal Resection: A Case Report and Review of Literature
Seung Ho BAEK ; Jang Ho LEE ; Dong Ryeol YOO ; Hye Yeong KIM ; Meihua JIN ; Ah Reum JANG ; Dong Hoon YANG ; Jeong Sik BYEON
Clinical Endoscopy 2019;52(4):377-381
Colon interposition is a surgical procedure used for maintenance of luminal conduit after esophagectomy. Although epithelial neoplasia, such as adenoma and adenocarcinoma, may develop in the interposed colon, there are only few case reports on the condition. Due to the rarity of this condition, there is no definite consensus on recommending screening endoscopy for the early detection of neoplasia in the interposed colons. Here, we report a case of intramucosal adenocarcinoma in an interposed colon. Initial endoscopic resection for this tumor failed to accomplish complete resection. A subsequent endoscopic resection was performed 1 month later and complete resection was achieved. Based on our experience and recommendation on screening endoscopy for gastric cancer in Korea, we suggest that regular screening esophagogastroduodenoscopies should be performed following esophagectomy to detect early neoplasia in the stomach and interposed colon and avoid adverse results induced by delayed detection.
Adenocarcinoma
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Adenoma
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Colon
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Consensus
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Endoscopy
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Endoscopy, Digestive System
;
Esophagectomy
;
Korea
;
Mass Screening
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Phenobarbital
;
Stomach
;
Stomach Neoplasms
8.Outcomes of a Modified CALGB 19802 Regimen in Adult Acute Lymphoblastic Leukemia.
A Reum HAN ; Kihyun KIM ; Jun Ho JANG ; Won Seog KIM ; Jin Seok AHN ; Chul Won JUNG ; Mark H LEE ; Won Ki KANG
Journal of Korean Medical Science 2008;23(2):278-283
We analyzed the efficacy and toxicity of a modified Cancer and Leukemia Group B (CALGB) 19802 regimen in adult acute lymphoblastic leukemia (ALL). From February 2002 to August 2005, 25 adults with untreated ALL were enrolled in the study. Compared to the original regimen, the modified CALGB 19802 regimen consisted of a 4-drug induction (cyclophosphamide, daunorubicin, vincristine, and prednisone) instead of a 5-drug induction (L-asparaginase was added to the previous regimen). This was followed by high-dose methotrexate (1,000 mg/m(2)X3 days) and cytarabine (2,000 mg/m(2)X4 days) for the consolidation cycles. High-dose systemic and intrathecal methotrexate was given for central nervous system prophylaxis. Twentythree patients (92%) achieved a complete remission (CR), and two patients (8%) had refractory disease. With a median follow-up of 21.5 months, 10 patients (40%) were alive and continued to be in CR. The 3-yr probability of an event-free survival and the overall survival were 39.0% and 47.4%, respectively. Treatment related mortality and major grade 3 to 4 neurotoxicity occurred in 1 patient and 3 patients, respectively. The modified CALGB 19802 regimen demonstrated a high remission rate and a favorable survival rate.
Adolescent
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Adult
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Aged
;
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
;
Cyclophosphamide/*administration & dosage
;
Daunorubicin/*administration & dosage
;
Disease-Free Survival
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Female
;
Humans
;
Male
;
Middle Aged
;
Precursor Cell Lymphoblastic Leukemia-Lymphoma/*drug therapy
;
Prednisone/*administration & dosage
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Remission Induction
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Treatment Outcome
;
Vincristine/*administration & dosage
9.A Case of Chemical Pneumonitis Induced by Glutaraldehyde Aspiration.
Suk Hyun JANG ; Min Ji PARK ; A Reum CHO ; Mi Young LEE ; Sung Woo CHO ; Won Min HWANG ; Sung Ro YUN
Korean Journal of Medicine 2012;83(4):498-502
Glutaraldehyde is a five-carbon dialdehyde with highly reactive chemical properties. It has bactericidal, sporicidal, and fungicidal activities and is used as a disinfectant to combat foot-and-mouth disease in Korea. To our knowledge, there are no reports of chemical pneumonitis caused by glutaraldehyde aspiration. Chemical pneumonitis is defined as lung irritation caused by substances toxic to the lungs. We treated a 71-year-old patient who had a dyspnea and hoarseness that worsened 7 h after ingesting three mouthfuls of 10% glutaraldehyde. Upon arrival at the emergency room, he had severe laryngeal swelling. A chest radiograph showed diffuse haziness of both lower-lung fields. Despite all our efforts at treatment, he died from chemical pneumonitis and its secondary complications.
Acute Kidney Injury
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Aged
;
Animals
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Dyspnea
;
Emergencies
;
Foot-and-Mouth Disease
;
Glutaral
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Hoarseness
;
Humans
;
Korea
;
Lung
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Mouth
;
Pneumonia
;
Thorax
10.A case of cardiac malignant fibrous histiocytoma treated by cardiac autotransplantation.
Hye Won JANG ; Hyo Song KIM ; Hyo Kyung CHOI ; A Reum HAN ; Kay Hyun PARK ; Geung Hwan AHN ; Joon Oh PARK
Korean Journal of Medicine 2007;73(2):223-227
Primary cardiac tumors are rare findings and they are mostly benign. Malignant primary cardiac tumors make up 25% of the primary cardiac tumors and most of them are sarcomas. Malignant fibrous histiocytoma (MFH) is the most common soft tissue sarcoma in late adulthood, and it is an extremely rare sub-type of cardiac sarcoma. It is known that MFH displays a poor clinical course with complete resection being the most important prognostic factor for survival. We described here the case of a malignant fibrous histiocytoma of the heart in a 54-year-old woman who presented with dyspnea. The tumor was treated by mass excision via cardiac explantation and autotransplantation followed by adjuvant chemotherapy. This is the first report of cardiac autotransplantation in Korea.
Autografts*
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Chemotherapy, Adjuvant
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Dyspnea
;
Female
;
Heart
;
Heart Neoplasms
;
Histiocytoma, Malignant Fibrous*
;
Humans
;
Korea
;
Middle Aged
;
Sarcoma
;
Transplantation, Autologous