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Clinicopathologic Characteristics of Trop Family Proteins (Trop-2 and EpCAM) in Gastric Carcinoma

  • Hye Sung Kim;Younghoon Kim;Hye Seung Lee
    • Journal of Gastric Cancer
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    • v.24 no.4
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    • pp.391-405
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    • 2024
  • Purpose: Trop family proteins, including epithelial cell adhesion molecule (EpCAM) and Trop-2, have garnered attention as potential therapeutic and diagnostic targets for various malignancies. This study aimed to elucidate the clinicopathological significance of these proteins in gastric carcinoma (GC) and to reinforce their potential as biomarkers for patient stratification in targeted therapies. Materials and Methods: Immunohistochemical (IHC) analyses of EpCAM and Trop-2 were performed on GC and precancerous lesions, following rigorous orthogonal validation of the antibodies to ensure specificity and sensitivity. Results: Strong membranous staining (3+) for Trop-2 was observed in 49.3% of the GC cases, whereas EpCAM was strongly expressed in almost all cases (93.2%), indicating its widespread expression in GC. A high Trop-2 expression level, characterized by an elevated H-score, was significantly associated with intestinal type by Lauren classification, gastric mucin type, presence of lymph node metastasis, human epidermal growth factor receptor 2-positivity, and Epstein-Barr virus (EBV)-positivity. Patients with a high Trop-2 expression level exhibited poorer survival outcomes on univariate and multivariate analyses. High EpCAM expression levels were prevalent in differentiated histologic type, microsatellite instability-high, and EBV-negative cancer, and were correlated with high densities of CD3 and CD8 T cells and elevated combined positive score for programmed death-ligand 1. Conclusions: These results highlight the differential expression of Trop-2 and EpCAM and their prognostic implications in GC. The use of meticulously validated antibodies ensured the reliability of our IHC data, thereby offering a robust foundation for future therapeutic strategies targeting Trop family members in GC.

Evaluating the Accuracy of Artificial Intelligence-Based Chatbots on Pediatric Dentistry Questions in the Korean National Dental Board Exam

  • Yun Sun Jung;Yong Kwon Chae;Mi Sun Kim;Hyo-Seol Lee;Sung Chul Choi;Ok Hyung Nam
    • Journal of the korean academy of Pediatric Dentistry
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    • v.51 no.3
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    • pp.299-309
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    • 2024
  • This study aimed to assess the competency of artificial intelligence (AI) in pediatric dentistry and compare it with that of dentists. We used open-source data obtained from the Korea Health Personnel Licensing Examination Institute. A total of 32 item multiple-choice pediatric dentistry exam questions were included. Two AI-based chatbots (ChatGPT 3.5 and Gemini) were evaluated. Each chatbot received the same questions seven times in separate chat sessions initiated on April 25, 2024. The accuracy was assessed by measuring the percentage of correct answers, and consistency was evaluated using Cronbach's alpha coefficient. Both ChatGPT 3.5 and Gemini demonstrated similar accuracy, with no significant differences observed between them. However, neither chatbot achieved the minimum passing score set by the Pediatric Dentistry National Examination. However, both chatbots exhibited acceptable consistency in their responses. Within the limits of this study, both AI-based chatbots did not sufficiently answer the pediatric dentistry exam questions. This finding suggests that pediatric dentists should be aware of the advantages and limitations of this new tool and effectively utilize it to promote patient health.

Meta-analysis of pancreatic re-resection for locally recurrent pancreatic cancer following index pancreatectomy

  • Shahin Hajibandeh;Shahab Hajibandeh;Daisy Evans;Tejinderjit S. Athwal
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.3
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    • pp.315-324
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    • 2024
  • The role of surgical resection in patients with recurrent pancreatic cancer is unclear. We aimed to evaluate the survival outcomes of pancreatic re-resection for locally recurrent pancreatic cancer following index pancreatectomy. A literature search was carried out in CENTRAL, EMBASE, MEDLINE, CINAHL, and Web of Science. Proportion meta-analysis model was constructed to quantify 1 to 5-year survival after pancreatic re-resection for locally recurrent pancreatic cancer. Random-effects modelling was applied to calculate pooled outcome data. Fifteen retrospective studies were included, reporting a total of 250 patients who underwent pancreatic re-resection for locally recurrent pancreatic cancer following their index pancreatectomy. Pancreatic re-resection was associated with 1-year survival 70.6% (95% confidence interval [CI], 65.0-76.2), 2-year survival 38.8% (95% CI, 28.6-49.0), 3-year survival 20.2% (95% CI, 13.8-26.7), and 5-year survival 9.2% (95% CI, 5.5-12.8). The between-study heterogeneity was insignificant in all outcome syntheses. Repeat pancreatectomy for local recurrence of pancreatic cancer in the remnant pancreas following the index pancreatectomy is associated with acceptable overall patient survival. We recommend selective re-resection of such recurrences in younger patients with favorable tumor size and location. Our findings may encourage more robust studies to be conducted in this context to provide stronger evidence.

Assessment of mechanical allodynia in healthy teeth adjacent and contralateral to endodontically diseased teeth: a clinical study

  • Vaishnavi Ratnakar Patankar;Ashish K Jain;Rahul D Rao;Prajakta R Rao
    • Restorative Dentistry and Endodontics
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    • v.49 no.3
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    • pp.31.1-31.11
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    • 2024
  • Objectives: The present study investigated the prevalence of mechanical allodynia (MA) in healthy teeth adjacent and contralateral to endodontically diseased teeth. Materials and Methods: This cross-sectional study included 114 patients with symptomatic irreversible pulpitis and apical periodontitis in permanent mandibular first molars who possessed healthy teeth adjacent and contralateral to the endodontically diseased tooth. The mechanical sensitivity of the teeth was determined by percussion testing. The presence or absence of pain on percussion in the teeth adjacent and contralateral to the endodontically diseased tooth and the tooth distal to the contralateral symmetrical tooth was recorded according to coding criteria. The prevalence of MA was computed as a percentage, and binary logistic regression analysis was done. The Fisher exact test and Mann-Whitney U test were used for binary and ordinal data. Results: Age and sex did not influence the prevalence of MA. An increased prevalence of MA was found in patients with higher levels of spontaneous pain (p < 0.001). The prevalence of allodynia was 57% in teeth adjacent to endodontically diseased teeth and 10.5% in teeth contralateral to endodontically diseased teeth. In addition, on the ipsilateral side, there were more painful sensations distal to the diseased tooth than mesially. Conclusions: Despite being disease-free, teeth adjacent and contralateral to endodontically diseased teeth exhibited pain on percussion. There was a direct association between the severity of the patient's pain and the presence of MA.

The Analysis of Disease Distribution of patients discharged from a general hospital in a farming and fishing village region (일개 종합병원을 이용한 농.어촌지역 퇴원환자의 질병분포에 관한 연구)

  • Yu, Eun-Yeong;Kim, Youl
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.12
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    • pp.4863-4872
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    • 2010
  • This study examined the disease conditions of patients from a farming and fishing village area. In order to analyze the medical service utilization, the necessary data were obtained from established health and medical care service plans from medical treatment related organizations. The following results were based on the analysis of data from the medical records of 2,365 discharged patients during a six months period from July to December 2009 at a general hospital in an aging farming and fishing village area. Results: The sex of the patients investigated was male 55.3%, female 44.7%, and the most frequent age category at 42.0% was 70 years of age or older. Based on type of hospital admission, 65.5% of patients who were admitted were originally outpatients. Patients were admitted according to the following departments: 49.7% for the department of internal medicine, 16.7% for the department of orthopedics, and 13.8% for the department of neurosurgery. The average number of days hospitalized was 14.8 days. The following ranks the principal diagnosis among patients in this study: S00-T98 18.4%, J00-J99 15.5%, and I00-I99 11.5%. The average number of diagnosis listed per patient was 5.6. There was a statistically significant difference for the following general characteristics according to principal diagnosis list: gender, type of insurance, admission process, and age category distribution had statistically significant differences. Monthly distribution of principal diagnoses were statistically significant difference. There was a statistically significant difference for principal diagnosis lists according to the average number of days admitted and the number of diagnosis. The results of this study showed the types of disease from typical farming and fishing village regions as disease from external injury due to the work environment of farming and fishing village regions and excessive labor throughout the year, respiratory disease, and various chronic disease from aging.

A Study of Image Quality Improvement Through Changes in Posture and Kernel Value in Neck CT Scanning (경부 CT검사 시 Kernel 값과 검사자세 변화를 통한 화질개선에 관한 연구)

  • Kim, Hyeon-Ju;Chung, Woo-Jun;Cho, Jae-Hwan
    • Journal of the Korean Society of Radiology
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    • v.5 no.2
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    • pp.59-66
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    • 2011
  • There is a difficulty because of classifying the anatomical structure in the neck CT scan by the beam hardening artifact no more than disease and it including the 6, 7 number cervical spine and intervertebral disk. In case of enforcing the neck CT scan cause of the inner diameter of beam artifact tried to be inquired by the image evaluation according to the change of the image evaluation according to the direction of the shoulder joint applying the variation method of a posture and location and Kernel value and it was most appropriate, the lion tax and Kernel value try to be searched for through an experiment. Somatom Sensation 16 (Siemens, Enlarge, Germany) equipment was used in a patient 30 people coming to the hospital for the neck CT scan. A workstation used the AW 4.4 version (GE, USA). According to a direction and location of the shoulder joint, the patient posture gave a change to the direction of the shoulder joint as the group S it gave a change as three postures and placed the both arms comfortably and helps a group N and augmented unipolar left in the wealthy merchant and group P it memorized the both hands and ordered the eversion and drops below to the utmost and enforced a scan. By using a reconstructing method as the second opinion, it gave and reconstructed the Kernel value a change based on scan data with B 10 (very smooth), B 20 (smooth), B 30 (medium smooth), B 40 (medium), B 50 (medium sharp), B 60 (sharp), and B 70 (very sharp). By using image data which gave the change of the examination posture and change of the Kernel value and are obtained, we analyzed through the noise value measurement and image evaluation of. The outside wire eversion orders the both hands and the examination posture is cost in the neck CT scan with the group P it drops below to the utmost. And in case of when reconstructing with B 40 (medium) or B 50 (medium sharp) being most analyzed into the inappropriate posture and Kernel value and applying the Kernel value to a clinical, it is considered to be very useful.

A study on the implementation of Medical Telemetry systems using wireless public data network (무선공중망을 이용한 의료 정보 데이터 원격 모니터링 시스템에 관한 연구)

  • 이택규;김영길
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2000.10a
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    • pp.278-283
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    • 2000
  • As information communication technology developed we could check our blood pressure, pulsation electrocardiogram, SpO2 and blood test easily at home. To check our health at ordinary times is able though interlocking the house medical instrument with the wireless public data network This service will help the inconvenience to visit the hospital everytime and will save the individual's time and cost. In each house an organism data which is detected from the human body will be transmitted to the distance hospital and will be essentially applied through wireless public data network The medical information transmit system is utilized by wireless close range network It would transmit the obtained organism signal wirelessly from the personal device to the main center system in the hospital. Remote telemetry system is embodied by utilizing wireless media access protocol. The protocol is embodied by grafting CSMA/CA(Carrier Sense Multiple Access with Collision Avoidance) protocol falling mode which is standards from IEEE 802.11. Among the house care telemetry system which could measure blood pressure, pulsation, electrocardiogram, SpO2 the study embodies the ECC(electrocardiograph) measure part. It within the ECC function into the movable device and add 900㎒ band wireless public data interface. Then the aged, the patients even anyone in the house could obtain ECG and keep, record the data. It would be essential to control those who had a health-examination heart diseases or more complicated heart diseases and to observe the latent heart disease patient continuously. To embody the medical information transmit system which is based on wireless network. It would transmit the ECG data among the organism signal data which would be utilized by wireless network modem and NCL(Native Control Language) protocol to contact through wireless network Through the SCR(Standard Context Routing) protocol in the network it will be connected to the wired host computer. The computer will check the recorded individual information and the obtained ECC data then send the correspond examination to the movable device. The study suggests the medical transmit system model utilized by the wireless public data network.

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Cost-Benefit Analysis on Rubella Vaccination Policy (풍진 예방접종사업의 비용-편익분석)

  • Shin, Young-Jeon;Choi, Bo-Youl;Park, Hung-Bae;Moon, Ok-Ryun;Yoon, Bae-Joong
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.337-365
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    • 1994
  • Rubella is a viral disease with mild constitutional symptoms and generalized rashes. In childhood, it is an inconsequential illness, but when it occurs during early pregnant period, there are significant risks of heart defects, cataract, mental retardation to the fetus. The series of congenital defects induced by rubella is called 'congenital rubella syndrome'. Many research have been performed to find out more effective prevention program on rubella. The objectives of this study are, first, to calculate the incidence rate of acute rubella infection and congenital rubella syndrome in Korea, second, to evaluate economic efficiency of several rubella vaccination policies and to offer data for the most reasonable decision on vaccination policy. Study populations are 663,312 children of one year-old in 1992. The author has performed cost-benefit analyses according to the three vaccination policies-U.S.A.'s. U.K.'s and Sweden's. In this Study, the author got the incidence rate of acute rubella infection using the catalytic model. In the meantime, the author used 50 per 100,000 live births as the incidence rate of congenital rubella syndrome. The discount rate used in this study was 5 percent per annum. The sensitivity analyses were done with different discount rates (4%, 7%) and different incidence rate of congenital rubella syndrome (10,100 per 100,000 live births) : The study results are as follows: 1. Without vaccination, lifetime expenditures per patient for acute rubella infeciton amount to 14,822 won and the total expenditures to about 3.1 billion won. Meanwhile, lifetime expenditures per patient for congenital rubella syndrome amount to about 91 million won and the total expenditures to about 16.3 billion won without vaccination. 2. The cost of vaccination for a child of one year old was 2,322 won and the total cost for the one year old children was about 1.5 billion won (American style). The cost for vaccination of female children at fifteen was about 339 million won (Birtish style). And the cost of vaccination at one for both sex and female children at fifteen was about 1.9 billion won (Swedish style). 3. The benefit to cost ratios of vaccination of female children at fifteen that is the british mode of rubella vaccination, was 60.0 at the level of 80% population coverage and 48.6 at 100% coverage. It shows much higher benefit to cost ratio than those of the other two vaccination policies. 4. Both net benefits of vaccination at one (American style) and that of vaccinations at one and fifteen (Swedish style) range from about 17.0 billion to 17.8 billion won, those were larger than that of vaccinations of female children at fifteen (Birtish style, about 16.0 billion). 5. In marginal cost-benefit analysis of only additional program of revaccination, the benefit to cost ratios were 3.6 (80% coverage rate) or 0.6 (100% coverage rate). It implies that additional program was less efficient or inefficient. 6. In sensitivity analysis with different discount rates(4% or 7%) and different incidence rates of congenital rubella syndrome (10 or 100 per 100,000 live births), the benefit to cost ratios has fluctuated in wide range. However, all the ratios of vaccination of female children at fifteen were higher than those of the others. Even under the most conservative assumption, the benefit to cost ratios of all the rubella vaccination policies were higher than 3.3. In conclusion, all the rubella vaccination policies found to be cost-effective and particularly the vaccination of female children at fifteen was strongly recommended.

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Peritoneal Dialysis Associated Peritonitis and Empirical Antibiotics Therapy in Korean Children with Chronic Renal Failure (소아 복막 투석 환자에서 발생한 복막염의 경험적 항생제 치료에 관한 연구)

  • Lee, Sang-Goo;Cho, Joong-Bum;Sohn, Young-Bae;Park, Sung-Won;Kim, Su-Jin;Jin, Dong-Kyu;Paik, Kyung-Hoon
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.213-220
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    • 2008
  • Purpose : This study aims to verify the effectiveness of initial empirical antibiotic choice recommended by the International Society for Peritoneal Dialysis(ISPD) guide among Korean children. Methods : We have collected data on peritonitis from January 2001 to December 2007 in Samsung Medical Center. Results : Of the 42 patients, 48 episodes of peritonitis had occurred in 21 patients. The rate of peritonitis was one episode over 35.3 patient-months. Mean dialysis duration before peritonitis was 18.06$\pm$15.81 months. Gram-positive organisms accounted for 58.3% of all episodes. Of the gram-positive organisms, the most common pathogen was Staphylococcus aureus(29.2%), the next common pathogens were Coagulase negative staphylococcus(14.6%) and Streptococcus species(6.3%). 35.7% of gram-positive pathogens were resistant to 1st cephalosporin. However, in patients younger than 4 years old, 50% of gram-positive pathogens were resistant to 1st generation cephalosporin. 10 episodes of peritonitis were methicillin-resistant and were treated by vancomycin. Of the gram-negative organisms, E. coli was the most common (8.3%). 64.8% of all pathogens were sensitive to cephalothin or ceftazidime. Conclusion : The empirical therapy with 1st generation cephalosporin and ceftazidime can be also effective to peritoneal dialysis associated peritonitis in Korean children. However, in patients younger than 4 years old, glycopeptide should be considered as the first empirical therapy in Korean children.

Comparison Research of Clinical Effect of Eastern and Western Medical Treatment on Frozen Shoulder Patients (동결견(凍結肩) 환자의 동서협진 치료의 임상효과 비교연구 - 견관절 가동운동범위(ROM) 변화를 중심으로 -)

  • Nam, Dong-Woo;Kim, Haeng-Beom;Yang, Dong-Hoon;Lim, Sa-Bi-Na;Kim, Keon-Sik;Lee, Doo-Ik;Lee, Jae-Dong;Choi, Do-Young;Lee, Yun-Ho
    • Journal of Acupuncture Research
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    • v.23 no.5
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    • pp.105-113
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    • 2006
  • Objectives : To establish an effective collaborate medicine treatment of acupuncture and western medicine for treating frozen shoulder patients. Methods : 59 voluntary patients were randomly assigned to Eastern treatment group(E group, n=22), Western treatment group(W group, n=17) and East-West treatment group(EW group, n=20). The E group received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. The EW group received acupuncture and injection treatment including nerve block All groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after treatment based on the change in shoulder Range of Motion(ROM) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). The obtained data were analyzed and compared. Results : The patient's satisfaction scores were E group 5.67, W group 7.73 and EW group 7.67. The E group and the EW group showed significant improvement in abbduction, adduction and flexion(p<0.05). The W group showed significant improvement in adduction(p<0.05). Abduction significantly improved(p<0.05) in the EW group compared to E group and W group. Flexion also showed improvement in the EW group, but the difference among the 3 groups was statistically insignificant. The three group's difference of change in extension and adduction was insignificant(p>0.05). Conclusion : Acupuncture and nerve block alone significantly improved ROM in frozen shoulder patients. Also collaborate treatment of acupuncture and nerve block significantly improved ROM in frozen shoulder patients. But the difference of the three treatments were significant only for improving abduction(p<0.05).

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