• Journal of Pathology and Translational Medicine
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• v.52 no.6
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• pp.396-403
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• 2018

Background: In the current American Joint Committee on Cancer staging system of breast cancer, only tumor size determines T-category regardless of whether the tumor is single or multiple. This study evaluated if tumor multiplicity has prognostic value and can be used to subclassify breast cancer. Methods: We included 5,758 patients with invasive breast cancer who underwent surgery at Samsung Medical Center, Seoul, Korea, from 1995 to 2012. Results: Patients were divided into two groups according to multiplicity (single, n=4,744; multiple, n=1,014). Statistically significant differences in lymph node involvement and lymphatic invasion were found between the two groups (p<.001). Patients with multiple masses tended to have luminal A molecular subtype (p<.001). On Kaplan-Meier survival analysis, patients with multiple masses had significantly poorer disease-free survival (DFS) (p=.016). The prognostic significance of multiplicity was seen in patients with anatomic staging group I and prognostic staging group IA (p=.019 and p=.032, respectively). When targeting patients with T1-2 N0 M0, hormone receptor-positive, and human epidermal growth factor receptor 2 (HER2)-negative cancer, Kaplan-Meier survival analysis also revealed significantly reduced DFS with multiple cancer (p=.031). The multivariate analysis indicated that multiplicity was independently correlated with worse DFS (hazard ratio, 1.23; 95% confidence interval, 1.03 to 1.47; p=.025). The results of this study indicate that tumor multiplicity is frequently found in luminal A subtype, is associated with frequent lymph node metastasis, and is correlated with worse DFS. Conclusions: Tumor multiplicity has prognostic value and could be used to subclassify invasive breast cancer at early stages. Adjuvant chemotherapy would be necessary for multiple masses of T1-2 N0 M0, hormone-receptor-positive, and HER2-negative cancer.

• Tuberculosis and Respiratory Diseases
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• v.84 no.4
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• pp.282-290
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• 2021

Background: Radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB) has improved the diagnostic yield of bronchoscopic biopsy of peripheral pulmonary lesions (PPLs). The diagnostic yield and complications of RP-EBUS-TBLB for PPLs vary depending on the technique, such as using a guide sheath (GS) or fluoroscopy. In this study, we investigated the utility of RP-EBUS-TBLB using a GS without fluoroscopy for diagnosing PPLs. Methods: We retrospectively reviewed data from 607 patients who underwent RP-EBUS of PPLs from January 2019 to July 2020. TBLB was performed using RP-EBUS with a GS without fluoroscopy. The diagnostic yield and complications were assessed. Multivariable logistic regression analyses were used to identify factors affecting the diagnostic yields. Results: The overall diagnostic accuracy was 76.1% (462/607). In multivariable analyses, the size of the lesion (≥20 mm; odds ratio [OR], 2.06; 95% confidence interval [CI], 1.27-3.33; p=0.003), positive bronchus sign in chest computed tomography (OR, 2.30; 95% CI, 1.40-3.78; p=0.001), a solid lesion (OR, 2.40; 95% CI, 1.31-4.41; p=0.005), and an EBUS image with the probe within the lesion (OR, 6.98; 95% CI, 4.38-11.12; p<0.001) were associated with diagnostic success. Pneumothorax occurred in 2.0% (12/607) of cases and chest tube insertion was required in 0.5% (3/607) of patients. Conclusion: RP-EBUS-TBLB using a GS without fluoroscopy is a highly accurate diagnostic method in diagnosing PPLs that does not involve radiation exposure and has acceptable complication rates.

• The Journal of the Korea institute of electronic communication sciences
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• v.16 no.4
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• pp.591-598
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• 2021

The digital phase-locked loops(DPLL) is a circuit used for phase synchronization and has been generally used in various fields such as communication and circuit fields. State estimators are used to design digital phase-locked loops, and infinite impulse response state estimators such as the well-known Kalman filter have been used. In general, the performance of the infinite impulse response state estimator-based digital phase-locked loop is excellent, but a sudden performance degradation may occur in unexpected situations such as inaccuracy of initial value, model error, and disturbance. In this paper, we propose a minimum variance finite impulse response filter with optimal horizon for designing a new digital phase-locked loop. A numerical method is introduced to obtain the measured value interval length, which is an important parameter of the proposed finite impulse response filter, and to obtain a gain, the covariance matrix of the error is set as a cost function, and a linear matrix inequality is used to minimize it. In order to verify the superiority and robustness of the proposed digital phase-locked loop, a simulation was performed for comparison and analysis with the existing method in a situation where noise information was inaccurate.

• Journal of Cardiovascular Imaging
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• v.26 no.4
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• pp.217-225
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• 2018

BACKGROUND: In patients with acute heart failure (AHF), diastolic dysfunction, especially pseudonormal (PN) or restrictive filling pattern (RFP) of left ventricle (LV), is considered to be implicated in a poor prognosis. However, prognostic significance of diastolic dysfunction in patients with ischemic heart disease (IHD) has been rarely investigated in Korea. METHODS: We enrolled 138 patients with IHD presenting as AHF and sinus rhythm during echocardiographic study. Diastolic dysfunction of LV was graded as ${\geq}2$ (group 1) or 1 (group 2) according to usual algorithm using E/A ratio and deceleration time of mitral inflow, E'/A' ratio of tissue Doppler echocardiography and left atrial size. RESULTS: Patients in group 1 showed higher 2-year mortality rate ($36.2%{\pm}6.7%$) than those in group 2 ($13.6%{\pm}4.5%$; p = 0.008). Two-year mortality rate of patient with LV ejection fraction (LVEF) < 40% ($26.8%{\pm}6.0%$) was not different from those with LVEF 40%-49% ($28.0%{\pm}8.0%$) or ${\geq}50%$ ($13.7%{\pm}7.4%$; p = 0.442). On univariate analysis, PN or RFP of LV, higher stage of chronic kidney disease (CKD) and higher New York Heart Association (NYHA) functional class were poor prognostic factors, but LVEF or older age ${\geq}75$ years did not predict 2-year mortality. On multivariate analysis, PN or RFP of LV (hazard ratio [HR], 2.52; 95% confidence interval [CI], 1.09-5.84; p = 0.031), higher stage of CKD (HR, 1.57; 95% CI, 1.14-2.17; p = 0.006) and higher NYHA functional class (HR, 1.81; 95% CI, 1.11-2.94; p = 0.017) were still significant prognostic factors for 2-year mortality. CONCLUSIONS: PN or RFP of LV was a more useful prognostic factor for long-term mortality than LVEF in patients with IHD presenting as AHF.

• Korean Journal of Breeding Science
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• v.43 no.4
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• pp.304-310
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• 2011

In previous studies, we reported QTLs for grain weight (GW), qGW3 and for spikelets per panicle (SPP), qSPP3 linked to RM60 on chromosome 3 using advanced backcross lines derived from a cross between Oryza sativa ssp. Indica cv. Milyang 23 and O. glaberrima. The O. glaberrima alleles at this locus increased GW and spikelets per panicle in the Milyang 23 background. To further confirm and narrow down the position of the QTLs on chromosome 3, substitution mapping was performed using five lines containing the target O. glaberrima segment on chromosome 3. The size and position of the O. glaberrima segment on chromosome 3 were different in each line. These lines possessed 3-10 non-target O. glaberrima introgressions in the Milyang 23 background. These five lines were evaluated for seven agronomic traits including 1,000 grain weight and spikelets per panicle and also genotyped with seven SSR markers. Four lines were informative in delimiting the position of QTLs, qGW3 and qSPP3. Two lines with the O. glaberrima segment flanked by SSR markers, RM60 and RM523 displayed significantly higher values than Milyang 23 in GW and SPP whereas two lines without that O. glaberrima segment displayed no difference in GW and SPP compared to Milyang 23. The result indicates that two QTL, qGW3 and qSPP3 are located in the interval between RM60 and RM523 which are 1.2-Mb apart. Introgression lines having QTLs, qGW3 and qSPP3 would be useful materials not only to indentify the relationship between these two yield QTLs, but also to develop high yielding variety via marker-aided selection technology.

• Pediatric Infection and Vaccine
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• v.26 no.2
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• pp.112-117
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• 2019

Eikenella corrodens rarely causes invasive head and neck infections in immunocompetent children. We report a case of epidural abscess caused by E. corrodens in a previously healthy 13-year-old boy who presented with fever, headache, and vomiting. On physical examination upon admission, there was no neck stiffness, but discharge from the right ear was observed. Brain magnetic resonance imaging (MRI) revealed approximately 4.5-cm-sized epidural empyema on the right temporal lobe as well as bilateral ethmoid and sphenoid sinusitis, right mastoiditis, and right otitis media. During treatment with vancomycin and cefotaxime, purulent ear discharge aggravated, and on follow-up brain MRI, the empyema size increased to $5.6{\times}3.4cm$ with interval development of an abscess at the right sphenoid sinus. Burr hole trephination was performed, and foul-smelling pus was aspirated from the epidural abscess near the right temporal lobe. Pus culture yielded E. corrodens. Endoscopic sphenoidotomy was also performed with massive pus drainage, and the same organism was grown. The patient was treated with intravenous cefotaxime for 3 weeks and recovered well with no other complications. Therefore, E. corrodens can cause serious complications in children with untreated sinusitis.

• Journal of Korean Neurosurgical Society
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• v.62 no.6
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• pp.643-648
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• 2019

Objective : Shunt-dependent hydrocephalus (SdHCP) is a well-known complication of aneurysmal subarachnoid hemorrhage (SAH). The risk factors for SdHCP have been widely investigated, but few risk scoring systems have been established to predict SdHCP. This study was performed to investigate the risk factors for SdHCP and devise a risk scoring system for use before aneurysm obliteration. Methods : We reviewed the data of 301 consecutive patients who underwent aneurysm obliteration following SAH from September 2007 to December 2016. The exclusion criteria for this study were previous aneurysm obliteration, previous major cerebral infarction, the presence of a cavum septum pellucidum, a midline shift of >10 mm on initial computed tomography (CT), and in-hospital mortality. We finally recruited 254 patients and analyzed the following data according to the presence or absence of SdHCP : age, sex, history of hypertension and diabetes mellitus, Hunt-Hess grade, Fisher grade, aneurysm size and location, type of treatment, bicaudate index on initial CT, intraventricular hemorrhage, cerebrospinal fluid drainage, vasospasm, and modified Rankin scale score at discharge. Results : In the multivariate analysis, acute HCP (bicaudate index of ${\geq}0.2$) (odds ratio [OR], 6.749; 95% confidence interval [CI], 2.843-16.021; p=0.000), Fisher grade of 4 (OR, 4.108; 95% CI, 1.044-16.169; p=0.043), and an age of ${\geq}50years$ (OR, 3.938; 95% CI, 1.375-11.275; p=0.011) were significantly associated with the occurrence of SdHCP. The risk scoring system using above parameters of acute HCP, Fisher grade, and age (AFA score) assigned 1 point to each (total score of 0-3 points). SdHCP occurred in 4.3% of patients with a score of 0, 8.5% with a score of 1, 25.5% with a score of 2, and 61.7% with a score of 3 (p=0.000). In the receiver operating characteristic curve analysis, the area under the curve (AUC) for the risk scoring system was 0.820 (p=0.080; 95% CI, 0.750-0.890). In the internal validation of the risk scoring system, the score reliably predicted SdHCP (AUC, 0.895; p=0.000; 95% CI, 0.847-0.943). Conclusion : Our results suggest that the herein-described AFA score is a useful tool for predicting SdHCP before aneurysm obliteration. Prospective validation is needed.

• Tuberculosis and Respiratory Diseases
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• v.82 no.4
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• pp.306-310
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• 2019

Background: Tuberculosis (TB) is increasing in immigrants. We aimed to investigate the current status of latent tuberculosis infection (LTBI) treatment for North Korean Refugees (NKR) compared to South Koreans Contacts (SKC). Methods: TB close contacts in a closed facility of SKC and NKR who underwent LTBI screening in a settlement support center for NKR were analyzed retrospectively. Results: Among tuberculin skin test (TST) ${\geq}10mm$ (n=298) reactors, the males accounted for 72.2% in SKC (n=126) and 19.5% in NKR (n=172) (p<0.01). The mean age was higher in South Korea ($42.8{\pm}9.9years$ vs. $35.4{\pm}10.0years$, p<0.01). Additionally, the mean TST size was significantly bigger in NKR ($17.39{\pm}3.9mm$ vs. $16.57{\pm}4.2mm$, p=0.03). The LTBI treatments were initiated for all screened NKR, and LTBI completion rate was only 68.0%. However, in NKR, LTBI treatment completion rate was significantly increased by shorter 4R regimen (odds ratio [OR], 9.296; 95% confidence interval [CI], 4.159-20.774; p<0.01) and male (OR, 3.447; 95% CI, 1.191-9.974; p=0.02). Conclusion: LTBI treatment compliance must be improved in NKR with a shorter regimen. In addition, a larger study regarding a focus on LTBI with easy access to related data for NKR should be conducted.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.7
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• pp.158-165
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• 2019

Although evaluation of writing disabilities identification and timely intervention are required, clinicians adopt a manual scoring method and there is a possibility of error due to subjective evaluation. In this study, the size ratio and position of letters are digitized and quantified through image processing of offline handwritten characters. We tried to evaluate objectively and accurately the performance of writing through comparison with existing methods. From November 12th to 16th, 2018, 20 adults without neurological injury were selected. They used a pencil to follow the 10 words, 2 sentence stimuli after keeping the usual habit, and we collected the writing test data. The results showed that the height of the word was 1.2 times larger than the width and it tilted to the lower left. The spacing interval was 9mm on average. In the Paired T test, a high correlation was showed between our system and existing methods in the word and sentence 2. This demonstrated the possibility as a testing tool. This study evaluated objectively and precisely writing performance of offline handwritten characters through image processing and provided preliminary data for performance standards. In the future, it can be suggested as a basic data on writing diagnosis of various ages.

• Journal of Korean Medicine for Obesity Research
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• v.20 no.2
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• pp.178-192
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• 2020

Objectives: The present study aimed to compare the impacts of cognitive behavioral therapy (CBT) and behavioral treatment (BT) on weight loss and psychological outcomes among patients with three different subtypes of obesity: simple obesity, obesity with binge eating disorder, and obesity with depression. Methods: Embase, PubMed, the Cochrane Central Register of Controlled Trials, Research Information Sharing Service, and Korean Studies Information Service System were systematically searched for randomized controlled trials conducted on or before May 2020, that used CBT to treat obesity. Methodological quality was assessed using Cochrane's risk of bias tool 2 and publication bias was evaluated through the funnel plot using the trim and fill method, Egger's test, and Begg and Mazumdar rank correlation test. A meta-analysis was conducted using a random-effects model and the standardized mean difference with 95% confidence interval (CI) was used to determine effect size. Results: Twenty-one randomized controlled trials with a total of 22 intervention arms and 2,590 patients were included. Our study results revealed that the effects of CBT, compared with BT, on weight loss distinctly differed across all patient subgroups. In the simple obesity group, CBT was more effective than BT (Hedges' g=0.138, CI=0.012~0.264); however, in the obesity with binge eating disorder group, BT was more effective than CBT (Hedges' g=-0.228, CI=-0.418~-0.038); in the obesity with depression group, the effect of CBT was not statistically different from that of BT (Hedges' g=0.276, CI=-0.307~0.859). Further studies with larger sample sizes are required to confirm the outcomes observed in this study. Conclusions: Our results indicated that the effects of CBT on obesity treatment vary based on patient subtype. Therefore, our findings suggest that CBT or BT should be selectively recommended as a treatment strategy for different obesity subtypes.