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Prediction of large vessel occlusion for ischaemic stroke by using the machine learning model random forests

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Stroke & Vascular neurology 2022年第2期7卷 94-100页

作者： Jianan Wang Jungen Zhang Xiaoxian Gong Wenhua Zhang Ying Zhou Min Lou department of neurology Zhejiang University School of Medicine Second Affiliated Hospital Department of NeurologyHangzhouZhejiangChina

Backgrounds The timely identification of large vessel occlusion(LVO)in the prehospital stage is extremely important given the disease morbidity and narrow time window for *** current evaluation strategies still remain *** goal of this study was to develop a machine learning(ML)model to predict LVO using prehospital accessible *** Consecutive acute ischaemic stroke patients who underwent CT or MR angiography and received reperfusion therapy within 8 hours from symptom onset in the Computer-based Online Database of Acute Stroke Patients for Stroke Management Quality Evaluation-II dataset from January 2016 to August 2021 were *** developed eight ML models to integrate National Institutes of Health Stroke Scale(NIHSS)items with demographics,medical history and vascular risk factors to identify LVO and validate its *** Finally,15365 patients were included in the training set and 4215 patients were included in the test *** the test set,random forests(RF),gradient boosting machine and extreme gradient boosting presented area under the curve(AUC)of 0.831(95%CI 0.819 to 0.843),which were higher than other models,and RF presented the highest specificity(0.827).In addition,the AUC of RF was higher than other scales,and the accuracy of the model was improved by 6.4%compared with *** also found the top five items of identifying LVO were total NIHSS score,gaze deviation,level of consciousness(LOC),LOC commands and motor left *** Our proposed model could be a useful screening tool to predict LVO based on the prehospital accessible medical data.

关键词： boosting random narrow

Long-term follow up of endoscopic resection for type 3 gastric NET

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World Journal of Gastroenterology 2013年第46期19卷 8703-8708页

作者： Yong Hwan Kwon Seong Woo Jeon Gwang Ha Kim Jin Il Kim Il-Kwun Chung Sam Ryong Jee Heung Up Kim Geom Seog Seo Gwang Ho Baik Kee Don Choi Jeong Seop Moon department of internal medicine Kyungpook National University Hospital department of internal medicine Busan National University School of Medicine department of internal medicine Catholic University of Korea College of Medicine department of internal medicine Soonchunhyang University department of internal medicine Inje University Pusan Paik Hospital department of internal medicine Jeju National University School of Medicine department of internal medicine Digestive Disease Research InstituteWonkwang University College of Medicine department of internal medicine Hallym University College of Medicine department of internal medicine University of Ulsan College of MedicineAsan Medical Center department of internal medicine Inje University Seoul Paik Hospital

AIM:To clarify the short and long-term results and to prove the usefulness of endoscopic resection in type 3gastric neuroendocrine tumors(NETs).METHODS:Of the 119 type 3 gastric NETs diagnosed from January 1996 to September 2011,50 patients treated with endoscopic resection were enrolled in this *** endoscopic resection,endoscopic mucosal resection(EMR)or endoscopic submucosal dissection(ESD)was *** efficacy,complications,and follow-up results were evaluated ***:EMR was performed in 41 cases and ESD in 9 *** complete resection was performed in 40 cases(80.0%)and incomplete resection specimens were observed in 10 cases(7 vs 3 patients in the EMR vs ESD group,P=0.249).Upon analysis of the incomplete resection group,lateral or vertical margin invasion was found in six cases(14.6%)in the EMR group and in one case in the ESD group(11.1%).Lymphovascular invasions were observed in two cases(22.2%)in the ESD group and in one case(2.4%)in the EMR group(P=0.080).During the follow-up period(43.73;13-60 mo),there was no evidence of tumor recurrence in either the pathologically complete resection group or the incomplete resection *** recurrence was reported during *** addition,no mortality was reported in either the complete resection group or the incomplete resection group for the duration of the follow-up ***:Less than 2 cm sized confined submucosal layer type 3 gastric NET with no evidence of lymphovascular invasion,endoscopic treatment could be considered at initial treatment.

关键词： Stomach Neuroendocrine tumor Endo-scopic resection Treatment Carcinoid

Severe isolated sciatic neuropathy due to a modified lotus position

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World Journal of Clinical Cases 2014年第2期2卷 39-41页

作者： Jacob Wycher Bosma Juerd Wijntjes Ton Antonius Hilgevoord Jan Veenstra department of internal medicine Sint Lucas Andreas Hospital department of neurology Sint Lucas Andreas Hospital

A 51-year-old man presented to our hospital with progressive pain and weakness in his right leg. Neurological examination revealed atrophy of all muscles of the right leg, unilateral foot drop and paralysis of the anterior tibial and gastrocnemicus muscles. Electromyography confirmed a severe isolated sciatic neuropathy in the thigh. For unclear reasons, our patient habitually used to sit in a modified lotus position. We concluded that this position, in literature known as "lotus neuropathy" had resulted in the sciatic neuropathy. After more than a year our patient was referred again to our outpatient clinic. At that time there was only minimal improvement, now with an achilles tendon contracture and pes equinus due to immobility.

关键词： Sciatic neuropathy Lotus neuropathy Sciatic nerve

Prediction of the indication criteria for endoscopic resection of early gastric cancer

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World Journal of Gastroenterology 2015年第39期21卷 11160-11167页

作者： Jae Hyun Park Si Hyung Lee Joon Mo Park Chan Seo Park Kyung Sik Park Eun Soo Kim Kwang Bum Cho department of internal medicine Yeungnam University College of Medicine department of internal medicine Keimyung University College of Medicine

AIM: To find risk factors of lymph node metastasis(LNM) in early gastric cancer(EGC) and to find proper endoscopic therapy indication in ***: We retrospectively reviewed the 2270 patients who underwent curative operation for EGC from January 2001 to December 2008. EGC was defined as malignant lesions that do not invade beyond the submucosal layer of the stomach wall irrespective of presence of lymph node ***: Among 2270 enrolled patients, LNM was observed in 217(9%) patients. LNM in intramucosal(M) cancer and submucosal(SM) cancer was detectedin 3 8( 2. 8 %, 3 8 / 1 3 4 0) patients and 1 7 9(19%, 179/930) patients, respectively. In univariate analysis, the risk factors for LNM in EGC were size of tumor, Lauren classification, ulcer, lymphatic invasion, vascular invasion, and depth of invasion. However, in multivariate analysis, size of tumor, lymphatic invasion, vascular invasion, and depth of invasion were risk factors for LNM in EGC. Size of tumor, lymphatic invasion, vascular invasion, and depth of invasion were risk factors for LNM in cases of intramucosal cancer and submucosal cancer. In particular, there was no lymph node metastasis in cases of well differentiated early gastric cancer below 1 cm in size without ulcer regardless of lymphovascular ***: Tumor size, perilymphatic-vascular invasion, and depth of invasion were risk factors for LNM in EGC. There was no LNM in EGC below 1 cmregardless risk factors.

关键词： Early gastric cancer Lymph node metastasis Endosco

Significance of scintigraphy for the localisation of obscure gastrointestinal bleedings

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World Journal of Gastroenterology 2008年第32期14卷 5015-5019页

作者： Tanja Brünnler Frank Klebl Sascha Mundorff Christoph Eilles Michael Reng Hans von Korn Jürgen Schlmerich Julia Langgartner Stefan Grüne department of internal medicine I University of Regensburg department of Surgery Hospital Neumarkt department of Nuclear medicine University of Regensburg department of internal medicine Hospital Bogen department of internal medicine II Hospital Hetzelstift

AIM： To determine the role of scintigraphy in patients with gastrointestinal （GI） bleeding of unknown Iocalisation. METHODS： We performed retrospective analyses on 92 patients receiving scintigraphies from 1993 to 2000 in the University of Regensburg hospital, which were done for Iocalisation of GI bleeding as a diagnostic step after an unsuccessful endoscopy. In addition to the scintigraphies, further diagnostic steps such as endoscopy, angiography or operations were performed. In some of the scintigraphies with negative results, a provocation test for bleeding with heparinisation was carried out. RESULTS： 73% of all scintigraphies showed a positive result. In 4.5% of the positive results, the source was located in the stomach, in 37% the source was the small bowel, in 25% the source was the right colon, in 4.5% the source was the left colon, and in 20% no clear Iocalisation was possible. Only 4% of all scintigraphies were false positive. A reliable positive scintigraphy was independent of the age of the examined patient. A provocation test for bleeding with heparin resulted in an additional 46% of positive scintigraphies with a reliable Iocalisation in primary negative scintigraphies. CONCLUSION- Our results show that scintigraphy and scintigraphy with heparin provocation tests are reliable procedures. They enable a reliable Iocalisation in about half of the obscure GI-bleeding cases. Scintigraphy is superior to angiography in locating a bleeding. It is shown that even in the age of video capsule endoscopy and double-balloon enteroscopy, scintigraphy provides a reliable and directed localization of GI bleeding and offers carefully targeted guidance for other procedures.

关键词： Gastrointestinal bleeding Scintigraphy Localisation Angiography

Effect of pronase as mucolytic agent on imaging quality of magnifying endoscopy

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World Journal of Gastroenterology 2015年第8期21卷 2483-2489页

作者： Gwang Ha Kim Yu Kyung Cho Jae Myung Cha Sun-Young Lee Il-Kwun Chung department of internal medicine Pusan National University School of Medicine department of internal medicine The Catholic University of Korea department of internal medicine Kyung Hee University Hospital at Gang Dong department of internal medicine Konkuk University Medical Center department of internal medicine Soonchunhyang University

AIM:To investigate the efficacy of premedication with pronase,a proteolytic enzyme,in improving imagequality during magnifying ***:The study was of a blinded,randomized,prospective *** were assigned to groups administered oral premedication of either pronase and simethicone(Group A)or simethicone alone(Group B).First,the gastric mucosal visibility grade(1-4)was determined during conventional endoscopy,and then a magnifying endoscopic examination was *** quality of images obtained by magnifying endoscopy at the stomach and the esophagus was scored from1 to 3,with a lower score indicating better *** endoscopist used water flushes as needed to obtain satisfactory magnifying endoscopic *** main study outcomes were the visibility scores during magnifying endoscopy and the number of water ***:A total of 144 patients were enrolled,and data from 143 patients(M:F=90:53,mean age 57.5 years)were *** visibility score was significantly higher in the stomach following premedication with pronase(73%with a score of 1 in Group A vs 49%in Group B,P<0.05),but there was no difference in the esophagus visibility scores(67%with a score of 1in Group A vs 58%in Group B).Fewer water flushes[mean 0.7±0.9 times(range:0-3 times)in Group A vs 1.9±1.5 times(range:0-6 times)in Group B,P<0.05]in the pronase premedication group did not affect the endoscopic procedure times[mean 766 s(range:647-866 s)for Group A vs 760 s(range:678-854 s)for Group B,P=0.88].The total gastric mucosal visibility score was also lower in Group A(4.9±1.5 vs 8.3±1.8in Group B,P<0.01).CONCLUSION:The addition of pronase to simethicone premedication resulted in clearer images during magnifying endoscopy and reduced the need for water flushes.

关键词： Pronase Narrow-band imaging,EndoscopyImage enhance

MicroRNA-98 induces an Alzheimer's disease-like disturbance by targeting insulin-like growth factor 1

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Neuroscience Bulletin 2013年第6期29卷 745-751页

作者： Yi-Kui Hu Xun Wang Lian Li Yan-Hua Du Heng-Tai Ye Cheng-Yan Li Medical School of Wuhan University internal medicine Wuhan Wuchang Hospital department of neurology Pu Ai Hospital of Tongji Medical CollegeHuazhong University of Science and Technology department of neurology Renmin Hospital of Wuhan University

Alzheimer ’s disease（ A D） is a progressive neurodegenerative disorder characterized by extracellular senile plaques and intracellular neurofibrillary *** microRNAs（miRs） participate in regulating amyloid β（Aβ） formation and the metabolism of tau protein in the process of AD,and some are up-regulated in AD patients or transgenic models of ***,the role of miR-98 in AD remains ***,we showed that the expression of miR-98 was negatively correlated with the insulin-like growth factor 1（IGF-1） protein level in APP/PS1 ***-98 target sites in IGF-1 were confirmed by luciferase assay in HEK293 *** of miR-98 in N2a/APP cells down-regulated the IGF-1 protein level and promoted Aβ production,whereas inhibition of miR-98 in N2a/APP cells up-regulated the IGF-1 protein level and suppressed Aβ ***,overexpression of miR-98 in N2a/WT cells increased the phosphorylation of tau,whereas inhibition of miR-98 reduced *** results suggest that miR-98 increases Aβ formation and tau phosphorylation by inhibiting the translation of IGF-1,which might provide a therapeutic strategy for AD.

关键词： Alzheimer’s disease microRNA miR-98 IGF-1

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Neural Regeneration Research 2010年第24期5卷 1845-1850页

作者： Jing Hou Haihong Wang Tong Chen Zhenfu Wang department of neurology PLA General Hospital Beijing 100853 China department of internal medicine the 313 Hospital of Chinese PLA Huludao 125000 Liaoning Province China

Event-related potential （ERP） studies of cognitive function in Parkinson＇s disease （PD） have focused on P300 and N270. However, little is known regarding face recognition ERP in PD. The present study assessed cognitive function in PD patients using neuropsychological scales and analyzed N170 of visuospatial function impairment （VFI） in PD. Results showed that Montreal cognitive assessment can be used for assessing cognitive impairment when visuospatial functioning is changed during the early stage of PD. Face recognition has clinical significance for detecting changes in visuospatial functioning. However, N170 is not sensitive for detection of VFI in PD, which implies that VFI does not appear in the stage of structure coding in face recognition. In addition, VFI affects face recognition.

关键词： Parkinson's disease visuospatial function impairment face recognition event-related potential

On-treatment predictions of success in peg-interferon/ribavirin treatment using a novel formula

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World Journal of Gastroenterology 2010年第1期16卷 89-97页

作者： Hidetsugu Saito Hirotoshi Ebinuma Keisuke Ojiro Kanji Wakabayashi Mika Inoue Shinichiro Tada Toshifumi Hibi department of internal medicine School of MedicineKeio University

AIM:To predict treatment success using only simple clinical data from peg-interferon plus ribavirin therapy for chronic hepatitis C. METHODS:We analyzed the clinical data of 176 patients with chronic hepatitis and hepatitis C virus genotype 1 who received 48 wk standard therapy, derived a predictive formula to assess a sustained virological response of the individual patient using a logistic regression model and confirmed the validity of this *** formula was constructed using data from the first 100 patients enrolled and validated using data from the remaining 76 patients. RESULTS:Sustained virological response was obtained in 83(47.2%)of the patients and we derived formulae to predict sustained virological response at pretreatment and weeks 4,12 and *** likelihood of sustained virological response could be predicted effectively bythe formulae at weeks 4,12 and 24(the area under the curve of the receiver operating characteristic:0.821, 0.802,and 0.891,respectively),but not at baseline (0.570).The formula at week 48 was also constructed and validation by test data achieved good prediction with 0.871 of the area under the curve of the receiver operating *** by this formula was always superior to that by viral kinetics. CONCLUSION:These results suggested that our formula combined with viral kinetics provides a clear direction of therapy for each patient and enables the best tailored treatment.

关键词： Logistic regression analysis Predictive formula Prolongation of the therapy Response-guided therapy Viral kinetics