1.Predictive factors of radiographic progression in ankylosing spondylitis.
Hyungjin KIM ; Jaejoon LEE ; Joong Kyong AHN ; Jiwon HWANG ; Eun Jung PARK ; Hyemin JEONG ; Hoon Suk CHA ; Eun Mi KOH
The Korean Journal of Internal Medicine 2015;30(3):391-397
BACKGROUND/AIMS: The course of ankylosing spondylitis (AS) is rather variable, and the factors that predict radiographic progression remain largely obscure. In this study, we tried to determine the clinical factors and laboratory measures that are useful in predicting the radiographic progression of patients with AS. METHODS: In 64 consecutive patients with AS, we collected radiographic and laboratory data over 3 years. Radiographic data included images of the sacroiliac (SI) and hip joints and laboratory data included areas under the curve (AUC) of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), alkaline phosphatase (ALP), and hemoglobin (Hb). We investigated associations among changes in radiographic scores, initial clinical manifestations and laboratory measurements. RESULTS: Changes in scores for the SI joint and lumbar spine did not correlate with AUC for ESR, CRP, or ALP. AUC for Hb did not significantly correlate with radiographic progression in any joint. Patients with hip arthritis at the initial visit showed significantly higher radiographic score changes after 3 years in the SI and hip joint compared to those without hip arthritis. Patients who had shoulder arthritis as the initial manifestation had significantly increased AUCs for ESR and CRP compared to those without shoulder arthritis. However, at 3 years, the change of the lumbar spine score was significantly higher in patients without shoulder arthritis. CONCLUSIONS: These results indicate that hip arthritis at presentation is a useful clinical marker for predicting the structural damage to the SI and hip joint, and suggest that initial shoulder arthritis correlates with slower radiographic progression of the lumbar spine.
Adolescent
;
Adult
;
Alkaline Phosphatase/blood
;
Biomarkers/blood
;
Blood Sedimentation
;
C-Reactive Protein/metabolism
;
Disease Progression
;
Female
;
Hemoglobins/metabolism
;
Hip Joint/*radiography
;
Humans
;
Male
;
Osteoarthritis, Hip/blood/*radiography
;
Predictive Value of Tests
;
Retrospective Studies
;
Risk Factors
;
Sacroiliac Joint/*radiography
;
Severity of Illness Index
;
Spondylitis, Ankylosing/blood/*radiography
;
Time Factors
;
Young Adult
2.Hepatic Sarcoidosis in a Patient with Chronic Hepatitis B Virus Infection.
Hye Sun PARK ; Hyemin KIM ; Ji Yeon LEE ; Su Young JUNG ; Seunghee HAN ; Yong Beom PARK ; Soo Kon LEE ; Sang Hoon AHN ; Sang Won LEE
Journal of Rheumatic Diseases 2015;22(3):200-204
Sarcoidosis is a systemic inflammatory granulomatous disease affecting multiple organs, including liver, spleen, heart, eyes, and skin. Liver involvement is reported in 11.5% of cases and many studies have reported on the association between hepatitis C virus infection and sarcoidosis. However, the role of hepatitis B virus (HBV) infection as a trigger for sarcoidosis has never been reported. We describe a case of hepatic sarcoidosis in a patient with chronic hepatitis B infection, with a possible link between the two. It is the first case report of a patient with interferon-alpha-naive chronic HBV infection presenting with hepatic sarcoidosis accompanied by portal hypertension and liver cirrhosis.
Heart
;
Hepacivirus
;
Hepatitis B virus
;
Hepatitis B, Chronic*
;
Humans
;
Hypertension, Portal
;
Liver
;
Liver Cirrhosis
;
Sarcoidosis*
;
Skin
;
Spleen
3.Hepatoduodenal fistula formation following transcatheter arterial chemoembolization and radiotherapy for hepatocellular carcinoma: treatment with endoscopic Histoacryl injection.
Jaryong JEON ; Joonseong AHN ; Hongseok YOO ; Taek Kyu PARK ; Dongmo JE ; Hyemin JEONG ; Kwang Hyuck LEE
The Korean Journal of Internal Medicine 2014;29(1):101-105
A 71-year-old male patient was readmitted to our hospital 1 month after discharge because of relapse of abdominal pain. He had been diagnosed with hepatocellular carcinoma (HCC) 1 year prior and had undergone repeated transcatheter arterial chemoembolization and radiotherapy. During the last hospitalization, he was diagnosed with a liver abscess complicated by previous treatments for HCC and was treated with intravenous antibiotics and abscess aspiration. Follow-up abdominal computed tomography revealed a liver abscess with a duodenal fistula, which was successfully treated with endoscopic Histoacryl injection into the fistula. Liver abscesses with duodenal fistulas rarely occur, but they are intractable and possibly fatal in patients with HCC. In the literature, they have frequently been managed only with abscess treatment without fistula management. We herein report the first case of a patient with a liver abscess complicated by a fistula between the duodenum and the abscess, which was treated with endoscopic Histoacryl injection.
Abscess/*complications
;
Aged
;
Carcinoma, Hepatocellular/radiotherapy
;
Chemoembolization, Therapeutic/*adverse effects
;
Cholangiopancreatography, Endoscopic Retrograde
;
Duodenal Diseases/*etiology/therapy
;
Enbucrilate/*administration & dosage
;
Humans
;
Intestinal Fistula/*etiology/therapy
;
Liver Diseases/*etiology/therapy
;
Male
;
Radiotherapy/adverse effects
4.Drug survival of tumor necrosis factor α inhibitors in patients with ankylosing spondylitis in Korea.
Hyemin JEONG ; Yeong Hee EUN ; In Young KIM ; Hyungjin KIM ; Joong Kyong AHN ; Jaejoon LEE ; Eun Mi KOH ; Hoon Suk CHA
The Korean Journal of Internal Medicine 2018;33(2):407-416
BACKGROUND/AIMS: To evaluate drug survival of the tumor necrosis factor α inhibitors (TNFi) and risk factors for the drug discontinuation in patients with ankylosing spondylitis (AS). METHODS: We retrospectively evaluated 487 AS patients at a single tertiary hospital. Among the TNFi users, drug survival and risk factors of TNFi discontinuation were investigated. RESULTS: Among 487 patients, 128 AS patients were treated with at least one TNFi. Patients who were treated with TNFi were younger at disease onset, had more peripheral manifestations, and had higher level of acute phase reactants and body mass index than those of TNFi non-users at baseline. Of 128 patients, 28 patients (21.9%) discontinued first TNFi therapy during the follow-up period of 65.1 ± 27.9 months. In the multivariable analysis, female (hazard ratio [HR], 6.08; 95% confidence interval [CI], 2.27 to 16.27; p = 0.003), hip involvement (HR, 2.52; 95% CI, 1.08 to 5.87; p = 0.033) and a high C-reactive protein (CRP; HR, 1.10; 95% CI, 1.00 to 1.21; p = 0.044) were risk factors for drug discontinuation. Etanercept showed better survival rate than infliximab. The main reason for discontinuation of TNFi was inefficacy. CONCLUSIONS: TNFi discontinuation rate of Korean patients with AS seems to be similar to those with the European patients. Female sex, hip involvement, CRP, and the type of TNFi were associated with TNFi discontinuation.
Acute-Phase Proteins
;
Body Mass Index
;
C-Reactive Protein
;
Drug Users
;
Etanercept
;
Female
;
Follow-Up Studies
;
Hip
;
Humans
;
Infliximab
;
Korea*
;
Retrospective Studies
;
Risk Factors
;
Spondylitis, Ankylosing*
;
Survival Rate
;
Tertiary Care Centers
;
Tumor Necrosis Factor-alpha*
5.Prognostic Value of Sarcopenia and Myosteatosis in Patients with Resectable Pancreatic Ductal Adenocarcinoma
Dong Wook KIM ; Hyemin AHN ; Kyung Won KIM ; Seung Soo LEE ; Hwa Jung KIM ; Yousun KO ; Taeyong PARK ; Jeongjin LEE
Korean Journal of Radiology 2022;23(11):1055-1066
Objective:
The clinical relevance of myosteatosis has not been well evaluated in patients with pancreatic ductal adenocarcinoma (PDAC), although sarcopenia has been extensively researched. Therefore, we evaluated the prognostic value of muscle quality, including myosteatosis, in patients with resectable PDAC treated surgically.
Materials and Methods:
We retrospectively evaluated 347 patients with resectable PDAC who underwent curative surgery (mean age ± standard deviation, 63.6 ± 9.6 years; 202 male). Automatic muscle segmentation was performed on preoperative computed tomography (CT) images using an artificial intelligence program. A single axial image of the portal phase at the inferior endplate level of the L3 vertebra was used for analysis in each patient. Sarcopenia was evaluated using the skeletal muscle index, calculated as the skeletal muscle area (SMA) divided by the height squared. The mean SMA attenuation was used to evaluate myosteatosis. Diagnostic cutoff values for sarcopenia and myosteatosis were devised using the Contal and O’Quigley methods, and patients were classified according to normal (nMT), sarcopenic (sMT), myosteatotic (mMT), or combined (cMT) muscle quality types. Multivariable Cox regression analyses were conducted to assess the effects of muscle type on the overall survival (OS) and recurrence-free survival (RFS) after surgery.
Results:
Eighty-four (24.2%), 73 (21.0%), 75 (21.6%), and 115 (33.1%) patients were classified as having nMT, sMT, mMT, and cMT, respectively. Compared to nMT, mMT and cMT were significantly associated with poorer OS, with hazard ratios (HRs) of 1.49 (95% confidence interval, 1.00–2.22) and 1.68 (1.16–2.43), respectively, while sMT was not (HR of 1.40 [0.94–2.10]). Only mMT was significantly associated with poorer RFS, with an HR of 1.59 (1.07–2.35), while sMT and cMT were not.
Conclusion
Myosteatosis was associated with poor OS and RFS in patients with resectable PDAC who underwent curative surgery.
6.Effects of Contrast Phases on Automated Measurements of Muscle Quantity and Quality Using CT
Dong Wook KIM ; Kyung Won KIM ; Yousun KO ; Taeyong PARK ; Jeongjin LEE ; Jung Bok LEE ; Jiyeon HA ; Hyemin AHN ; Yu Sub SUNG ; Hong-Kyu KIM
Korean Journal of Radiology 2021;22(11):1909-1917
Objective:
Muscle quantity and quality can be measured with an automated system on CT. However, the effects of contrast phases on the muscle measurements have not been established, which we aimed to investigate in this study.
Materials and Methods:
Muscle quantity was measured according to the skeletal muscle area (SMA) measured by a convolutional neural network-based automated system at the L3 level in 89 subjects undergoing multiphasic abdominal CT comprising unenhanced phase, arterial phase, portal venous phase (PVP), or delayed phase imaging. Muscle quality was analyzed using the mean muscle density and the muscle quality map, which comprises normal and low-attenuation muscle areas (NAMA and LAMA, respectively) based on the muscle attenuation threshold. The SMA, mean muscle density, NAMA, and LAMA were compared between PVP and other phases using paired t tests. Bland-Altman analysis was used to evaluate the inter-phase variability between PVP and other phases. Based on the cutoffs for low muscle quantity and quality, the counts of individuals who scored lower than the cutoff values were compared between PVP and other phases.
Results:
All indices showed significant differences between PVP and other phases (p < 0.001 for all). The SMA, mean muscle density, and NAMA increased during the later phases, whereas LAMA decreased during the later phases. Bland-Altman analysis showed that the mean differences between PVP and other phases ranged -2.1 to 0.3 cm2 for SMA, -12.0 to 2.6 cm2 for NAMA, and -2.2 to 9.9 cm2 for LAMA.The number of patients who were categorized as low muscle quantity did not significant differ between PVP and other phases (p ≥ 0.5), whereas the number of patients with low muscle quality significantly differed (p ≤ 0.002).
Conclusion
SMA was less affected by the contrast phases. However, the muscle quality measurements changed with the contrast phases to greater extents and would require a standardization of the contrast phase for reliable measurement.
7.Reconstruction of mandibular defects in osteoradionecrosis and medication-related osteonecrosis of the jaw using fibula free flap and management of postoperative wound infections
Hyemin OH ; Dohyun KWON ; Jaemyung AHN ; Jun‑Young PAENG
Maxillofacial Plastic and Reconstructive Surgery 2022;44(1):37-
Background:
Complications from osteoradionecrosis (ORN) and medication-related osteonecrosis of the jaw (MRONJ) include oro-cutaneous fistulas, necrotic bone exposure, soft-tissue defects, and pathologic fractures. The fibula free flap (FFF) is a common free flap method used to reconstruct the mandible in severe cases. Recently, we have used the FFF successfully for the reconstruction of ORN and MRONJ mandibular defects. We report this method as a recommended technique for the treatment of ORN and MRONJ and the management method of postoperative infections.
Methods:
Four patients who were diagnosed with ORN of the mandible and 3 patients who were diagnosed with MRONJ of the mandible were included in the study. Among the 7 patients, 3 patients also had pathologic fractures. Partial mandibulectomy and FFF reconstruction were performed at the Department of Oral and Maxillofacial Surgery, Samsung Medical Center from April 2019 to March 2021.
Results:
All 7 patients recovered following the reconstruction of the defect by FFF. Four patients experienced infections after surgery and pus cultures were performed. All were well healed without flap damage after changing the antibiotics by consultation with infectious medicine experts.
Conclusion
FFF is a widely used method and can provide an extensive flap to reconstruct the mandible, especially those affected by ORN or MRONJ. If an infection occurs after surgery, appropriate antibiotic changes should be made through cooperation with the infectious medicine department. Therefore, FFF is a well-established and recommended method even in cases of challenging reconstruction.
8.Guidelines for Manufacturing and Application of Organoids: Liver
Hye-Ran MOON ; Seon Ju MUN ; Tae Hun KIM ; Hyemin KIM ; Dukjin KANG ; Suran KIM ; Ji Hyun SHIN ; Dongho CHOI ; Sun-Ju AHN ; Myung Jin SON
International Journal of Stem Cells 2024;17(2):120-129
Recent amendments to regulatory frameworks have placed a greater emphasis on the utilization of in vitro testing platforms for preclinical drug evaluations and toxicity assessments. This requires advanced tissue models capable of accurately replicating liver functions for drug efficacy and toxicity predictions. Liver organoids, derived from human cell sources, offer promise as a reliable platform for drug evaluation. However, there is a lack of standardized quality evaluation methods, which hinders their regulatory acceptance. This paper proposes comprehensive quality standards tailored for liver organoids, addressing cell source validation, organoid generation, and functional assessment. These guidelines aim to enhance reproducibility and accuracy in toxicity testing, thereby accelerating the adoption of organoids as a reliable alternative or complementary tool to animal testing in drug development. The quality standards include criteria for size, cellular composition, gene expression, and functional assays, thus ensuring a robust hepatotoxicity testing platform.
9.The Cortical Neuroanatomy Related to Specific Neuropsychological Deficits in Alzheimer's Continuum
Sung Hoon KANG ; Yu Hyun PARK ; Daun LEE ; Jun Pyo KIM ; Juhee CHIN ; Yisuh AHN ; Seong Beom PARK ; Hee Jin KIM ; Hyemin JANG ; Young Hee JUNG ; Jaeho KIM ; Jongmin LEE ; Ji Sun KIM ; Bo Kyoung CHEON ; Alice HAHN ; Hyejoo LEE ; Duk L NA ; Young Ju KIM ; Sang Won SEO
Dementia and Neurocognitive Disorders 2019;18(3):77-95
BACKGROUND AND PURPOSE: In Alzheimer's continuum (a comprehensive of preclinical Alzheimer's disease [AD], mild cognitive impairment [MCI] due to AD, and AD dementia), cognitive dysfunctions are often related to cortical atrophy in specific brain regions. The purpose of this study was to investigate the association between anatomical pattern of cortical atrophy and specific neuropsychological deficits. METHODS: A total of 249 participants with Alzheimer's continuum (125 AD dementia, 103 MCI due to AD, and 21 preclinical AD) who were confirmed to be positive for amyloid deposits were collected from the memory disorder clinic in the department of neurology at Samsung Medical Center in Korea between September 2013 and March 2018. To analyze neuropsychological test-specific neural correlates representing the relationship between cortical atrophy measured by cortical thickness and performance in specific neuropsychological tests, a linear regression analysis was performed. Two neural correlates acquired by 2 different standardized scores in neuropsychological tests were also compared. RESULTS: Cortical atrophy in several specific brain regions was associated with most neuropsychological deficits, including digit span backward, naming, drawing-copying, verbal and visual recall, semantic fluency, phonemic fluency, and response inhibition. There were a few differences between 2 neural correlates obtained by different z-scores. CONCLUSIONS: The poor performance of most neuropsychological tests is closely related to cortical thinning in specific brain areas in Alzheimer's continuum. Therefore, the brain atrophy pattern in patients with Alzheimer's continuum can be predict by an accurate analysis of neuropsychological tests in clinical practice.
Alzheimer Disease
;
Atrophy
;
Brain
;
Cognition
;
Dementia
;
Humans
;
Korea
;
Linear Models
;
Memory Disorders
;
Mild Cognitive Impairment
;
Neuroanatomy
;
Neurology
;
Neuropsychological Tests
;
Plaque, Amyloid
;
Semantics
10.Organizing an in-class hackathon to correct PDF-to-text conversion errors of Genomics & Informatics 1.0
Sunho KIM ; Royoung KIM ; Ryeo-Gyeong KIM ; Enjin KO ; Han-Su KIM ; Jihye SHIN ; Daeun CHO ; Yurhee JIN ; Soyeon BAE ; Ye Won JO ; San Ah JEONG ; Yena KIM ; Seoyeon AHN ; Bomi JANG ; Jiheyon SEONG ; Yujin LEE ; Si Eun SEO ; Yujin KIM ; Ha-Jeong KIM ; Hyeji KIM ; Hye-Lynn SUNG ; Hyoyoung LHO ; Jaywon KOO ; Jion CHU ; Juwon LIM ; Youngju KIM ; Kyungyeon LEE ; Yuri LIM ; Meongeun KIM ; Seonjeong HWANG ; Shinhye HAN ; Sohyeun BAE ; Sua KIM ; Suhyeon YOO ; Yeonjeong SEO ; Yerim SHIN ; Yonsoo KIM ; You-Jung KO ; Jihee BAEK ; Hyejin HYUN ; Hyemin CHOI ; Ji-Hye OH ; Da-Young KIM ; Hee-Jo NAM ; Hyun-Seok PARK
Genomics & Informatics 2020;18(3):e33-
This paper describes a community effort to improve earlier versions of the full-text corpus of Genomics & Informatics by semi-automatically detecting and correcting PDF-to-text conversion errors and optical character recognition errors during the first hackathon of Genomics & Informatics Annotation Hackathon (GIAH) event. Extracting text from multi-column biomedical documents such as Genomics & Informatics is known to be notoriously difficult. The hackathon was piloted as part of a coding competition of the ELTEC College of Engineering at Ewha Womans University in order to enable researchers and students to create or annotate their own versions of the Genomics & Informatics corpus, to gain and create knowledge about corpus linguistics, and simultaneously to acquire tangible and transferable skills. The proposed projects during the hackathon harness an internal database containing different versions of the corpus and annotations.