Publications by authors named "Y-J Chang"
Background: Transthoracic echocardiography (TTE) is the primary modality for diagnosing aortic stenosis (AS), yet it requires skilled operators and can be resource-intensive. We developed and validated an artificial intelligence (AI)-based system for evaluating AS that is effective in both resource-limited and advanced settings.
Methods: We created a dual-pathway AI system for AS evaluation using a nationwide echocardiographic dataset (developmental dataset, n = 8427): 1) a deep learning (DL)-based AS continuum assessment algorithm using limited 2D TTE videos, and 2) automating conventional AS evaluation.
Background: We developed the FORCE platform to overcome limitations of oligonucleotide delivery to muscle and enable their applicability to neuromuscular disorders. The platform consists of an antigen-binding fragment, highly specific for the human transferrin receptor 1 (TfR1), conjugated to an oligonucleotide via a cleavable valine-citrulline linker. Myotonic dystrophy type 1 (DM1) is a neuromuscular disorder caused by expanded CUG triplets in the DMPK RNA, which sequester splicing proteins in the nucleus, lead to spliceopathy, and drive disease progression.
View Article and Find Full Text PDFObjective: To investigate baseline and change of pulmonary damage biomarkers (serum Krebs von den Lungen 6 [KL-6], human surfactant protein D [hSP-D], and matrix metalloproteinase 7 [MMP-7]) with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) progression.
Methods: In the Korean Rheumatoid Arthritis Interstitial Lung Disease (KORAIL) cohort, a prospective cohort, we enrolled patients with RA and ILD confirmed by chest computed tomography imaging and followed annually. ILD progression was defined as worsening in physiological and radiological domains of the 2022 American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society guideline for progressive pulmonary fibrosis (PPF).
Background/aims: The incidence of steatotic liver disease (SLD) is increasing across all age groups as the incidence of obesity increases worldwide. The existing noninvasive prediction models for SLD require laboratory tests or imaging and perform poorly in the early diagnosis of infrequently screened populations such as young adults and individuals with healthcare disparities. We developed a machine learning-based point-of-care prediction model for SLD that is readily available to the broader population with the aim of facilitating early detection and timely intervention and ultimately reducing the burden of SLD.
View Article and Find Full Text PDFPurpose: To compare clinical outcomes and retear rates of medium-sized rotator cuff tears repaired with incomplete footprint coverage using the transosseous-equivalent technique versus those with complete footprint coverage plus bone marrow stimulation.
Methods: The retrospective study, conducted from March 2019 to December 2021, included consecutive patients with medium-sized (1-3 cm) posterosuperior rotator cuff tears repaired using the transosseous-equivalent technique and bone marrow stimulation, with a minimum follow-up of 2 years. Patients were divided into 2 groups based on the degree of footprint coverage achieved: group C (complete coverage) and group I (incomplete coverage).
Article Synopsis
- The study examines the link between liver disease type (alcohol-related vs non-alcohol-related) and 6-week mortality following acute variceal bleeding (AVB) in patients with cirrhosis.
- Researchers analyzed data from two large cohorts in the U.S. and Singapore, including 1,349 patients, and found that non-ALD patients had a significantly higher risk of mortality compared to ALD patients.
- Incorporating the etiology of cirrhosis into existing mortality prediction models improved accuracy, highlighting the importance of considering the type of liver disease for patient care.
Although stroke is a frequent cause of permanent disability, our ability to promote stroke recovery is limited. Here, we design a small-molecule stroke recovery promoting agent that works by dissociating γ-aminobutyric acid (GABA) transporter 1 (GAT-1) from syntaxin1A (Synt1A), a soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) protein. Stroke induces an increase in GAT-1-Synt1A interaction in the subacute phase, a critical period for functional recovery.
View Article and Find Full Text PDFPurpose: To assess macular microstructural changes associated with internal limiting membrane peeling (ILMP) using 3-dimensional optical coherence tomography (3D-OCT) in primary macula-off rhegmatogenous retinal detachment (RRD) repairs with vitrectomy and silicone oil (SO) tamponade.
Design: Retrospective, consecutive, interventional case series.
Methods: Setting: Institutional practice.
In the CLL14 study, patients with previously untreated chronic lymphocytic leukemia (CLL) and coexisting conditions were randomized to 12 cycles of venetoclax-obinutuzumab (Ven-Obi, n = 216) or chlorambucil-obinutuzumab (Clb-Obi, n = 216). Progression-free survival (PFS) was the primary end point. Key secondary end points included time-to-next-treatment (TTNT), rates of undetectable minimal residual disease (uMRD), overall survival (OS), and rates of adverse events.
View Article and Find Full Text PDFArticle Synopsis
- - The study evaluated how various cardiometabolic risk factors, such as metabolic syndrome and individual factors like high fasting glucose and low HDL cholesterol, impact the progression of coronary plaque and the likelihood of major cardiovascular events in patients with stable coronary artery disease.
- - In a cohort of 1,200 patients followed over several years, 28% experienced rapid coronary plaque progression, identified primarily through increased atheroma volume, which indicates worsening arterial health.
- - The findings suggest that a combination of risk factors, particularly high blood sugar and blood pressure, significantly forecast both plaque progression and serious cardiovascular incidents, highlighting the importance of monitoring these factors in at-risk patients.
Background: Evaluating left ventricular diastolic function (LVDF) is crucial in echocardiography; however, the complexity and time demands of current guidelines challenge clinical use. This study aimed to develop an artificial intelligence (AI)-based framework for automatic LVDF assessment to reduce subjectivity and improve accuracy and outcome prediction.
Methods: We developed an AI-based LVDF assessment framework using a nationwide echocardiographic dataset from five tertiary hospitals.
Article Synopsis
- A phase 1 trial (NCT03944499) explored the safety and effectiveness of FS-1502, an anti-HER2 antibody-drug conjugate, in patients with HER2-positive breast cancer and other solid tumors.
- The trial included two phases: phase 1a focused on finding the maximum tolerated dose (MTD) and phase 1b evaluated the recommended phase 2 dose (RP2D) for patients with metastatic HER2-positive breast cancer.
- Results showed FS-1502 was generally well tolerated with few side effects, had a recommended dose of 2.3 mg/kg, and demonstrated a promising objective response rate of 53.7% in patients receiving this dose.
Purpose: The purpose of this study was to evaluate the risk of newly diagnosed retinal vein occlusion (RVO) in patients with type 2 diabetes (T2D) using sodium-glucose cotransporter-2 inhibitors (SGLT-2i) compared to dipeptidyl peptidase-4 inhibitors (DPP-4i).
Methods: Claims data from the National Health Insurance Research Database of Taiwan were used in this nationwide retrospective cohort study. A target trial emulation framework was applied.
Purpose: The purpose of this study was to analyze human corneal endothelial cells (HCECs) morphology and ocular biometrics in premature (PM) children with or without retinopathy of prematurity (ROP).
Methods: Retrospective data on patient demographics, HCECs status, and ocular biometrics with at least 2 visits between 2016 and 2021 were reviewed. The main outcomes were endothelial cell density (ECD), coefficient of variation (CV), hexagonal cell ratio (HEX), central corneal thickness (CCT), axial length, anterior chamber depth, keratometry, corneal diameter, pupil diameter, and refraction status.
Article Synopsis
- Akkermansia muciniphila is important for gut health as it aids in gut immunity, intestinal development, and barrier integrity.
- The study focuses on a newly discovered protein, Amuc_1409, secreted by A. muciniphila, which enhances intestinal stem cell (ISC) growth and recovery in both lab models and aging male mice.
- Amuc_1409 works by interacting with E-cadherin, activating Wnt/β-catenin signaling, and is suggested as a potential biological agent for promoting gut health.
Background: Observational studies suggest that hepatocyte growth factor (HGF) is associated with the risk and prognosis of ischemic stroke, but the causality of these associations remains unclear. Therefore, we conducted Mendelian randomization (MR) analyses to explore the associations of genetically determined plasma HGF levels with the risk and prognosis of ischemic stroke.
Methods: A total of 13 single-nucleotide polymorphisms associated with plasma HGF were selected as genetic instruments based on the data from a genome-wide association study with 21 758 European participants.
Article Synopsis
- Glycoursodeoxycholic acid (GUDCA) has been shown to help with metabolic disorders and has now been studied for its potential effects on reducing arterial thrombosis, with an aim to understand its mechanisms.
- The research involved analyzing GUDCA levels in patients and diet-induced obese mice, using various models to assess its impact on platelet function and thrombosis while also studying lipid changes in platelets after GUDCA treatment.
- Results indicated that lower GUDCA levels are linked to higher thrombosis risk and that GUDCA significantly reduces platelet activity and thrombogenesis by inhibiting diacylglycerol kinase (DGK), suggesting that it could be beneficial for managing thrombosis, particularly in obese individuals.
Article Synopsis
- Transcription factors (TFs) are important proteins that help guide how stem cells behave, including how they grow and develop.
- Scientists studied certain TFs using a special technique to look at individual cells from human stem cells and found that SOX7, SOX17, and SOX18 were more active in a specific type of stem cell called endothelial progenitors (EPs).
- They discovered that increasing SOX17 made it much easier for these stem cells to change into cells that can become blood vessels, highlighting how important SOX17 is in helping stem cells become EPs.
Purpose: To investigate the risk of noninfectious uveitis following the first dose of coronavirus disease 2019 (COVID-19) vaccination based on the uveitis history.
Design: Retrospective matched cohort and crossover case series study.
Methods: A random sample of 7 917 457 individuals who received COVID-19 vaccine between January 2021 and March 2022 in Korea, and had no recorded history of COVID-19 were categorized into the control and uveitis groups based on their uveitis history.
Purpose: This study aimed to ascertain the occurrence of foveal hypoplasia (FH) in individuals diagnosed with familial exudative vitreoretinopathy (FEVR).
Design: Retrospective cohort study.
Methods: In this study, FEVR families and sporadic cases were diagnosed at the Eye and ENT Hospital, Fudan University, between 2017 and 2023.
Article Synopsis
- A study was conducted to evaluate whether a new mapping technique, PRISM, could improve catheter ablation outcomes for patients with persistent atrial fibrillation (AF) when combined with traditional methods.
- The trial involved 170 patients and showed that those who underwent the PRISM-guided procedure had a significantly higher success rate in maintaining normal heart rhythm after 12 months compared to the conventional approach.
- The findings suggest that PRISM mapping may enhance the precision of AF treatment and reduce the recurrence of atrial arrhythmias, making it a promising alternative for persistent AF management.
Purpose: To determine the diagnostic potential of next-generation sequencing (NGS) in vitreous samples, analyze genotype-phenotype characteristics, and compare NGS of matched vitreous and brain samples in patients with associated central nervous system lymphoma (CNSL).
Methods: A total of 32 patients suspected of vitreoretinal lymphoma (VRL) who underwent diagnostic vitrectomy and NGS were included in this retrospective observational case-series. Fresh vitreous specimens from diagnostic vitrectomy of VRL-suspected patients underwent NGS using a custom panel targeting 747 candidate genes for lymphoma.
Purpose: To investigate the incidence and risk of noninfectious uveitis (NIU) following COVID-19 vaccination compared with an unvaccinated, uninfected control group.
Design: Retrospective population-based cohort study.
Methods: We included 5,185,153 individuals who received the first vaccine dose in the exposed group and 2,680,164 individuals in the unexposed, uninfected control group.
Background: Pancreatic ductal adenocarcinoma (PDAC) remains a devastating cancer due to its poor survival rate, early detection, and resectability. This study aimed to determine the peripheral blood mononuclear cell (PBMC) immune biomarkers in patients with PDAC and investigate the PDAC-specific peripheral blood biomarker panel and validate its clinical performance.
Methods: In this prospective, blinded, case-control study, a biomarker panel formula was generated using a development cohort-including healthy controls, patients at high risk of PDAC, and patients with benign pancreatic disease, PDAC, or other gastrointestinal malignancies-and its diagnostic performance was verified using a validation cohort, including patients with ≥ 1 lesion suspected as PDAC on computed tomography (CT).
Background: Elevated blood pressure and intrarenal renin-angiotensin system activity are closely related to chronic kidney disease (CKD) progression. However, interrelationship between blood pressure and intrarenal renin-angiotensin system activity on the risk of CKD progression is unknown.
Methods: We analyzed 2076 participants from the Korean Cohort Study for Outcomes in Patients With CKD.