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Imaging Predictors of Survival in Patients with Single Small Hepatocellular Carcinoma Treated with Transarterial Chemoembolization

  • Chan Park;Jin Hyoung Kim;Pyeong Hwa Kim;So Yeon Kim;Dong Il Gwon;Hee Ho Chu;Minho Park;Joonho Hur;Jin Young Kim;Dong Joon Kim
    • Korean Journal of Radiology
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    • v.22 no.2
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    • pp.213-224
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    • 2021
  • Objective: Clinical outcomes of patients who undergo transarterial chemoembolization (TACE) for single small hepatocellular carcinoma (HCC) are not consistent, and may differ based on certain imaging findings. This retrospective study was aimed at determining the efficacy of pre-TACE CT or MR imaging findings in predicting survival outcomes in patients with small HCC upon being treated with TACE. Besides, the study proposed to build a risk prediction model for these patients. Materials and Methods: Altogether, 750 patients with functionally good hepatic reserve who received TACE as the first-line treatment for single small HCC between 2004 and 2014 were included in the study. These patients were randomly assigned into training (n = 525) and validation (n = 225) sets. Results: According to the results of a multivariable Cox analysis, three pre-TACE imaging findings (tumor margin, tumor location, enhancement pattern) and two clinical factors (age, serum albumin level) were selected and scored to create predictive models for overall, local tumor progression (LTP)-free, and progression-free survival in the training set. The median overall survival time in the validation set were 137.5 months, 76.1 months, and 44.0 months for low-, intermediate-, and high-risk groups, respectively (p < 0.001). Time-dependent receiver operating characteristic curves of the predictive models for overall, LTP-free, and progression-free survival applied to the validation cohort showed acceptable areas under the curve values (0.734, 0.802, and 0.775 for overall survival; 0.738, 0.789, and 0.791 for LTP-free survival; and 0.671, 0.733, and 0.694 for progression-free survival at 3, 5, and 10 years, respectively). Conclusion: Pre-TACE CT or MR imaging findings could predict survival outcomes in patients with small HCC upon treatment with TACE. Our predictive models including three imaging predictors could be helpful in prognostication, identification, and selection of suitable candidates for TACE in patients with single small HCC.

Biotransformation of Diterpenoids From Aralia continentalis Roots by the Genus Fusarium (곰팡이 Fusarium 속을 이용한 독활 뿌리 추출물로부터 디테르페노이드의 생물전환)

  • Keumok Moon;Seola Lee;Eunhye Jo;Areum Lee;Jaeho Cha
    • Journal of Life Science
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    • v.34 no.4
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    • pp.215-226
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    • 2024
  • Aralia continentalis is widely distributed in Far East Asian countries such as Korea, China, and Japan. A. continentalis has traditionally been used as an herbal remedy for various conditions, including analgesia, headache, inflammation, lameness, lumbago, rheumatism, and dental diseases in Korea. Previously, epi-continentalic acid, continentalic acid, and kaurenoic acid as major active biological compounds belonging to the diterpenoid class were identified. To synthesize diterpenoid derivatives with enhanced bioavailability, Fusarium fujikuroi was employed to biotransform diterpenoids due to its known antibacterial activity. This yielded two derivatives of kaurenoic acid, namely 16α-hydroxyent-kauran-2-on-19-oic acid and 2β, 16α-dihydroxy-ent-kauran-19-oic acid, with their chemical structures elucidated via NMR analysis. These derivatives exhibited increased polarity compared to kaur- enoic acid, as evidenced by their retention time on preparative HPLC using the ODS-A column and structural modifications. Evaluation of their antidiabetic activity targeting PTP1B, a negative regulator of the insulin signaling pathway, revealed inhibitory activities of 30.8% and 27.6%, respectively, at a concentration of 4 ㎍/ml. Additionally, both derivatives demonstrated low cytotoxicity, with an IC50 value 18 times higher than kaurenoic acid. Therefore, the augmented water solubility and reduced toxicity of 16α-hydroxy-ent-kauran-2-on-19-oic acid and 2β, 16α-dihydroxy-ent-kauran-19-oic acid, resulting from biotransformation by F. fujikuroi, render them promising candidates for industrial applications.

Ovarian potential of Cameroonian Zebu cattle (Bos indicus) slaughtered in Etoudi - Yaoundé

  • Nsiyapnze Katte Yato Katte;Tchoffo Herve;Azafack Kana Dorice;Chongsi Margaret Mary Momo;Ngoula Ferdinand
    • Journal of Animal Reproduction and Biotechnology
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    • v.38 no.4
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    • pp.236-246
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    • 2023
  • Background: This study helps to evaluate the Ovarian potential of Cameroonian Zebu cattle (Bos indicus) slaughtered in Etoudi - Yaoundé for implementing Assisted Reproductive Techniques (ARTs). The aim was to enhance the productivity of the cattle sub-sector in Cameroon while conserving local genetic resources. Methods: A total of 144 cows, including 94 cycled cows and 50 pregnant cows, were included in the study. Live weights were determined by measuring the thoracic perimeter of each cow using a Rondo measuring tape. Age was determined postmortem through examination of dentition and horns, while the uterus and ovaries were removed, weighed, and classified based on physiological status (pregnant or nonpregnant). Follicles were counted, and their diameters were measured and categorized into small (Ø < 3 mm), medium (Ø 3-8 mm), and large (Ø > 8 mm). Results: The results revealed an average follicular population of 32.02 ± 9.31 per cow, with 22.43 ± 8.45 small follicles, 8.42 ± 3.87 medium follicles, and 0.76 ± 0.34 large follicles. The weight of the right ovary was significantly higher than that of the left ovary (p < 0.05), and cows aged 6 to 9 years exhibited a higher number of follicles compared to other age groups. Cows with medium (BCS = 3) and large (BCS = 4-5) body reserves had the heaviest ovaries. Additionally, pregnant cows had heavier uteri compared to non-pregnant cows, and cows with a body condition score of 3 or higher had higher uterine weights than lean cows (BCS = 1-2). Conclusions: This study demonstrates that age, body condition score, and pregnancy status influence ovarian weight. Body Condition Score serves as a reliable indicator of cow nutritional status, and cows with BCS of 3-5 are excellent candidates for in vitro production of embryos.

Segmentation Foundation Model-based Automated Yard Management Algorithm (의미론적 분할 기반 모델을 이용한 조선소 사외 적치장 객체 자동 관리 기술)

  • Mingyu Jeong;Jeonghyun Noh;Janghyun Kim;Seongheon Ha;Taeseon Kang;Byounghak Lee;Kiryong Kang;Junhyeon Kim;Jinsun Park
    • Smart Media Journal
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    • v.13 no.2
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    • pp.52-61
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    • 2024
  • In the shipyard, aerial images are acquired at regular intervals using Unmanned Aerial Vehicles (UAVs) for the management of external storage yards. These images are then investigated by humans to manage the status of the storage yards. This method requires a significant amount of time and manpower especially for large areas. In this paper, we propose an automated management technology based on a semantic segmentation foundation model to address these challenges and accurately assess the status of external storage yards. In addition, as there is insufficient publicly available dataset for external storage yards, we collected a small-scale dataset for external storage yards objects and equipment. Using this dataset, we fine-tune an object detector and extract initial object candidates. They are utilized as prompts for the Segment Anything Model(SAM) to obtain precise semantic segmentation results. Furthermore, to facilitate continuous storage yards dataset collection, we propose a training data generation pipeline using SAM. Our proposed method has achieved 4.00%p higher performance compared to those of previous semantic segmentation methods on average. Specifically, our method has achieved 5.08% higher performance than that of SegFormer.

A Pre-Selection of Candidate Units Using Accentual Characteristic In a Unit Selection Based Japanese TTS System (일본어 악센트 특징을 이용한 합성단위 선택 기반 일본어 TTS의 후보 합성단위의 사전선택 방법)

  • Na, Deok-Su;Min, So-Yeon;Lee, Kwang-Hyoung;Lee, Jong-Seok;Bae, Myung-Jin
    • The Journal of the Acoustical Society of Korea
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    • v.26 no.4
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    • pp.159-165
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    • 2007
  • In this paper, we propose a new pre-selection of candidate units that is suitable for the unit selection based Japanese TTS system. General pre-selection method performed by calculating a context-dependent cost within IP (Intonation Phrase). Different from other languages, however. Japanese has an accent represented as the height of a relative pitch, and several words form a single accentual phrase. Also. the prosody in Japanese changes in accentual phrase units. By reflecting such prosodic change in pre-selection. the qualify of synthesized speech can be improved. Furthermore, by calculating a context-dependent cost within accentual phrase, synthesis speed can be improved than calculating within intonation phrase. The proposed method defines AP. analyzes AP in context and performs pre-selection using accentual phrase matching which calculates CCL (connected context length) of the Phoneme's candidates that should be synthesized in each accentual phrase. The baseline system used in the proposed method is VoiceText, which is a synthesizer of Voiceware. Evaluations were made on perceptual error (intonation error, concatenation mismatch error) and synthesis time. Experimental result showed that the proposed method improved the qualify of synthesized speech. as well as shortened the synthesis time.

Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Management of the Underlying Etiologies and Comorbidities of Heart Failure

  • Sang Min Park;Soo Youn Lee;Mi-Hyang Jung;Jong-Chan Youn;Darae Kim;Jae Yeong Cho;Dong-Hyuk Cho;Junho Hyun;Hyun-Jai Cho;Seong-Mi Park;Jin-Oh Choi;Wook-Jin Chung;Seok-Min Kang;Byung-Su Yoo;Committee of Clinical Practice Guidelines, Korean Society of Heart Failure
    • Korean Circulation Journal
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    • v.53 no.7
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    • pp.425-451
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    • 2023
  • Most patients with heart failure (HF) have multiple comorbidities, which impact their quality of life, aggravate HF, and increase mortality. Cardiovascular comorbidities include systemic and pulmonary hypertension, ischemic and valvular heart diseases, and atrial fibrillation. Non-cardiovascular comorbidities include diabetes mellitus (DM), chronic kidney and pulmonary diseases, iron deficiency and anemia, and sleep apnea. In patients with HF with hypertension and left ventricular hypertrophy, renin-angiotensin system inhibitors combined with calcium channel blockers and/or diuretics is an effective treatment regimen. Measurement of pulmonary vascular resistance via right heart catheterization is recommended for patients with HF considered suitable for implantation of mechanical circulatory support devices or as heart transplantation candidates. Coronary angiography remains the gold standard for the diagnosis and reperfusion in patients with HF and angina pectoris refractory to antianginal medications. In patients with HF and atrial fibrillation, longterm anticoagulants are recommended according to the CHA2DS2-VASc scores. Valvular heart diseases should be treated medically and/or surgically. In patients with HF and DM, metformin is relatively safer; thiazolidinediones cause fluid retention and should be avoided in patients with HF and dyspnea. In renal insufficiency, both volume status and cardiac performance are important for therapy guidance. In patients with HF and pulmonary disease, beta-blockers are underused, which may be related to increased mortality. In patients with HF and anemia, iron supplementation can help improve symptoms. In obstructive sleep apnea, continuous positive airway pressure therapy helps avoid severe nocturnal hypoxia. Appropriate management of comorbidities is important for improving clinical outcomes in patients with HF.

2023 Korea Digital Business Trend Study: Listening to Voices from Academia and Industry (2023 대한민국 디지털 비즈니스 트렌드 인식조사: 학계와 산업계의 다양한 목소리를 들어보다)

  • Heedong Yang;Hyunchul Ahn;Jung Lee;Hyunjeong Kang
    • Information Systems Review
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    • v.25 no.1
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    • pp.189-212
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    • 2023
  • This study uses various methods, including media analysis, expert interviews, and large-scale surveys, to derive notable digital business trends in 2023. Most trend studies have yet to deal with digital business trends in Korea. They also often have limitations in the objectivity of the results using unclear methods. On the other hand, this study emphasizes the validity of the results by collecting opinions from Korean digital business experts in various fields. First, Korean IT news articles were collected and analyzed through topic modeling analysis. Then, based on the results, interviews were conducted with 13 academic and industrial experts to derive 16 IT business trend candidates. Then, a survey was conducted on 210 experts to finalize the list of Korean IT business trends. Finally, to compare overseas and domestic views, we conducted an additional survey using the items developed by the Society for Information Management, SIM. This study is meaningful in that it drew prospects for digital business trends in consideration of the domestic business environment by scientifically converging various opinions of Korean digital business leaders. Our study contributes to developing strategies for IT technology and IT service business markets.

Evaluation of Malignancy Risk of Ampullary Tumors Detected by Endoscopy Using 2-[18F]FDG PET/CT

  • Pei-Ju Chuang;Hsiu-Po Wang;Yu-Wen Tien;Wei-Shan Chin;Min-Shu Hsieh;Chieh-Chang Chen;Tzu-Chan Hong;Chi-Lun Ko;Yen-Wen Wu;Mei-Fang Cheng
    • Korean Journal of Radiology
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    • v.25 no.3
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    • pp.243-256
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    • 2024
  • Objective: We aimed to investigate whether 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (2-[18F]FDG PET/CT) can aid in evaluating the risk of malignancy in ampullary tumors detected by endoscopy. Materials and Methods: This single-center retrospective cohort study analyzed 155 patients (79 male, 76 female; mean age, 65.7 ± 12.7 years) receiving 2-[18F]FDG PET/CT for endoscopy-detected ampullary tumors 5-87 days (median, 7 days) after the diagnostic endoscopy between June 2007 and December 2020. The final diagnosis was made based on histopathological findings. The PET imaging parameters were compared with clinical data and endoscopic features. A model to predict the risk of malignancy, based on PET, endoscopy, and clinical findings, was generated and validated using multivariable logistic regression analysis and an additional bootstrapping method. The final model was compared with standard endoscopy for the diagnosis of ampullary cancer using the DeLong test. Results: The mean tumor size was 17.1 ± 7.7 mm. Sixty-four (41.3%) tumors were benign, and 91 (58.7%) were malignant. Univariable analysis found that ampullary neoplasms with a blood-pool corrected peak standardized uptake value in earlyphase scan (SUVe) ≥ 1.7 were more likely to be malignant (odds ratio [OR], 16.06; 95% confidence interval [CI], 7.13-36.18; P < 0.001). Multivariable analysis identified the presence of jaundice (adjusted OR [aOR], 4.89; 95% CI, 1.80-13.33; P = 0.002), malignant traits in endoscopy (aOR, 6.80; 95% CI, 2.41-19.20; P < 0.001), SUVe ≥ 1.7 in PET (aOR, 5.43; 95% CI, 2.00-14.72; P < 0.001), and PET-detected nodal disease (aOR, 5.03; 95% CI, 1.16-21.86; P = 0.041) as independent predictors of malignancy. The model combining these four factors predicted ampullary cancers better than endoscopic diagnosis alone (area under the curve [AUC] and 95% CI: 0.925 [0.874-0.956] vs. 0.815 [0.732-0.873], P < 0.001). The model demonstrated an AUC of 0.921 (95% CI, 0.816-0.967) in candidates for endoscopic papillectomy. Conclusion: Adding 2-[18F]FDG PET/CT to endoscopy can improve the diagnosis of ampullary cancer and may help refine therapeutic decision-making, particularly when contemplating endoscopic papillectomy.

Validation of Ultrasound and Computed Tomography-Based Risk Stratification System and Biopsy Criteria for Cervical Lymph Nodes in Preoperative Patients With Thyroid Cancer

  • Young Hun Jeon;Ji Ye Lee;Roh-Eul Yoo;Jung Hyo Rhim;Kyung Hoon Lee;Kyu Sung Choi;Inpyeong Hwang;Koung Mi Kang;Ji-hoon Kim
    • Korean Journal of Radiology
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    • v.24 no.9
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    • pp.912-923
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    • 2023
  • Objective: This study aimed to validate the risk stratification system (RSS) and biopsy criteria for cervical lymph nodes (LNs) proposed by the Korean Society of Thyroid Radiology (KSThR). Materials and Methods: This retrospective study included a consecutive series of preoperative patients with thyroid cancer who underwent LN biopsy, ultrasound (US), and computed tomography (CT) between December 2006 and June 2015. LNs were categorized as probably benign, indeterminate, or suspicious according to the current US- and CT-based RSS and the size thresholds for cervical LN biopsy as suggested by the KSThR. The diagnostic performance and unnecessary biopsy rates were calculated. Results: A total of 277 LNs (53.1% metastatic) in 228 patients (mean age ± standard deviation, 47.4 years ± 14) were analyzed. In US, the malignancy risks were significantly different among the three categories (all P < 0.001); however, CT-detected probably benign and indeterminate LNs showed similarly low malignancy risks (P = 0.468). The combined US + CT criteria stratified the malignancy risks among the three categories (all P < 0.001) and reduced the proportion of indeterminate LNs (from 20.6% to 14.4%) and the malignancy risk in the indeterminate LNs (from 31.6% to 12.5%) compared with US alone. In all image-based classifications, nodal size did not affect the malignancy risks (short diameter [SD] ≤ 5 mm LNs vs. SD > 5 mm LNs, P ≥ 0.177). The criteria covering only suspicious LNs showed higher specificity and lower unnecessary biopsy rates than the current criteria, while maintaining sensitivity in all imaging modalities. Conclusion: Integrative evaluation of US and CT helps in reducing the proportion of indeterminate LNs and the malignancy risk among them. Nodal size did not affect the malignancy risk of LNs, and the addition of indeterminate LNs to biopsy candidates did not have an advantage in detecting LN metastases in all imaging modalities.

Cutoff Values for Diagnosing Hepatic Steatosis Using Contemporary MRI-Proton Density Fat Fraction Measuring Methods

  • Sohee Park;Jae Hyun Kwon;So Yeon Kim;Ji Hun Kang;Jung Il Chung;Jong Keon Jang;Hye Young Jang;Ju Hyun Shim;Seung Soo Lee;Kyoung Won Kim;Gi-Won Song
    • Korean Journal of Radiology
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    • v.23 no.12
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    • pp.1260-1268
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    • 2022
  • Objective: To propose standardized MRI-proton density fat fraction (PDFF) cutoff values for diagnosing hepatic steatosis, evaluated using contemporary PDFF measuring methods in a large population of healthy adults, using histologic fat fraction (HFF) as the reference standard. Materials and Methods: A retrospective search of electronic medical records between 2015 and 2018 identified 1063 adult donor candidates for liver transplantation who had undergone liver MRI and liver biopsy within a 7-day interval. Patients with a history of liver disease or significant alcohol consumption were excluded. Chemical shift imaging-based MRI (CS-MRI) PDFF and high-speed T2-corrected multi-echo MR spectroscopy (HISTO-MRS) PDFF data were obtained. By temporal splitting, the total population was divided into development and validation sets. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance of the MRI-PDFF method. Two cutoff values with sensitivity > 90% and specificity > 90% were selected to rule-out and rule-in, respectively, hepatic steatosis with reference to HFF ≥ 5% in the development set. The diagnostic performance was assessed using the validation set. Results: Of 921 final participants (624 male; mean age ± standard deviation, 31.5 ± 9.0 years), the development and validation sets comprised 497 and 424 patients, respectively. In the development set, the areas under the ROC curve for diagnosing hepatic steatosis were 0.920 for CS-MRI-PDFF and 0.915 for HISTO-MRS-PDFF. For ruling-out hepatic steatosis, the CS-MRI-PDFF cutoff was 2.3% (sensitivity, 92.4%; specificity, 63.0%) and the HISTO-MRI-PDFF cutoff was 2.6% (sensitivity, 88.8%; specificity, 70.1%). For ruling-in hepatic steatosis, the CS-MRI-PDFF cutoff was 3.5% (sensitivity, 73.5%; specificity, 88.6%) and the HISTO-MRI-PDFF cutoff was 4.0% (sensitivity, 74.7%; specificity, 90.6%). Conclusion: In a large population of healthy adults, our study suggests diagnostic thresholds for ruling-out and ruling-in hepatic steatosis defined as HFF ≥ 5% by contemporary PDFF measurement methods.