1.Rare Neurovascular Diseases in Korea: Classification and Related Genetic Variants
Yunsun SONG ; Boseong KWON ; Abdulrahman Hamed AL-ABDULWAHHAB ; Yeo Kyoung NAM ; Yura AHN ; So Yeong JEONG ; Eul-Ju SEO ; Jong-Keuk LEE ; Dae Chul SUH
Korean Journal of Radiology 2021;22(8):1379-1396
Rare neurovascular diseases (RNVDs) have not been well-recognized in Korea. They involve the central nervous system and greatly affect the patients’ lives. However, these diseases are difficult to diagnose and treat due to their rarity and incurability. We established a list of RNVDs by referring to the previous literature and databases worldwide to better understand the diseases and their current management status. We categorized 68 RNVDs based on their pathophysiology and clinical manifestations and estimated the prevalence of each disease in Korea. Recent advances in genetic, molecular, and developmental research have enabled further understanding of these RNVDs. Herein, we review each disease, while considering its classification based on updated pathologic mechanisms, and discuss the management status of RNVD in Korea.
2.Rare Neurovascular Diseases in Korea: Classification and Related Genetic Variants
Yunsun SONG ; Boseong KWON ; Abdulrahman Hamed AL-ABDULWAHHAB ; Yeo Kyoung NAM ; Yura AHN ; So Yeong JEONG ; Eul-Ju SEO ; Jong-Keuk LEE ; Dae Chul SUH
Korean Journal of Radiology 2021;22(8):1379-1396
Rare neurovascular diseases (RNVDs) have not been well-recognized in Korea. They involve the central nervous system and greatly affect the patients’ lives. However, these diseases are difficult to diagnose and treat due to their rarity and incurability. We established a list of RNVDs by referring to the previous literature and databases worldwide to better understand the diseases and their current management status. We categorized 68 RNVDs based on their pathophysiology and clinical manifestations and estimated the prevalence of each disease in Korea. Recent advances in genetic, molecular, and developmental research have enabled further understanding of these RNVDs. Herein, we review each disease, while considering its classification based on updated pathologic mechanisms, and discuss the management status of RNVD in Korea.
3.Associations among the Duodenal Ecosystem, Gut Microbiota, and Nutrient Intake in Functional Dyspepsia
Sang Hoon KIM ; Yura CHOI ; Jihong OH ; Eui Yeon LIM ; Jung Eun LEE ; Eun-Ji SONG ; Young-Do NAM ; Hojun KIM
Gut and Liver 2024;18(4):621-631
Background/Aims:
Functional dyspepsia (FD) has long been regarded as a syndrome because its pathophysiology is multifactorial. However, recent reports have provided evidence that changes in the duodenal ecosystem may be the key. This study aimed to identify several gastrointestinal factors and biomarkers associated with FD, specifically changes in the duodenal ecosystem that may be key to understanding its pathophysiology.
Methods:
In this case-control study, 28 participants (12 with FD and 16 healthy control individuals) were assessed for dietary nutrients, gastrointestinal symptom severity, immunological status of the duodenal mucosa, and microbiome composition from oral, duodenal, and fecal samples. Integrated data were analyzed using immunohistochemistry, real-time polymerase chain reaction, 16S rRNA sequencing, and network analysis.
Results:
Duodenal mucosal inflammation and impaired expression of tight junction proteins were confirmed in patients with FD. The relative abundance of duodenal Streptococcus (p=0.014) and reductions in stool Butyricicoccus (p=0.047) were confirmed. These changes in the gut microbiota were both correlated with symptom severity. Changes in dietary micronutrients, such as higher intake of valine, were associated with improved intestinal barrier function and microbiota.
Conclusions
This study emphasizes the relationships among dietary nutrition, oral and gut microbiota, symptoms of FD, impaired function of the duodenal barrier, and inflammation. Assessing low-grade inflammation or increased permeability in the duodenal mucosa, along with changes in the abundance of stool Butyricicoccus, is anticipated to serve as effective biomarkers for enhancing the objectivity of FD diagnosis and monitoring.
4.Prognostic Implication of Right Ventricle Parameters Measured on Preoperative Cardiac MRI in Patients with Functional Tricuspid Regurgitation
Yura AHN ; Hyun Jung KOO ; Joon-Won KANG ; Won Jin CHOI ; Dae-Hee KIM ; Jong-Min SONG ; Duk-Hyun KANG ; Jae-Kwan SONG ; Joon Bum KIM ; Sung-Ho JUNG ; Suk Jung CHOO ; Cheol Hyun CHUNG ; Jae Won LEE ; Dong Hyun YANG
Korean Journal of Radiology 2021;22(8):1253-1265
Objective:
To investigate the prognostic value of preoperative cardiac magnetic resonance imaging (MRI) for long-term major adverse cardiac and cerebrovascular events (MACCEs) in patients undergoing tricuspid valve (TV) surgery for functional tricuspid regurgitation (TR).
Materials and Methods:
The preoperative cardiac MR images, New York Heart Association functional class, comorbidities, and clinical events of 78 patients (median [interquartile range], 59 [51–66.3] years, 28.2% male) who underwent TV surgery for functional TR were comprehensively reviewed. Cox proportional hazards analyses were performed to assess the associations of clinical and imaging parameters with MACCEs and all-cause mortality.
Results:
For the median follow-up duration of 5.4 years (interquartile range, 1.2–6.6), MACCEs and all-cause mortality were 51.3% and 23.1%, respectively. The right ventricular (RV) end-systolic volume index (ESVI) and the systolic RV mass index (RVMI) were higher in patients with MACCEs than those without them (77 vs. 68 mL/m2 , p = 0.048; 23.5 vs. 18.0%, p = 0.011, respectively). A high RV ESVI was associated with all-cause mortality (hazard ratio [HR] per value of 10 higher ESVI = 1.10, p = 0.03). A high RVMI was also associated with all-cause mortality (HR per increase of 5 mL/m2 RVMI = 1.75, p < 0.001).After adjusting for age and sex, only RVMI remained a significant predictor of MACCEs and all-cause mortality (p < 0.05 for both). After adjusting for multiple clinical variables, RVMI remained significantly associated with all-cause mortality (p = 0.005).
Conclusion
RVMI measured on preoperative cardiac MRI was an independent predictor of long-term outcomes in patients who underwent TV surgery for functional TR.
5.Prognostic Implication of Right Ventricle Parameters Measured on Preoperative Cardiac MRI in Patients with Functional Tricuspid Regurgitation
Yura AHN ; Hyun Jung KOO ; Joon-Won KANG ; Won Jin CHOI ; Dae-Hee KIM ; Jong-Min SONG ; Duk-Hyun KANG ; Jae-Kwan SONG ; Joon Bum KIM ; Sung-Ho JUNG ; Suk Jung CHOO ; Cheol Hyun CHUNG ; Jae Won LEE ; Dong Hyun YANG
Korean Journal of Radiology 2021;22(8):1253-1265
Objective:
To investigate the prognostic value of preoperative cardiac magnetic resonance imaging (MRI) for long-term major adverse cardiac and cerebrovascular events (MACCEs) in patients undergoing tricuspid valve (TV) surgery for functional tricuspid regurgitation (TR).
Materials and Methods:
The preoperative cardiac MR images, New York Heart Association functional class, comorbidities, and clinical events of 78 patients (median [interquartile range], 59 [51–66.3] years, 28.2% male) who underwent TV surgery for functional TR were comprehensively reviewed. Cox proportional hazards analyses were performed to assess the associations of clinical and imaging parameters with MACCEs and all-cause mortality.
Results:
For the median follow-up duration of 5.4 years (interquartile range, 1.2–6.6), MACCEs and all-cause mortality were 51.3% and 23.1%, respectively. The right ventricular (RV) end-systolic volume index (ESVI) and the systolic RV mass index (RVMI) were higher in patients with MACCEs than those without them (77 vs. 68 mL/m2 , p = 0.048; 23.5 vs. 18.0%, p = 0.011, respectively). A high RV ESVI was associated with all-cause mortality (hazard ratio [HR] per value of 10 higher ESVI = 1.10, p = 0.03). A high RVMI was also associated with all-cause mortality (HR per increase of 5 mL/m2 RVMI = 1.75, p < 0.001).After adjusting for age and sex, only RVMI remained a significant predictor of MACCEs and all-cause mortality (p < 0.05 for both). After adjusting for multiple clinical variables, RVMI remained significantly associated with all-cause mortality (p = 0.005).
Conclusion
RVMI measured on preoperative cardiac MRI was an independent predictor of long-term outcomes in patients who underwent TV surgery for functional TR.
6.Preoperative Cardiac Computed Tomography Characteristics Associated with Recurrent Aortic Regurgitation after Aortic Valve Re-Implantation
Yura AHN ; Hyun Jung KOO ; Sahmin LEE ; Dae Hee KIM ; Jong Min SONG ; Duk Hyun KANG ; Jae Kwan SONG ; Ho Jin KIM ; Joon Bum KIM ; Sung Ho JUNG ; Suk Jung CHOO ; Cheol Hyun CHUNG ; Jae Won LEE ; Joon Won KANG ; Dong Hyun YANG
Korean Journal of Radiology 2020;21(2):181-191
24 mm² (sensitivity, 76.5%; specificity 64.8%), and the area under the ROC curve (AUC) was 0.72. For ASR(area), the cut-off value was > 1.58 (sensitivity, 76.5%; specificity, 58.0%) and the AUC was 0.64. Multivariable Cox regression showed that ARO > 24 mm² (hazard ratio = 3.79, p = 0.020) was a potential independent parameter for recurrent 3 + AR. ROC for the linear regression model showed that the AUC for both ARO and ASR(area) was 0.73 (95% confidence interval, 0.64–0.81, p < 0.001).CONCLUSION: ARO and ASR(area) detected on preoperative cardiac CT would be potentially helpful for identifying AR patients who may benefit from the David operation.]]>
Aortic Valve Insufficiency
;
Aortic Valve
;
Area Under Curve
;
Echocardiography
;
Humans
;
Linear Models
;
Retrospective Studies
;
ROC Curve
;
Sensitivity and Specificity
;
Tomography, X-Ray Computed
7.Clinical implications of proliferation activity in T1 or T2 male gastric cancer patients.
Young Woo KIM ; Bang Wool EOM ; Myeong Cherl KOOK ; Han Seong KIM ; Mi Kyung KIM ; Hai Li HWANG ; Vishal CHANDRA ; Shiv POOJAN ; Yura SONG ; Jae Soo KOH ; Chang Dae BAE ; Jungsil RO ; Kyeong Man HONG
Experimental & Molecular Medicine 2015;47(11):e193-
Proliferation activity has already been established as a prognostic marker or as a marker for anticancer drug sensitivity. In gastric cancer, however, the prognostic significance of proliferation activity is still being debated. Several studies evaluating proliferation activity using Ki-67 have shown controversial results in terms of the relationship between proliferation activity and overall survival (OS) or drug sensitivity in gastric cancer patients. Because cytoskeleton-associated protein 2 (CKAP2) staining has recently been introduced as a marker of proliferation activity, we analyzed 437 gastric cancer tissues through CKAP2 immunohistochemistry, and we evaluated the chromatin CKAP2-positive cell count (CPCC) for proliferation activity. Although the CPCC did not show any significant correlation with OS in the male, female or total number of cases, it did show a significant correlation in the T1 or T2 male patient subgroup, according to log-rank tests (P=0.001) and univariate analysis (P=0.045). Additionally, multivariate analysis with the Cox proportional hazard regression model showed a significant correlation between the CPCC and OS (P=0.039) for the co-variables of age, gender, T stage, N stage, histology, tumor location, tumor size and adjuvant chemotherapy. In male gastric cancer cell lines, faster-growing cancer cells showed higher sensitivity to cisplatin than slow-growing cells. Thus our study indicates that CPCC-measured proliferation activity demonstrates a significantly worse prognosis in T1 or T2 male gastric cancer patients. The CPCC will help to more precisely classify gastric cancer patients and to select excellent candidates for adjuvant chemotherapy, which in turn will facilitate further clinical chemotherapeutic trials.
Aged
;
Antineoplastic Agents/therapeutic use
;
Biomarkers, Tumor/analysis
;
Cell Proliferation
;
Cisplatin/therapeutic use
;
Cytoskeletal Proteins/*analysis
;
Female
;
Humans
;
Immunohistochemistry
;
Male
;
Middle Aged
;
Multivariate Analysis
;
Prognosis
;
Proportional Hazards Models
;
Stomach/drug effects/*pathology
;
Stomach Neoplasms/diagnosis/drug therapy/*pathology
;
Survival Analysis
8.Computer-Aided Diagnosis System for the Evaluation of Thyroid Nodules on Ultrasonography: Prospective Non-Inferiority Study according to the Experience Level of Radiologists
Sae Rom CHUNG ; Jung Hwan BAEK ; Min Kyoung LEE ; Yura AHN ; Young Jun CHOI ; Tae Yon SUNG ; Dong Eun SONG ; Tae Yong KIM ; Jeong Hyun LEE
Korean Journal of Radiology 2020;21(3):369-376
OBJECTIVE: To determine whether a computer-aided diagnosis (CAD) system for the evaluation of thyroid nodules is non-inferior to radiologists with different levels of experience.MATERIALS AND METHODS: Patients with thyroid nodules with a decisive diagnosis of benign or malignant nodule were consecutively enrolled from November 2017 to September 2018. Three radiologists with different levels of experience (1 month, 4 years, and 7 years) in thyroid ultrasound (US) reviewed the thyroid US with and without using the CAD system. Statistical analyses included non-inferiority testing of the diagnostic accuracy for malignant thyroid nodules between the CAD system and the three radiologists with a non-inferiority margin of 10%, comparison of the diagnostic performance, and the added value of the CAD system to the radiologists.RESULTS: Altogether, 197 patients were included in the study cohort. The diagnostic accuracy of the CAD system (88.48%, 95% confidence interval [CI] = 82.65–92.53) was non-inferior to that of the radiologists with less experience (1 month and 4 year) of thyroid US (83.03%, 95% CI = 76.52–88.02; p < 0.001), whereas it was inferior to that of the experienced radiologist (7 years) (95.76%, 95% CI = 91.37–97.96; p = 0.138). The sensitivity and negative predictive value of the CAD system were significantly higher than those of the less-experienced radiologists were, whereas no significant difference was found with those of the experienced radiologist. A combination of US and the CAD system significantly improved sensitivity and negative predictive value, although the specificity and positive predictive value deteriorated for the less-experienced radiologists.CONCLUSION: The CAD system may offer support for decision-making in the diagnosis of malignant thyroid nodules for operators who have less experience with thyroid US.
Cohort Studies
;
Diagnosis
;
Humans
;
Prospective Studies
;
Sensitivity and Specificity
;
Thyroid Gland
;
Thyroid Neoplasms
;
Thyroid Nodule
;
Ultrasonography