• Title/Summary/Keyword: Medical AI

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Vitamin D Sufficiency: How Should it be Defined and what are its Functional Indicators?

  • Hollis Broce W.
    • Nutritional Sciences
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    • v.8 no.2
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    • pp.111-117
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    • 2005
  • It has been more than three decades since the first assay assessing circulating 25 (OH)D in human subjects was performed That publication as well as several that followed it defined 'normal' nutritional vitamin D status in human populations. Recently, the wisdom by which 'normal' circulating 25 (OH)D levels in human subjects were assigned in the past has come under question. It appears that sampling human subjects, who appear to be free from disease, and assessing 'normal' circulating 25 (OH)D levels by plotting a Gaussian distribution is grossly inaccurate. There are many reasons why this method is inaccurate, including race, lifestyle habits, sunscreen usage, age, latitude, and inappropriately low dietary recommendations for vitamin D. For instance, a 400 IU/day. AI for vitamin D is insignificant when one considers that a 10-15 minute whole body exposure to peak summer sun will generate and release up to 20,000 IU vitamin $D_3$ into the circulation. Recent studies, which orally administered up to 10,000 IU/day vitamin $D_3$ to human subjects for several months, have successfully elevated circulating 25 (OH)D levels to those observed in individuals from sun-rich environments. Further, we are now able to accurately assess sufficient circulating 25 (OH)D levels utilizing specific biomarkers instead of guessing what an adequate level is. These biomarkers include intact parathyroid hormone (PTH), calcium absorption, bone mineral density (BMD), insulin resistance and pancreatic beta cell function. Using the data from these biomarkers, vitamin D deficiency should be defined as circulating levels of 25 (OH)D$\leq$30 ng/mL. In certain cases, such as pregnancy and lactation, significantly higher circulating 25 (OH)D levels would almost certainly be beneficial to both the mother and recipient fetus/infant.

The Effect of Backrest Elevation Education on ICU Nurse's Knowledge, Perception and Performance (침상각도 상승 교육에 대한 중환자실 간호사의 지식, 인식 및 수행 정도)

  • Lee, Hyun Sim;Park, Young Woo;Kim, Jung Yeon;Lee, Eun Sook;Park, Ai Soon;Han, A Reum;Kim, Eun A;Lee, Ho Sun;Koh, Shin Ok
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.3
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    • pp.117-128
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    • 2008
  • Purpose: This study was conducted to examine the differences of knowledge, perception, and performance between the points of time before and after ICU nurses had the backrest elevation education. Method: The study subjects were 58 nurses at a medical and surgical ICU of one general Y hospital located in Seoul. They received the education, including backrest elevation guideline and related education materials. Data were collected from May 11 throughout August 12, 2007 with a structured questionnaire. Results: 1) There were significant differences in the mean scores of knowledge(2.21 at pre-education, 5.24 at post-education), perception(36.96 at pre-education, 53.36 at post-education), and performance(32.08 at pre-education, 43.51 at post-education), 2) There was a significant correlation between nurse's perception and performance (p=.000). 3) The nurse's perception regarding the importance of the back rest elevation education was significantly effective on their performance (p=.000). Conclusion: The backrest elevation education would contribute to improve ICU nurse's knowledge, perception and performance. The more the nurses would consider the importance of this education, the better they would perform the nursing intervention of backrest elevation.

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Clinical Significance of Atypical Squamous Cells of Undetermined Significance among Patients Undergoing Cervical Conization

  • Nishimura, Mai;Miyatake, Takashi;Nakashima, Ayaka;Miyoshi, Ai;Mimura, Mayuko;Nagamatsu, Masaaki;Ogita, Kazuhide;Yokoi, Takeshi
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8145-8147
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    • 2016
  • Background: Atypical squamous cells of undetermined significance (ASCUS) feature a wide variety of cervical cells, including benign and malignant examples. The management of ASCUS is complicated. Guidelines for office gynecology in Japan recommend performing a high-risk human papillomavirus (HPV) test as a rule. The guidelines also recommend repeat cervical cytology after 6 and 12 months, or immediate colposcopy. The purpose of this study was to determine the clinical significance of ASCUS. Materials and Methods: Between January 2012 and December 2014, a total of 162 patients underwent cervical conization for cervical intraepithelial neoplasia grade 3 (CIN3), carcinoma in situ, squamous cell carcinoma, microinvasive squamous cell carcinoma, and adenocarcinoma in situ at our hospital. The results of cervical cytology prior to conization, the pathology after conization, and high-risk HPV testing were obtained from clinical records and analyzed retrospectively. Results: Based on cervical cytology, 31 (19.1%) of 162 patients were primarily diagnosed with ASCUS. Among these, 25 (80.6%) were positive for high-risk HPV, and the test results of the remaining 6 patients (19.4%) were uncertain. In the final pathological diagnosis after conization, 27 (87.1%) and 4 patients (12.9%) were diagnosed with CIN3 and carcinoma in situ, respectively. Conclusions: Although ASCUS is known as a low-risk abnormal cervical cytology, approximately 20% of patients who underwent cervical conization had ASCUS. The relationship between the cervical cytology of ASCUS and the final pathological results for CIN3 or invasive carcinoma should be investigated statistically. In cases of ASCUS, we recommend HPV tests or colposcopic examination rather than cytological follow-up, because of the risk of missing CIN3 or more advanced disease.

Preliminary Application of Synthetic Computed Tomography Image Generation from Magnetic Resonance Image Using Deep-Learning in Breast Cancer Patients

  • Jeon, Wan;An, Hyun Joon;Kim, Jung-in;Park, Jong Min;Kim, Hyoungnyoun;Shin, Kyung Hwan;Chie, Eui Kyu
    • Journal of Radiation Protection and Research
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    • v.44 no.4
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    • pp.149-155
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    • 2019
  • Background: Magnetic resonance (MR) image guided radiation therapy system, enables real time MR guided radiotherapy (RT) without additional radiation exposure to patients during treatment. However, MR image lacks electron density information required for dose calculation. Image fusion algorithm with deformable registration between MR and computed tomography (CT) was developed to solve this issue. However, delivered dose may be different due to volumetric changes during image registration process. In this respect, synthetic CT generated from the MR image would provide more accurate information required for the real time RT. Materials and Methods: We analyzed 1,209 MR images from 16 patients who underwent MR guided RT. Structures were divided into five tissue types, air, lung, fat, soft tissue and bone, according to the Hounsfield unit of deformed CT. Using the deep learning model (U-NET model), synthetic CT images were generated from the MR images acquired during RT. This synthetic CT images were compared to deformed CT generated using the deformable registration. Pixel-to-pixel match was conducted to compare the synthetic and deformed CT images. Results and Discussion: In two test image sets, average pixel match rate per section was more than 70% (67.9 to 80.3% and 60.1 to 79%; synthetic CT pixel/deformed planning CT pixel) and the average pixel match rate in the entire patient image set was 69.8%. Conclusion: The synthetic CT generated from the MR images were comparable to deformed CT, suggesting possible use for real time RT. Deep learning model may further improve match rate of synthetic CT with larger MR imaging data.

Prognosis and Clinicopathology of CXCR4 in Colorectal Cancer Patients: a Meta-analysis

  • Li, Lu-Ning;Jiang, Kai-Tong;Tan, Peng;Wang, Ai-Hua;Kong, Qing-Yin;Wang, Cui-Yue;Lu, Hua-Rong;Wang, Jing
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.4077-4080
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    • 2015
  • The chemokine receptor 4 (CXCR4) has been widely used in diagnosis and prognosis of colorectal cancer (CRC). However, there is no current consensus on the impact of CXCR4 on CRC patients. The purpose of this study was to evaluate the prognostic and clinicopathological importance of CXCR4 in CRC patients. Databases, such as PubMed, Cochrane library, CBM and EMBASE updated to 2014 were searched to include eligible articles. We analysed correlations between CXCR4 expression and clinicopathological features and overall survival (OS). A total of 1, 055 CRC patients from twelve studies were included in the study. The pooled odds ratios (ORs) which indicated CXCR4 expression was likely to be associated with TNM stage (OR=0.43, CI=0.34-0.55, P<0.00001), lymph node status (OR=2.23, CI=1.23-4.05, P=0.008) and vascular invasion (OR=2.21, CI=1.11-4.39, P=0.02). Poor overall survival of CRC cancer was found to be significantly related to CXCR4 overexpression (hazard ratio (HR) 1.36 CI=1.17-1.59, P<0.0001), whereas combined ORs revealed that CXCR4 expression had no correlation with gender or differentiation. Based on the published studies, CXCR4 overexpression in patients w ith CRC indicates poor survival outcome and clinicopathological factors.

Fucosyltransferase IV Enhances Expression of MMP-12 Stimulated by EGF via the ERK1/2, p38 and NF-kB Pathways in A431Cells

  • Yang, Xue-Song;Liu, Shui-Ai;Liu, Ji-Wei;Yan, Qiu
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1657-1662
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    • 2012
  • Fucosyltransferase IV (FUT4) has been implicated in cell adhesion, motility, and tumor progression in human epidermoid carcinoma A431 cells. We previously reported that it promotes cell proliferation through the ERK/MAPK and PI3K/Akt signaling pathways; however, the molecular mechanisms underlying FUT4-induced cell invasion remain unknown. In this study we determined the effect of FUT4 on expression of matrix metalloproteinase (MMP)-12 induced by EGF in A431 cells. Treatment with EGF resulted in an alteration of cell morphology and induced an increase in the expression of MMP-12. EGF induced nuclear translocation of nuclear factor kB (NF-${\kappa}B$) and resulted in phosphorylation of $IkB{\alpha}$ in a time-dependent manner. In addition, ERK1/2 and p38 MAPK were shown to play a crucial role in mediating EGF-induced NF-${\kappa}B$ translocation and phosphorylation of $I{\kappa}B{\alpha}$ when treated with the MAPK inhibitors, PD98059 and SB203580, which resulted in increased MMP-12 expression. Importantly, we showed that FUT4 up-regulated EGF-induced MMP-12 expression by promoting the phosphorylation of ERK1/2 and p38 MAPK, thereby inducing phosphorylation/degradation of $I{\kappa}B{\alpha}$, NF-${\kappa}B$ activation. Base on our data, we propose that FUT4 up-regulates expression of MMP-12 via a MAPK-NF-${\kappa}B$-dependent mechanism.

Vitamin D Sufficiency: How should it be defined and what are its functional indicators?

  • Hollis Bruce W.
    • Proceedings of the Korean Nutrition Society Conference
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    • 2004.11a
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    • pp.22-33
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    • 2004
  • It has been more than three decades since the first assay assessing circulating 25(OH)D in human subjects was performed. That publication as well as several that followed it defined 'normal' nutritional vitamin D status in human populations. Recently, the wisdom by which 'normal' circulating 25(OH)D levels in human subjects were assigned in the past has come under question. It appears that sampling human subjects, who appear to be free from disease, and assessing 'normal' circulating 25(OH)D levels by plotting a Gaussian distribution is grossly inaccurate. There are many reasons why this method is inaccurate, including race, lifestyle habits, sunscreen usage, age, latitude, and inappropriately low dietary recommendations for vitamin D. For instance, a 400IU/day. AI for vitamin D is insignificant when one considers that a 10-15 minute whole body exposure to peak summer sun will generate and release up to 20,000 IU vitamin $D_3$ into the circulation. Recent studies, which orally administered up to 10,000 IU/day vitamin $D_3$ to human subjects for several months, have successfully elevated circulating 25(OH)D levels to those observed in individuals from sun-rich environments. Further, we are now able to accurately assess sufficient circulating 25(OH)D levels utilizing specific biomarkers instead of guessing what an adequate level is. These biomarkers include intact parathyroid hormone (PTH), calcium absorption, bone mineral density (BMD), insulin resistance and pancreatic beta cell function. Using the data from these biomarkers, vitamin D deficiency should be defined as circulating levels of $25(OH)D{\leq}30ng/mL$. In certain cases, such as pregnancy and lactation, significantly higher circulating 25(OH)D levels would almost certainly be beneficial to both the mother and recipient fetus/infant.

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A COMPARISON OF ACCURACY BETWEEN FIXTURE IMPRESSION AND ABUTMENT IMPRESSION FOR DENTAL IMPLANTS (치과 임플랜트용 고정체 인상법과 지대원주 인상법간의 정확성 비교)

  • Choi, Hyun-Sik;Yim, Soon-Ho;Cho, In-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.35 no.4
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    • pp.662-673
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    • 1997
  • The purpose of this study was to compare the accuracy between future impression and abutment impression using strain gauges. The master model used in this study was a partially edentulous mandibular metal cast with two fixture analogs on both sides. On the left, two future analogs were parallel, whereas right side, posterior future analog exhibiting a 15-degree lingual inclination. From master cast, 10 impressions were made for each of the three impression methods. The master frameworks was fabricated on the master model, and two-element strain gauge was attached to a master framework. The master framework was seated on each cast, and gold screws were tightened to 10 Ncm using a torque controller AI-1600 strain measurement system was used for strain measuring. Impression methods studied were : Group 1:abutment impression Group 2:fixture impression Group 3:combined impression (anterior:fixture impression, posterior:abutment impression) The results were as followed. 1. The strain values on X-axis and Y-axis according to the three impression methods showed no significant difference. 2. The strain values on parallel and angulated groups according to the three impression methods showed no significant difference. 3. The parallel group exhibited significantly higher accuracy in adaptation than angulated group for all experimental groups (p<0.05). In conclusion, it is considered that accuracy of implant prostheses is more affected by implant angulation than impression methods.

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Constitutive Expression and Changes of Cytochrome P450 Isozymes mRNAs by Vehicles (Petrolatum, DMSO, Ethanol) in Rat Skin Using Semi-quantitative RT-PCR

  • Lee, Ai-Young;Lee, Kyung-Hoon;Ko, Duck-Sung;Chey, Won-Young
    • The Korean Journal of Physiology and Pharmacology
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    • v.5 no.5
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    • pp.407-412
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    • 2001
  • Many drugs are primarily metabolized by the cytochrome P450s (CYPs). Drug metabolites would be important allergens for adverse drug reactions such as drug eruptions. Skin tests with a suspected drug have conducted to identify causative drugs of drug eruptions, with vehicles such as white petrolatum, DMSO, ethanol. This study will compare the expression of rat CYP isozyme mRNAs between the skin and the liver, with examining an effect of the vehicles on the cutaneous CYPs using semi-quantitative RT-PCR. Thirty-two Sprague-Dawley rats between the ages of six and eight weeks were divided as four groups. One group was used to compare the constitutive mRNA expression between skin and liver, while the others were to examine the effects of three vehicles. The ratios of expression of CYP1A2, CYP2B1/2, CYP2E1, CYP3A1, and CYP4A1 were significantly higher in the liver than the skin. However, CYP1A1 and CYP2C11 were higher in the skin than liver. The effects of vehicles were quite different; white petrolatum significantly induced CYP1A1 (p=0.012) and CYP2C11 mRNAs, while ethanol inhibited CY P1A1 and CYP2B1/2. DMSO did not make any changes. The results suggest that rat skin can participate in drug metabolism with their own CYP isozymes. The effects of vehicles on the cutaneous CYP expression should not be ignored and may be applied for determination of an appropriate vehicle for certain drug(s).

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Effect of Bee Venom Acupuncture on the Recovery of Chondrocyte Phenotype in Rabbit Cartilage (봉독약침이 연골세포 활성에 미치는 영향)

  • Zhao Mei-Ai;Lee Seung-Ki;Kim Gun-Ho;Choi Sun-Mi;Shim In-Sop;Kang Sung-Keel;Lee Hye-Jung;Hahm Dae-Hyun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.5
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    • pp.1251-1255
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    • 2005
  • Articular cartilage is an important factor for studying the arthritic diseases. The chondrocyte isolated from cartilage has the characieristic of differentiation and rf-differentiation when cultured in monolayer The bee venom (BV) acupuncture was investigated to examine their abilities on chondrocyte re-differentiation via rabbit chondrocyte primary culture. And the expression profiles of type II collagen (COL2) was analyzed using RT-PCR and western hybridization at third passage chondrocyte. In general, the mRNA expression of type II collagen was reduced step by step with the subculture of the chondrocyte. However, after the BV treatment for 48hr at third passage, the expressions of type II collagen were found to be significantly up-regulated, the same result was confirmed by western blotting. These results suggested that the diluted solution of BV for herb-acupuncture was very effective on the recovery of articular chondrocyte phenotype.