1.Relationship of MicroRNA according to Immune Components of Breast Milk in Korean Lactating Mothers
You Jin CHOI ; Da Hye LEE ; Jeonglyn SONG ; Ki-Uk KIM ; Hyeyoung MIN ; Sung-Hoon CHUNG ; Tae Hyeong KIM ; Chae-Young KIM ; Insoo KANG ; Na Mi LEE ; Dae Yong YI
Pediatric Gastroenterology, Hepatology & Nutrition 2024;27(5):322-331
		                        		
		                        			 Purpose:
		                        			Human breast milk (HBM) contains immune components that produced and delivered from the mother along with nutrients necessary for the baby. MicroRNA (miRNA) is a small noncoding RNA molecule, that is used as an ideal biomarker for diagnosis and prognosis of various diseases and are more abundant in HBM. We analyzed and compared the immune components and miRNAs of HBM. 
		                        		
		                        			Methods:
		                        			HBM were collected from 20 healthy breastfeeding mothers. We measured the amount of lactoferrin, lysozyme, and immunoglobulin A (IgA) and extracted the miRNAs from each breast milk samples. Next, the top 5 and bottom 5 expressed miRNAs were compared and analyzed based on the amounts of the 3 immune components. 
		                        		
		                        			Results:
		                        			The mean levels and ranges of lactoferrin, lysozyme, and IgA were 6.33 (2.24–14.77)×106 ng/mL, 9.90 (1.42–17.59)×107 pg/mL, and 6.64 (0.48–20.01)×105 ng/mL, respectively. The miRNAs concentration per 1 mL of skim milk was 40.54 (14.95–110.01) ng/μL. Comparing the bottom 5 and top 5 groups of each immune component, 19 miRNAs were significantly upregulated (6, 9, and 4 targeting lactoferrin, lysozyme, and IgA, respectively) and 21 were significantly downregulated (4, 9, and 8 targeting lactoferrin, lysozyme, and IgA, respectively). There were no miRNAs that were expressed significantly higher or lower in common to all 3 components.However, 2 and 3 miRNAs were commonly overexpressed and underexpressed, in the top 5 groups of lysozyme and IgA concentrations. 
		                        		
		                        			Conclusion
		                        			We identified the immune components and miRNAs in breast milk and found that each individual has different ingredients. 
		                        		
		                        		
		                        		
		                        	
2.Relationship of MicroRNA according to Immune Components of Breast Milk in Korean Lactating Mothers
You Jin CHOI ; Da Hye LEE ; Jeonglyn SONG ; Ki-Uk KIM ; Hyeyoung MIN ; Sung-Hoon CHUNG ; Tae Hyeong KIM ; Chae-Young KIM ; Insoo KANG ; Na Mi LEE ; Dae Yong YI
Pediatric Gastroenterology, Hepatology & Nutrition 2024;27(5):322-331
		                        		
		                        			 Purpose:
		                        			Human breast milk (HBM) contains immune components that produced and delivered from the mother along with nutrients necessary for the baby. MicroRNA (miRNA) is a small noncoding RNA molecule, that is used as an ideal biomarker for diagnosis and prognosis of various diseases and are more abundant in HBM. We analyzed and compared the immune components and miRNAs of HBM. 
		                        		
		                        			Methods:
		                        			HBM were collected from 20 healthy breastfeeding mothers. We measured the amount of lactoferrin, lysozyme, and immunoglobulin A (IgA) and extracted the miRNAs from each breast milk samples. Next, the top 5 and bottom 5 expressed miRNAs were compared and analyzed based on the amounts of the 3 immune components. 
		                        		
		                        			Results:
		                        			The mean levels and ranges of lactoferrin, lysozyme, and IgA were 6.33 (2.24–14.77)×106 ng/mL, 9.90 (1.42–17.59)×107 pg/mL, and 6.64 (0.48–20.01)×105 ng/mL, respectively. The miRNAs concentration per 1 mL of skim milk was 40.54 (14.95–110.01) ng/μL. Comparing the bottom 5 and top 5 groups of each immune component, 19 miRNAs were significantly upregulated (6, 9, and 4 targeting lactoferrin, lysozyme, and IgA, respectively) and 21 were significantly downregulated (4, 9, and 8 targeting lactoferrin, lysozyme, and IgA, respectively). There were no miRNAs that were expressed significantly higher or lower in common to all 3 components.However, 2 and 3 miRNAs were commonly overexpressed and underexpressed, in the top 5 groups of lysozyme and IgA concentrations. 
		                        		
		                        			Conclusion
		                        			We identified the immune components and miRNAs in breast milk and found that each individual has different ingredients. 
		                        		
		                        		
		                        		
		                        	
3.Relationship of MicroRNA according to Immune Components of Breast Milk in Korean Lactating Mothers
You Jin CHOI ; Da Hye LEE ; Jeonglyn SONG ; Ki-Uk KIM ; Hyeyoung MIN ; Sung-Hoon CHUNG ; Tae Hyeong KIM ; Chae-Young KIM ; Insoo KANG ; Na Mi LEE ; Dae Yong YI
Pediatric Gastroenterology, Hepatology & Nutrition 2024;27(5):322-331
		                        		
		                        			 Purpose:
		                        			Human breast milk (HBM) contains immune components that produced and delivered from the mother along with nutrients necessary for the baby. MicroRNA (miRNA) is a small noncoding RNA molecule, that is used as an ideal biomarker for diagnosis and prognosis of various diseases and are more abundant in HBM. We analyzed and compared the immune components and miRNAs of HBM. 
		                        		
		                        			Methods:
		                        			HBM were collected from 20 healthy breastfeeding mothers. We measured the amount of lactoferrin, lysozyme, and immunoglobulin A (IgA) and extracted the miRNAs from each breast milk samples. Next, the top 5 and bottom 5 expressed miRNAs were compared and analyzed based on the amounts of the 3 immune components. 
		                        		
		                        			Results:
		                        			The mean levels and ranges of lactoferrin, lysozyme, and IgA were 6.33 (2.24–14.77)×106 ng/mL, 9.90 (1.42–17.59)×107 pg/mL, and 6.64 (0.48–20.01)×105 ng/mL, respectively. The miRNAs concentration per 1 mL of skim milk was 40.54 (14.95–110.01) ng/μL. Comparing the bottom 5 and top 5 groups of each immune component, 19 miRNAs were significantly upregulated (6, 9, and 4 targeting lactoferrin, lysozyme, and IgA, respectively) and 21 were significantly downregulated (4, 9, and 8 targeting lactoferrin, lysozyme, and IgA, respectively). There were no miRNAs that were expressed significantly higher or lower in common to all 3 components.However, 2 and 3 miRNAs were commonly overexpressed and underexpressed, in the top 5 groups of lysozyme and IgA concentrations. 
		                        		
		                        			Conclusion
		                        			We identified the immune components and miRNAs in breast milk and found that each individual has different ingredients. 
		                        		
		                        		
		                        		
		                        	
4.Relationship of MicroRNA according to Immune Components of Breast Milk in Korean Lactating Mothers
You Jin CHOI ; Da Hye LEE ; Jeonglyn SONG ; Ki-Uk KIM ; Hyeyoung MIN ; Sung-Hoon CHUNG ; Tae Hyeong KIM ; Chae-Young KIM ; Insoo KANG ; Na Mi LEE ; Dae Yong YI
Pediatric Gastroenterology, Hepatology & Nutrition 2024;27(5):322-331
		                        		
		                        			 Purpose:
		                        			Human breast milk (HBM) contains immune components that produced and delivered from the mother along with nutrients necessary for the baby. MicroRNA (miRNA) is a small noncoding RNA molecule, that is used as an ideal biomarker for diagnosis and prognosis of various diseases and are more abundant in HBM. We analyzed and compared the immune components and miRNAs of HBM. 
		                        		
		                        			Methods:
		                        			HBM were collected from 20 healthy breastfeeding mothers. We measured the amount of lactoferrin, lysozyme, and immunoglobulin A (IgA) and extracted the miRNAs from each breast milk samples. Next, the top 5 and bottom 5 expressed miRNAs were compared and analyzed based on the amounts of the 3 immune components. 
		                        		
		                        			Results:
		                        			The mean levels and ranges of lactoferrin, lysozyme, and IgA were 6.33 (2.24–14.77)×106 ng/mL, 9.90 (1.42–17.59)×107 pg/mL, and 6.64 (0.48–20.01)×105 ng/mL, respectively. The miRNAs concentration per 1 mL of skim milk was 40.54 (14.95–110.01) ng/μL. Comparing the bottom 5 and top 5 groups of each immune component, 19 miRNAs were significantly upregulated (6, 9, and 4 targeting lactoferrin, lysozyme, and IgA, respectively) and 21 were significantly downregulated (4, 9, and 8 targeting lactoferrin, lysozyme, and IgA, respectively). There were no miRNAs that were expressed significantly higher or lower in common to all 3 components.However, 2 and 3 miRNAs were commonly overexpressed and underexpressed, in the top 5 groups of lysozyme and IgA concentrations. 
		                        		
		                        			Conclusion
		                        			We identified the immune components and miRNAs in breast milk and found that each individual has different ingredients. 
		                        		
		                        		
		                        		
		                        	
5.Relationship of MicroRNA according to Immune Components of Breast Milk in Korean Lactating Mothers
You Jin CHOI ; Da Hye LEE ; Jeonglyn SONG ; Ki-Uk KIM ; Hyeyoung MIN ; Sung-Hoon CHUNG ; Tae Hyeong KIM ; Chae-Young KIM ; Insoo KANG ; Na Mi LEE ; Dae Yong YI
Pediatric Gastroenterology, Hepatology & Nutrition 2024;27(5):322-331
		                        		
		                        			 Purpose:
		                        			Human breast milk (HBM) contains immune components that produced and delivered from the mother along with nutrients necessary for the baby. MicroRNA (miRNA) is a small noncoding RNA molecule, that is used as an ideal biomarker for diagnosis and prognosis of various diseases and are more abundant in HBM. We analyzed and compared the immune components and miRNAs of HBM. 
		                        		
		                        			Methods:
		                        			HBM were collected from 20 healthy breastfeeding mothers. We measured the amount of lactoferrin, lysozyme, and immunoglobulin A (IgA) and extracted the miRNAs from each breast milk samples. Next, the top 5 and bottom 5 expressed miRNAs were compared and analyzed based on the amounts of the 3 immune components. 
		                        		
		                        			Results:
		                        			The mean levels and ranges of lactoferrin, lysozyme, and IgA were 6.33 (2.24–14.77)×106 ng/mL, 9.90 (1.42–17.59)×107 pg/mL, and 6.64 (0.48–20.01)×105 ng/mL, respectively. The miRNAs concentration per 1 mL of skim milk was 40.54 (14.95–110.01) ng/μL. Comparing the bottom 5 and top 5 groups of each immune component, 19 miRNAs were significantly upregulated (6, 9, and 4 targeting lactoferrin, lysozyme, and IgA, respectively) and 21 were significantly downregulated (4, 9, and 8 targeting lactoferrin, lysozyme, and IgA, respectively). There were no miRNAs that were expressed significantly higher or lower in common to all 3 components.However, 2 and 3 miRNAs were commonly overexpressed and underexpressed, in the top 5 groups of lysozyme and IgA concentrations. 
		                        		
		                        			Conclusion
		                        			We identified the immune components and miRNAs in breast milk and found that each individual has different ingredients. 
		                        		
		                        		
		                        		
		                        	
6.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. 
		                        		
		                        		
		                        		
		                        	
7.Development of an Instrument for Slit-lamp Examination of Donor Corneas in Preservation Medium
Ga Hee NAM ; Da Ran KIM ; Young Chae YOON ; Soon Won YANG ; Woong Joo WHANG ; Yong-Soo BYUN ; Hyung Bin HWANG ; Kyung Sun NA ; Hyun Soo LEE ; So Hyang CHUNG ; Eun Chul KIM ; Yang Kyung CHO ; Hyun Seung KIM ; Ho Sik HWANG
Journal of the Korean Ophthalmological Society 2024;65(2):108-116
		                        		
		                        			 Purpose:
		                        			To evaluate the effectiveness of an instrument devised for slit-lamp examination of donor corneas suspended in preservation medium. 
		                        		
		                        			Methods:
		                        			The study examined two donor corneas received at Yeouido St. Mary's Hospital in February 2023 and March 2023. The instrument has three main components: a plastic holder to hold the preservation medium bottle, a cube with a mirror for reflecting the slit beam, and a stand to attach the device to the slit-lamp. Using the instrument, the donor corneas were examined via slit-lamp: microscopy with the endothelium facing upward and downward. Specular microscopy and anterior segment optical coherence tomography (OCT) were also performed on the preserved donor corneas. 
		                        		
		                        			Results:
		                        			Slit-lamp examination of donor corneas in preservation medium using the instrument showed overall corneal buttoning and optical sections of the donor cornea. Using specular reflection and retroillumination, the endothelial layer was partially visible. However, specular microscopy and anterior segment OCT could not examine the donor cornea in preservation medium using the instrument. 
		                        		
		                        			Conclusions
		                        			The devised instrument facilitates slit-lamp examination of donor corneas in preservation medium, enabling a qualitative assessment of donor corneas before corneal transplantation surgery. 
		                        		
		                        		
		                        		
		                        	
8.Categorization of Meibomian Gland Dysfunction Using Lipid Layer Thickness and Meibomian Gland Dropout in Dry Eye Patients: A Retrospective Study
Phil Kyu LEE ; Jae Lim CHUNG ; Da Ran KIM ; Young Chae YOON ; SoonWon YANG ; Woong-Joo WHANG ; Yong-Soo BYUN ; HyungBin HWANG ; Kyung Sun NA ; HyunSoo LEE ; So Hyang CHUNG ; Eun Chul KIM ; YangKyung CHO ; Hyun Seung KIM ; Ho Sik HWANG
Korean Journal of Ophthalmology 2024;38(1):64-70
		                        		
		                        			 Purpose:
		                        			In the present study, we determined the prevalence of obstructive meibomian gland dysfunction (MGD), hyposecretory MGD, grossly normal MG, and hypersecretory MGD in patients with dry eye syndrome using lipid layer thickness (LLT) and MG dropout. 
		                        		
		                        			Methods:
		                        			Eighty-eight patients with dry eye syndrome were included in the study. Patients were categorized into four groups according to the LLT and weighted total meiboscore. The proportion of patients in each group was calculated. The age, sex, Ocular Surface Disease Index, LLT, Schirmer, tear film breakup time, cornea stain, weighted total meiboscore, expressibility, and quality of meibum were compared between the four groups. 
		                        		
		                        			Results:
		                        			Fifteen eyes (17.0%) had obstructive MGD, two eyes (2.3%) had hyposecretory MGD, 40 eyes (45.5%) had grossly normal MG, and 17 eyes (19.3%) had hypersecretory MGD. The obstructive MGD group was younger than the grossly normal MG group. In obstructive MGD, the ratio of men to women was higher than that of the other groups. However, Ocular Surface Disease Index, Schirmer, tear film breakup time, and corneal stain did not show statistically significant differences between the four groups. The meibum expressibility of the hyposecretoy MGD group was worse than those of the other groups. The meibum expressibility of the hyposecretoy MGD group was poor than those of the obstructive and hypersecretory MGD group. 
		                        		
		                        			Conclusions
		                        			This categorization was expected to help determine the best treatment method for dry eye syndrome, according to the MG status. 
		                        		
		                        		
		                        		
		                        	
9.In Vivo Human Lacrimal Gland Imaging Using an Ultrasound Biomicroscopy
Chanjoon PARK ; Da Ran KIM ; Young Chae YOON ; Soonwon YANG ; Woong-Joo WHANG ; Yong-Soo BYUN ; Hyung Bin HWANG ; Kyung Sun NA ; Hyun Soo LEE ; So Hyang CHUNG ; Eun Chul KIM ; Yang Kyung CHO ; Hyun Seung KIM ; Hosik HWANG
Korean Journal of Ophthalmology 2024;38(3):227-235
		                        		
		                        			 Purpose:
		                        			In the present study, we introduce human lacrimal gland imaging using an ultrasound biomicroscopy (UBM) with a soft cover and show their findings 
		                        		
		                        			Methods:
		                        			The representative UBM findings of palpebral lobes in seven subjects (four with non-Sjögren dry eye syndrome, one with Sjögren syndrome, and two healthy subjects) were described in this study. To prolapse the palpebral lobe, the examiner pulled the temporal part of the upper eyelid in the superotemporal direction and directed the subject to look in the inferonasal direction. We scanned the palpebral lobes longitudinally and transversely using UBM. We used an Aviso UBM with a 50 MHz linear probe and ClearScan. 
		                        		
		                        			Results:
		                        			In UBM of two healthy subjects, the echogenicity of the lacrimal gland was lower than that of the sclera and homogeneous. But the parenchyma of a patient with Sjögren dry eye syndrome was quite inhomogeneous compared to the healthy subjects. In two patients with dry eye syndrome, we were able to observe some lobules in the parenchyma. We could find excretory ducts running parallel at the surface of the longitudinal section in some subjects. In the longitudinal UBM scan of a subject, we observed a tubular structure at a depth of 1,500 μm that was considered a blood vessel. It ran from the superonasal to the inferotemporal direction. In a subject, we observed a large cyst beneath the conjunctiva. 
		                        		
		                        			Conclusions
		                        			Lacrimal gland imaging using UBM has both advantages of optical coherence tomography and sonography, and could be useful for evaluating dry eye syndrome. 
		                        		
		                        		
		                        		
		                        	
10.Clinical Relevance of Enlarged Perivascular Spaces in Neurodegenerative Disease
Yu-Ri JE ; Hong-Gi HAM ; Yu-Hyun PARK ; Tae-Yun KIM ; Min-su GO ; Hye-In LEE ; Da Eun KIM ; Na-Yeon JUNG ; Myung Jun LEE ; Sang-Won SEO ; Eun-Joo KIM
Journal of the Korean Neurological Association 2023;41(4):281-292
		                        		
		                        			 Background:
		                        			Enlarged perivascular space (ePVS) is recently reported to be associated with cerebral small vessel disease (SVD) and Alzheimer’s disease (AD). The topographical location of ePVS may relate to the underlying pathology; basal ganglia (BG)-ePVS has been associated with cerebral vascular diseases and centrum semi-ovale (CSO)-ePVS associated with cerebral amyloid angiopathy (CAA). However, the effects of ePVS on various neurological conditions remain still controversial. To investigate the clinical relevance of ePVS in neurodegenerative diseases, we tested relationships between ePVS and cognition, markers of SVD, vascular risk factors, or amyloid pathology. 
		                        		
		                        			Methods:
		                        			We retrospectively reviewed 292 patients (133 AD dementia, 106 mild cognitive impairment, 39 other neurodegenerative diseases, 14 subjective cognitive decline) who underwent both amyloid positron emission tomography and brain magnetic resonance imaging. Vascular risk factors and cognitive tests results were collected. The ePVS in the BG and CSO, SVD markers and the volume of white matter hyperintensities were measured. 
		                        		
		                        			Results:
		                        			There were no significant differences in the severity and distribution of ePVS among clinical syndromes. Both BG- and CSO-ePVS were not related to cognitive function. Patients with lacunes were more likely to have high-degree BG-ePVS. High degree CSO-ePVS had an odds ratio (OR) for amyloid positive of 2.351, while BG-ePVS was a negative predictor for amyloid pathology (OR, 0.336). 
		                        		
		                        			Conclusions
		                        			Our findings support that ePVS has different underlying pathologies according to the cerebral topography. BG-ePVS would be attributed to hypertensive angiopathy considering the relation with SVD markers, whereas and CSO-ePVS would be attributed to CAA considering the association with amyloid pathology. 
		                        		
		                        		
		                        		
		                        	
            
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