The common data model (CDM) has found widespread application in healthcare studies, but its utilization in cancer research has been limited. This article describes the development and implementation strategy for Cancer Clinical Library Databases (CCLDs), which are standardized cancer-specific databases established under the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) project by the Korean Ministry of Health and Welfare. Fifteen leading hospitals and fourteen academic associations in Korea are engaged in constructing CCLDs for 10 primary cancer types. For each cancer type-specific CCLD, cancer data experts determine key clinical data items essential for cancer research, standardize these items across cancer types, and create a standardized schema. Comprehensive clinical records covering diagnosis, treatment, and outcomes, with annual updates, are collected for each cancer patient in the target population, and quality control is based on six-sigma standards. To protect patient privacy, CCLDs follow stringent data security guidelines by pseudonymizing personal identification information and operating within a closed analysis environment. Researchers can apply for access to CCLD data through the K-CURE portal, which is subject to Institutional Review Board and Data Review Board approval. The CCLD is considered a pioneering standardized cancer-specific database, significantly representing Korea’s cancer data. It is expected to overcome limitations of previous CDMs and provide a valuable resource for multicenter cancer research in Korea.

The common data model (CDM) has found widespread application in healthcare studies, but its utilization in cancer research has been limited. This article describes the development and implementation strategy for Cancer Clinical Library Databases (CCLDs), which are standardized cancer-specific databases established under the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) project by the Korean Ministry of Health and Welfare. Fifteen leading hospitals and fourteen academic associations in Korea are engaged in constructing CCLDs for 10 primary cancer types. For each cancer type-specific CCLD, cancer data experts determine key clinical data items essential for cancer research, standardize these items across cancer types, and create a standardized schema. Comprehensive clinical records covering diagnosis, treatment, and outcomes, with annual updates, are collected for each cancer patient in the target population, and quality control is based on six-sigma standards. To protect patient privacy, CCLDs follow stringent data security guidelines by pseudonymizing personal identification information and operating within a closed analysis environment. Researchers can apply for access to CCLD data through the K-CURE portal, which is subject to Institutional Review Board and Data Review Board approval. The CCLD is considered a pioneering standardized cancer-specific database, significantly representing Korea’s cancer data. It is expected to overcome limitations of previous CDMs and provide a valuable resource for multicenter cancer research in Korea.

The common data model (CDM) has found widespread application in healthcare studies, but its utilization in cancer research has been limited. This article describes the development and implementation strategy for Cancer Clinical Library Databases (CCLDs), which are standardized cancer-specific databases established under the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) project by the Korean Ministry of Health and Welfare. Fifteen leading hospitals and fourteen academic associations in Korea are engaged in constructing CCLDs for 10 primary cancer types. For each cancer type-specific CCLD, cancer data experts determine key clinical data items essential for cancer research, standardize these items across cancer types, and create a standardized schema. Comprehensive clinical records covering diagnosis, treatment, and outcomes, with annual updates, are collected for each cancer patient in the target population, and quality control is based on six-sigma standards. To protect patient privacy, CCLDs follow stringent data security guidelines by pseudonymizing personal identification information and operating within a closed analysis environment. Researchers can apply for access to CCLD data through the K-CURE portal, which is subject to Institutional Review Board and Data Review Board approval. The CCLD is considered a pioneering standardized cancer-specific database, significantly representing Korea’s cancer data. It is expected to overcome limitations of previous CDMs and provide a valuable resource for multicenter cancer research in Korea.

Purpose: High-dose radiotherapy (RT) for localized prostate cancer requires careful consideration of target position changes and adjacent organs-at-risk (OARs), such as the rectum and bladder. Therefore, daily monitoring of target position and OAR changes is crucial in minimizing interfractional dosimetric uncertainties. For efficient monitoring of the internal condition of patients, we assessed the feasibility of an auto-segmentation of OARs on the daily acquired images, such as megavoltage computed tomography (MVCT), via a commercial artificial intelligence (AI)-based solution in this study. Materials and Methods: We collected MVCT images weekly during the entire course of RT for 100 prostate cancer patients treated with the helical TomoTherapy system. Based on the manually contoured body outline, the bladder including prostate area, and rectal balloon regions for the 100 MVCT images, we trained the commercially available fully convolutional (FC)-DenseNet model and tested its auto-contouring performance. Results: Based on the optimally determined hyperparameters, the FC-DenseNet model successfully auto-contoured all regions of interest showing high dice similarity coefficient (DSC) over 0.8 and a small mean surface distance (MSD) within 1.43 mm in reference to the manually contoured data. With this well-trained AI model, we have efficiently monitored the patient's internal condition through six MVCT scans, analyzing DSC, MSD, centroid, and volume differences. Conclusion We have verified the feasibility of utilizing a commercial AI-based model for auto-segmentation with low-quality daily MVCT images. In the future, we will establish a fast and accurate auto-segmentation and internal organ monitoring system for efficiently determining the time for adaptive replanning.

The germinal center reaction is a key event of humoral immunity, providing long-lived immunological memory. Follicular helper T (T(FH)) cells are a specialized subset of CD4⁺ T cells located in the follicles, which help B cells and thus control the germinal center reaction. T(FH) cell development is achieved by multi-step processes of interactions with dendritic cells and B cells along with the coordination of various transcription factors. Since the T helper cell fate decision program is determined by subtle changes in regulatory molecules, fine tuning of these dynamic interactions is crucial for the generation functional T(FH) cells. MicroRNAs (miRNAs) have emerged as important post-transcriptional regulatory molecules for gene expression, which consequently modulate diverse biological functions. In the last decade, the miRNA-mediated regulation network for the germinal center reaction has been extensively explored in T cells and B cells, resulting in the identification of several key miRNA species and their target genes. Here, we review the current knowledge of the miRNA-mediated control of the germinal center reaction, focusing on the aspect of T cell regulation in particular. In addition, we highlight the most important issues related to defining the functional target genes of the relevant miRNAs. We believe that the studies that uncover the miRNA-mediated regulatory axis of T(FH) cell generation and functions by defining their functional target genes might provide additional opportunities to understand germinal center reactions.
B-Lymphocytes ; Dendritic Cells ; Gene Expression ; Germinal Center ; Immunity, Humoral ; Immunologic Memory ; MicroRNAs ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer* ; Transcription Factors

In diabetic and diabetic renal failure patients on continuous ambulant peritoneal dialysis(CAPD) treatment, the peritoneal membrane and vascular beds are continuously exposed to the high glucose concentration contained in the dialysate and blood. This may lead to the local generation of advanced glycosylated end-products(AGEs), formed from nonenzymatic glycation of proteins and lipids with reducing sugars and have been implicated in many diabetic complications. AGEs is cross linked to the circulating proteins resulting in peritoneal dysfunction and vascular thickening. To elucidate the deposition of AGEs in diabetic rats(n=10) induced by streptozotocin(STZ, 75mg/kg) injection via tail vein and those of age-matched control rats(n=10), peritoneums were examined light microscopically and immunohistochemically with monoclonal antibody specific for AGEs after 5 weeks of disease. Histologically, the peritoneum of the STZ diabetic rats showed mild interstitial fibrosis and no mesothelial alteration, vascular proliferation, compared with age-matched, non-diabetic control group. Immunohistochemical staining with AGEs demonstrated that weakly accumulation in the submesothelial layer, but it was not different from comparison with control group. We speculate that the peritoneum of the STZ-induced diabetic rat did not stain with monoclonal antibody against AGEs after 5 weeks of disease, but long-term experiments may demonstrate significant functional and morphological alterations of peritoneum.
Animals ; Carbohydrates ; Diabetes Complications ; Fibrosis ; Glucose ; Humans ; Membranes ; Peritoneum* ; Rats* ; Renal Insufficiency ; Streptozocin* ; Veins

PURPOSE: Gallstone disease has been presumed to be a sequellae of gastrectomy. To know correlation between gallbladder disease and gastrectomy, we check anatomical and functional status of gallbladder with ultrasonogram in our study. METHODS: Gallbladder motility after gastrectomy was studied by means of measuring fasting and postprandial gallbladder volume using real time ultrasonography in 50 gastrectomized patients and in 28 controls (healthy but not operated gastric cancer patients) were selected as study subjects. RESULTS: Mean fasting and postprandial gallbladder volume was significantly increased in gastrectomized patient group (FV: 37.63+/-20.70 ml, PV: 11.50+/-10.26 ml) than control group (FV: 22.17+/-10.35 ml, PV: 5.44+/-3.67 ml, p<0.01). The ejection fraction of gallbladder in gastrectomized patient group (69.05+/-14.57%)was significantly smaller than control group (75.57+/-10.26%, p<0.05). CONCLUSION: The risk of gallbladder disease was independent of age, sex, and post-operative duration in our study. Gastrectomy may have the possibility of increasing the risk of gallbladder disease by causing gallbladder dysmotility and bile stasis. So, gallbladder motility evaluation would be helpful for prevention and understanding gallstone formation. Further study will be needed about the clinical benefits of prophylactic cholecystectomy during gastrectomy.
Bile ; Cholecystectomy ; Fasting ; Gallbladder Diseases ; Gallbladder* ; Gallstones* ; Gastrectomy* ; Humans ; Stomach Neoplasms* ; Ultrasonography

BACKGROUND: The present study was done to elucidate the effects of acute normovolemic hemodilution (ANH) on intrapulmonary shunt (Qs/Qt) and systemic oxygen delivery balance during one lung ventilation (OLV). METHODS: To induce one lung ventilation, an atelectasis of the right lung was produced in anesthetized mongrel dogs. In 6 dogs with OLV, ANH was produced by sequential hemodilution with hydroxyethyl starch. ANH was divided into 3 stages (ANH0: no hemodilition, ANH1: first hemodilution, ANH2: second hemodilution). Qs/Qt was measured by using blood gas analysis. Various hemodynamic parameters, oxygen delivery, and consumption were measured or calculated indirectly. RESULTS: After hemodilution, hemoglobin levels at each stage were 9.9 +/- 1.3 g/dl (ANH0), 7.0 +/- 1.0 g/dl (ANH1), and 5.2 +/- 0.7 g/dl (ANH2). The Qs/Qt of ANH2 stage increased from 25.0 11.4% of ANH0 to 35.4 9.2% (P < 0.05). Cardiac output of ANH2 increased from 2.4 +/- 0.8 ml/min of ANH0 to 3.2 +/- 0.8 ml/min (P < 0.05). Pulmonary and systemic vascular resistance measurements in ANH2 were lower than those of ANH0 (P < 0.05). The changes in pH and carbon dioxide tension and mixed venous oxygen tension by ANH were not significant in comparison with ANH0 (P > 0.05). Global oxygen delivery was markedly decreased by hemodilution in OLV (P < 0.05), whereas global oxygen consumption was maintained. CONCLUSIONS: We conclude that global oxygen delivery balance is preserved by ANH in this study. However, extreme ANH has a deleterious effect on pulmonary gas exchange, possibly through the attenuation of hypoxic pulmonary vasoconstriction during one-lung ventilation. On the basis of this study, increased cardiac output generated by ANH might be the cause of inhibition or blunting of hypoxic pulmonary vasoconstriction.
Animals ; Blood Gas Analysis ; Carbon Dioxide ; Cardiac Output ; Dogs* ; Hemodilution* ; Hemodynamics ; Hydrogen-Ion Concentration ; Lung ; One-Lung Ventilation* ; Oxygen Consumption ; Oxygen* ; Pulmonary Atelectasis ; Pulmonary Gas Exchange ; Starch ; Vascular Resistance ; Vasoconstriction

BACKGROUND: It is already known that systemic vascular resistance (SVR) is decreased during pregnancy. In addition, one of the large hemodynamic changes when using propofol is also a decrease in SVR, more profoundly than is found with enflurane. It might therefore be suggested that hemodynamic changes are more prominent in cesarean section during propofol anesthesia, compared with enflurane anesthesia. This study was designed to investigate these possible changes by propofol anesthesia. METHODS: One hundred thirty six women for elective cesarean section were involved in this study. They were divided into 2 groups: group E (n = 74), anesthesia with thiopental, enflurane, and N2O, and group P (n = 62), anesthesia with propofol and N2O. All patient were given glycopyrrolate as premedicants. The hemodynamic variables (MAP, HR, CO, CI, SVR, SVRI, SI, and EF) were measured by bioimpedence at the five different time points: at preoperation, after induction, after intubation, during push abdomen, and after delivery. RESULTS: The variables of hemodynamics did not change significantly when both groups were compared, except that MAP, SVR and SVRI at after induction and HR during push and after delivery in group P were lower compared with respective variables in group E. CONCLUSION: From these results, we concluded that there were no significant changes in cardiovascular system (CVS) by propofol anesthesia, compared with enflurane anesthesia in cesarean section patients. It is therefore suggested that propofol anesthesia is safe in considering hemodynamics for cesarean section.
Abdomen ; Anesthesia* ; Cardiovascular System ; Cesarean Section* ; Enflurane ; Female ; Glycopyrrolate ; Hemodynamics* ; Humans ; Intubation ; Pregnancy ; Propofol* ; Thiopental ; Vascular Resistance

The blowout fracture needs early diagnosis and active treatment if the fracture site, the degree of injury and herniation of orbital soft tissue are identified. It is more important than diagnosis itself that doctors identify the combined injury of orbital structures such as fat herniation and entrapment of the extraocular muscle with radiologic methods. Computed tomography(CT) is the standard method in the diagnosis of blowout fracture today, but with this method herniated orbital fat or extraocular muscle is not well differentiated from hematoma in case of the minimal blowout fracture. MRI(magnetic resonance image) was taken for further evaluation of extraocular muscle and orbital fat in 20 patients(16 males, 4 females) among 58 patients who were suspected or diagnosed as blowout fracture on simple X-ray or CT view. Fractured sites were located on the medial wall in 4 patients, orbital floor in 6 patients. 10 patients suffered from the blowout fracture on more than 2 walls. In 18 of total 20 patients, the herniation of orbital fat or extraocular muscle was identified on MRI view. In 2 patients whose orbital soft tissue was not herniated, the fracture was observed on CT view but not observed on MRI view. In case of suspicious hematoma or herniation of orbital soft tissue within maxillary sinus, CT view could not identify the hematoma or herniation of orbital soft tissue, but oblique sagittal MRI view could identify the herniation of inferior rectus muscle and differentiation of the herniation of orbital soft tissue from hematoma within maxillary sinus on T1 and T2-weighted images. In 7 patients who were difficult to decide the operative indication on CT view, MRI identified herniation and entrapment of extraocular muscle. MRI is especially useful when you differentiate hematoma from herniated orbital fat or extraocular muscle in case of minimal blowout fracture. MRI is useful in deciding the operative method and evaluating the soft tissue involvement in case of blowout fracture.
Diagnosis ; Early Diagnosis ; Hematoma ; Humans ; Magnetic Resonance Imaging* ; Male ; Maxillary Sinus ; Orbit