1.Comparison of survival outcomes after anatomical resection and non-anatomical resection in patients with hepatocellular carcinoma.
Seheon KIM ; Seokwhan KIM ; Insang SONG ; Kwangsik CHUN
Korean Journal of Hepato-Biliary-Pancreatic Surgery 2015;19(4):161-166
BACKGROUNDS/AIMS: Liver resection is a curative procedure performed worldwide for hepatocellular carcinoma (HCC). Deciding on the appropriate resection range for postoperative hepatic function preservation is an important surgical consideration. This study compares survival outcomes of HCC patients who underwent anatomical or non-anatomical resection, to determine which offers the best clinical survival benefit. METHODS: One hundred and thirty-one patients underwent liver resection with HCC, between January 2007 and February 2015, and were divided into two groups: those who underwent anatomical liver resection (n=88) and those who underwent non-anatomical liver resection (n=43). Kaplan-Meier survival analysis and Cox regressions were used to compare the disease-free survival (DFS) and overall survival (OS) rates between the groups. RESULTS: The mean follow-up periods were 27 and 40 months in the anatomical and non-anatomical groups, respectively (p=0.229). The 3- and 5-year DFS rates were 70% and 60% in the anatomical group and 62% and 48% in the non-anatomical group, respectively. The 3 and 5-year OS rates were 94% and 78% in the anatomical group, and 86% and 80% in the non-anatomical group, respectively. The anatomical group tended to show better outcomes, but the findings were not significant. However, a relative risk of OS between the anatomical and non-anatomical group was 0.234 (95% CI, 0.061-0.896; p=0.034), which is statistically significant. CONCLUSIONS: Although statistical significance was not detected in survival curves, anatomical resection showed better results. In this respect, anatomical resection is more likely to perform in HCC patients with preserve liver function than non-anatomical resection.
Carcinoma, Hepatocellular*
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Disease-Free Survival
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Follow-Up Studies
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Humans
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Liver
2.Loss of Caveolin 1 is Associated With the Expression of Aquaporin 1 and Bladder Dysfunction in Mice.
Seheon JUNG ; Sun Ouck KIM ; Kyung Aa CHO ; Seung Hee SONG ; Teak Won KANG ; Kwangsung PARK ; Dongdeuk KWON
International Neurourology Journal 2015;19(1):34-38
PURPOSE: It is suggested that caveolin and aquaporin might be closely associated with bladder signal activity. We investigated the effect of the deletion of caveolin 1, using caveolin 1 knockout mice, on the expression of aquaporin 1 in order to identify their relation in the urothelium of the urinary bladder. METHODS: The cellular localization and expressions of aquaporin 1 and caveolin 1, in the wild type and caveolin 1 knockout mice urinary bladder, were examined by Western blot and immunofluorescence techniques. RESULTS: Aquaporin 1 and caveolin 1 were coexpressed in the arterioles, venules, and capillaries of the suburothelial layer in the wild type controls. Aquaporin 1 protein expression was significantly higher in the caveolin 1 knockout mice than in the wild type controls (P <0.05). CONCLUSIONS: The results imply that aquaporin 1 and caveolin 1 may share a distinct relation with the bladder signal activity. This might play a specific role in bladder dysfunction.
Animals
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Aquaporin 1*
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Arterioles
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Blotting, Western
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Capillaries
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Caveolin 1*
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Fluorescent Antibody Technique
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Mice*
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Mice, Knockout
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Urinary Bladder*
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Urothelium
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Venules
3.Short-term Evaluation of Efficacy and Biocompatibility of Artificial Corneal Transplantation in Rabbit Model
Jungyeob HAN ; Jeong Hye SUNWOO ; Seheon OH ; Su Young MOON ; Sanghyu NAM ; Hun LEE ; Jae Yong KIM ; Hungwon TCHAH
Journal of the Korean Ophthalmological Society 2022;63(10):823-833
Purpose:
To examine the efficacy and biocompatibility of a new artificial cornea using a rabbit model.
Methods:
Artificial cornea were transplanted into 20 New Zealand white rabbits. The disc-shaped artificial cornea is of diameter 8.0 mm (the core, clear optical zone diameter is 5.0 mm and that of the peripheral skirt 1.5 mm); of thickness 0.5 mm; and is fabricated from PHEMA, PMMA, and PETTA. Transplantation proceeded in two stages; all rabbits were then observed weekly to 12 weeks. Anterior segment photographs were taken, and anterior segment optical coherence tomography and histological analysis performed, to confirm the biocompatibility of the skirt and the extents of cell proliferation in surrounding tissues.
Results:
Two rabbits were sacrificed for histological examination in weeks 4 and 8 (one each). Four eyes failed because of surgical errors (artificial corneal decentration or excessively thin flaps). Of the 12 eyes for which surgery was technically successful, six (50.0%) maintained the optical zone structure and transparency to 12 weeks. Histology revealed that cells proliferated in the skirt and bound to surrounding tissues. Six eyes (50.0%) evidenced protrusions of the artificial cornea.
Conclusions
Transplantation of a new artificial cornea into rabbits met with some success (as confirmed anatomically and optically). However, corneal improvement and new surgical techniques are required to increase the success rate. Also, long-term follow-up is needed.
4.Early Prediction of Mortality for Septic Patients Visiting Emergency Room Based on Explainable Machine Learning: A Real-World Multicenter Study
Sang Won PARK ; Na Young YEO ; Seonguk KANG ; Taejun HA ; Tae-Hoon KIM ; DooHee LEE ; Dowon KIM ; Seheon CHOI ; Minkyu KIM ; DongHoon LEE ; DoHyeon KIM ; Woo Jin KIM ; Seung-Joon LEE ; Yeon-Jeong HEO ; Da Hye MOON ; Seon-Sook HAN ; Yoon KIM ; Hyun-Soo CHOI ; Dong Kyu OH ; Su Yeon LEE ; MiHyeon PARK ; Chae-Man LIM ; Jeongwon HEO ; On behalf of the Korean Sepsis Alliance (KSA) Investigators
Journal of Korean Medical Science 2024;39(5):e53-
Background:
Worldwide, sepsis is the leading cause of death in hospitals. If mortality rates in patients with sepsis can be predicted early, medical resources can be allocated efficiently. We constructed machine learning (ML) models to predict the mortality of patients with sepsis in a hospital emergency department.
Methods:
This study prospectively collected nationwide data from an ongoing multicenter cohort of patients with sepsis identified in the emergency department. Patients were enrolled from 19 hospitals between September 2019 and December 2020. For acquired data from 3,657 survivors and 1,455 deaths, six ML models (logistic regression, support vector machine, random forest, extreme gradient boosting [XGBoost], light gradient boosting machine, and categorical boosting [CatBoost]) were constructed using fivefold cross-validation to predict mortality. Through these models, 44 clinical variables measured on the day of admission were compared with six sequential organ failure assessment (SOFA) components (PaO 2 /FIO 2 [PF], platelets (PLT), bilirubin, cardiovascular, Glasgow Coma Scale score, and creatinine).The confidence interval (CI) was obtained by performing 10,000 repeated measurements via random sampling of the test dataset. All results were explained and interpreted using Shapley’s additive explanations (SHAP).
Results:
Of the 5,112 participants, CatBoost exhibited the highest area under the curve (AUC) of 0.800 (95% CI, 0.756–0.840) using clinical variables. Using the SOFA components for the same patient, XGBoost exhibited the highest AUC of 0.678 (95% CI, 0.626–0.730). As interpreted by SHAP, albumin, lactate, blood urea nitrogen, and international normalization ratio were determined to significantly affect the results. Additionally, PF and PLTs in the SOFA component significantly influenced the prediction results.
Conclusion
Newly established ML-based models achieved good prediction of mortality in patients with sepsis. Using several clinical variables acquired at the baseline can provide more accurate results for early predictions than using SOFA components. Additionally, the impact of each variable was identified.