2.Development and Validation of a Deep Learning System for Segmentation of Abdominal Muscle and Fat on Computed Tomography
Hyo Jung PARK ; Yongbin SHIN ; Jisuk PARK ; Hyosang KIM ; In Seob LEE ; Dong Woo SEO ; Jimi HUH ; Tae Young LEE ; TaeYong PARK ; Jeongjin LEE ; Kyung Won KIM
Korean Journal of Radiology 2020;21(1):88-100
dataset of 883 CT scans from 467 subjects. Axial CT images obtained at the inferior endplate level of the 3rd lumbar vertebra were used for the analysis. Manually drawn segmentation maps of the skeletal muscle, visceral fat, and subcutaneous fat were created to serve as ground truth data. The performance of the fully convolutional network-based segmentation system was evaluated using the Dice similarity coefficient and cross-sectional area error, for both a separate internal validation dataset (426 CT scans from 308 subjects) and an external validation dataset (171 CT scans from 171 subjects from two outside hospitals).RESULTS: The mean Dice similarity coefficients for muscle, subcutaneous fat, and visceral fat were high for both the internal (0.96, 0.97, and 0.97, respectively) and external (0.97, 0.97, and 0.97, respectively) validation datasets, while the mean cross-sectional area errors for muscle, subcutaneous fat, and visceral fat were low for both internal (2.1%, 3.8%, and 1.8%, respectively) and external (2.7%, 4.6%, and 2.3%, respectively) validation datasets.CONCLUSION: The fully convolutional network-based segmentation system exhibited high performance and accuracy in the automatic segmentation of abdominal muscle and fat on CT images.]]>
Abdominal Muscles
;
Adipose Tissue
;
Artificial Intelligence
;
Dataset
;
Intra-Abdominal Fat
;
Learning
;
Muscle, Skeletal
;
Muscles
;
Sarcopenia
;
Spine
;
Subcutaneous Fat
;
Tomography, X-Ray Computed
3.Involvement of the TNF-α Pathway in TKI Resistance and Suggestion of TNFR1 as a Predictive Biomarker for TKI Responsiveness in Clear Cell Renal Cell Carcinoma
Hee Sang HWANG ; Yun Yong PARK ; Su Jin SHIN ; Heounjeong GO ; Ja Min PARK ; Sun Young YOON ; Jae Lyun LEE ; Yong Mee CHO
Journal of Korean Medical Science 2020;35(5):31-
dataset from patient-derived xenograft model for TKI-treated ccRCC (GSE76068) was retrieved. Commonly altered pathways between the datasets were investigated by Ingenuity Pathway Analysis using commonly regulated differently expressed genes (DEGs). The significance of candidate DEG on intrinsic TKI resistance was assessed through immunohistochemistry in a separate cohort of 101 TKI-treated ccRCC cases.RESULTS: TNFRSF1A gene expression and tumor necrosis factor (TNF)-α pathway were upregulated in ccRCCs with acquired TKI resistance in both microarray datasets. Also, high expression (> 10% of labeled tumor cells) of TNF receptor 1 (TNFR1), the protein product of TNFRSF1A gene, was correlated with sarcomatoid dedifferentiation and was an independent predictive factor of clinically unfavorable response and shorter survivals in separated TKI-treated ccRCC cohort.CONCLUSION: TNF-α signaling may play a role in TKI resistance, and TNFR1 expression may serve as a predictive biomarker for clinically unfavorable TKI responses in ccRCC.]]>
Biomarkers
;
Carcinoma, Renal Cell
;
Cohort Studies
;
Dataset
;
Drug Resistance
;
Gene Expression
;
Gene Expression Profiling
;
Heterografts
;
Humans
;
Immunohistochemistry
;
Protein-Tyrosine Kinases
;
Receptors, Tumor Necrosis Factor
;
Receptors, Tumor Necrosis Factor, Type I
;
Tumor Necrosis Factor-alpha
4.Pathologic discrepancies between colposcopy-directed biopsy and loop electrosurgical excision procedure of the uterine cervix in women with cytologic high-grade squamous intraepithelial lesions
Se Ik KIM ; Se Jeong KIM ; Dong Hoon SUH ; Kidong KIM ; Jae Hong NO ; Yong Beom KIM
Journal of Gynecologic Oncology 2020;31(2):13-
OBJECTIVE: To investigate pathologic discrepancies between colposcopy-directed biopsy (CDB) of the cervix and loop electrosurgical excision procedure (LEEP) in women with cytologic high-grade squamous intraepithelial lesions (HSILs).METHODS: We retrospectively identified 297 patients who underwent both CDB and LEEP for HSILs in cervical cytology between 2015 and 2018, and compared their pathologic results. Considering the LEEP to be the gold standard, we evaluated the diagnostic performance of CDB for identifying cervical intraepithelial neoplasia (CIN) grades 2 and 3, adenocarcinoma in situ, and cancer (HSIL+). We also performed age subgroup analyses.RESULTS: Among the study population, 90.9% (270/297) had pathologic HSIL+ using the LEEP. The diagnostic performance of CDB for identifying HSIL+ was as follows: sensitivity, 87.8%; specificity, 59.3%; balanced accuracy, 73.6%; positive predictive value, 95.6%; and negative predictive value, 32.7%. Thirty-three false negative cases of CDB included CIN2,3 (n=29) and cervical cancer (n=4). The pathologic HSIL+ rate in patients with HSIL− by CDB was 67.3% (33/49). CDB exhibited a significant difference in the diagnosis of HSIL+ compared to LEEP in all patients (p<0.001). In age subgroup analyses, age groups <35 years and 35–50 years showed good agreement with the entire data set (p=0.496 and p=0.406, respectively), while age group ≥50 years did not (p=0.036).CONCLUSION: A significant pathologic discrepancy was observed between CDB and LEEP results in women with cytologic HSILs. The diagnostic inaccuracy of CDB increased in those ≥50 years of age.
Adenocarcinoma in Situ
;
Biopsy
;
Cervical Intraepithelial Neoplasia
;
Cervix Uteri
;
Colposcopy
;
Conization
;
Dataset
;
Diagnosis
;
Early Detection of Cancer
;
Female
;
Humans
;
Papanicolaou Test
;
Retrospective Studies
;
Sensitivity and Specificity
;
Squamous Intraepithelial Lesions of the Cervix
;
Uterine Cervical Neoplasms
5.Nationwide Cross-sectional Study of Association between Pterygium and Alkaline Phosphatase in a Population from Korea
Hyun Joon KIM ; Sang Hoon RAH ; Sun Woong KIM ; Soo Han KIM
Journal of the Korean Ophthalmological Society 2020;61(1):9-16
PURPOSE: We determined whether elevated serum alkaline phosphatase (ALP) was related to prevalence, location, type, length, and recurrence of pterygium in a population from the Republic of Korea.METHODS: A nationwide cross-sectional dataset, the Korean National Health and Nutrition Examination Survey (2008–2011), was used in this study. All participants were > 30 years of age and underwent the ALP test and ophthalmic evaluation (n = 22,359). One-way analysis of variance, the chi-square test, and Fisher's exact test were used to compare characteristics and outcomes among participants. Multivariable logistic regression was used to examine the possible associations between serum ALP levels and various types of pterygium. Data were adjusted for known risk factors for development of pterygium and ALP elevation (age, sex, residence, sunlight exposure, drinking, smoking, hypertension, diabetes, BMI, AST, ALT, vitamin D, and HDL).RESULTS: The overall prevalence of pterygium was 8.1%, and participants with pterygium had higher levels of serum ALP (p < 0.001). Participants with higher serum ALP had a significantly higher prevalence of all types of pterygium than those in the lower serum ALP quartiles. After adjusting for potential confounding factors, multivariate logistic regression analysis revealed that ALP was associated with the prevalence of pterygium (odds ratio [OR], 1.001; p = 0.038). Trend analysis between the OR and ALP quartiles revealed a linear trend in overall prevalence and in the intermediate type of pterygium. Subgroup analysis revealed a stronger correlation in participants > 50 years of age. One-way analysis of variance revealed an association between the size of pterygium and serum ALP quartile levels. Serum ALP was not associated with recurrence of pterygium.CONCLUSIONS: Increased serum ALP was associated with the prevalence and size of pterygium.
Alkaline Phosphatase
;
Cross-Sectional Studies
;
Dataset
;
Drinking
;
Hypertension
;
Korea
;
Logistic Models
;
Nutrition Surveys
;
Prevalence
;
Pterygium
;
Recurrence
;
Republic of Korea
;
Risk Factors
;
Smoke
;
Smoking
;
Sunlight
;
Vitamin D
6.Feasibility of fully automated classification of whole slide images based on deep learning
Kyung Ok CHO ; Sung Hak LEE ; Hyun Jong JANG
The Korean Journal of Physiology and Pharmacology 2020;24(1):89-99
Although microscopic analysis of tissue slides has been the basis for disease diagnosis for decades, intra- and inter-observer variabilities remain issues to be resolved. The recent introduction of digital scanners has allowed for using deep learning in the analysis of tissue images because many whole slide images (WSIs) are accessible to researchers. In the present study, we investigated the possibility of a deep learning-based, fully automated, computer-aided diagnosis system with WSIs from a stomach adenocarcinoma dataset. Three different convolutional neural network architectures were tested to determine the better architecture for tissue classifier. Each network was trained to classify small tissue patches into normal or tumor. Based on the patch-level classification, tumor probability heatmaps can be overlaid on tissue images. We observed three different tissue patterns, including clear normal, clear tumor and ambiguous cases. We suggest that longer inspection time can be assigned to ambiguous cases compared to clear normal cases, increasing the accuracy and efficiency of histopathologic diagnosis by pre-evaluating the status of the WSIs. When the classifier was tested with completely different WSI dataset, the performance was not optimal because of the different tissue preparation quality. By including a small amount of data from the new dataset for training, the performance for the new dataset was much enhanced. These results indicated that WSI dataset should include tissues prepared from many different preparation conditions to construct a generalized tissue classifier. Thus, multi-national/multi-center dataset should be built for the application of deep learning in the real world medical practice.
Adenocarcinoma
;
Classification
;
Dataset
;
Diagnosis
;
Learning
;
Observer Variation
;
Stomach
7.Dual deep neural network-based classifiers to detect experimental seizures.
The Korean Journal of Physiology and Pharmacology 2019;23(2):131-139
Manually reviewing electroencephalograms (EEGs) is labor-intensive and demands automated seizure detection systems. To construct an efficient and robust event detector for experimental seizures from continuous EEG monitoring, we combined spectral analysis and deep neural networks. A deep neural network was trained to discriminate periodograms of 5-sec EEG segments from annotated convulsive seizures and the pre- and post-EEG segments. To use the entire EEG for training, a second network was trained with non-seizure EEGs that were misclassified as seizures by the first network. By sequentially applying the dual deep neural networks and simple pre- and post-processing, our autodetector identified all seizure events in 4,272 h of test EEG traces, with only 6 false positive events, corresponding to 100% sensitivity and 98% positive predictive value. Moreover, with pre-processing to reduce the computational burden, scanning and classifying 8,977 h of training and test EEG datasets took only 2.28 h with a personal computer. These results demonstrate that combining a basic feature extractor with dual deep neural networks and rule-based pre- and post-processing can detect convulsive seizures with great accuracy and low computational burden, highlighting the feasibility of our automated seizure detection algorithm.
Animals
;
Dataset
;
Electroencephalography
;
Epilepsy
;
Mice
;
Microcomputers
;
Seizures*
8.Non-compartmental data analysis using SimBiology and MATLAB
Translational and Clinical Pharmacology 2019;27(3):89-91
MATLAB® is widely used for numerical analysis, modeling, and simulation. One of MATLAB's tools, SimBiology®, is often used for pharmacokinetic, pharmacodynamic model and dynamic systems; however, SimBiology seems to be rarely used for non-compartmental analysis (NCA), and the published official documentation provides a poor description of the analysis algorithm for NCA. Therefore, we conducted NCAs with a hypothetical dataset and some scenarios and compared the results. According to the results of this study, SimBiology estimates parameters using the unweighted linear regression for the terminal slope and linear interpolation method. Moreover, although the documentation describing the actual analysis algorithm used to process non-numeric data is not easily accessible to users, users may introduce numeric data at time zero to perform NCA properly. Using the command window, users can perform analyses more quickly and effectively. If the NCA official documentation were improved, SimBiology might be more widely adopted to perform NCA in clinical pharmacology.
Dataset
;
Linear Models
;
Methods
;
Pharmacokinetics
;
Pharmacology, Clinical
;
Statistics as Topic
9.A Disintegrin and Metalloproteinase 8 as a Potential Blood Biomarker for Early Diagnosis of Gastric Cancer
Hye Won CHUNG ; Jin Ju KIM ; Jae Il CHOI ; Hae Rim LEE ; Jong Baeck LIM
Yonsei Medical Journal 2019;60(8):713-719
PURPOSE: We aimed to evaluate the clinical significance of a disintegrin and metalloproteinase 8 (ADAM 8) as a potential blood biomarker for gastric cancer (GC). MATERIALS AND METHODS: Blood ADAM 8 was measured by ELISA. Cytokines/chemokines [interleukin-23 (IL-23), stromal cell-derived factor 1α/CXC chemokine ligand 12 (SDF-1α/CXCL12), interleukin-8 (IL-8), and soluble CD40 ligand (sCD40L)] were measured by chemiluminescent immunoassay. They were compared among five groups; normal/gastritis, high-risk, early GC (EGC), advanced GC (AGC) without distant metastasis, and AGC with distant metastasis by one-way analysis of variance in both training (n=80) and validation dataset (n=241). Clinicopathological features of GC and GC-associated cytokines were evaluated for their correlations with blood ADAM 8. To evaluate the diagnostic accuracy to predict GC, receiver operating characteristic (ROC) curve and logistic regression were used. RESULTS: Blood ADAM 8 significantly increased along GC carcinogenesis in both training (ANOVA, p<0.001) and validation dataset (p<0.001). It was significantly higher in EGC compared to high-risk (post-hoc Bonferroni, p=0.041) and normal (p<0.001). It was also higher in AGC compared with high-risk (p<0.001) and normal (p<0.001) groups. However, no significant difference was found between cancer groups. Blood ADAM 8 was correlated with N-stage (Spearman's correlation, γs=0.320, p=0.011), but not with T-stage or M-stage. Pearson's correlations showed blood ADAM 8 was closely correlated with pre-inflammatory cytokines, IL-23 (p=0.036) and SDF-1α/CXCL12 (p=0.037); however, it was not correlated with pro-angiogenic cytokine IL-8 (p=0.313), and sCD40L (p=0.702). ROC curve and logistic regression demonstrated that blood ADAM 8 showed higher diagnostic accuracy (sensitivity, 73.7%; specificity, 86.2%) than CEA (sensitivity, 23.1%; specificity, 91.4%). Combination of ADAM 8 and CEA further increased the diagnostic accuracy to predict GC (sensitivity, 81.8%; specificity, 84.0%). CONCLUSION: Blood ADAM 8 is a promising biomarker for early detection of GC.
Carcinogenesis
;
CD40 Ligand
;
Cytokines
;
Dataset
;
Early Diagnosis
;
Enzyme-Linked Immunosorbent Assay
;
Immunoassay
;
Interleukin-23
;
Interleukin-8
;
Logistic Models
;
Neoplasm Metastasis
;
ROC Curve
;
Sensitivity and Specificity
;
Stomach Neoplasms
10.Correlations between a Flexible Parental Visiting Environment and Parental Stress in Neonatal Intensive Care Units
Su Jin LEE ; Eun Kyoung CHOI ; Jeongok PARK ; Hee Soon KIM
Child Health Nursing Research 2019;25(4):377-387
PURPOSE: The purpose of this study was to examine the correlation between a flexible parental visiting environment and parental stress in neonatal intensive care units (NICUs).METHODS: The study participants included 60 parents of premature infants in NICUs. Structured questionnaires and interviews, as well as observations by researchers using a caregiving behavior checklist, were used to measure the flexibility of the parental visiting environment and parents' stress levels. Quantitative and qualitative data were collected concurrently and were initially analyzed as separate data sets. Data collection extended from March 11, 2018 to June 30. 2018 and the data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, and Pearson correlation coefficients.RESULTS: There was a negative correlation (r=−.30, p=.021) between parental stress and the total number of visits in 7 days. We also found that the average duration of each visit and the number of caregiving behaviors performed by parents were positively correlated (r=.73, p<.001).CONCLUSION: When designing a flexible visiting environment for parents, parents should be encouraged to visit their babies. By doing so, stress can be reduced both for babies and for parents. Therefore, it is suggested that the related polices and regulations in South Korea should be changed to provide more a flexible visiting environment to promote better parent-child attachment and family adjustment.
Checklist
;
Data Collection
;
Dataset
;
Family Nursing
;
Humans
;
Infant, Newborn
;
Infant, Premature
;
Intensive Care Units, Neonatal
;
Intensive Care, Neonatal
;
Korea
;
Parents
;
Pliability
;
Social Control, Formal
;
Stress, Psychological
;
Visitors to Patients

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