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Development of a Malignancy Potential Binary Prediction Model Based on Deep Learning for the Mitotic Count of Local Primary Gastrointestinal Stromal Tumors

  • Jiejin Yang;Zeyang Chen;Weipeng Liu;Xiangpeng Wang;Shuai Ma;Feifei Jin;Xiaoying Wang
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.344-353
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    • 2021
  • Objective: The mitotic count of gastrointestinal stromal tumors (GIST) is closely associated with the risk of planting and metastasis. The purpose of this study was to develop a predictive model for the mitotic index of local primary GIST, based on deep learning algorithm. Materials and Methods: Abdominal contrast-enhanced CT images of 148 pathologically confirmed GIST cases were retrospectively collected for the development of a deep learning classification algorithm. The areas of GIST masses on the CT images were retrospectively labelled by an experienced radiologist. The postoperative pathological mitotic count was considered as the gold standard (high mitotic count, > 5/50 high-power fields [HPFs]; low mitotic count, ≤ 5/50 HPFs). A binary classification model was trained on the basis of the VGG16 convolutional neural network, using the CT images with the training set (n = 108), validation set (n = 20), and the test set (n = 20). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated at both, the image level and the patient level. The receiver operating characteristic curves were generated on the basis of the model prediction results and the area under curves (AUCs) were calculated. The risk categories of the tumors were predicted according to the Armed Forces Institute of Pathology criteria. Results: At the image level, the classification prediction results of the mitotic counts in the test cohort were as follows: sensitivity 85.7% (95% confidence interval [CI]: 0.834-0.877), specificity 67.5% (95% CI: 0.636-0.712), PPV 82.1% (95% CI: 0.797-0.843), NPV 73.0% (95% CI: 0.691-0.766), and AUC 0.771 (95% CI: 0.750-0.791). At the patient level, the classification prediction results in the test cohort were as follows: sensitivity 90.0% (95% CI: 0.541-0.995), specificity 70.0% (95% CI: 0.354-0.919), PPV 75.0% (95% CI: 0.428-0.933), NPV 87.5% (95% CI: 0.467-0.993), and AUC 0.800 (95% CI: 0.563-0.943). Conclusion: We developed and preliminarily verified the GIST mitotic count binary prediction model, based on the VGG convolutional neural network. The model displayed a good predictive performance.

Blood-Blister Aneurysms of the Internal Carotid Artery in Tibetan and Han Populations : A Retrospective Observational Study

  • Bowen Huang;Yanming Ren;Hao Liu;Anqi Xiao;Lunxin Liu;Hong Sun;Yi Liu;Hao Li;Lu Ma;Chang-Wei Zhang;Chao-Hua Wang;Min He;Yuekang Zhang;Chao You;Jin Li
    • Journal of Korean Neurosurgical Society
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    • v.67 no.3
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    • pp.345-353
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    • 2024
  • Objective : Blood-blister aneurysms (BBAs) of the internal carotid artery (ICA) are challenging lesions with high morbidity and mortality rates. Although research on BBAs is well documented in different populations, the study of BBAs in the Tibetan population is extremely rare. This study aimed to evaluate the characteristics of BBAs and analyze the treatment modalities and long-term outcomes in the Tibetan population in comparison with the Han population. Methods : The characteristics of patients with BBAs of the ICA from January 2009 to January 2021 at our institution were reviewed. The features of aneurysms, treatment modalities, complications, and follow-up outcomes were retrospectively analyzed. Results : A total of 130 patients (41 Tibetan and 89 Han patients) with BBAs of the ICA who underwent treatment were enrolled. Compared with the Han group, the Tibetan group significantly demonstrated a high ratio of BBAs among ICAs (8.6%, 41/477 vs. 1.6%, 89/5563; p<0.05), a high ratio of vasospasm (34.1%, 14/41 vs. 6.7%, 6/89; p=0.001), a high risk of ischemic events (43.9%, 18/41 vs. 22.5%, 20/89; p<0.05), and a low ratio of good outcomes (modified Rankin scale, 0-2) at the 1-year follow-up (51.2%, 21/41 vs. 74.2%, 66/89; p<0.05). The multivariate regression model showed that ischemic events significantly contributed to the prediction of outcomes at 1 year. Further analysis revealed that microsurgery and vasospasm were associated with ischemic events. Conclusion : In comparison with Han patients, the Tibetan population had a high ratio of BBA occurrence, a high incidence of ischemic events, and a high ratio of poor outcomes. The endovascular approach showed more benefits in BBA patients.

Evaluation of stingless bee (Tetragonula pagdeni) honey properties and melissopalynological analysis from different geographical origins in Thailand

  • Jakkrawut Maitip;Amonwit Polgate;Woranika Promsart;Jinatchaya Butdee;Athitta Rueangwong;Tanatip Sittisorn;Wankuson Chanasit;Satasak Jorakit;Prapai Kodcharin
    • Journal of Ecology and Environment
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    • v.48 no.1
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    • pp.24-31
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    • 2024
  • Background: Honey from different geographical origins can have distinct characteristics due to variations in the floral sources available to stingless bees in different regions. The most abundant stingless bee for meliponiculture in Thailand is Tetragonula pagdeni. However, only a few studies about the properties of honey from a different origin were carried out. The objective of this study was focused on a comparative study to evaluate the melissopalynological, physicochemical, antioxidant activities, and total phenolic contents (TPCs) of stingless bee honey produced by T. pagdeni from different parts of Thailand. Results: Fifty honey samples were collected from five locations, and the physicochemical properties of T. pagdeni honey samples are acidic (pH 3.02-4.15) and have a high water content (18.42-25.06 %w/w), which is related to the regions of meliponary. Melisopalynological analysis reveals the predominant pollen from Melaleuca quinquenervia, Cocus nuciferca, Nephelium lappaceum, Salacca wallichiana, and multiflora honey. All honey samples were analyzed for their TPC and 2,2-diphenyl1-picrylhydrazyl radical scavenging activity. The results show that all samples had high TPC and antioxidant activities with a strong correlation (p < 0.05). Conclusions: The data from this study indicates the importance of geographical origin, which links physicochemical properties, phenolic compounds, and functional characteristics to their floral. Besides, the floral sources and harvesting location affected the properties of stingless bee honey. Our results identify Melaleuca honey as a promising source of phenolic content and antioxidant activity that can be used as a functional food, as well as multiflora and Cocus honey. However, further studies are required to characterize the phenolic compound and its biological potential, which could be a stingless bee honey biomarker and quality control, simultaneously with the physicochemical analysis.

Determination of Structural Member Section based on Nonlinear Behaviors of Steel Cable-Stayed Bridges and Harmony Search Algorithm (강사장교 비선형거동과 하모니 서치 알고리즘에 기반한 사장교 구성 단면 결정)

  • Sang-Soo Ma;Tae-Yun Kwon;Won-Hong Lee;Jin-Hee Ahn
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.28 no.4
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    • pp.1-12
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    • 2024
  • In this study, a determination method of structural member section based on Nonlinear behaviors of steel cable-stayed bridges and the Harmony Search algorithm was presented. The Harmony Search algorithm determines the structural member section of cable-stayed bridges by repeating the process of setting the initial value, initializing the harmony memory, configuring the new harmony memory, and updating the harmony memory to search for the optimal value. The nonlinear initial shape analysis of a three-dimensional steel cable-stayed bridge was performed with the cross-section of the main member selected by the Harmony Search algorithm, and the optimal cross-section of the main members of the cable-stayed bridge, such as pylons, girders, cross-beams, and cables, reflecting the complex behavior characteristics and the nonlinearity of each member was determined in consideration of the initial tension and shape. The total weight was used as the objective function for determining the cross-section of the main member of the cable-stayed bridges, and the load resistance ability and serviceability based on the ultimate state design method were used as the restraint conditions. The width and height ratio of the girder and cross-section were considered additional restraint conditions. The optimal sections of the main members were made possible to be determined by considering the geometry and material nonlinearity of the pylons, girders, and cross-sections and the nonlinearity of the cable members. As a result of determining the optimal cross-section, it was confirmed that the proposed analysis method can determine the optimal cross-section according to the various constraint conditions of the cable-stayed bridge, and the structural member section of the cable-stayed bridge considering the nonlinearity can be determined through the Harmony Search algorithm.

The Geochemistry of Copper-bearing Hydrothermal Vein Deposits in Goseong Mining District (Samsan Area), Gyeongsang Basin, Korea (경상분지내 삼산지역 열수동광상에 관한 지화학적 연구)

  • Choi, Sang Hoon;So, Chil Sup;Kweon, Soon Hag;Choi, Kwang Jun
    • Economic and Environmental Geology
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    • v.27 no.2
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    • pp.147-160
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    • 1994
  • Copper-bearing hydrothermal vein mineralization of the Samsan area was deposited in two stages (I and II) of quartz-calcite-sulfide veins which fill fissures in Cretaceous volcanic and sedimentary rocks of the Gyeongsang basin. The major ore minerals, chalcopyrite and sphalerite, together with pyrite, galena, hematite, and minor sulfosalts, occur with epidote and chlorite as gangue minerals in stage I quartz veins. Chlorite geothermometry, fluid inclusion and stable isotope data indicate that copper ore was deposited mainly at temperatures between $330^{\circ}C$ and $280^{\circ}C$ from fluids with salinities between 12 and 3 equiv. wt % NaCl. Evidence of fluid boiling indicates a range of pressures from ${\leq}100$ to 200 bars bars. Within ore stage I there was an apparent decrease in ${\delta}^{34}S$ values of $H_{2}S$ with paragenetic time, from 8.0 to 2.3 per mil. This pattern was likely achieved through progressive increases in activity of oxygen accompanying boiling and mixing. In the early part of the first stage, the high temperature, high salinity fluids gave way to progressively cooler and more dilute fluids of the late parts in the first stage and of the second stage. There is a systematic decrease in calculated ${\delta}^{18}O_{water}$ values with decreasing temperature in the Samsan hydrothermal system, from values of -86 per mil for early portion of stage I through -5.9 per mil for late portion of stage I to -6.3 per mil for stage II. The ${\delta}D$ values of fluid inclusion waters also decrease with paragenetic time from -76 per mil to -86 per mil. These trends combined with mineral paragenesis and fluid inclusion data are interpreted to indicate progressive cooler, more oxidizing meteoric water inundation of an early exchanged meteoric hydrothermal system.

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Effect of Pulsatile Versus Nonpulsatile Blood Flow on Renal Tissue Perfusion in Extracorporeal Circulation (체외순환에서 박동 혈류와 비박동 혈류가 신장의 조직관류에 미치는 영향)

  • Kim Hyun Koo;Son Ho Sung;Fang Yang Hu;Park Sung Young;Kim Kwang Taik;Kim Hark Jei;Sun Kyung
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.13-22
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    • 2005
  • It has been known that pulsatile flow is physiologic and more favorable to tissue perfusion than nonpulsatile flow. The purpose of this study is to directly compare the effect of pulsatile versus nonpulsatile blood flow to renal tissue perfusion in extracorporeal circulation by using a tissue perfusion measurement system. Material and Method: Total cardiopulmonary bypass circuit was constructed to twelve Yorkshire swines, weighing 20$\~ $30 kg. Animals were randomly assigned to group 1 (n=6, non pulsatile centrifugal pump) or group 2 (n=6, pulsatile T-PLS pump). A probe of the tissue perfusion measurement system $(QFlow^{TM}-500)$ was inserted into the renal pa­renchymal tissue. Extracorporeal circulation was maintained for an hour at a pump flow of 2 L/min after aortic cross-clamping. Tissue perfusion flow of the kidney was measured at baseline (before bypass) and every 10 minutes after bypass. Serologic parameters were collected at baseline and 60 minutes after bypass. Result: Baseline parameters were not different between the groups. Renal tissue perfusion flow was substantially higher in the pulsatile group throughout the bypass (ranged 48.5$\~$ 64 in group 1 vs. 65.8$\~$88.3 mL/min/100 g in group 2, p=0.026$\~$ 0.45) The difference was significant at 30 minutes bypass $(47.5{\pm}18.3\;in\;group\;1\;vs.\;83.4{\pm}28.5$ mL/min/100 g in group 2, p=0.026). Serologic parameters including plasma free hemoglobin, blood urea nitrogen, and creatinine showed no differences between the groups at 60 minutes after bypass (p=NS). Conclusion: Pulsatile flow is more beneficial to tissue perfusion of the kidney in short-term extracorporeal circulation. Further study is suggested to observe the effects to other vital organs or long-term significance.

Bronchoalveolar Cellularity and IL-8 Levels in Patients with Post-measles Wheezing (홍역 후 천명환아의 기도내 세포양상 및 IL-8치)

  • Jung, Da Eun;Kim, Byeong Eui;Chung, Ju Young;Kim, Jeong Yeon;Ma, Sang Hyuk;Kim, Chang Keun
    • Clinical and Experimental Pediatrics
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    • v.46 no.8
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    • pp.763-768
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    • 2003
  • Purpose : This study was conducted to investigate the pulmonary cellular profiles and IL-8 levels in patients with post-measles wheezing. Methods : Twelve previously healthy infants with a minimum of three episodes of wheezing after measles pneumonia(Measles wheezing, median age, 1.3 years) were recruited by a retrospective examination of hospital records. They underwent bronchoalveolar lavage(BAL) with flexible bronchoscopy, and high-resolution computed tomography(HRCT) with a mean six(1-15) months interval. Comparisons were made with seven normal controls(Control, median age : 7.4 years). BAL cell counts and differentials were determined. IL-8 levels also were measured by ELISA. Results : The BAL cellular profiles were characterized by a significantly increased percentage of neutrophils in the Measles wheezing group(median 16.0%) compared to the control group(median 3.8 %)(P<0.01). IL-8 levels were markedly increased in the Measles wheezing group($mean{\pm}SD$, $512.7{\pm}324.0pg/mL$) compared to the control group($41.7{\pm}67.7pg/mL$)(P<0.01). Furthermore, IL-8 levels correlated significantly(r=0.816, P=0.001) with neutrophil percentages in BAL fluids in the Measles wheezing group. Abnormal HRCT findings were mosaic perfusion, bronchiectasis, bronchial wall thickening, and decreased vascularity. Conclusion : These results suggest that pulmonary neutrophils and IL-8 may play an important role in the pathogenesis of the post-measles wheezing.

The Egg Detection Rates of Enterobius Vermicularis among Preschool and School Children in Masan and Changwon Areas in Korea (마산, 창원지역에서 아동들의 요충 감염 실태 연구)

  • Jo, Mi Hyun;Kim, Won Yeob;Chuung, Won Jo;Ma, Sang Hyeok;Choi, Sang Ho;Kong, Hyun-Hee;Chung, Dong-Il
    • Pediatric Infection and Vaccine
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    • v.6 no.1
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    • pp.107-115
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    • 1999
  • Purpose : Enterobiasis is probably one of the most common parasitic infection world-wide. Human is the only known host of Enterobius vermicularis. Children are more commonly infected with Enterobius vermicularis than adults and infections are commonly recurred. In Korea, there is a high prevalence. So, we performed this study to evaluate the present status of Enterobius vermicularis infection among children in the Masan, Changwon areas and to determine the efficacy of flubendazole against this parasitic nematode. Methods : From November to December, 1997, urban and rural elementary school children and urban preschool children were examined for the presence of Enterobius vermicularis egg. All the children were examined once by an adhesive cellotape anal swab technique in the early morning at home by their parents guided by specific instructions for the technique. Results : 1) A total of 644 adhesive cellotape anal swab specimens was collected from 205 urban elementary school children, 290 rural elementary school children and 145 urban preschool children. Among them, 114(17.7%) were positive for Enterobius vermicularis eggs. There was no significant differences in the rate with regard to sex. 2) In the preschool children, the egg detection rate was 42(29.0%) out of 145 children. This rate was significantly higher compared with 72(14.4%) of 499 school children. 3) The egg detection rates in the rural and urban school children were 15.2, 13.7% respectively. There was no significant difference in both groups. In the 3rd grade and below in elementary school children, there was a higher rate compared with above 4th grade group. 4) In day care center where egg detection rate was high as 41%, the children were given two doses of 100mg flubendazole every 3 weeks, including staffs and family members. After treatment, egg detection rate fatted as 6%. Conclusion : Our data demonstrated that there was high prevalence of Enterobius vermicularis infection. In the light of these results, it is necessary to examine and treat children as soon as possible.

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Surgical Technique for Korean Artificial Heart(AnyHeart) Implantation Using a Right Thoracotomy Approach (우측 개흉술을 이용한 한국형 인공심장(AnyHeart)의 이식기법)

  • Son. Ho-Sung;Sun, Kyung;Shin, Jae-Seung;Lee, Sung-Ho;Jung, Jae-Seung;Lee, Hye-Won;Kim, Kwang-Taik;Kim, Seung-Chul;Won, Yong-Soon;Min, Byoung-Goo;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.329-335
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    • 2002
  • Background: The surgical technique for biventricular assist device(BVAD) implantation has mainly consisted of cannulation procedures. A median sternotomy has been the technique of choice as it gives a surgeon an excellent exposure of the heart. However, considering that most patients require a future sternotomy or already have a previous sternotomy, sternotomy-related complication remains a major concern in BVAD implantation. Based on this consideration as well as the clinical experiences of conventional heart surgery, the authors have hypothesized that the cardiac chambers for BVAD cannulation can be approached from the right side of the heart. The purpose of this studs to develop a novel surgical technique of right thoracotomy for BVAD implantation in an animals study. Material and Method: For last two years, 16 (11 calves, 3 canines, and 2 sheep) out of 30 experimental animals with AnyHeart implantation underwent a right thoracotomy. The device was used as an implantable BVAD in 14 animals, a wearable BVAD in 1, and an implantable LVAD in 1. The chest cavity was entered through the 4th intercostal space or the 5th periosteal bed. As for the BVAD use, a right inflow cannula was inserted into the right atrial free wall and a right outflow cannula was grafted onto the main pulmonary artery. A left inflow cannula was inserted into the interatrial groove and a left outflow cannula was grafted on the innominate artery of the ascending aorta. The connecting tubes were brought out through the thoracotomy wound and connected to the pump located in the subcutaneous pocket at the right flank. Result: Except for the 5 animals for a lilting test or during the early learning curve, all recovered smoothly from the procedures. The inflow drainage allowed the pump output 6.5 L/min at the maximum with 3-3.5 L/min in an average. Of the survivors, there noted no procedure-related mortality or morbidity. Necropsy findings demonstrated the well-positioned cannula tips in the each cardiac chamber

Clarithromycin Therapy for Scrub Typus (쯔쯔가무시(Tsutusgamushi)병에서 Clarithromycin의 치료 효과)

  • Kim, Soon;Jung, Eun Mi;Moon, Kyung Hyun;Yoe, Sung Yeob;Eum, Soo Jung;Lee, Joo Hyung;Jo, Sung Rae;Ma, Sang Hyuk
    • Pediatric Infection and Vaccine
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    • v.9 no.2
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    • pp.175-181
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    • 2002
  • Purpose : Scrub typhus(tsutsugamushi disease) is a febrile disease characterized by fever, rash, eschar, lymphadenopathy. Therapy with tetracycline(doxycycline) or chloramphenicol is currently recommended for the treatment for scrub typhus. But there are limitations in usage a tetracycline(doxycycline) for scrub typhus in the children. Recently, there was a report that azithromycin, a macrolide antibiotic was used for scrub typhus in pregnant woman successfully. So we evaluated the effectiveness of the Clarithromycin, other a macrolide antibiotic, for scrub typhus. Methods : Seven patients with scrub typhus at department of internal medicine and three patients with scrub typhus at department of pediatrics Masan Fatima Hospital were involved for this study. A serologic diagnosis for scrub typhus were performed by use of passive hemagglutination test. Clarithromycin(Abbott Laboratories, North Chicago, IL, USA) was administrated orally in a daily dose of 500 mg for adult patients and 15 mg/kg/bid/day for pediatric patients. Results : There were 7 cases of adult patients, varying from 28 to 76 years of age and 3 cases of pediatirc patients, varying from 4 to 7 years of age with scrub typhus. All of cases had fever, myalgia, headache, rash, eschar. Seven cases had positive passive hemagglutination test and eight cases had abnormal liver function. Mean duration for the removal of fever after medication was 1.3 day(1~2 days) and all cases were recovered without complications. Conclusion : Our results suggest that Clarithromycin therapy may be effective for scrub typhus.

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