Yonsei Medical Journal最新文献_第10页

Analysis of Prognoses according to Breast MRI Results in Patients with Axillary Lymph Node Metastases from an Unknown Primary Origin. 根据乳腺MRI结果分析不明原发性腋窝淋巴结转移患者的预后。

IF 2.4 4区医学

Yonsei Medical Journal Pub Date : 2023-10-01 DOI: 10.3349/ymj.2023.0181

E-Ryung Choi, Ok Hee Woo, Eun Young Ko, Boo-Kyung Han, Ji Soo Choi, Eun Sook Ko, Haejung Kim, Myoung Kyoung Kim, Jeong Eon Lee

{"title":"Analysis of Prognoses according to Breast MRI Results in Patients with Axillary Lymph Node Metastases from an Unknown Primary Origin.","authors":"E-Ryung Choi, Ok Hee Woo, Eun Young Ko, Boo-Kyung Han, Ji Soo Choi, Eun Sook Ko, Haejung Kim, Myoung Kyoung Kim, Jeong Eon Lee","doi":"10.3349/ymj.2023.0181","DOIUrl":"https://doi.org/10.3349/ymj.2023.0181","url":null,"abstract":"Purpose: To compare the prognosis of patients with axillary adenocarcinoma from an unknown primary (ACUPax) origin with negative MRI results and those with MRI-detected primary breast cancers.Materials and methods: The breast MRI images of 32 patients with ACUPax without signs of primary breast cancer on mammography and ultrasound (US) were analyzed. Spot compression-magnification mammography and second-look US were performed for the area of MRI abnormality in patients with positive results; any positive findings corresponding to the MRI abnormality were confirmed by biopsy. If suspicious MRI lesions could not be localized on mammography or US, MR-guided biopsy or excision biopsy after MR-guided localization was performed. We compared the prognosis of patients with negative breast MRI with that for patients with MRI-detected primary breast cancers.Results: Primary breast cancers were confirmed in 8 (25%) patients after breast MRI. Primary breast cancers were not detected on MRI in 24 (75%) patients, including five cases of false-positive MRI results. Twenty-three patients underwent axillary lymph node dissection (ALND) followed by whole breast radiation therapy (WBRT) and chemotherapy (n=17) or subsequent chemotherapy only (n=2). Recurrence or distant metastasis did not occur during follow up in 7/8 patients with MRI-detected primary breast cancers and 22/24 patients with negative MRI results. Regional recurrence or distant metastasis did not occur in any MR-negative patient who received adjuvant chemotherapy after ALND and WBRT.Conclusion: The prognoses of MR-negative patients with ACUPax who received ALND and WBRT followed by chemotherapy were as good as those of patients with MRI-detected primary breast cancers.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/15/2b/ymj-64-633.PMC10522875.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Drug-Coated Balloons for De Novo Coronary Artery Lesions: A Meta-Analysis of Randomized Clinical Trials. 药物涂层球囊治疗新冠状动脉病变：随机临床试验的荟萃分析。

IF 2.6 4区医学

Yonsei Medical Journal Pub Date : 2023-10-01 DOI: 10.3349/ymj.2022.0606

Dejin Wang, Xiqian Wang, Tianxiao Yang, Hongliang Tian, Yuanzhen Su, Qilei Wang

{"title":"Drug-Coated Balloons for De Novo Coronary Artery Lesions: A Meta-Analysis of Randomized Clinical Trials.","authors":"Dejin Wang, Xiqian Wang, Tianxiao Yang, Hongliang Tian, Yuanzhen Su, Qilei Wang","doi":"10.3349/ymj.2022.0606","DOIUrl":"10.3349/ymj.2022.0606","url":null,"abstract":"Purpose: Through meta-analysis, we aimed to assess the efficacy and safety of drug-coated balloons (DCB), compared with drug-eluting stents (DES) or uncoated devices, in the treatment of de novo coronary lesions.Materials and methods: Only randomized controlled trials were included. The primary outcomes were late lumen loss (LLL), target lesion revascularization (TLR), and major adverse cardiac events (MACEs). Subgroup analyses were conducted based on clinical indications, whether DCBs were used with a systematic or bailout stent, and types of DESs.Results: The present meta-analysis demonstrated that DCBs elicit significantly lower incidences of TLR, MACE, and LLL, compared with uncoated devices, and similar incidences, compared with DESs, in the treatment of de novo coronary lesions. Subgroup analysis indicated that DCBs used with a bailout stent achieved lower incidences of binary restenosis and myocardial infarction, compared with uncoated devices, and provided less LLL than DESs. DCBs showed similar rates of TLR and MACE, with significantly less LLL, than DESs in treating de novo small-vessel diseases. The clinical efficacy of DCBs was similar to that of second-generation DES.Conclusion: Overall, DCB is favored over bare metal stent alone in treating de novo coronary lesions. DCBs appear to be a promising alternative to DESs in the treatment of de novo coronary lesions.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/db/d0/ymj-64-593.PMC10522878.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disseminated Nontuberculous Mycobacterial Infection in a Tertiary Referral Hospital in South Korea: A Retrospective Observational Study. 韩国一家三级转诊医院的播散性非结核分枝杆菌感染：一项回顾性观察研究。

IF 2.4 4区医学

Yonsei Medical Journal Pub Date : 2023-10-01 DOI: 10.3349/ymj.2023.0046

Hyejin Park, Young Ae Kang, Youngmok Park

{"title":"Disseminated Nontuberculous Mycobacterial Infection in a Tertiary Referral Hospital in South Korea: A Retrospective Observational Study.","authors":"Hyejin Park, Young Ae Kang, Youngmok Park","doi":"10.3349/ymj.2023.0046","DOIUrl":"https://doi.org/10.3349/ymj.2023.0046","url":null,"abstract":"Purpose: Disseminated nontuberculous mycobacterial (D-NTM) disease occurs primarily in immunocompromised hosts. However, these cases have rarely been reported in South Korea. This study aimed to describe the clinical manifestations, disease course, and underlying immune deficiencies of patients with D-NTM disease.Materials and methods: We retrospectively reviewed the cases of D-NTM disease from January 2005 to December 2019 at a tertiary referral hospital in South Korea. D-NTM disease was defined as a bloodstream infection or infection of two or more non-contiguous body organs with species identification.Results: Of the 53342 mycobacterial samples from 23338 patients, extrapulmonary NTM was detected in 104 patients, and 3 (2.9%) were diagnosed with D-NTM disease. Mycobacterium avium was isolated from two patients, while M. abscessus subspecies abscessus was identified in one. The patients were aged between 18 and 25 years, and two patients were male. All patients were immunocompromised - one received lung transplantation, one was diagnosed with anhidrotic ectodermal dysplasia with T-cell immune deficiency, and one had monocytopenia and mycobacterial infection syndrome associated with GATA2 mutations. All patients underwent a standard macrolide-based regimen for >5 months, and their sputum tested negative. However, one patient died of bacterial sepsis, while the other two survived.Conclusion: D-NTM disease is rare in a tertiary referral center in South Korea. They occur primarily in immunocompromised patients at a relatively young age. Careful investigation of the underlying immune status is required when treating patients with D-NTM disease.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/e2/ymj-64-612.PMC10522876.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41147187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hyperpolarized [1-¹³C]pyruvate Magnetic Resonance Spectroscopy Shows That Agmatine Increased Lactate Production in the Brain of Type 2 Diabetic Mice. 超极化[1-13C]丙酮酸盐磁共振波谱显示，胍丁胺增加了2型糖尿病小鼠大脑中乳酸的产生。

IF 2.4 4区医学

Yonsei Medical Journal Pub Date : 2023-10-01 DOI: 10.3349/ymj.2022.0554

Young-Suk Choi, Jae Eun Song, Eosu Kim, Chul Hoon Kim, Jong Eun Lee, Ho-Taek Song

{"title":"Hyperpolarized [1-13C]pyruvate Magnetic Resonance Spectroscopy Shows That Agmatine Increased Lactate Production in the Brain of Type 2 Diabetic Mice.","authors":"Young-Suk Choi, Jae Eun Song, Eosu Kim, Chul Hoon Kim, Jong Eun Lee, Ho-Taek Song","doi":"10.3349/ymj.2022.0554","DOIUrl":"https://doi.org/10.3349/ymj.2022.0554","url":null,"abstract":"Purpose: Type 2 diabetes mellitus (T2DM) is associated with a 2-fold increased risk of developing Alzheimer's disease. In earlier research, agmatine has been demonstrated to alleviate diabetes symptoms and increase cognitive performance. However, it is unclear whether the improvement of cognitive function is attributable to the reduction of diabetic symptoms or its direct influence on brain metabolism. Using hyperpolarized (HP) [1-13C]pyruvate magnetic resonance spectroscopy (MRS), this study intends to evaluate the influence of agmatine on brain metabolism.Materials and methods: ICR mice were fed a high-fat diet and injected with streptozotocin to develop a T2DM animal model. During a 2-week period, T2DM mice were treated with normal saline or 100 mg/kg of agmatine, and brain HP [1-13C]pyruvate MRS was performed. The effect of agmatine on lactate generation and NADH/NAD+ redox state was investigated using C6 and neuro-2a (N2a) cells.Results: As a perfusion marker, the total 13C signals in the brain of T2DM mice (p=0.07) and agmatine-treated mice (p<0.05) were reduced. The conversion constant (Kpl) from [1-13C]pyruvate to [1-13C]lactate was not distinguishable in the brains of T2DM mice but was significantly increased in the brains of agmatine-treated T2DM mice. Treating C6 and N2a cells with agmatine increased NADH/NAD+ratio and lactate generation.Conclusion: Agmatine influences the NADH/NAD+ redox state in the brains of T2DM mice, which may be connected with enhanced cognitive performance and increased conversion of HP [1-13C]pyruvate to HP [1-13C]lactate.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/98/e1/ymj-64-625.PMC10522877.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Rechallenge with Anti-PD-1 Inhibitors in Patients with Recurrent Gynecologic Malignancies. 复发性妇科恶性肿瘤患者的抗PD-1抑制剂再激发。

IF 2.4 4区医学

Yonsei Medical Journal Pub Date : 2023-10-01 DOI: 10.3349/ymj.2023.0063

Migang Kim, Chi-Son Chang, Min Chul Choi, Jeong-Won Lee, Hyun Park, Won Duk Joo

{"title":"Rechallenge with Anti-PD-1 Inhibitors in Patients with Recurrent Gynecologic Malignancies.","authors":"Migang Kim, Chi-Son Chang, Min Chul Choi, Jeong-Won Lee, Hyun Park, Won Duk Joo","doi":"10.3349/ymj.2023.0063","DOIUrl":"https://doi.org/10.3349/ymj.2023.0063","url":null,"abstract":"Purpose: We investigated the treatment outcomes of immune checkpoint inhibitor (ICI) rechallenge in patients with recurrent gynecologic cancers.Materials and methods: We retrospectively reviewed the medical records of 20 patients who underwent rechallenge with PD-1 inhibitors for recurrent gynecologic cancers at two tertiary centers between January 2018 and September 2022.Results: The median age of the patients was 56 years (range, 35-79). Seven (35%), 1 (5%), 11 (55%), and 1 (5%) patients presented with cervical, vulvar, ovarian, and endometrial cancers, respectively. Sixteen (80%) patients received pembrolizumab and 4 (20%) received nivolumab at first treatment. Eight (40%) and 12 (60%) patients received pembrolizumab and nivolumab, respectively, at second treatment. At initial ICI treatment, 1 (5%) and 4 (20%) cases of a complete response (CR) and a partial response (PR) were observed, respectively, with a median progression-free survival (PFS) of 2.8 months (range, 1.4-49.6). Reasons for first ICI discontinuation were disease progression (n=16), severe adverse events (AEs) (n=2), and treatment withdrawal (n=2). During second ICI treatment, 1 (5%) patient achieved CR, 2 (10%) showed PR, and 5 (25%) experienced stable disease. The median PFS to second ICI was 1.8 months (range, 0.4-10.4). The median overall survival was 21.3 months (range, 10.1-52.7). Neither patient who discontinued ICI treatment due to AEs experienced AE relapse during second ICI treatment.Conclusion: These results suggest that responses to ICI rechallenge are not as intolerable as responses to previous ICI. Clinicians should carefully consider rechallenge with PD-1 inhibitors outside of clinical trials until there are sufficient data to routinely support this practice.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f9/b6/ymj-64-587.PMC10522879.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41152009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Vasculitis Activity-Predicting Ability of IL-12 Family Cytokines in Patients with Microscopic Polyangiitis and Granulomatosis with Polyangiitis. 显微镜下多血管炎和伴多血管炎的肉芽肿患者的血管炎活性预测IL-12家族细胞因子的能力。

IF 2.4 4区医学

Yonsei Medical Journal Pub Date : 2023-10-01 DOI: 10.3349/ymj.2023.0226

Taejun Yoon, Jang Woo Ha, Eunhee Ko, Jason Jungsik Song, Yong-Beom Park, Sung Soo Ahn, Sang-Won Lee

{"title":"Vasculitis Activity-Predicting Ability of IL-12 Family Cytokines in Patients with Microscopic Polyangiitis and Granulomatosis with Polyangiitis.","authors":"Taejun Yoon, Jang Woo Ha, Eunhee Ko, Jason Jungsik Song, Yong-Beom Park, Sung Soo Ahn, Sang-Won Lee","doi":"10.3349/ymj.2023.0226","DOIUrl":"https://doi.org/10.3349/ymj.2023.0226","url":null,"abstract":"Purpose: The present study investigated and compared the antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) activity-predicting ability of the serum concentrations of the four interleukin (IL)-12 family cytokines including IL-23, IL-27, IL-35, and IL-39 in patients with microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA).Materials and methods: The present study included 70 patients with MPA and GPA. Clinical and laboratory data, particularly Birmingham Vasculitis Activity Score (BVAS), at the time of blood collection were obtained. The serum concentrations of IL-23, IL-27, IL-35, and IL-37 were measured using sera stored at -80℃. Patients were divided into two groups: the upper half of BVAS (BVAS ≥12) and the lower half of BVAS (BVAS <12).Results: The serum concentrations of IL-23 and IL-27 reflected AAV activity. Patients with the upper half of BVAS exhibited significantly higher serum concentrations of IL-23 and IL-27 than those without. Patients with the serum concentrations of IL-23 ≥132.1 pg/mL or IL-27 ≥684.7 pg/mL exhibited higher frequency and risk for the upper half of BVAS than those without [relative risks (RR) 5.143 and RR 4.091, respectively]. The serum concentrations of IL-27 were associated with age ≥65 years and proteinase 3-ANCA (or C-ANCA) negativity, whereas, those of IL-23 were associated with MPA. However, the serum concentrations of IL-35 and IL-39 were not useful in predicting AAV activity in this study.Conclusion: The present study is the first to demonstrate that among the various members of IL-12 family cytokines, the serum concentrations of IL-23 and IL-27 possess AAV activity-predicting ability.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c4/f1/ymj-64-604.PMC10522880.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41136735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of Transcutaneous Trigeminal Electrical Stimulation and Sound Therapy in Patients with Tinnitus. 经皮三叉神经电刺激和声音疗法对耳鸣患者的影响。

IF 2.4 4区医学

Yonsei Medical Journal Pub Date : 2023-10-01 DOI: 10.3349/ymj.2022.0611

Young Sang Cho, Sungwon Park, Ga-Young Kim, Mini Jo, Sung Hwa Hong, Il Joon Moon

{"title":"Effects of Transcutaneous Trigeminal Electrical Stimulation and Sound Therapy in Patients with Tinnitus.","authors":"Young Sang Cho, Sungwon Park, Ga-Young Kim, Mini Jo, Sung Hwa Hong, Il Joon Moon","doi":"10.3349/ymj.2022.0611","DOIUrl":"https://doi.org/10.3349/ymj.2022.0611","url":null,"abstract":"Purpose: Tinnitus is one of the most common health conditions worldwide. Although various methods of treatment have been used, the condition is still difficult to manage or cure. This study aimed to evaluate the therapeutic effects of transcutaneous trigeminal electrical stimulation (TTES) combined with notched sound therapy (NST) on patients with tinnitus.Materials and methods: A clinical trial was conducted prospectively from September 2020 to September 2021 at a single center in South Korea. In total, 14 patients took part in this trial. Periodic visits and tele-monitoring were used to assess treatment compliance and collect data, including electroencephalography (EEG), photoplethysmography (PPG), tinnitus handicap inventory (THI), tinnitus magnitude index, Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and 36-item short-form survey (SF-36) results.Results: Changes after intervention were analyzed with paired t-test. This study showed that alpha waves in the left hemisphere measured by EEG (p=0.024), autonomic nervous system balance (p=0.007), and stress level (p=0.022) measured by PPG significantly changed after intervention. Also, THI scores especially emotional symptoms (p=0.029) and catastrophic symptoms (p=0.043) decreased after treatment. The SF-36 score, both mental component summary and physical component summary score (each p<0.001), increased significantly, whereas the PSQI score (p<0.001) and BDI score (p<0.001) decreased after TTES and NST.Conclusion: Based on the results of our study, we could confirm that TTES combined with NST can significantly improve tinnitus, catastrophic symptoms, and the overall quality of life of patients.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dd/db/ymj-64-618.PMC10522882.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41164149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fatal Primary Amebic Meningoencephalitis due to Naegleria fowleri: The First Imported Case in Korea. 由福氏奈格里氏菌引起的致命原发性阿米巴脑膜脑炎：韩国首例输入性病例。

IF 2.4 4区医学

Yonsei Medical Journal Pub Date : 2023-10-01 DOI: 10.3349/ymj.2023.0189

Kyung-Wook Hong, Jong Hwan Jeong, Jung-Hyun Byun, Sung-Hee Hong, Jung-Won Ju, In-Gyu Bae

引用次数: 0

A Radiomics-Based Model for Potentially More Accurate Identification of Subtypes of Breast Cancer Brain Metastases. 基于放射组学的乳腺癌脑转移亚型更准确识别模型

IF 2.4 4区医学

Yonsei Medical Journal Pub Date : 2023-09-01 DOI: 10.3349/ymj.2023.0047

Seonghyeon Cho, Bio Joo, Mina Park, Sung Jun Ahn, Sang Hyun Suh, Yae Won Park, Sung Soo Ahn, Seung-Koo Lee

{"title":"A Radiomics-Based Model for Potentially More Accurate Identification of Subtypes of Breast Cancer Brain Metastases.","authors":"Seonghyeon Cho, Bio Joo, Mina Park, Sung Jun Ahn, Sang Hyun Suh, Yae Won Park, Sung Soo Ahn, Seung-Koo Lee","doi":"10.3349/ymj.2023.0047","DOIUrl":"https://doi.org/10.3349/ymj.2023.0047","url":null,"abstract":"Purpose: Breast cancer brain metastases (BCBM) may involve subtypes that differ from the primary breast cancer lesion. This study aimed to develop a radiomics-based model that utilizes preoperative brain MRI for multiclass classification of BCBM subtypes and to investigate whether the model offers better prediction accuracy than the assumption that primary lesions and their BCBMs would be of the same subtype (non-conversion model) in an external validation set.Materials and methods: The training and external validation sets each comprised 51 cases (102 cases total). Four machine learning classifiers combined with three feature selection methods were trained on radiomic features and primary lesion subtypes for prediction of the following four subtypes: 1) hormone receptor (HR)+/human epidermal growth factor receptor 2 (HER2)-, 2) HR+/HER2+, 3) HR-/HER2+, and 4) triple-negative. After training, the performance of the radiomics-based model was compared to that of the non-conversion model in an external validation set using accuracy and F1-macro scores.Results: The rate of discrepant subtypes between primary lesions and their respective BCBMs were 25.5% (n=13 of 51) in the training set and 23.5% (n=12 of 51) in the external validation set. In the external validation set, the accuracy and F1-macro score of the radiomics-based model were significantly higher than those of the non-conversion model (0.902 vs. 0.765, p=0.004; 0.861 vs. 0.699, p=0.002).Conclusion: Our radiomics-based model represents an incremental advance in the classification of BCBM subtypes, thereby facilitating a more appropriate personalized therapy.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e9/dc/ymj-64-573.PMC10462808.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10490422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of Active Surgical Co-Management by Medical Hospitalists in Urology Inpatient Care: A Retrospective Cohort Study. 一项回顾性队列研究:医院医师积极外科联合管理对泌尿外科住院病人护理的影响。

IF 2.4 4区医学

Yonsei Medical Journal Pub Date : 2023-09-01 DOI: 10.3349/ymj.2023.0143

Eun Sun Kim, Jung Hun Ohn, Yejee Lim, Jongchan Lee, Hye Won Kim, Sun-Wook Kim, Jiwon Ryu, Hee-Sun Park, Jae Ho Cho, Jong Jin Oh, Seok-Soo Byun, Hak Chul Jang, Nak-Hyun Kim

{"title":"Effect of Active Surgical Co-Management by Medical Hospitalists in Urology Inpatient Care: A Retrospective Cohort Study.","authors":"Eun Sun Kim, Jung Hun Ohn, Yejee Lim, Jongchan Lee, Hye Won Kim, Sun-Wook Kim, Jiwon Ryu, Hee-Sun Park, Jae Ho Cho, Jong Jin Oh, Seok-Soo Byun, Hak Chul Jang, Nak-Hyun Kim","doi":"10.3349/ymj.2023.0143","DOIUrl":"https://doi.org/10.3349/ymj.2023.0143","url":null,"abstract":"Purpose: This study aimed to evaluate the use of active surgical co-management (SCM) by medical hospitalists for urology inpatient care.Materials and methods: Since March 2019, a hospitalist-SCM program was implemented at a tertiary-care medical center, and a retrospective cohort study was conducted among co-managed urology inpatients. We assessed the clinical outcomes of urology inpatients who received SCM and compared passive SCM (co-management of patients by hospitalists only on request; March 2019 to June 2020) with active SCM (co-management of patients based on active screening by hospitalists; July 2020 to October 2021). We also evaluated the perceptions of patients who received SCM toward inpatient care quality, safety, and subjective satisfaction with inpatient care at discharge or when transferred to other wards.Results: We assessed 525 patients. Compared with the passive SCM group (n=205), patients in the active SCM group (n=320) required co-management for a significantly shorter duration (p=0.012) and tended to have a shorter length of stay at the urology ward (p=0.062) and less frequent unplanned readmissions within 30 days of discharge (p=0.095) while triggering significantly fewer events of rapid response team activation (p=0.002). No differences were found in the proportion of patients transferred to the intensive care unit, in-hospital mortality rates, or inpatient care questionnaire scores.Conclusion: Active surveillance and co-management of urology inpatients by medical hospitalists can improve the quality and efficacy of inpatient care without compromising subjective inpatient satisfaction.","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/01/cb/ymj-64-558.PMC10462814.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10490423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0