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Comparative effectiveness of combined antiplatelet treatments in acute minor ischaemic stroke

Stroke & Vascular Neurology 2022年第1期7卷 13-21页

作者： Shina Kim Joon-Tae Kim Ji Sung Lee Beom Joon Kim Jong-Moo Park Kyusik Kang Soo Joo Lee Jae Guk Kim Jae-Kwan Cha Dae-Hyun Kim Tai Hwan Park Sang-Soon Park Kyung Bok Lee Jun Lee Keun-Sik Hong Yong-Jin Cho Hong-Kyun Park Byung-Chul Lee Kyung-Ho Yu Mi Sun Oh Dong-Eog Kim Wi-Sun Ryu jay chol choi Jee-Hyun Kwon Wook-Joo Kim Dong-Ick Shin Sung-Il Sohn Jeong-Ho Hong Man-Seok Park Kang-Ho choi Ki-Hyun Cho Juneyoung Lee Hee-Joon Bae Department of Neurology Chonnam National University HospitalChonnam National University Medical SchoolGwangjuKorea Clinical Research Center Asan Institute for Life SciencesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea Department of Neurology Cerebrovascular CenterSeoul National University Bundang HospitalSeongnamKorea Department of Neurology Uijeongbu Eulji Medical CenterEulji University School of MedicineUijeongbu-siKorea Department of Neurology Nowon Eulji Medical CenterEulji UniversitySeoulKorea Department of Neurology Eulji University HospitalEulji UniversityDaejeonKorea Department of Neurology Dong-a UniversityBusanKorea Department of Neurology Seoul Medical CenterSeoulKorea Department of Neurology Soonchunhyang University HospitalSeoulKorea Department of Neurology Yeungnam University HospitalDaeguKorea Department of Neurology Inje University Ilsan Paik HospitalInje University College of MedicineGoyangKorea Department of Neurology Hallym University Sacred Heart HospitalAnyangKorea Department of Neurology Dongguk University Ilsan HospitalGoyangKorea Department of Neurology Jeju National University HospitalJeju National University School of MedicineJejuKorea Department of Neurology University of Ulsan College of MedicineUlsanKorea Department of Neurology Chungbuk National University HospitalCheongjuKorea Department of Neurology Keimyung University Dongsan Medical CenterDaeguKorea Department of Biostatistics Korea University College of MedicineSeoulKorea

Background No study has thoroughly compared the effectiveness of combined antiplatelet treatments(other than clopidogrel–aspirin)versus clopidogrel–aspirin or aspirin alone for early secondary prevention in acute ischaemic stroke.Methods We identified patients with acute,minor,non-cardiogenic ischaemic stroke treated with aspirin alone,clopidogrel–aspirin or other combination treatment.Propensity scores considering the inverse probability of treatment weighting were used to adjust for baseline imbalances.The primary outcome was the composite of all strokes(ischaemic or haemorrhagic),myocardial infarction and all-cause mortality at 3 months.Results Among 12234 patients(male:61.9%;age:65.5±13 years)who met the eligibility criteria,aspirin,clopidogrel–aspirin and other combination treatments were administered in 52.2%,42.9%and 4.9%of patients,respectively.In the crude analysis,the primary outcome event at 3 months occurred in 14.5%of the other combination group,14.4%of the aspirin group and 13.0%of the clopidogrel–aspirin group.In the weighted Cox proportional hazards analysis,the 3-month primary outcome event occurred less frequently in the clopidogrel–aspirin group than in the other combination group(weighted HR:0.82(0.59–1.13)),while no association was found between the aspirin group(weighted HR:1.04(0.76–1.44))or other combination group and the 3-month primary outcome.Conclusion Other combined antiplatelet treatment,compared with aspirin alone or clopidogrel–aspirin,was not associated with reduced risks of primary composite vascular events or recurrent stroke during the first 3 months after stroke.Therefore,the results suggest that other combination treatments,particularly the cilostazol-based combination,may not be effective alternatives for clopidogrel–aspirin to prevent early vascular events in patients with acute minor stroke.Further exploration in clinical trials will be needed.

关键词： prevention treatment alone

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Exploratory Data Analysis Applied in Mapping Multi-element Soil Geochemical Anomalies for Drill Target Definition:A Case Study from the Unpha Layered Non-magmatic Hydrothermal Pb-Zn Deposit,DPR Korea

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Acta Geologica Sinica(English Edition) 2021年第4期95卷 1357-1365页

作者： JANG Gwang-Hyok WON Hyon-chol HWANG Bo-Hyon choi chol-Man Faculty of Geology Kim Il Sung UniversityPyongyangDemocratic People's Republic of Korea

A factor analysis was applied to soil geochemical data to define anomalies related to buried Pb-Zn mineralization.A favorable main factor with a strong association of the elements Zn,Cu and Pb,related to mineralization,was selected for interpretation.The median+2 MAD(median absolute deviation)method of exploratory data analysis(EDA)and C-A(concentration-area)fractal modeling were then applied to the Mahalanobis distance,as defined by Zn,Cu and Pb from the factor analysis to set the thresholds for defining multi-element anomalies.As a result,the median+2 MAD method more successfully identified the Pb-Zn mineralization than the C-A fractal model.The soil anomaly identified by the median+2 MAD method on the Mahalanobis distances defined by three principal elements(Zn,Cu and Pb)rather than thirteen elements(Co,Zn,Cu,V,Mo,Ni,Cr,Mn,Pb,Ba,Sr,Zr and Ti)was the more favorable reflection of the ore body.The identified soil geochemical anomalies were compared with the in situ economic Pb-Zn ore bodies for validation.The results showed that the median+2 MAD approach is capable of mapping both strong and weak geochemical anomalies related to buried Pb-Zn mineralization,which is therefore useful at the reconnaissance drilling stage.

关键词： factor analysis exploratory data analysis Mahalanobis distance multi-element Unpha

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Comprehensive evaluation of marine waste heat recovery technologies based on Hierarchy-Grey correlation analysis

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Journal of Ocean Engineering and Science 2019年第4期4卷 308-316页

作者： Jong Ju-Yong Rim Chang-Hyon choi Myong-Sin Om Hyon-chol Department of Energy Science Kim Il Sung UniversityPyongyangDemocratic People’s Republic of Korea College of Mechanical Science and Technical KimCheak University of TechnologyPyongyangDemocratic People’s Republic of Korea

In this study,comprehensive evaluation of the technologies on waste heat recovery technologies for maritime applications has been carried out.We have focused our research on exhaust gas turbine system(EGT),thermodynamic organic rankine cycle(RC),Kalina cycle(KC)and thermoelectric generators(TG),which are the most appropriate and most up-to-date techniques for recovering power from marine engines.Each technology has its own advantages and disadvantages,so the comprehensive evaluation of these technologies is essential to accurately determine which technology will be applied to which target.This belongs to the multi-criteria decision(MCDM)process.The combined assessment methodology,consisting of gray correlation and analysis hierarchy processes,has been applied to evaluate four waste heat recovery techniques in terms of technical,economic,social and environmental aspects.According to the comparison results,the exhaust gas turbine system has been evaluated as the most promising technology among the various WHR technologies that can be applied to marine engines.Sensitivity analysis suggests that if investment cost of TG falls to about the same level as the one of EGT,TG could be the best method among these technologies.Reduction of investment cost of TG technology could be realized by development of low cost thermoelectric material.We have analyzed the correlation between each cost through DOE analysis and investigate the effect of individual costs on the total cost.This work helps in identifying the most suitable heat recovery technologies for marine engine.

关键词： Waste heat recovery Marine engine Grey relational analysis Analytic hierarchy process Comprehensive evaluation

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Clinical significance of isolated biliary candidiasis in patients with unresectable cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2016年第5期15卷 533-539页

作者： In-Ho Kim Jae-Ki choi Dong-Gun Lee In Seok Lee Tae Ho Hong Young Kyoung You Ho Jong Chun Myung Ah Lee Departments of Internal Medicine Division of Medical 0ncologySeoul St. Mary’s Hospital The Catholic University of Korea Seoul Korea Departments of Internal Medicine Division of Infectious Diseases Bucheon St. Mary’s Hospital The Catholic University of Korea Seoul Korea Division of Infectious Diseases Seoul St. Mary’s Hospital The Catholic University of Korea Seoul Korea Division of Gastroenterology Seoul St. Mary’s Hospital The Catholic University of Korea Seoul Korea Department of Surgery Seoul St. Mary’s Hospital The Catholic University of Korea Seoul Korea Department of Radiology Seoul St. Mary’s Hospital The Catholic University of Korea Seoul Korea Department of Hepato-Biliary-Pancreatic Cancer Center Seoul St. Mary’s Hospital The Catholic University of Korea Seoul Korea

BACKGROUND: The frequency of isolated biliary candidiasis is increasing in cancer patients. The clinical signiifcance of isolated biliary candidiasis remains unclear. We analyzed the risk factors of biliary candidiasis and outcomes of the patients with unresectable cholangiocarcinoma after percutaneous transhepatic biliary drainage (PTBD). METHODS: Among 430 patients who underwent PTBD between January 2012 and March 2015, 121 patients had unresectable cholangiocarcinoma. Bile and blood samples were collected for consecutive fungal culture. RESULTS: The study cohort included 49 women and 72 men with a median age of 71 years. Multivariate analysis showed that cancer progression (P=0.013), concurrent presence of another microorganism (P=0.010), and previous long-term (>7 days) antibiotic use (P=0.011) were potential risk factors of biliary candidiasis. Chemotherapy was not associated with overall biliary candidiasis (P=0.196), but was signiifcantly related to repeated biliary candidiasis (P=0.011). Patients with isolated biliary candidiasis showed remarkably reduced survival compared with those without (median overall sur-vival (OS): 32 vs 62 days,P=0.011)Subgroup analysis was also performed. Patients with repeated candidiasis had markedly decreased survival compared with those with transient candi-diasis (median OS: 30 vs 49 days,P=0.046). Biliary candidiasis was identiifed as a poor prognostic factor by univariate and multivariate analyses (P=0.033). Four cases of repeated can-didiasis (4/19, 21%) showedCandida species in consecutive blood culture until the end of the study, but others showed no candidemia. CONCLUSIONS: Isolated biliary candidiasis may be associ-ated with poor prognosis in patients with unresectable chol-angiocarcinoma. Especially, repeated biliary candidiasis may have the possibility of progression to candidemia. We suggest that biliary dilatation treatment or antifungal agents might be helpful for patients with biliary candidiasis.

关键词： biliary candidiasis biliary obstruction cholangiocarcinoma percutaneous transhepatic biliary drainage

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