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Imaging of Facial Nerve With 3D-DESS-WE-MRI Before Parotidectomy: Impact on Surgical Outcomes

  • Han-Sin Jeong;Yikyung Kim;Hyung-Jin Kim;Hak Jung, Kim;Eun-hye Kim;Sook-young Woo;Man Ki Chung;Young-Ik Son
    • Korean Journal of Radiology
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    • v.24 no.9
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    • pp.860-870
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    • 2023
  • Objective: The intra-parotid facial nerve (FN) can be visualized using three-dimensional double-echo steady-state water-excitation sequence magnetic resonance imaging (3D-DESS-WE-MRI). However, the clinical impact of FN imaging using 3D-DESS-WE-MRI before parotidectomy has not yet been explored. We compared the clinical outcomes of parotidectomy in patients with and without preoperative 3D-DESS-WE-MRI. Materials and Methods: This prospective, non-randomized, single-institution study included 296 adult patients who underwent parotidectomy for parotid tumors, excluding superficial and mobile tumors. Preoperative evaluation with 3D-DESS-WE-MRI was performed in 122 patients, and not performed in 174 patients. FN visibility and tumor location relative to FN on 3D-DESS-WE-MRI were evaluated in 120 patients. Rates of FN palsy (FNP) and operation times were compared between patients with and without 3D-DESS-WE-MRI; propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to adjust for surgical and tumor factors. Results: The main trunk, temporofacial branch, and cervicofacial branch of the intra-parotid FN were identified using 3D-DESS-WE-MRI in approximately 97.5% (117/120), 44.2% (53/120), and 25.0% (30/120) of cases, respectively. The tumor location relative to FN, as assessed on magnetic resonance imaging, concurred with surgical findings in 90.8% (109/120) of cases. Rates of temporary and permanent FNP did not vary between patients with and without 3D-DESS-WE-MRI according to PSM (odds ratio, 2.29 [95% confidence interval {CI} 0.64-8.25] and 2.02 [95% CI: 0.32-12.90], respectively) and IPTW (odds ratio, 1.76 [95% CI: 0.19-16.75] and 1.94 [95% CI: 0.20-18.49], respectively). Conversely, operation time for surgical identification of FN was significantly shorter with 3D-DESS-WE-MRI (median, 25 vs. 35 min for PSM and 25 vs. 30 min for IPTW, P < 0.001). Conclusion: Preoperative FN imaging with 3D-DESS-WE-MRI facilitated anatomical identification of FN and its relationship to the tumor during parotidectomy. This modality reduced operation time for FN identification, but did not significantly affect postoperative FNP rates.

Bone Age Assessment Using Artificial Intelligence in Korean Pediatric Population: A Comparison of Deep-Learning Models Trained With Healthy Chronological and Greulich-Pyle Ages as Labels

  • Pyeong Hwa Kim;Hee Mang Yoon;Jeong Rye Kim;Jae-Yeon Hwang;Jin-Ho Choi;Jisun Hwang;Jaewon Lee;Jinkyeong Sung;Kyu-Hwan Jung;Byeonguk Bae;Ah Young Jung;Young Ah Cho;Woo Hyun Shim;Boram Bak;Jin Seong Lee
    • Korean Journal of Radiology
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    • v.24 no.11
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    • pp.1151-1163
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    • 2023
  • Objective: To develop a deep-learning-based bone age prediction model optimized for Korean children and adolescents and evaluate its feasibility by comparing it with a Greulich-Pyle-based deep-learning model. Materials and Methods: A convolutional neural network was trained to predict age according to the bone development shown on a hand radiograph (bone age) using 21036 hand radiographs of Korean children and adolescents without known bone development-affecting diseases/conditions obtained between 1998 and 2019 (median age [interquartile range {IQR}], 9 [7-12] years; male:female, 11794:9242) and their chronological ages as labels (Korean model). We constructed 2 separate external datasets consisting of Korean children and adolescents with healthy bone development (Institution 1: n = 343; median age [IQR], 10 [4-15] years; male: female, 183:160; Institution 2: n = 321; median age [IQR], 9 [5-14] years; male: female, 164:157) to test the model performance. The mean absolute error (MAE), root mean square error (RMSE), and proportions of bone age predictions within 6, 12, 18, and 24 months of the reference age (chronological age) were compared between the Korean model and a commercial model (VUNO Med-BoneAge version 1.1; VUNO) trained with Greulich-Pyle-based age as the label (GP-based model). Results: Compared with the GP-based model, the Korean model showed a lower RMSE (11.2 vs. 13.8 months; P = 0.004) and MAE (8.2 vs. 10.5 months; P = 0.002), a higher proportion of bone age predictions within 18 months of chronological age (88.3% vs. 82.2%; P = 0.031) for Institution 1, and a lower MAE (9.5 vs. 11.0 months; P = 0.022) and higher proportion of bone age predictions within 6 months (44.5% vs. 36.4%; P = 0.044) for Institution 2. Conclusion: The Korean model trained using the chronological ages of Korean children and adolescents without known bone development-affecting diseases/conditions as labels performed better in bone age assessment than the GP-based model in the Korean pediatric population. Further validation is required to confirm its accuracy.

Digital Breast Tomosynthesis versus MRI as an Adjunct to Full-Field Digital Mammography for Preoperative Evaluation of Breast Cancer according to Mammographic Density

  • Haejung Kim;So Yeon Yang;Joong Hyun Ahn;Eun Young Ko;Eun Sook Ko;Boo-Kyung Han;Ji Soo Choi
    • Korean Journal of Radiology
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    • v.23 no.11
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    • pp.1031-1043
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    • 2022
  • Objective: To compare digital breast tomosynthesis (DBT) and MRI as an adjunct to full-field digital mammography (FFDM) for the preoperative evaluation of women with breast cancer based on mammographic density. Materials and Methods: This retrospective study enrolled 280 patients with breast cancer who had undergone FFDM, DBT, and MRI for preoperative local tumor staging. Three radiologists independently sought the index cancer and additional ipsilateral and contralateral breast cancers using either FFDM alone, DBT plus FFDM, or MRI plus FFDM. Diagnostic performances across the three radiologists were compared among the reading modes in all patients and subgroups with dense (n = 186) and non-dense breasts (n = 94) according to mammographic density. Results: Of 280 patients, 46 (16.4%) had 48 additional (39 ipsilateral and nine contralateral) cancers in addition to the index cancer. For index cancers, both DBT plus FFDM and MRI plus FFDM showed sensitivities of 100% in the non-dense group. In the dense group, DBT plus FFDM showed lower sensitivity than that of MRI plus FFDM (94.6% vs. 99.6%, p < 0.001). For additional ipsilateral cancers, DBT plus FFDM showed specificity and positive predictive value (PPV) of 100% in the non-dense group, but sensitivity and negative predictive value (NPV) were not statistically different from those of MRI plus FFDM (p > 0.05). In the dense group, DBT plus FFDM showed higher specificity (98.2% vs. 94.1%, p = 0.005) and PPV (83.1% vs. 65.4%; p = 0.036) than those of MRI plus FFDM, but lower sensitivity (59.9% vs. 75.3%; p = 0.049). For contralateral cancers, DBT plus FFDM showed higher specificity than that of MRI plus FFDM (99.0% vs. 96.7%, p = 0.014), however, the other values did not differ (all p > 0.05) in the dense group. Conclusion: DBT plus FFDM showed an overall higher specificity than that of MRI plus FFDM regardless of breast density, perhaps without substantial loss in sensitivity and NPV in the diagnosis of additional cancers. Thus, DBT may have the potential to be used as a preoperative breast cancer staging tool.

Appendiceal Visualization on 2-mSv CT vs. Conventional-Dose CT in Adolescents and Young Adults with Suspected Appendicitis: An Analysis of Large Pragmatic Randomized Trial Data

  • Jungheum Cho;Youngjune Kim;Seungjae Lee;Hooney Daniel Min;Yousun Ko;Choong Guen Chee;Hae Young Kim;Ji Hoon Park;Kyoung Ho Lee;LOCAT Group
    • Korean Journal of Radiology
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    • v.23 no.4
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    • pp.413-425
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    • 2022
  • Objective: We compared appendiceal visualization on 2-mSv CT vs. conventional-dose CT (median 7 mSv) in adolescents and young adults and analyzed the undesirable clinical and diagnostic outcomes that followed appendiceal nonvisualization. Materials and Methods: A total of 3074 patients aged 15-44 years (mean ± standard deviation, 28 ± 9 years; 1672 female) from 20 hospitals were randomized to the 2-mSv CT or conventional-dose CT group (1535 vs. 1539) from December 2013 through August 2016. A total of 161 radiologists from 20 institutions prospectively rated appendiceal visualization (grade 0, not identified; grade 1, unsure or partly visualized; and grade 2, clearly and entirely visualized) and the presence of appendicitis in these patients. The final diagnosis was based on CT imaging and surgical, pathologic, and clinical findings. We analyzed undesirable clinical or diagnostic outcomes, such as negative appendectomy, perforated appendicitis, more extensive than simple appendectomy, delay in patient management, or incorrect CT diagnosis, which followed appendiceal nonvisualization (defined as grade 0 or 1) and compared the outcomes between the two groups. Results: In the 2-mSv CT and conventional-dose CT groups, appendiceal visualization was rated as grade 0 in 41 (2.7%) and 18 (1.2%) patients, respectively; grade 1 in 181 (11.8%) and 81 (5.3%) patients, respectively; and grade 2 in 1304 (85.0%) and 1421 (92.3%) patients, respectively (p < 0.001). Overall, undesirable outcomes were rare in both groups. Compared to the conventional-dose CT group, the 2-mSv CT group had slightly higher rates of perforated appendicitis (1.1% [17] vs. 0.5% [7], p = 0.06) and false-negative diagnoses (0.4% [6] vs. 0.0% [0], p = 0.01) following appendiceal nonvisualization. Otherwise, these two groups were comparable. Conclusion: The use of 2-mSv CT instead of conventional-dose CT impairs appendiceal visualization in more patients. However, appendiceal nonvisualization on 2-mSv CT rarely leads to undesirable clinical or diagnostic outcomes.

A Study on the Extraction of Psychological Distance Embedded in Company's SNS Messages Using Machine Learning (머신 러닝을 활용한 회사 SNS 메시지에 내포된 심리적 거리 추출 연구)

  • Seongwon Lee;Jin Hyuk Kim
    • Information Systems Review
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    • v.21 no.1
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    • pp.23-38
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    • 2019
  • The social network service (SNS) is one of the important marketing channels, so many companies actively exploit SNSs by posting SNS messages with appropriate content and style for their customers. In this paper, we focused on the psychological distances embedded in the SNS messages and developed a method to measure the psychological distance in SNS message by mixing a traditional content analysis, natural language processing (NLP), and machine learning. Through a traditional content analysis by human coding, the psychological distance was extracted from the SNS message, and these coding results were used for input data for NLP and machine learning. With NLP, word embedding was executed and Bag of Word was created. The Support Vector Machine, one of machine learning techniques was performed to train and test the psychological distance in SNS message. As a result, sensitivity and precision of SVM prediction were significantly low because of the extreme skewness of dataset. We improved the performance of SVM by balancing the ratio of data by upsampling technique and using data coded with the same value in first content analysis. All performance index was more than 70%, which showed that psychological distance can be measured well.

Factors Affecting Breast Cancer Detectability on Digital Breast Tomosynthesis and Two-Dimensional Digital Mammography in Patients with Dense Breasts

  • Soo Hyun Lee;Mi Jung Jang;Sun Mi Kim;Bo La Yun;Jiwon Rim;Jung Min Chang;Bohyoung Kim;Hye Young Choi
    • Korean Journal of Radiology
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    • v.20 no.1
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    • pp.58-68
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    • 2019
  • Objective: To compare digital breast tomosynthesis (DBT) and conventional full-field digital mammography (FFDM) in the detectability of breast cancers in patients with dense breast tissue, and to determine the influencing factors in the detection of breast cancers using the two techniques. Materials and Methods: Three blinded radiologists independently graded cancer detectability of 300 breast cancers (288 women with dense breasts) on DBT and conventional FFDM images, retrospectively. Hormone status, histologic grade, T stage, and breast cancer subtype were recorded to identify factors affecting cancer detectability. The Wilcoxon signed-rank test was used to compare cancer detectability by DBT and conventional FFDM. Fisher's exact tests were used to determine differences in cancer characteristics between detectability groups. Kruskal-Wallis tests were used to determine whether the detectability score differed according to cancer characteristics. Results: Forty breast cancers (13.3%) were detectable only with DBT; 191 (63.7%) breast cancers were detected with both FFDM and DBT, and 69 (23%) were not detected with either. Cancer detectability scores were significantly higher for DBT than for conventional FFDM (median score, 6; range, 0-6; p < 0.001). The DBT-only cancer group had more invasive lobular-type breast cancers (22.5%) than the other two groups (i.e., cancer detected on both types of image [both-detected group], 5.2%; cancer not detected on either type of image [both-non-detected group], 7.3%), and less detectability of ductal carcinoma in situ (5% vs. 16.8% [both-detected group] vs. 27.5% [both-non-detected group]). Low-grade cancers were more often detected in the DBT-only group than in the both-detected group (22.5% vs. 10%, p = 0.026). Human epidermal growth factor receptor-2 (HER-2)-negative cancers were more often detected in the DBT-only group than in the both-detected group (92.3% vs. 70.5%, p = 0.004). Cancers surrounded by mostly glandular tissue were detected less often in the DBT only group than in the both-non-detected group (10% vs. 31.9%, p = 0.016). DBT cancer detectability scores were significantly associated with cancer type (p = 0.012), histologic grade (p = 0.013), T and N stage (p = 0.001, p = 0.024), proportion of glandular tissue surrounding lesions (p = 0.013), and lesion type (p < 0.001). Conclusion: Invasive lobular, low-grade, or HER-2-negative cancer is more detectable with DBT than with conventional FFDM in patients with dense breasts, but cancers surrounded by mostly glandular tissue might be missed with both techniques.

Antiproliferative Activity of Piceamycin by Regulating Alpha-Actinin-4 in Gemcitabine-Resistant Pancreatic Cancer Cells

  • Jee-Hyung Lee;Jin Ho Choi;Kyung-Min Lee;Min Woo Lee;Ja-Lok Ku;Dong-Chan Oh;Yern-Hyerk Shin;Dae Hyun Kim;In Rae Cho;Woo Hyun Paik;Ji Kon Ryu;Yong-Tae Kim;Sang Hyub Lee;Sang Kook Lee
    • Biomolecules & Therapeutics
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    • v.32 no.1
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    • pp.123-135
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    • 2024
  • Although gemcitabine-based regimens are widely used as an effective treatment for pancreatic cancer, acquired resistance to gemcitabine has become an increasingly common problem. Therefore, a novel therapeutic strategy to treat gemcitabine-resistant pancreatic cancer is urgently required. Piceamycin has been reported to exhibit antiproliferative activity against various cancer cells; however, its underlying molecular mechanism for anticancer activity in pancreatic cancer cells remains unexplored. Therefore, the present study evaluated the antiproliferation activity of piceamycin in a gemcitabine-resistant pancreatic cancer cell line and patient-derived pancreatic cancer organoids. Piceamycin effectively inhibited the proliferation and suppressed the expression of alpha-actinin-4, a gene that plays a pivotal role in tumorigenesis and metastasis of various cancers, in gemcitabine-resistant cells. Long-term exposure to piceamycin induced cell cycle arrest at the G0/G1 phase and caused apoptosis. Piceamycin also inhibited the invasion and migration of gemcitabine-resistant cells by modulating focal adhesion and epithelial-mesenchymal transition biomarkers. Moreover, the combination of piceamycin and gemcitabine exhibited a synergistic antiproliferative activity in gemcitabine-resistant cells. Piceamycin also effectively inhibited patient-derived pancreatic cancer organoid growth and induced apoptosis in the organoids. Taken together, these findings demonstrate that piceamycin may be an effective agent for overcoming gemcitabine resistance in pancreatic cancer.

Agrobacterium-mediated transformation produces transgenic oilseed rape with a high-yield trait (아그로박테리움 형질전환법을 이용한 수량증대 유채 식물체 개발)

  • Jong Bo Kim
    • Journal of Plant Biotechnology
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    • v.50
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    • pp.63-69
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    • 2023
  • This study includes the transformation of genes such as ORE7, the increase of gene expression, and the use of the bar gene as a selectable marker that shows herbicide resistance with Agrobacterium tumefaciens using hypocotyls from the oilseed rape "Youngsan" cultivar. To establish an Agrobacterium transformation system for the production of oilseed rape with a high-yield trait, infection time and co-cultivation period with Agrobacterium were tested. Therefore, when hypocotyls from the oilseed rape "Youngsan" cultivar were infected with Agrobacterium for 20 min and co-cultivated for 3 days, approximately 32-36 putatively transformed hypocotyls with shoots including roots survived from 100 inoculated hypocotyls after 4 weeks of transformation on a selection medium containing 20 mg/L of phosphinothricin (PPT) as a selectable agent. Additionally, a PCR assay was performed to confirm the insertion of target genes and showed the presence of the ORE7 gene as a high-yielding trait and the bar gene as a selectable marker. Treatment with 0.5% (v/v) Basta solution as a selectable agent for 6 days with leaves from transformed oilseed rape expressed the bar gene. Therefore, this study can contribute to the development of special oilseed rapes containing agriculturally useful traits such as herbicide resistance, drought tolerance, high yielding traits, and high oleic acid content.

High-efficiency development of herbicide-resistant transgenic lilies via an Agrobacterium-mediated transformation system (고효율의 아그로박테리움 형질전환법을 이용한 제초제저항성 나리 식물체 개발)

  • Jong Bo Kim
    • Journal of Plant Biotechnology
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    • v.50
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    • pp.56-62
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    • 2023
  • Transgenic lilies have been obtained using Agrobacterium tumefaciens (AGL1) with the plant scale explants, followed by DL-phosphinothricin (PPT) selection. In this study, scales of lily plants cv. "red flame" were transformed with the pCAMBIA3301 vector containing the gus gene as a reporter and the blpR gene as a selectable marker, as well as a gene of interest showing herbicide tolerance, both driven by the CaMV 35S promoter. Using a 20-minute infection time and a 5-day cultivation period, factors that optimized and demonstrated a high transformation efficiency were achieved. With these conditions, approximately 22-27% efficiency was observed for Agrobacterium-mediated transformation in lilies. After transformation with Agrobacterium, scales of lilies were transferred to MS medium without selective agents for 2 weeks. They were then placed on selection MS medium containing 5 mg/L PPT for a month of further selection and then cultured for another 4-8 weeks with a 4-week subculture regime on the same selection medium. PPT-resistant scales with shoots were successfully rooted and regenerated into plantlets after transferring into hormone-free MS medium. Also, most survived putatively transformed plantlets indicated the presence of the blpR gene by PCR analysis and showed a blue color indicating expression of the gus gene. In conclusion, when 100 scales of lily cv. "red flame" are transformed with Agrobacterium, approximately 22-27 transgenic plantlets can be produced following an optimized protocol. Therefore, this protocol can contribute to the lily breeding program in the future.

Emergence of Conjugative Multidrug-Resistant Pseudomonas aeruginosa (접합가능한다제내성녹농균의출현)

  • Miyoung Lee
    • Microbiology and Biotechnology Letters
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    • v.51 no.4
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    • pp.517-525
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    • 2023
  • The emergence and spread of multidrug-resistant Pseudomonas aeruginosa (MRPA) have become a serious problem worldwide. The involvement of metallo-β-lactamases (MBLs) in inducing carbapenem resistance is particularly acute. However, unlike other members of the Enterobacteriaceae genus, new clones of P. aeruginosa are constantly emerging and rapidly replacing previously prevalent dominant clones. Therefore, this study aimed to perform antimicrobial resistance gene analysis, integron gene cassette analysis using DNA sequencing, and plasmid transfer analysis by conjugation to investigate the antimicrobial resistance dynamics of 18 P. aeruginosa strains isolated from various medical samples at a general hospital in Busan from September 2017 to September 2019. All 18 strains showed extensively drug-resistant (XDR) phenotype and were resistant to most antibiotics, except colistin (100%) but were susceptible to aztreonam (22.2%) and ceftazidime (16.6%). Approximately 66.7% of the strains had Class 1 integrons showing various antimicrobial resistances. Notably, IMP-6 ST235 (66.7%), VIM-2 ST357 (16.7%), and IMP-1 ST446(16.7%) were identified. The identification of IMP-1-producing ST446, previously unreported in Korea, is noteworthy considering the emergence and prevalence of another MRPA high-risk clone.