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Prediction of short-term algal bloom using the M5P model-tree and extreme learning machine
Hye-Suk Yi,Bomi Lee,Sangyoung Park,Keun-Chang Kwak,Kwang-Guk An 대한환경공학회 2019 Environmental Engineering Research Vol.24 No.3
In this study, we designed a data-driven model to predict chlorophyll-a using M5P model tree and extreme learning machine (ELM). The Juksan weir in the Youngsan River has high chlorophyll-a, which is the primary indicator of algal bloom every year. Short-term algal bloom prediction is important for environmental management and ecological assessment. Two models were developed and evaluated for short-term algal bloom prediction. M5P is a classification and regression-analysis-based method, and ELM is a feed-forward neural network with fast learning using the least square estimate for regression. The dataset used in this study includes water temperature, rainfall, solar radiation, total nitrogen, total phosphorus, N/P ratio, and chlorophyll-a, which were collected on a daily basis from January 2013 to December 2016. The M5P model showed that the prediction model after one day had the highest performance power and dropped off rapidly starting with predictions after three days. Comparing the performance power of the ELM model with the M5P model, it was found that the performance power of the 1-7 d chlorophyll-a prediction model was higher. Moreover, in a period of rapidly increasing algal blooms, the ELM model showed higher accuracy than the M5P model.
소설 ( Seol So ),이상영 ( Sangyoung Yi ),박한빛 ( Han-bit Park ),조윤경 ( Yun Kyung Cho ),정지원 ( Jiwon Jung ),김성한 ( Sung-han Kim ),이상암 ( Sang-ahm Lee ) 대한내과학회 2016 대한내과학회지 Vol.91 No.3
경막외농양은 폐렴알균수막염 치료 중 발생하는 매우 드문 합병증으로써 빠른 진단과 항생제 사용 및 수술적 조치가 필요하다. 본 증례에서는 폐렴알균수막염 치료 중 경막외농양의 합병증이 생긴 환자에서 합병증이 발견되기 전에 뇌척수액세포증가증을 관찰하였다. 이 현상은 임상적 악화의 전조 징후일 수 있어 임상의의 면밀한 관찰이 필요하다고 생각한다. There have been a few reports of pneumococcal meningitis complicated by spinal epidural abscess. A 58-year-old female with Streptococcus pneumoniae meningitis underwent a recurrent pleocytosis without apparent clinical deterioration after appropriate antibiotic treatment. Subsequently, she developed a spinal epidural abscess. Spinal epidural abscess is a rare complication of pneumococcal meningitis, and subclinical deterioration of neutrophil-dominant pleocytosis may precede development of a spinal epidural abscess in individuals with bacterial meningitis. (Korean J Med 2016;91:330-333)
Lung Disease Caused by Mycobacterium malmoense in an Immunocompetent Patient
Jeon, Min Kyung,Yoon, Jung A,Kim, Junhwan,Yi, Sangyoung,Sung, Heungsup,Shim, Tae Sun,Jo, Kyung-Wook The Korean Academy of Tuberculosis and Respiratory 2015 Tuberculosis and Respiratory Diseases Vol.78 No.3
Mycobacterium malmoense is a very rare cause of lung disease in South Korea. We reported the first case of lung disease caused by M. malmoense in an immunocompetent patient. The patient was successfully treated with a 14-month course of antibiotics.
( Jihyun An ),( Ju Hyun Shim ),( Ha Il Kim ),( Seheon Chang ),( Sangyoung Yi ),( Jonggi Choi ),( Gwang Hyeon Choi ),( Danbi Lee ),( Kang Mo Kim ),( Young-suk Lim ),( Han Chu Lee ),( Young-hwa Chung ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Evidence-based guidelines recommend radiofrequency ablation (RFA) as a non-transplant option in treating patients with multiple hepatocellular carcinomas (HCCs) meeting the Milan criteria. Previous comparative studies have reported that local recurrence rate is higher in patients experiencing RFA than surgery. The purpose of this study is to compare the efficacy of RFA versus surgical resection in patients with operable HCCs within the Milan criteria. Methods: Between 2007 and 2011, 650 asymptomatic patients with HCC fulfilling the Milan criteria were initially treated with RFA or surgery at our hospital. Among these, 129 patients with Child-Pugh A liver function who had more than one tumor were included in this study: RFA and resection were performed in 48 (37.2%) and 81 (62.8%), respectively. The patient median age was 56 years, 79.1% were males, and 83.7% were HBV-positive. Overall and recurrence- free survivals were compared between the two treatment groups. Clinical variables affecting survival or recurrence were also identified. Results: The mean size of the largest tumor was 1.8±0.5 and 2.1±0.5 cm, respectively in the RFA and resection groups (P<0.05). Signs of portal hypertension were noted in 24 (50%) and 18 (22.2%) patients, respectively in the corresponding groups (P<0.05). During a median observation of 6.5 years, 34 (70.8%) and 50 (61.7%) recurrences; and 15 (31.3%) and 16 (19.8%) deaths occurred in the RFA and resection groups, respectively. The 5-year cumulative rates of recurrence-free- and overall survivals were 31.6% versus 32.7%; and 72.9% versus 85.2%, respectively in the corresponding groups (Ps=NS). Multivariate Cox analysis adjusted for significant confounders showed that no significant difference in the risk of recurrence or death was observed according to treatment method (Ps=NS). Conclusions: Our data indicate that surgical resection may be not preferred over RFA in patients with multifocal HCCs at BCLC A stage, as recommended by current guidelines.
( Seheon Chang ),( Jihyun An ),( Ju Hyun Shim ),( Ha Il Kim ),( Sangyoung Yi ),( Jonggi Choi ),( Gwang Hyeon Choi ),( Danbi Lee ),( Kang Mo Kim ),( Young-suk Lim ),( Han Chu Lee ),( Young-hwa Chung ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Surgical resection is not universally recommended in hepatocellular carcinoma (HCC) patients with established portal hypertension, even in single small cases. Radiofrequency ablation (RFA) is a formal alternative in treating such patients. A number of studies have concluded that portal hypertension should not be a contraindication for hepatic resection. We aimed to compare prognostic outcomes of surgical resection versus RFA in patients with solitary ablatable HCC and portal hypertension. Methods: This retrospective study included 189 resected or ablated patients who had a subclinical single HCC ≤3 cm and clinical signs of portal hypertension. All patients had well-preserved liver function with 105 (55.6%) and 84 (44.4%) primarily receiving surgery and RFA, respectively. Overall and recurrence-free survivals were compared between the two subsets, and clinical factors related to survival endpoints were identified in the entire set. Results: The number of patients belonging to BCLC 0 stage was 45 (42.9%) and 55 (65.5%), respectively in the resection and ablation groups (P<0.05). The mean count of platelet before treatment was greater in the resection group (81.7±13.8K vs.71.7±19.3K; P<0.05). During the median follow-up of 6.2 years, tumor recurrence and mortality from any cause were noted in 62 (59.0%) and 27 (25.7%) patients; and 50 (59.5%) and 26 (31.0%), respectively in the resection and ablation groups. The respective 5-year cumulative rates of recurrence- free and overall survivals were 40.6% and 82.9% versus 33.6% and 76.2% in the corresponding groups (Ps=NS). In multivariate Cox model adjusted for other confounders, resection and RFA was comparable in terms of risk of recurrence and death (Ps=NS). Conclusions: Our data indicate that guidelines-based RFA treatment can be justified as a primary option for compensated patients with single small HCC and portal hypertension, even though a tumor is resectable.
Refractory Pleural Effusion in Systemic Lupus Erythematosus Treated by Pleurectomy
( Sichan Kim ),( Han-bit Park ),( Yun Kyung Cho ),( Sangyoung Yi ),( Kyunghwan Oh ),( Dong Kwan Kim ),( Bin Yoo ) 대한류마티스학회 2017 대한류마티스학회지 Vol.24 No.1
Pleural effusion is a common pulmonary manifestation of systemic lupus erythematosus (SLE) and often occurs as bilateral exudative pleural effusion. The condition usually responds quickly to corticosteroid therapy. However, massive pleural effusion refractory to immunosuppressive drugs has rarely been reported; thus, the proper therapeutic modality is largely decided on a case-by-case basis. In this case, we describe successful treatment with surgical pleurectomy for massive refractory pleural effusion in a patient with SLE. (J Rheum Dis 2017;24:43-47)
( Jihyun An ),( Ju Hyun Shim ),( Ha Il Kim ),( Seheon Chang ),( Sangyoung Yi ),( Jonggi Choi ),( Gwang Hyeon Choi ),( Danbi Lee ),( Kang Mo Kim ),( Young-suk Lim ),( Han Chu Lee ),( Young-hwa Chung ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Transarterial chemoembolization (TACE) is usually considered as second-line therapy for patients with non-ablatable and non-transplantable multifocal hepatocellular carcinomas (HCCs) who meet the Milan criteria. However, there are data suggesting that patients with multiple tumors may be suitable for resection in spite of the higher risk of postoperative recurrence. Given the non-curability of TACE, the aim of this study was to evaluate the therapeutic performance of surgery compared with TACE in such cases. Methods: A total of 300 Milan-in subclinical patients who had more than one HCC nodule and ≤3cm in diameter and Child-Pugh A liver function were included. Patients were treated with surgical resection (n=81) or TACE (n=219) as initial treatment. The median age of patients was 57 years; 80.7% was male; and 79.3% was infected by hepatitis B virus. Results: Patients having three nodules or clinical signs of portal hypertension was more frequently observed in the TACE group than in the surgery group (32.4% vs. 6.2%; and 47.0% vs. 22.2%, respectively; Ps<0.05). During the median observation period of 5.6 years, overall and cancer-specific deaths occurred more frequently in the TACE group (57.5% vs. 19.8%; and 37.4% vs. 12.3%, respectively; Ps<0.05). The median overall survival time in the TACE group was 5.2 years with 5-year overall survival rates of 52.5%, which was lower than 6.6 years with 85.2% in the surgery group (P<0.05). Similar trends were observed for cancer-specific mortality data (P<0.05). Multivariate analyses showed that surgical resection provided better outcomes regarding overall and cancer-specific survivals independently of other clinical predictors including tumor factors (HRs [95% CI], 0.28 [0.16-0.48] and 0.24 [0.12-0.48], respectively; Ps<0.05). Conclusions: Taking our findings and non-curability of TACE into account, surgical resectability should be assessed before TACE rescue in patients with multifocal HCCs meeting Milan who are not eligible for local ablation or liver transplantation.
( Jihyun An ),( Ju Hyun Shim ),( Ha Il Kim ),( Seheon Chang ),( Sangyoung Yi ),( Jonggi Choi ),( Gwang Hyeon Choi ),( Danbi Lee ),( Kang Mo Kim ),( Young-suk Lim ),( Han Chu Lee ),( Young-hwa Chung ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: A cut-off point of 5 cm for classifying a single hepatocellular carcinoma (HCC) as BCLC stage A is no longer used in the updated BCLC guidelines. However, there is a continuing debate about the need for size criteria for a single A stage tumor. We aimed to assess whether such size limit was necessary based on survival outcomes of patients receiving treatment recommended by the guidelines. Methods: This study included 301 patients with solitary BCLC-A HCC >5 cm and normal portal hypertension who initially underwent resection (n=238; standard A group) or transarterial chemoembolization (TACE) (n=63; non-standard A group); and 385 with BCLC-B HCC undergoing TACE (standard B group). All patients had Child-Pugh A liver function. Overall survival was compared between the standard and non-standard treatment groups at different stages. We also examined an independent effect of each treatment modality on survival. Results: The mean size of tumor was similar between the standard and non-standard A groups (8.8±3.2 vs. 8.9±3.4cm; P=NS). During the median follow-up of 5.5 years, the 5-year survival rate was 69.7% in the standard A group; and 34.9% in the non-standard A group (P<0.05). Compared with TACE, surgical resection had a multivariate hazard ratio (HR) of 0.34 for survival (95% CI, 0.24-0.50; P<0.05). The 5-year survival rate was significantly higher in the standard A group than in the standard B group (69.7% vs. 32.6%; P<0.05). This trend persisted after adjustment for confounding covariates with an adjusted HR of 0.27 in the standard A group (95% CI, 0.20-0.35; P<0.05). However, there was no significant difference in the 5-year survival outcome between the non-standard A and standard B groups (34.9% vs. 32.2%; P=NS). Conclusions: Our between-group comparison data on survival support that defining all single HCCs of any size as stage A is a reasonable classification in the BCLC staging system ultimately guiding treatment decisions.
CASE REPORT : Lung Disease Caused by Mycobacterium malmoense in an Immunocompetent Patient
( Min Kyung Jeon ),( Jung A Yoon ),( Junhwan Kim ),( Sangyoung Yi ),( Heungsup Sung ),( Tae Sun Shim ),( Kyung Wook Jo ) 대한결핵 및 호흡기학회 2015 Tuberculosis and Respiratory Diseases Vol.78 No.3
Mycobacterium malmoense is a very rare cause of lung disease in South Korea. We reported the first case of lung disease caused by M. malmoense in an immunocompetent patient. The patient was successfully treated with a 14-month course of antibiotics.
( Ha Il Kim ),( Jihyun An ),( Ju Hyun Shim ),( Seheon Chang ),( Sangyoung Yi ),( Jonggi Choi ),( Gwang Hyeon Choi ),( Danbi Lee ),( Kang Mo Kim ),( Young-suk Lim ),( Han Chu Lee ),( Young-hwa Chung ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Transarterial chemoembolization (TACE) is a current standard therapy based on scientific evidences for patients with intermediate stage hepatocellular carcinoma (HCC). A large number of these patients are usually incurable by TACE alone, and moreover repetition of TACE can increase the risk of liver deterioration. Multiplicity of lesions is not a contraindication for radical hepatectomy, although it is a potential risk factor of recurrence. Based on these backgrounds, we aimed to identify survival benefits of surgical resection compared with TACE, a standard-of-care, for patients with intermediate HCC. Methods: A total of 548 patients with BCLC B stage HCC and Child-Pugh A hepatic function underwent surgical resection (n=163) or TACE (n=385) as a primary therapy between 2007 and 2011 at our hospital. Their median age was 57 years (range 51-65), and most of them were male (85.9%) and positive for HBV (73.7%). All-cause and cancer-specific mortalities were measured and compared in the two groups (i.e, surgery and TACE). Results: The mean number of tumors (2.3±0.8 vs. 3.4±1.5) and the proportion of portal hypertension (8.6% vs. 26.0%) were greater in the TACE group than in the surgery group (Ps<0.05). During the median follow-up of 3.6 years, resection provided a survival benefit over TACE at 5 years (63.2% vs. 32.2%; P<0.05). Cancer-specific mortality rate at 5 years was also significantly lower in the surgery group (9.6% vs. 36.0%; P<0.05). In the adjusted Cox model, resection was identified as an independent predictor of better all-cause and cancer-specific mortality outcomes (adjusted HRs [95% CI], 0.46 [0.36-0.58] and 0.38 [0.28-0.51], respectively; Ps<0.05). Conclusions: Our data indicate that patients with resectable BCLC B stage HCC and good liver function may benefit from surgical resection as another first-line option more curable than TACE.