Analysis of a Blog for Gastrointestinal Disease in the View Point of the Big Data: A Single Institutional Study

Background/Aims: With the enormous increase in the amount of data, the concept of big data has emerged and this allows us to gain new insights and appreciate its value. However, analysis related to gastrointestinal diseases in the viewpoint of the big data has not been performed yet in Korea. This study analyzed the data of the blog’s visitors as a set of big data to investigate questions they did not mention in the clinical situation. Methods: We analyzed the blog of a professor whose subspecialty is gastroenterology at Gangnam Severance Hospital. We assessed the changes in the number of visitors, access path of visitors, and the queries from January 2011 to December2013.Results: A total of 50,084 visitors gained accessed to the blog. An average of 1,535.3 people visited the blog per month and 49.5 people per day. The number of visitors and the cumulative number of registered posts showed a positive correlation. The most utilized access path of visitors to the website was blog.iseverance.com (42.2%), followed by Google (32.8%) and Daum (6.6%). The most searched term by the visitors in the blog was intestinal metaplasia (16.6%), followed by dizziness(8.3%) and gastric submucosal tumor (7.0%).Conclusions: Personal blog can function as a communication route for patients with digestive diseases. The most frequently searched word necessitating explanation and education was ‘intestinal metaplasia’. Identifying and analyzing even unstructured data as a set of big data is expected to provide meaningful information.ope

Usefulness of the controlled attenuation parameter for detecting liver steatosis in health checkup examinees

BACKGROUND/AIMS: The controlled attenuation parameter (CAP) implemented in FibroScan® is reported to be a noninvasive means of detecting steatosis (>10% steatosis). We aimed to evaluate the usefulness of CAP in detecting steatosis among health checkup examinees and to assess its correlation with ultrasonography (US). METHODS: Consecutive CAP results were retrospectively collected. A total of 280 subjects were included. RESULTS: Fatty liver was detected in 119 subjects (42.5%) by US, whereas it was detected in 160 subjects (57.1%) by the CAP. The numbers of subjects with S0S1S2S3 steatosis according to the CAP value were 120595843, respectively. The mean CAP values were 203.34±28.39 dB/m for S0, 248.83±6.14 dB/m for S1, 274.33±8.53 dB/m for S2, and 322.35±22.20 dB/m for S3. CAP values were correlated with body weight (r=0.404, p<0.001), body mass index (r=0.445, p<0.001), and the fatty liver grade by US (r=0.472, p<0.001). Among the 161 subjects with normal US findings, steatosis was detected in 65 subjects (40.4%) using the CAP. CONCLUSIONS: The CAP seems to be useful for detecting very low-grade hepatic steatosis in health checkup examinees. Its role in predicting subjects with a risk of metabolic derangement needs to be evaluated.ope

An Insertion/Deletion Polymorphism in the α2B-Adrenoceptor Gene is not a Genetic Risk Factor for Coronary Artery Disease in the Korean Population

BACKGROUND AND OBJECTIVES: Cardiovascular disease (CVD) is a complex multigenic disorder, with significant inheritable elements having important roles relating to environmental factors. Recently, the alpha 2 adrenoceptor (alpha(2)-AR) gene has been reported to be involved in the development of coronary artery disease (CAD). The aim of this study was to investigate the relationships between an insertion/deletion (I/D) in alpha(2B)-AR and CAD in Korean subjects. SUBJECTS AND METHODS: The alpha(2B)-AR I/D polymorphism, which was located in the third intracellular loop of the receptor polypeptide, was examined in 292 patients (M:F=219:73) with CAD and 151 healthy control subjects (M:F=70:81) who visited the Cardiovascular Genome Center in Yonsei Cardiovascular Hospital. RESULTS: In the patient group, 77 men (35.1%) and 26 women (35.6%) had the I/I genotype; 105 men (47.9%) and 39 women (53.4%) a heterozygous genotype and 37 (17.0%) and 8 (11.0%) the D/D genotype. In the controls, 23 men (32.8%) and 29 women (35.8%) had the I/I genotype; 38 (54.3%) and 39 (48.1%) the I/D genotype and 9 (12.9%) and 13 (16.1%) the D/D genotype. There were no differences in the genotype frequencies between the patient and control groups, either in men or women. From a logistical regression analysis, the alpha(2B)-AR genotype was not significantly associated with CAD in our study group. CONCLUSION: The alpha(2B)-AR I/D polymorphism is not a risk factor for CAD in the Korean population.ope

A Case of Crohn's Disease Showing Favorable Response to Induction and Maintenance Therapy with Methotrexate after Failure of Anti-tumor Necrosis Factor Therapy

Thanks to the introduction of immumomodulators and biologics, therapeutic approaches in Crohn’s disease have changed significantly during the past decade. Although new biologic therapy has dramatically improved the treatment of Crohn’s disease, a substantial number of patients are refractory to these therapies or lose their initial response. Methotrexate (MTX) is a structural analogue of folic acid that can competitively inhibit the binding of dihydrofolic acid to the enzyme dihydrofolate reductase and has been widely used as immunomodulator in rheumatology area for patients with rheumatoid arthritis and psoriasis. Although MTX has also been shown to be an effective agent for remission induction and maintenance of remission in Crohn’s disease, the use of MTX in Crohn’s disease has not yet been reported in Korea. Herein, we report a case of Crohn’s disease patient who was successfully treated with MTX after treatment failure with thiopurine and anti-tumor necrosis factor.ope

Effects of Leptin on Differentiation of Mesenchymal Stem Cells Derived from Human Dental Tissues

학위논문(석사) --서울대학교 치의학대학원 :치의학과,2010.2.Maste

Genetic effects of apolipoprotein A5 on plasma lipoprotein level by case-control study and family-based association study

의과학과/박사[한글]본 연구에서는 환자-대조군 자료와 가계자료를 이용하여 한국인에서 apolipoprotein A-V(APOA5) 유전자와 혈중 중성지방(triglyceride, TG) 농도와의 관련성을 알아보고자 하였다. 환자-대조군 연구에 이용한 자료는 39명의 고중성지방혈증(hypertriglyceridemia, HTG) 환자군과 144명의 대조군이었고 가계 연구에서는 36개의 가계 자료를 대상으로 하여 APOA5 유전자내에 있는 단일염기서열 다형성(single nucleotide polymorphism, SNP)으로 구성된 haplotype과 HTG 위험여부와의 연관성을 비교 분석하였다. 48명의 정상인에서 직접 염기서열 분석(sequencing)을 통해 12개의 SNP를 발견했으며 이 중 6개의 SNP -1390C>T, -1020G>A, -3A>G, V150M, G182C, 1259T>C를 선정했다. 환자-대조군 자료에서 연관성 분석을 위해 사용한 통계적 방법은 haplotype에 근거한 우도비 검정법(likelihood ratio test, LRT)과 haplotype trend logistic regression test(HTR)이었고, 가계자료에서는 transmission disequilibrium test(TDT)와 family based association test(FBAT) 방법을 이용하여 연관성을 분석하였다. 또한 환자-대조군 자료에서 tag-SNP으로 선정된 SNP -1390C>T, -1020G>A, -3A>G, 1259T>C만을 이용하여 질병 발생과의 관련성을 알아보았다. 환자-대조군 연구에서 -3A>G, G182C 다형성이 대조군보다 환자군에서 더 많은 빈도로 나타났고 HTG와의 위험도에서 유의한 상관성이 있었다(pT와 -3A>G SNP가 TG와 통계적인 연관성이 있었고 haplotype TGAGGT가 HTG 위험여부에 유의적인 상관성이 있다는 것을 알 수 있었다(p<0.01). [영문]Recent studies using human and mice reported that apolipoprotein A-V (APOA5) gene plays an important role in controlling triglyceride (TG) concentrations. The aim of this study was to analyze these associations in Korean patients and also to test for association of APOA5 with susceptibility to hypertriglyceridemia (HTG). We examined a case-control samples consisting of 39 patients with HTG and 144 healthy control subjects and 36 nuclear families. Six single nucleotide polymorphisms (-1390C>T, -1020G>A, -3A>G, V150M, G182C and 1259T>C) were genotyped in the APOA5 gene. A haplotype CGGGTT was significantly predominant in patients with HTG (p C, -3A>G and TG (p < 0.01 and 0.03, respectively). These findings strongly support association of the APOA5 gene with susceptibility to HTG in Korean patients. Further studies are needed to confirm these findings in other populations and to identify functional variants in APOA5 that may be implicated in pathogenesis.ope

Proposal of pharmacogenetics-based warfarin dosing algorithm in Korean patients

Warfarin is a commonly prescribed anticoagulant drug for the prevention of thromboembolic disorders. We investigated the contribution of genetic variations of four genes and clinical factors to warfarin dose requirement and provided a warfarin-dosing algorithm based on genetic and clinical variables in Korean patients. We recruited 564 Korean patients on stable anticoagulation. Single nucleotide polymorphisms (SNPs) for the VKORC1, CYP2C9, CYP4F2 and GGCX were analyzed. Using multiple regression analysis, we developed a model to predict the warfarin requirement. The SNPs of VKORC1, CYP2C9, CYP4F2 and GGCX showed significant correlation with warfarin dose. Patients with the 3730AA genotype received significantly higher doses of warfarin than those with the 3730GG (P=0.0001). For CYP2C9, the highest maintenance dose was observed in the patients with wild-type genotype compared with the variant allele carriers (P&amp;amp;amp;lt;0.0001). The multiple regression model including age, gender, body surface area (BSA), international normalized ratio (INR) and four genetic polymorphisms accounted for 35% of total variations in warfarin dose (R2 = 0.3499; P&amp;amp;amp;lt;0.0001). This study shows that age, gender, BSA, INR and VKORC1, CYP2C9 and CYP4F2 polymorphism affect warfarin dose requirements in Koreans. Translation of this knowledge into clinical guidelines for warfarin prescription may contribute to improve the efficacy and safety of warfarin treatment for Korean patients. © 2011 The Japan Society of Human Genetics All rights reserved

Does altered basement membrane of melasma lesion affect treatment outcome in Asian skin?

[No abstract available

Magnetic compression anastomosis for treatment of benign biliary stricture

Endoscopic and percutaneous procedures have shown high success rates when used to treat benign biliary stricture. However, cases in which a guidewire cannot be passed through a refractory stricture or a complete obstruction are difficult to treat using conventional methods. Magnetic compression anastomosis (MCA) has emerged as a non-surgical alternative avoiding operational mortality and morbidity. The feasibility and safety of MCA have been experimentally and clinically verified in cases of biliobiliary and bilioenteric anastomosis. However, no pre-MCA assessment modality capable of predicting outcomes is as yet available, and no universally effective magnet delivery method has as yet been established, rendering it difficult to identify patients for whom MCA is appropriate. Various experimental studies seeking to overcome these limitations are underway. Such work will improve our in-depth understanding of MCA, which has been trialed in various fields. Upon further development, MCA may become a ground-breaking option for treatment of benign strictures that are difficult to resolve using conventional methods, and MCA may be expected to be minimally traumatic and highly effective. The aim of the present study was to discuss the current status of MCA and the direction of MCA development by reviewing clinical and experimental MCA data.ope