OBJECTIVE: To develop algorithms using convolutional neural networks (CNNs) for automatic segmentation of acute ischemic lesions on diffusion-weighted imaging (DWI) and compare them with conventional algorithms, including a thresholding-based segmentation. MATERIALS AND METHODS: Between September 2005 and August 2015, 429 patients presenting with acute cerebral ischemia (training:validation:test set = 246:89:94) were retrospectively enrolled in this study, which was performed under Institutional Review Board approval. Ground truth segmentations for acute ischemic lesions on DWI were manually drawn under the consensus of two expert radiologists. CNN algorithms were developed using two-dimensional U-Net with squeeze-and-excitation blocks (U-Net) and a DenseNet with squeeze-and-excitation blocks (DenseNet) with squeeze-and-excitation operations for automatic segmentation of acute ischemic lesions on DWI. The CNN algorithms were compared with conventional algorithms based on DWI and the apparent diffusion coefficient (ADC) signal intensity. The performances of the algorithms were assessed using the Dice index with 5-fold cross-validation. The Dice indices were analyzed according to infarct volumes (< 10 mL, ≥ 10 mL), number of infarcts (≤ 5, 6–10, ≥ 11), and b-value of 1000 (b1000) signal intensities (< 50, 50–100, > 100), time intervals to DWI, and DWI protocols. RESULTS: The CNN algorithms were significantly superior to conventional algorithms (p < 0.001). Dice indices for the CNN algorithms were 0.85 for U-Net and DenseNet and 0.86 for an ensemble of U-Net and DenseNet, while the indices were 0.58 for ADC-b1000 and b1000-ADC and 0.52 for the commercial ADC algorithm. The Dice indices for small and large lesions, respectively, were 0.81 and 0.88 with U-Net, 0.80 and 0.88 with DenseNet, and 0.82 and 0.89 with the ensemble of U-Net and DenseNet. The CNN algorithms showed significant differences in Dice indices according to infarct volumes (p < 0.001). CONCLUSION: The CNN algorithm for automatic segmentation of acute ischemic lesions on DWI achieved Dice indices greater than or equal to 0.85 and showed superior performance to conventional algorithms.
Brain Ischemia ; Consensus ; Diffusion ; Ethics Committees, Research ; Humans ; Retrospective Studies

Communicating bronchopulmonary foregut malformation (CBPFM) is a communication between the respiratory and gastrointestinal tracts that can be difficult to differentiate from pulmonary sequestration or H-type tracheoesophageal fistula (TEF) because of the similarities in clinical features. A female neonate born at full term had been experiencing respiratory difficulty during feeding from the third day of life. The esophagography performed to rule out H-type TEF revealed that the esophageal bronchus directly communicated with the left lower lobe (LLL) of the lung. Lobectomy of the LLL, fistulectomy of the esophagobronchial fistula, and primary repair of the esophagus were performed. Finally, CBPFM type III with pulmonary sequestration was confirmed on the basis of the postoperative histopathological finding. We report the first newborn case of CBPFM type III with pulmonary sequestration in Korea.
Bronchi ; Bronchial Fistula ; Bronchopulmonary Sequestration ; Esophagus ; Female ; Fistula ; Gastrointestinal Tract ; Humans ; Infant, Newborn ; Korea ; Lung ; Tracheoesophageal Fistula

BACKGROUND: Unhealthy weight control methods such as fasting and meal skipping can harm the mental health of individuals engaging in these methods. But this relationship has not been studied in Korean individuals. The aim of this study was to investigate the relationship between weight control methods and depressive symptoms among Korean adults.METHODS: We used data from the Korean National Health and Nutrition Examination Survey in 2014, 2016, which included 10,447 adults. Patient Health Questionnaire was used for the assessment of depressive symptoms. Multiple logistic regression analysis was conducted according to age and sex.RESULTS: Attempting to follow a one-food diet was higher among depressed men. There was a significant association between depressive symptoms and weight control methods such as fasting and skipping meals among women. Among women >30 years and <50 years, depressive symptoms were related to a high likelihood of fasting, prescribed drugs for weight loss and one-food diet.CONCLUSION: Our findings indicate that the correlation between the symptoms of depression and weight control methods varies depending on age and sex of the individuals. Our results could help formulate healthy weight management measures based on the on the depressive mood, age and sex of the individuals.
Adult ; Depression ; Diet ; Fasting ; Female ; Humans ; Logistic Models ; Male ; Meals ; Mental Health ; Methods ; Nutrition Surveys ; Obesity ; Weight Loss

PURPOSE: The aim of this study is to examine the tolerability and effect of early highdose amino acid administration in extremely low birth weight infants (ELBWIs). METHODS: This retrospective cohort study included ELBWI (birth weight < 1,000 g, n=142). Biochemical, nutritional, and neurodevelopmental data were compared between infants who received conventional low amino acid (LAA; 1.5 g/kg/day) and those who received high amino acid (HAA; 3 g/kg/day) within the first 48 hours after birth. Neurodevelopmental data included weight, height, and head circumference at discharge, 12 to 14 and 18 to 24 months of corrected age and the Korean Bayley Scale of Infant Development II (K-BSID-II) score at 18 to 24 months of corrected age. RESULTS: The HAA group demonstrated higher peak plasma albumin (3.0±0.4 vs. 3.2±0.5, P < 0.05) and lower serum creatinine (1.7±0.9 vs. 1.4±0.8, P < 0.05) during the first 14 days than the LAA group. Full enteral feeding was achieved significantly earlier in infants in the HAA group than in infants in the LAA group (46.2±23.0 days vs. 34.3±21 days, P < 0.01). There was no difference between the two groups in the z score changes in all growth indicators from birth to discharge and at 12 to 14 and 18 to 24 months of corrected age, as well as in the K-BSID-II score at 18 to 24 months of corrected age. CONCLUSION: Aggressive administration of amino acids during the first 2 days of life in ELBWI was well tolerated and correlated with earlier full enteral feeding, but did not improve growth and neurodevelopment.
Amino Acids ; Child ; Child Development ; Cohort Studies ; Creatinine ; Enteral Nutrition ; Head ; Humans ; Infant* ; Infant, Extremely Low Birth Weight ; Infant, Low Birth Weight* ; Infant, Newborn ; Parenteral Nutrition ; Parturition ; Retrospective Studies ; Serum Albumin

In the present study, Aeromonas (A.) hydrophila was isolated from a captive-bred adult freshwater stingray (Potamotrygon motoro) reared at a commercial aquarium in Korea. The stingray had bites on its fins, hemorrhages on the ventral part, and congested internal organs. A bacterium was isolated from kidney and subsequently identified as A. hydrophila. Based on phylogenetic analysis results, the isolate in the present study (SNUAh-LA1) was most closely related to A. hydrophila AH10 (China) and A. hydrophila AKR1 (Korea). It is most likely that the pathogen infection resulted from Potamotrygon motoro cohabiting with ricefish (Oryzias latipes).
Adult ; Aeromonas hydrophila* ; Aeromonas* ; Estrogens, Conjugated (USP) ; Fresh Water* ; Hemorrhage ; Humans ; Kidney ; Korea

BACKGROUND/OBJECTIVES: The purpose of this study is to analyze daily kimchi, vegetable and fruit consumption by general characteristics and vegetable and fruit consumption from 1998 to 2012 by the Korean population based on the data of the KNHANES (Korea National Health and Nutrition Examination Survey). SUBJECTS/METHODS: This study is based on the 1998-2012 KNHNES. Analysis data on 54,700 subjects aged 19 years and older were obtained from health behavior interviews and the 24-hour dietary recall method. RESULTS: Daily kimchi consumption and portion size of kimchi decreased significantly from 1998 to 2012 (adjusted P for trend < 0.0001). Meanwhile, daily consumption of both non-salted vegetable and fruit with and without kimchi did not significantly change between 1998 and 2012. Reduced consumption of kimchi, non-salted vegetable, and fruit was observed for both genders as well as daily meal episodes and cooking locations. Male and female subjects with insufficient non-salted vegetable and fruit intake were increased 1.4 times and 1.3 times, respectively, in 2012 than 1998. All subjects consumed at least 400 g/day of non-salted vegetable, fruit, and kimchi in each survey year, although they consumed insufficient amounts (< 400 g/day) of non-salted vegetable and fruit without kimchi. CONCLUSIONS: Since Koreans generally consume high amounts of fermented vegetables, including kimchi, total vegetables and fruit. Consumption of these foods by the Korean adult population reached 400 g, which is the recommended intake of the WCRF/AICR. Based on this result, it is necessary to promote consumption of kimchi in the Korean population and research the development of low sodium kimchi in the future.
Adult* ; Cooking ; Eating ; Female ; Fruit* ; Health Behavior ; Humans ; Korea* ; Male ; Meals ; Nutrition Surveys* ; Portion Size ; Sodium ; Vegetables*

BACKGROUND: We describe herein the application of whole exome sequencing (WES) for the molecular genetic diagnosis of a large Korean family with dominantly inherited myopathy. CASE REPORT: The affected individuals presented with slowly progressive proximal weakness and ankle contracture. They were initially diagnosed with limb-girdle muscular dystrophy (LGMD) based on clinical and pathologic features. However, WES and subsequent capillary sequencing identified a pathogenic splicing-site mutation (c.1056+1G>A) in COL6A1, which was previously reported to be an underlying cause of Bethlem myopathy. After identification of the genetic cause of the disease, careful neurologic examination revealed subtle contracture of the interphalangeal joint in the affected members, which is a characteristic sign of Bethlem myopathy. Therefore, we revised the original diagnosis from LGMD to Bethlem myopathy. CONCLUSIONS: This is the first report of identification of COL6A1-mediated Bethlem myopathy in Korea, and indicates the utility of WES for the diagnosis of muscular dystrophy.
Ankle ; Capillaries ; Contracture ; Diagnosis* ; Exome* ; Humans ; Joints ; Korea ; Molecular Biology* ; Muscular Diseases* ; Muscular Dystrophies ; Muscular Dystrophies, Limb-Girdle ; Neurologic Examination

The purpose of this study was to determine the antioxidant effect of fucoxanthin. After rats were fed a normal fat diet (NF), high fat diet (HF), and high fat with 0.2% fucoxanthin diet (HF + Fxn) for 4 weeks, the markers of oxidative stress and antioxidant capacity like lipid peroxidation, plasma total antioxidant capacity (TAC), and activities of antioxidant enzymes (catalase, superoxide dismutase (SOD), and gluthathione peroxidase (GSH-Px)) were determined. mRNA expression of transcription factor, nuclear erythroid factor like 2 (Nrf2), and its target genes such as NAD(P)H quinone oxidoreductase1 (NQO1) and heme oxygenase-1 (HO-1) were also determined. Mean weight gain in the HF + Fxn group was lower, without statistical significance, and the total food intake in the HF + Fxn group was lower than that in the HF group (P < 0.05). The activity of GSH-Px (P < 0.05) in plasma was significantly higher in the HF + Fxn group than those in the HF group (P < 0.05). In the liver, the activities of catalase (P < 0.05) and GSH-Px (P < 0.05) in the HF + Fxn group were significantly higher than those in the HF group. Plasma TAC level was significantly higher in the HF + Fxn group than that in the HF group (P < 0.05). Lipid peroxidation in plasma tended to be lower without statistical significance. Fucoxanthin supplements were shown to have higher mRNA expression of Nrf2 and NQO1 than those in the high fat diet only group (P < 0.05). In conclusion, supplementation of fucoxanthin improved the antioxidant capacity, depleted by high fat diet, by activating the Nrf2 pathway and its downstream target gene NQO1. Therefore, supplementation of fucoxanthin, especially for those who consume high fat in their diet, may benefit from reduced risk of oxidative stress.
Animals ; Antioxidants* ; Benzoquinones ; Catalase ; Diet ; Diet, High-Fat* ; Eating ; Heme Oxygenase-1 ; Lipid Peroxidation ; Liver ; Oxidative Stress ; Peroxidase ; Plasma ; Rats* ; RNA, Messenger ; Superoxide Dismutase ; Transcription Factors ; Weight Gain ; Xanthophylls

BACKGROUND: X-linked Charcot-Marie-Tooth disease type 5 (CMTX5) is caused by mutations in the gene encoding phosphoribosyl pyrophosphate synthetase I (PRPS1). There has been only one case report of CMTX5 patients. The aim of this study was to identify the causative gene in a family with CMTX with peripheral neuropathy and deafness. CASE REPORT: A Korean family with X-linked recessive CMT was enrolled. The age at the onset of hearing loss of the male proband was 5 months, and that of steppage gait was 6 years; he underwent cochlear surgery at the age of 12 years. In contrast to what was reported for the first patients with CMTX5, this patient did not exhibit optic atrophy. Furthermore, there was no cognitive impairment, respiratory dysfunction, or visual disturbance. Assessment of his family history revealed two male relatives with very similar clinical manifestations. Electrophysiological evaluations disclosed sensorineural hearing loss and peripheral neuropathy. Whole-exome sequencing identified a novel p.Ala121Gly (c.362C>G) PRPS1 mutation as the underlying genetic cause of the clinical phenotype. CONCLUSIONS: A novel mutation of PRPS1 was identified in a CMTX5 family in which the proband had a phenotype of peripheral neuropathy with early-onset hearing loss, but no optic atrophy. The findings of this study will expand the clinical spectrum of X-linked recessive CMT and will be useful for the molecular diagnosis of clinically heterogeneous peripheral neuropathies.
Charcot-Marie-Tooth Disease ; Deafness ; Diphosphates ; Exome* ; Gait ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Male ; Optic Atrophy* ; Peripheral Nervous System Diseases ; Phenotype ; Ribose-Phosphate Pyrophosphokinase