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A Study on Flow Characteristics around Foot to Investigate Principle of Underwater Exercise for Rheumatoid Arthritis Patients (류마티스 관절염 환자의 수중운동 원리 규명을 위한 발 주위 유동 특성 연구)

  • Choi, Ji-Hyun;Park, Sung-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.5
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    • pp.403-410
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    • 2021
  • There are positive effects, such as pain reduction, when rheumatism patients exercise in water, but the cause of the pain reduction is unclear, and research on this is inadequate. This study examined the flow of the surface of the foot and the principles of pain relief. Unsteady simulations were conducted to analyze the flow, which was performed by repeatedly setting the movement of the foot raising and descending three times. Pressure fluctuations and frequencies were analyzed by designating pressure points at the painful location. The results showed that a positive and negative pressure of approximately ±500Pa was applied overall. A pressure of approximately ±2000Pa was applied when the direction of movement was changed. A frequency of approximately 35 to 80Hz was generated in the area where rheumatoid arthritis pain frequently occurs. The effects of reducing pain could be predicted when continuous pressure fluctuations and frequencies are applied repeatedly to the painful location, blood circulation promotion. The results could be used as basic data to understand the principles of aquatic exercise and support the development of underwater exercise programs and developing related medical equipment.

Evaluation of the Relationship between the Exposure Level to Mixed Hazardous Heavy Metals and Health Effects Using Factor Analysis (요인분석을 이용한 유해 중금속 복합 노출수준과 건강영향과의 관련성 평가)

  • Kim, Eunseop;Moon, Sun-In;Yim, Dong-Hyuk;Choi, Byung-Sun;Park, Jung-Duck;Eom, Sang-Yong;Kim, Yong-Dae;Kim, Heon
    • Journal of Environmental Health Sciences
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    • v.48 no.4
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    • pp.236-243
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    • 2022
  • Background: In the case of multiple exposures to different types of heavy metals, such as the conditions faced by residents living near a smelter, it would be preferable to group hazardous substances with similar characteristics rather than individually related substances and evaluate the effects of each group on the human body. Objectives: The purpose of this study is to evaluate the utility of factor analysis in the assessment of health effects caused by exposure to two or more hazardous substances with similar characteristics, such as in the case of residents living near a smelter. Methods: Heavy metal concentration data for 572 people living in the vicinity of the Janghang smelter area were grouped based on several subfactors according to their characteristics using factor analysis. Using these factor scores as an independent variable, multiple regression analysis was performed on health effect markers. Results: Through factor analysis, three subfactors were extracted. Factor 1 contained copper and zinc in serum and revealed a common characteristic of the enzyme co-factor in the human body. Factor 2 involved urinary cadmium and arsenic, which are harmful metals related to kidney damage. Factor 3 encompassed blood mercury and lead, which are classified as related to cardiovascular disease. As a result of multiple linear regression analysis, it was found that using the factor index derived through factor analysis as an independent variable is more advantageous in assessing the relevance to health effects than when analyzing the two heavy metals by including them in a single regression model. Conclusions: The results of this study suggest that regression analysis linked with factor analysis is a good alternative in that it can simultaneously identify the effects of heavy metals with similar properties while overcoming multicollinearity that may occur in environmental epidemiologic studies on exposure to various types of heavy metals.

Added Value of Contrast Leakage Information over the CBV Value of DSC Perfusion MRI to Differentiate between Pseudoprogression and True Progression after Concurrent Chemoradiotherapy in Glioblastoma Patients

  • Pak, Elena;Choi, Seung Hong;Park, Chul-Kee;Kim, Tae Min;Park, Sung-Hye;Won, Jae-Kyung;Lee, Joo Ho;Lee, Soon-Tae;Hwang, Inpyeong;Yoo, Roh-Eul;Kang, Koung Mi;Yun, Tae Jin
    • Investigative Magnetic Resonance Imaging
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    • v.26 no.1
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    • pp.10-19
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    • 2022
  • Purpose: To evaluate whether the added value of contrast leakage information from dynamic susceptibility contrast magnetic resonance imaging (DSC MRI) is a better prognostic imaging biomarker than the cerebral blood volume (CBV) value in distinguishing true progression from pseudoprogression in glioblastoma patients. Materials and Methods: Forty-nine glioblastoma patients who had undergone MRI after concurrent chemoradiotherapy with temozolomide were enrolled in this retrospective study. Twenty features were extracted from the normalized relative CBV (nCBV) and extraction fraction (EF) map of the contrast-enhancing region in each patient. After univariable analysis, we used multivariable stepwise logistic regression analysis to identify significant predictors for differentiating between pseudoprogression and true progression. Receiver operating characteristic (ROC) analysis was employed to determine the best cutoff values for the nCBV and EF features. Finally, leave-one-out cross-validation was used to validate the best predictor in differentiating between true progression and pseudoprogression. Results: Multivariable stepwise logistic regression analysis showed that MGMT (O6-methylguanine-DNA methyltransferase) and EF max were independent differentiating variables (P = 0.004 and P = 0.02, respectively). ROC analysis yielded the best cutoff value of 95.75 for the EF max value for differentiating the two groups (sensitivity, 61%; specificity, 84.6%; AUC, 0.681 ± 0.08; 95% CI, 0.524-0.837; P = 0.03). In the leave-one-out cross-validation of the EF max value, the cross-validated values for predicting true progression and pseudoprogression accuracies were 69.4% and 71.4%, respectively. Conclusion: We demonstrated that contrast leakage information parameter from DSC MRI showed significance in differentiating true progression from pseudoprogression in glioblastoma patients.

Plasma Amino Acid and Urine Organic Acid in Diagnosis of MELAS (멜라스 증후군 진단에서의 혈장 아미노산과 소변 유기산 분석)

  • Ji-Hoon Na;Young-Mock Lee
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.23 no.1
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    • pp.17-24
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    • 2023
  • Purpose: In the past, detection of metabolic abnormalities in plasma amino acid (PAA) and urine organic acid (UOA) has been widely used to diagnose clinical mitochondrial diseases, such as mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS). In this study, the diagnostic values of PAA and UOA were reviewed, and their effectiveness in the diagnosis of MELAS was examined retrospectively. Methods: Blood and urine samples at the time of diagnosis were collected from all clinically diagnosed MELAS patients (n=31), and PAA and UOA tests were performed. All samples were collected in a fasting state to minimize artifacts in the results. The difference in the ratio of abnormal metabolites of PAA and UOA at initial diagnosis was statistically compared between the MELAS with genetic confirmation (n=19, m.3243A>G mutation) and MELAS without genetic confirmation (n=12) groups. The MELAS without genetic confirmation group was used as control. Results: Comparison of PAA and UOA between the two groups revealed that no abnormal metabolites showed characteristic differences between gene-confirmed MELAS patients with and those without genetic confirmation. Conclusions: Abnormal values of metabolites in PAA or UOA might be useful as a screening test but are not sufficient to diagnose MELAS patients.

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Serum exosomal miR-192 serves as a potential detective biomarker for early pregnancy screening in sows

  • Ruonan Gao;Qingchun Li;Meiyu Qiu;Su Xie;Xiaomei Sun;Tao Huang
    • Animal Bioscience
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    • v.36 no.9
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    • pp.1336-1349
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    • 2023
  • Objective: The study was conducted to screen differentially expressed miRNAs in sows at early pregnancy by high-throughput sequencing and explore its mechanism of action on embryo implantation. Methods: The blood serum of pregnant and non-pregnant Landrace×Yorkshire sows were collected 14 days after artificial insemination, and exosomal miRNAs were purified for high throughput miRNA sequencing. The expression patterns of 10 differentially expressed (DE) miRNAs were validated by quantitative reverse transcription-polymerase chain reaction (qRT-PCR). The qRT-PCR quantified the abundance of serum exosomal miR-192 in pregnant and control sows, and the diagnostic power was assessed by receiver operating characteristic (ROC) analysis. The target genes of DE miRNAs were predicted with bioinformatics software, and the functional and pathway enrichment analysis was performed on gene ontology and the Kyoto encyclopedia of genes and genomes terms. Furthermore, a luciferase reporter system was used to identify the target relation between miR-192 and integrin alpha 4 (ITGA4), a gene influencing embryo implantation in pigs. Finally, the expression levels of miRNAs and the target gene ITGA4 were analyzed by qRT-PCR, and western blot, with the proliferation of BeWo cells detected by cell counting kit-8 (CCK-8). Results: A total of 221 known miRNAs were detected in the libraries of the pregnant and non-pregnant sows, of which 55 were up-regulated and 67 were down-regulated in the pregnant individuals compared with the non-pregnant controls. From these, the expression patterns of 10 DE miRNAs were validated. The qRT-PCR analysis further confirmed a significantly higher expression of miR-192 in the serum exosomes extracted from pregnant sows, when compared to controls. The ROC analysis revealed that miR-192 provided excellent diagnostic accuracy for pregnancy (area under the ROC curve [AUC]=0.843; p>0.001). The dual-luciferase reporter assay indicated that miR-192 directly targeted ITGA4. The protein expression of ITGA4 was reduced in cells that overexpressed miR-192. Overexpression of miR-192 resulted in the decreased proliferation of BeWo cells and regulated the expression of cell cycle-related genes. Conclusion: Serum exosomal miR-192 could serve as a potential biomarker for early pregnancy in pigs. miR-192 targeted ITGA4 gene directly, and miR-192 can regulate cellular proliferation.

The Concept of Continuity in Confucianism through filial piety(孝) Ethics (효(孝) 윤리를 통해 본 유가(儒家)의 연속적 사유)

  • Lee, Cheon-Sung
    • The Journal of Korean Philosophical History
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    • no.29
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    • pp.179-202
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    • 2010
  • In addition to the emphasis on filial piety ethics in everyday life, filial piety obtained a further significance in Confucianism which had the strong sense of ancestor worship. This paper focuses on filial piety as a mechanism of continuity within Confucianism and points out that it owed its development to its connection to agricultural culture. The sedentary life with less mobility forged a relative intimacy among people and filial piety was the actual expression of that kind of intimate affection. Yet, filial piety in Confucianism created a unique culture in terms that it not only stipulated material and emotional support for parents but also expected one's piety to the further ancestors through a memorial service and made its connection to the infinite posterity through sons. From the perspective of Confucianism that established filial piety at the turning point from life to death, the self existing in present was not an isolated self anymore. Yet, one can see another characteristic of Confucianism from that filial piety, based on blood bonds, could move beyond paternalism to broaden itself. It could be expanded to the care for strangers. The aged experience and wisdom through agricultural life begot the insight that the nature made its infinite connections with everything through circulation. As a stone thrown in a pond would enlarge its boundary by drawing larger and larger concentric circles, this thought enabled people to enlarge their affection to their parents to universal humanity. In this enlarged network, though it was natural to make distinctions between the closer and the farther, Confucianism sought to overcome it by establishing oneself upright. Confucianism emphasized the moral cultivation with its filial piety concept that contained the diachronic thought penetrating life and death and the broadened perspective relating everything around. In Confucianism, filial piety provided an important medium in forming a moral subject that penetrated life and death and related self and others. Inherent in it is the Confucius thought of continuity that searched for a paragon of a moral human being regardless of time and space.

Application of Near-Infrared Spectroscopy in Neurological Disorders: Especially in Orthostatic Intolerance (신경계 질환에서 근적외선분광분석법의 적용: 기립불내증을 중심으로)

  • Kim, Yoo Hwan;Paik, Seung-ho;Phillips V, Zephaniah;Seok, Hung Youl;Jeon, Nam-Joon;Kim, Beop-Min;Kim, Byung-Jo
    • Journal of the Korean neurological association
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    • v.35 no.1
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    • pp.8-15
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    • 2017
  • Near-infrared spectroscopy (NIRS), a noninvasive optical method, utilizes the characteristic absorption spectra of hemoglobin in the near-infrared range to provide information on cerebral hemodynamic changes in various clinical situations. NIRS monitoring have been used mainly to detect reduced perfusion of the brain during orthostatic stress for three common forms of orthostatic intolerance (OI); orthostatic hypotension, neurally mediated syncope, and postural orthostatic tachycardia syndrome. Autonomic function testing is an important diagnostic test to assess their autonomic nervous systems for patients with symptom of OI. However, these techniques cannot measure dynamic changes in cerebral blood flow. There are many experimentations about study of NIRS to reveal the pathophysiology of patients with OI. Research using NIRS in other neurologic diseases (stroke, epilepsy and migraine) are ongoing. NIRS have been experimentally used in all stages of stroke and may complement the established diagnostic and monitoring tools. NIRS also provide pathophysiological approach during rehabilitation and secondary prevention of stroke. The hemodynamic response to seizure has long been a topic for discussion in association with the neuronal damage resulting from convulsion. One critical issue when unpredictable events are to be detected is how continuous NIRS data are analyzed. Besides, NIRS studies targeting pathophysiological aspects of migraine may contribute to a deeper understanding of mechanisms relating to aura of migraine. NIRS monitoring may play an important role to trend regional hemodynamic distribution of flow in real time and also highlights the pathophysiology and management of not only patients with OI symptoms but also those with various neurologic diseases.

Prediction of Patient Management in COVID-19 Using Deep Learning-Based Fully Automated Extraction of Cardiothoracic CT Metrics and Laboratory Findings

  • Thomas Weikert;Saikiran Rapaka;Sasa Grbic;Thomas Re;Shikha Chaganti;David J. Winkel;Constantin Anastasopoulos;Tilo Niemann;Benedikt J. Wiggli;Jens Bremerich;Raphael Twerenbold;Gregor Sommer;Dorin Comaniciu;Alexander W. Sauter
    • Korean Journal of Radiology
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    • v.22 no.6
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    • pp.994-1004
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    • 2021
  • Objective: To extract pulmonary and cardiovascular metrics from chest CTs of patients with coronavirus disease 2019 (COVID-19) using a fully automated deep learning-based approach and assess their potential to predict patient management. Materials and Methods: All initial chest CTs of patients who tested positive for severe acute respiratory syndrome coronavirus 2 at our emergency department between March 25 and April 25, 2020, were identified (n = 120). Three patient management groups were defined: group 1 (outpatient), group 2 (general ward), and group 3 (intensive care unit [ICU]). Multiple pulmonary and cardiovascular metrics were extracted from the chest CT images using deep learning. Additionally, six laboratory findings indicating inflammation and cellular damage were considered. Differences in CT metrics, laboratory findings, and demographics between the patient management groups were assessed. The potential of these parameters to predict patients' needs for intensive care (yes/no) was analyzed using logistic regression and receiver operating characteristic curves. Internal and external validity were assessed using 109 independent chest CT scans. Results: While demographic parameters alone (sex and age) were not sufficient to predict ICU management status, both CT metrics alone (including both pulmonary and cardiovascular metrics; area under the curve [AUC] = 0.88; 95% confidence interval [CI] = 0.79-0.97) and laboratory findings alone (C-reactive protein, lactate dehydrogenase, white blood cell count, and albumin; AUC = 0.86; 95% CI = 0.77-0.94) were good classifiers. Excellent performance was achieved by a combination of demographic parameters, CT metrics, and laboratory findings (AUC = 0.91; 95% CI = 0.85-0.98). Application of a model that combined both pulmonary CT metrics and demographic parameters on a dataset from another hospital indicated its external validity (AUC = 0.77; 95% CI = 0.66-0.88). Conclusion: Chest CT of patients with COVID-19 contains valuable information that can be accessed using automated image analysis. These metrics are useful for the prediction of patient management.

Qualitative and Quantitative Magnetic Resonance Imaging Phenotypes May Predict CDKN2A/B Homozygous Deletion Status in Isocitrate Dehydrogenase-Mutant Astrocytomas: A Multicenter Study

  • Yae Won Park;Ki Sung Park;Ji Eun Park;Sung Soo Ahn;Inho Park;Ho Sung Kim;Jong Hee Chang;Seung-Koo Lee;Se Hoon Kim
    • Korean Journal of Radiology
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    • v.24 no.2
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    • pp.133-144
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    • 2023
  • Objective: Cyclin-dependent kinase inhibitor (CDKN)2A/B homozygous deletion is a key molecular marker of isocitrate dehydrogenase (IDH)-mutant astrocytomas in the 2021 World Health Organization. We aimed to investigate whether qualitative and quantitative MRI parameters can predict CDKN2A/B homozygous deletion status in IDH-mutant astrocytomas. Materials and Methods: Preoperative MRI data of 88 patients (mean age ± standard deviation, 42.0 ± 11.9 years; 40 females and 48 males) with IDH-mutant astrocytomas (76 without and 12 with CDKN2A/B homozygous deletion) from two institutions were included. A qualitative imaging assessment was performed. Mean apparent diffusion coefficient (ADC), 5th percentile of ADC, mean normalized cerebral blood volume (nCBV), and 95th percentile of nCBV were assessed via automatic tumor segmentation. Logistic regression was performed to determine the factors associated with CDKN2A/B homozygous deletion in all 88 patients and a subgroup of 47 patients with histological grades 3 and 4. The discrimination performance of the logistic regression models was evaluated using the area under the receiver operating characteristic curve (AUC). Results: In multivariable analysis of all patients, infiltrative pattern (odds ratio [OR] = 4.25, p = 0.034), maximal diameter (OR = 1.07, p = 0.013), and 95th percentile of nCBV (OR = 1.34, p = 0.049) were independent predictors of CDKN2A/B homozygous deletion. The AUC, accuracy, sensitivity, and specificity of the corresponding model were 0.83 (95% confidence interval [CI], 0.72-0.91), 90.4%, 83.3%, and 75.0%, respectively. On multivariable analysis of the subgroup with histological grades 3 and 4, infiltrative pattern (OR = 10.39, p = 0.012) and 95th percentile of nCBV (OR = 1.24, p = 0.047) were independent predictors of CDKN2A/B homozygous deletion, with an AUC accuracy, sensitivity, and specificity of the corresponding model of 0.76 (95% CI, 0.60-0.88), 87.8%, 80.0%, and 58.1%, respectively. Conclusion: The presence of an infiltrative pattern, larger maximal diameter, and higher 95th percentile of the nCBV may be useful MRI biomarkers for CDKN2A/B homozygous deletion in IDH-mutant astrocytomas.

Evaluation of Albumin Creatinine Ratio as an Early Urinary Biomarker for Chronic Kidney Disease in Dogs

  • Hyun-Min Kang;Heyong-Seok Kim;Min-Hee Kang;Jong-Won Kim;Dong-Jae Kang;Woong-Bin Ro;Doo-Won Song;Ga-Won Lee;Hee-Myung Park;Hwi-Yool Kim
    • Journal of Veterinary Clinics
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    • v.40 no.6
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    • pp.399-407
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    • 2023
  • Chronic kidney disease (CKD) occurs in more than 15% of the dogs over 10 years of age and causes irreversible renal function deterioration. Therefore, it is important to diagnose CKD early and treat the disease properly. The purpose of this study aimed to to evaluate the clinical utility of urine albumin/creatinine ratio (ACR) using POC (point-of-care) device as an early detection urinary biomarker in CKD dogs and to confirm the correlation between ACR and other known CKD biomarkers. Urine and serum samples were obtained from 50 healthy dogs and 50 dogs with CKD. Serum blood urea nitrogen (BUN), creatinine, and symmetric dimethylarginine (SDMA) concentrations, and urine protein creatinine ratio (UPC) were measured. Urine specific gravity (USG) was evaluated using refractometer, and ACR was measured using an i-SENS A1Care analyzer. The ACR values of dogs with CKD were significantly different from those of healthy dogs (p < 0.001), as with other renal biomarkers. ACR showed significant differences between healthy dogs and dogs with CKD at every IRIS stage (p < 0.005), whereas no significant differences were observed between dogs with CKD IRIS stage I and healthy dogs with UPC. There are significant positive correlation between ACR and BUN (r = 0.611, p < 0.001), creatinine (r = 0.788, p < 0.001), SDMA (r = 0.747, p < 0.001), and UPC (r = 0.784, p < 0.001), and significant negative correlation between ACR and USG (r = -0.700, p < 0.001). In receiver operator characteristic curve analysis, the area under the curve (AUC) was 0.982 (95% CI 0.963-1.000, p < 0.001), with an optimal cut-off value of 64.20 mg/g (94% sensitivity and 94% specificity). Thus, ACR is a useful urinary biomarker for the early diagnosis of proteinuria in CKD and combined use of ACR and other renal biomarkers may be helpful for early diagnosis and prevention of CKD in dogs.