1.Enhancing Identification of High-Risk cN0 Lung Adenocarcinoma Patients Using MRI-Based Radiomic Features
Harim KIM ; Jonghoon KIM ; Soohyun HWANG ; You Jin OH ; Joong Hyun AHN ; Min-Ji KIM ; Tae Hee HONG ; Sung Goo PARK ; Joon Young CHOI ; Hong Kwan KIM ; Jhingook KIM ; Sumin SHIN ; Ho Yun LEE
Cancer Research and Treatment 2025;57(1):57-69
Purpose:
This study aimed to develop a magnetic resonance imaging (MRI)–based radiomics model to predict high-risk pathologic features for lung adenocarcinoma: micropapillary and solid pattern (MPsol), spread through air space, and poorly differentiated patterns.
Materials and Methods:
As a prospective study, we screened clinical N0 lung cancer patients who were surgical candidates and had undergone both 18F-fluorodeoxyglucose (FDG) positron emission tomography–computed tomography (PET/CT) and chest CT from August 2018 to January 2020. We recruited patients meeting our proposed imaging criteria indicating high-risk, that is, poorer prognosis of lung adenocarcinoma, using CT and FDG PET/CT. If possible, these patients underwent an MRI examination from which we extracted 77 radiomics features from T1-contrast-enhanced and T2-weighted images. Additionally, patient demographics, maximum standardized uptake value on FDG PET/CT, and the mean apparent diffusion coefficient value on diffusion-weighted image, were considered together to build prediction models for high-risk pathologic features.
Results:
Among 616 patients, 72 patients met the imaging criteria for high-risk lung cancer and underwent lung MRI. The magnetic resonance (MR)–eligible group showed a higher prevalence of nodal upstaging (29.2% vs. 4.2%, p < 0.001), vascular invasion (6.5% vs. 2.1%, p=0.011), high-grade pathologic features (p < 0.001), worse 4-year disease-free survival (p < 0.001) compared with non-MR-eligible group. The prediction power for MR-based radiomics model predicting high-risk pathologic features was good, with mean area under the receiver operating curve (AUC) value measuring 0.751-0.886 in test sets. Adding clinical variables increased the predictive performance for MPsol and the poorly differentiated pattern using the 2021 grading system (AUC, 0.860 and 0.907, respectively).
Conclusion
Our imaging criteria can effectively screen high-risk lung cancer patients and predict high-risk pathologic features by our MR-based prediction model using radiomics.
2.Enhancing Identification of High-Risk cN0 Lung Adenocarcinoma Patients Using MRI-Based Radiomic Features
Harim KIM ; Jonghoon KIM ; Soohyun HWANG ; You Jin OH ; Joong Hyun AHN ; Min-Ji KIM ; Tae Hee HONG ; Sung Goo PARK ; Joon Young CHOI ; Hong Kwan KIM ; Jhingook KIM ; Sumin SHIN ; Ho Yun LEE
Cancer Research and Treatment 2025;57(1):57-69
Purpose:
This study aimed to develop a magnetic resonance imaging (MRI)–based radiomics model to predict high-risk pathologic features for lung adenocarcinoma: micropapillary and solid pattern (MPsol), spread through air space, and poorly differentiated patterns.
Materials and Methods:
As a prospective study, we screened clinical N0 lung cancer patients who were surgical candidates and had undergone both 18F-fluorodeoxyglucose (FDG) positron emission tomography–computed tomography (PET/CT) and chest CT from August 2018 to January 2020. We recruited patients meeting our proposed imaging criteria indicating high-risk, that is, poorer prognosis of lung adenocarcinoma, using CT and FDG PET/CT. If possible, these patients underwent an MRI examination from which we extracted 77 radiomics features from T1-contrast-enhanced and T2-weighted images. Additionally, patient demographics, maximum standardized uptake value on FDG PET/CT, and the mean apparent diffusion coefficient value on diffusion-weighted image, were considered together to build prediction models for high-risk pathologic features.
Results:
Among 616 patients, 72 patients met the imaging criteria for high-risk lung cancer and underwent lung MRI. The magnetic resonance (MR)–eligible group showed a higher prevalence of nodal upstaging (29.2% vs. 4.2%, p < 0.001), vascular invasion (6.5% vs. 2.1%, p=0.011), high-grade pathologic features (p < 0.001), worse 4-year disease-free survival (p < 0.001) compared with non-MR-eligible group. The prediction power for MR-based radiomics model predicting high-risk pathologic features was good, with mean area under the receiver operating curve (AUC) value measuring 0.751-0.886 in test sets. Adding clinical variables increased the predictive performance for MPsol and the poorly differentiated pattern using the 2021 grading system (AUC, 0.860 and 0.907, respectively).
Conclusion
Our imaging criteria can effectively screen high-risk lung cancer patients and predict high-risk pathologic features by our MR-based prediction model using radiomics.
3.Enhancing Identification of High-Risk cN0 Lung Adenocarcinoma Patients Using MRI-Based Radiomic Features
Harim KIM ; Jonghoon KIM ; Soohyun HWANG ; You Jin OH ; Joong Hyun AHN ; Min-Ji KIM ; Tae Hee HONG ; Sung Goo PARK ; Joon Young CHOI ; Hong Kwan KIM ; Jhingook KIM ; Sumin SHIN ; Ho Yun LEE
Cancer Research and Treatment 2025;57(1):57-69
Purpose:
This study aimed to develop a magnetic resonance imaging (MRI)–based radiomics model to predict high-risk pathologic features for lung adenocarcinoma: micropapillary and solid pattern (MPsol), spread through air space, and poorly differentiated patterns.
Materials and Methods:
As a prospective study, we screened clinical N0 lung cancer patients who were surgical candidates and had undergone both 18F-fluorodeoxyglucose (FDG) positron emission tomography–computed tomography (PET/CT) and chest CT from August 2018 to January 2020. We recruited patients meeting our proposed imaging criteria indicating high-risk, that is, poorer prognosis of lung adenocarcinoma, using CT and FDG PET/CT. If possible, these patients underwent an MRI examination from which we extracted 77 radiomics features from T1-contrast-enhanced and T2-weighted images. Additionally, patient demographics, maximum standardized uptake value on FDG PET/CT, and the mean apparent diffusion coefficient value on diffusion-weighted image, were considered together to build prediction models for high-risk pathologic features.
Results:
Among 616 patients, 72 patients met the imaging criteria for high-risk lung cancer and underwent lung MRI. The magnetic resonance (MR)–eligible group showed a higher prevalence of nodal upstaging (29.2% vs. 4.2%, p < 0.001), vascular invasion (6.5% vs. 2.1%, p=0.011), high-grade pathologic features (p < 0.001), worse 4-year disease-free survival (p < 0.001) compared with non-MR-eligible group. The prediction power for MR-based radiomics model predicting high-risk pathologic features was good, with mean area under the receiver operating curve (AUC) value measuring 0.751-0.886 in test sets. Adding clinical variables increased the predictive performance for MPsol and the poorly differentiated pattern using the 2021 grading system (AUC, 0.860 and 0.907, respectively).
Conclusion
Our imaging criteria can effectively screen high-risk lung cancer patients and predict high-risk pathologic features by our MR-based prediction model using radiomics.
4.Effects of Individualized Exercise on Risk Factors of Metabolic Syndrome: A Scoping Review
Kyoung-Bae KIM ; Harim CHOE ; Hoyong SUNG
Journal of Obesity & Metabolic Syndrome 2024;33(1):20-26
Exercise intervention is effective in alleviating the severity of metabolic syndrome (MetS). However, the results of previous studies on the effect of exercise on MetS have demonstrated considerable individual variability in response to a specific dose of exercise, which was attributed to the lack of a personalized approach to exercise prescription. It is essential to consider individual factors to enhance the effectiveness of exercise in addressing MetS.This scoping review assesses the effectiveness of individualized exercise on the risk factors associated with MetS.Various databases and articles were examined based on eligibility criteria and nine studies were chosen for this review. Personal and adjusted factors were predominantly analyzed to tailor exercise prescriptions to individual needs. This review proposes that personal factors can be classified into three categories: fixed factors, adaptation factors, and response factors, considering both clinical and exercise science perspectives. It also suggests that a two-way communication approach between specialists and individuals is more effective for prescribing exercise to address MetS compared to a one-way method. A one-way communication approach relies solely on an expert’s decision, even whether or not he or she fully considers a client’s lifestyle and preferences. If the individualized selection of exercise prescriptions is achieved through two-way communication between specialists and subjects, significant improvements can be expected in terms of both MetS severity and exercise adherence.
5.Effects of Individualized Exercise on Risk Factors of Metabolic Syndrome: A Scoping Review
Kyoung-Bae KIM ; Harim CHOE ; Hoyong SUNG
Journal of Obesity & Metabolic Syndrome 2024;33(1):20-26
Exercise intervention is effective in alleviating the severity of metabolic syndrome (MetS). However, the results of previous studies on the effect of exercise on MetS have demonstrated considerable individual variability in response to a specific dose of exercise, which was attributed to the lack of a personalized approach to exercise prescription. It is essential to consider individual factors to enhance the effectiveness of exercise in addressing MetS.This scoping review assesses the effectiveness of individualized exercise on the risk factors associated with MetS.Various databases and articles were examined based on eligibility criteria and nine studies were chosen for this review. Personal and adjusted factors were predominantly analyzed to tailor exercise prescriptions to individual needs. This review proposes that personal factors can be classified into three categories: fixed factors, adaptation factors, and response factors, considering both clinical and exercise science perspectives. It also suggests that a two-way communication approach between specialists and individuals is more effective for prescribing exercise to address MetS compared to a one-way method. A one-way communication approach relies solely on an expert’s decision, even whether or not he or she fully considers a client’s lifestyle and preferences. If the individualized selection of exercise prescriptions is achieved through two-way communication between specialists and subjects, significant improvements can be expected in terms of both MetS severity and exercise adherence.
6.Effects of Individualized Exercise on Risk Factors of Metabolic Syndrome: A Scoping Review
Kyoung-Bae KIM ; Harim CHOE ; Hoyong SUNG
Journal of Obesity & Metabolic Syndrome 2024;33(1):20-26
Exercise intervention is effective in alleviating the severity of metabolic syndrome (MetS). However, the results of previous studies on the effect of exercise on MetS have demonstrated considerable individual variability in response to a specific dose of exercise, which was attributed to the lack of a personalized approach to exercise prescription. It is essential to consider individual factors to enhance the effectiveness of exercise in addressing MetS.This scoping review assesses the effectiveness of individualized exercise on the risk factors associated with MetS.Various databases and articles were examined based on eligibility criteria and nine studies were chosen for this review. Personal and adjusted factors were predominantly analyzed to tailor exercise prescriptions to individual needs. This review proposes that personal factors can be classified into three categories: fixed factors, adaptation factors, and response factors, considering both clinical and exercise science perspectives. It also suggests that a two-way communication approach between specialists and individuals is more effective for prescribing exercise to address MetS compared to a one-way method. A one-way communication approach relies solely on an expert’s decision, even whether or not he or she fully considers a client’s lifestyle and preferences. If the individualized selection of exercise prescriptions is achieved through two-way communication between specialists and subjects, significant improvements can be expected in terms of both MetS severity and exercise adherence.
7.Multicentric Breast Cancer of the Axillary and Pectoral Breasts:A Case Report and Literature Review
Harim KIM ; Eun Young KO ; Boo-Kyung HAN ; Ji-Yeon KIM ; Byung Joo CHAE ; Hyunwoo LEE
Journal of Breast Cancer 2022;25(5):436-442
Multicentric cancer of the pectoral and ectopic breasts is extremely rare, and diagnosing this malignancy remains challenging because axillary breast cancer is easily misdiagnosed as lymph node metastasis. Moreover, there are no established treatment guidelines for this disease. We present our experience with a multicentric breast cancer patient who showed different responses to neoadjuvant chemotherapy (NAC) and underwent surgical treatments that differed from those in previous studies. In our case, the preoperative imaging of both lesions and subsequent core needle biopsy of each lesion were crucial, as these procedures confirm the diagnosis and help decide the chemotherapy regimen based on the subtype.After NAC, the patient underwent right breast-conserving surgery, sentinel lymph node biopsy (SLNB), and excision of accessory breast tissue in the right axilla. SLNB should be the initial step in staging multicentric breast cancer, unless imaging scan shows evidence of lymph node metastasis.
8.Development and psychometric evaluation of Clinical Practice Self-Efficacy Scale for nursing students
Heejung CHOI ; Sueun KIM ; Harim JEONG
Journal of Korean Academic Society of Nursing Education 2022;28(3):236-247
Purpose:
The COVID-19 pandemic has increased the importance of nurses' clinical performance, and accordingly, nursing educators have emphasized students' clinical practice and performance. This study developed a Clinical Practice Self-Efficacy Scale for nursing students and examined its psychometric properties.
Methods:
The authors reviewed instruments for selecting items for the scale in the areas of clinical skills, communication, infection control, safety, and nursing process. After preliminary items were selected, ten experts consisting of nursing professors and clinical nurses reviewed the items considering Korean clinical and educational situations. The data for the psychometric evaluation was collected from 257 nursing students in their 2nd, 3rd, and 4th years and then analyzed.
Results:
The confirmatory factor analysis showed that the goodness of fit of this scale with five factors represented by 40 items was appropriate. The significant positive correlations with general self-efficacy indicated sound construct validity. The senior nursing students showed higher scores than others, as we expected. Cronbach’s alpha was .94.
Conclusion
The Clinical Practice Self-Efficacy Scale is appropriate for measuring Korean nursing students' self-efficacy of clinical practice. It is expected to act as a good tool to measure the effects of clinical practice education.
9.Association between Physical Activity Types and Mental Health in Korean Adults:Korea National Health and Nutrition Examination Survey, 2014–2018
Hak Kyun KIM ; Yeon Soo KIM ; Hoyong SUNG ; Jungjoon LIM ; Joonsik KIM ; Harim CHOI
The Korean Journal of Sports Medicine 2021;39(4):181-187
Purpose:
The purpose of this study was to examine the associations of aerobic physical activity and musclestrengthening exercise with mental health, respectively. Furthermore, the relationship between combined exercise with depression, stress, and suicidal thoughts was also examined.
Methods:
The association between adherence to physical activity guidelines and mental health was analyzed among 27,268 adults who participated in the 2014– 2018 Korea National Health and Nutrition Examination Survey. Logistic regression was used to predict the relationship between adherence to physical activity guidelines and mental health.
Results:
The odds ratio for depression and suicidal thoughts in groups that met both aerobic physical activity and muscle-strengthening exercise guidelines decreased by 27% (95% confidence interval [CI], 0.56– 0.94) and 40% (95% CI, 0.39– 0.93), respectively, compared to those that did not meet both. Stress awareness decreased by 22% (95% CI, 0.67– 0.90) in those who met muscular exercise guidelines, but did not meet aerobic physical activity guidelines. For those who met only the aerobic physical activity guidelines, stress awareness decreased by 12% (95% CI, 0.82 – 0.95). In addition, the odds ratio decreased by 29% (95% CI, 0.62 – 0.80) in groups that met both guidelines.
Conclusion
The most positive relationships between adherence to physical activity guidelines and mental health were found when both aerobic and muscular exercise guidelines were met.
10.Nonsurgical maxillary expansion in a 60-year-old patient with gingival recession and crowding
Harim KIM ; Sun-Hyung PARK ; Jae Hyun PARK ; Kee-Joon LEE
The Korean Journal of Orthodontics 2021;51(3):217-227
Maxillary transverse deficiency often manifests as a posterior crossbite or edgeto-edge bite and anterior crowding. However, arbitrary arch expansion in mature patients has been considered to be challenging due to the possible periodontal adverse effects such as alveolar bone dehiscence and gingival recession. To overcome these limitations, nonsurgical maxillary expansion of the basal bone has been demonstrated in young adults. However, the age range for successful orthopedic expansion has remained a topic of debate, possibly due to the underlying individual variations in suture maturity. This case report illustrates nonsurgical, miniscrew-assisted rapid palatal expansion (MARPE) in a 60-yearold patient with maxillary transverse deficiency accompanied by anterior and posterior crossbites, crowding, and gingival recession. The use of MARPE allowed relief of crowding and correction of the crossbite without causing significant periodontal adverse effects.

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