Perceived Risk of Re-Identification in OMOP-CDM Database: A CrossSectional Survey

Background@#The advancement of information technology has immensely increased the quality and volume of health data. This has led to an increase in observational study, as well as to the threat of privacy invasion. Recently, a distributed research network based on the common data model (CDM) has emerged, enabling collaborative international medical research without sharing patient-level data. Although the CDM database for each institution is built inside a firewall, the risk of re-identification requires management. Hence, this study aims to elucidate the perceptions CDM users have towards CDM and risk management for re-identification. @*Methods@#The survey, targeted to answer specific in-depth questions on CDM, was conducted from October to November 2020. We targeted well-experienced researchers who actively use CDM. Basic statistics (total number and percent) were computed for all covariates. @*Results@#There were 33 valid respondents. Of these, 43.8% suggested additional anonymization was unnecessary beyond, “minimum cell count” policy, which obscures a cell with a value lower than certain number (usually 5) in shared results to minimize the liability of re-identification due to rare conditions. During extract-transform-load processes, 81.8% of respondents assumed structured data is under control from the risk of re-identification. However, respondents noted that date of birth and death were highly re-identifiable information. The majority of respondents (n = 22, 66.7%) conceded the possibility of identifier-contained unstructured data in the NOTE table. @*Conclusion@#Overall, CDM users generally attributed high reliability for privacy protection to the intrinsic nature of CDM. There was little demand for additional de-identification methods. However, unstructured data in the CDM were suspected to have risks. The necessity for a coordinating consortium to define and manage the re-identification risk of CDM was urged.

The Relationship between Pulmonary Function and Serum Uric Acid Level in the Korean Population

BACKGROUND@#Forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), and the ratio of FEV₁ to FVC (FEV₁/FVC) are considered as the major spirometry parameters. Serum uric acid is associated with increased risk of gout and cardiovascular disease. We analyzed the relationship between pulmonary function and serum uric acid level in the Korean men and women.@*METHODS@#This study was based on the data collected during the 2016 Korea National Health and Nutrition Examination Survey (KNHANES VII-1). A total of 3,411 adults were retrieved from KNHANES VII-1. Among 3,411 adults, 1,500 were men and 1,911 were women.@*RESULTS@#In this study, a significant negative correlation was observed between serum uric acid level and pulmonary function values only in females. Also, in the male non-smoker group, pulmonary function values were negatively associated with serum uric acid level (FVC %predicted, β=−0.014; FEV₁ %predicted, β=−0.015).@*CONCLUSIONS@#In this study, hyperuricemia was associated with the low lung function in males and females. In order to obtain an accurate assessment of the association between hyperuricemia and pulmonary function values, further prospective cohort study in the future is necessary.

The Relationship between Pulmonary Function and Serum Uric Acid Level in the Korean Population

BACKGROUND: Forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), and the ratio of FEV₁ to FVC (FEV₁/FVC) are considered as the major spirometry parameters. Serum uric acid is associated with increased risk of gout and cardiovascular disease. We analyzed the relationship between pulmonary function and serum uric acid level in the Korean men and women.METHODS: This study was based on the data collected during the 2016 Korea National Health and Nutrition Examination Survey (KNHANES VII-1). A total of 3,411 adults were retrieved from KNHANES VII-1. Among 3,411 adults, 1,500 were men and 1,911 were women.RESULTS: In this study, a significant negative correlation was observed between serum uric acid level and pulmonary function values only in females. Also, in the male non-smoker group, pulmonary function values were negatively associated with serum uric acid level (FVC %predicted, β=−0.014; FEV₁ %predicted, β=−0.015).CONCLUSIONS: In this study, hyperuricemia was associated with the low lung function in males and females. In order to obtain an accurate assessment of the association between hyperuricemia and pulmonary function values, further prospective cohort study in the future is necessary.

Protrusive maxillomandibular fixation for intracapsular condylar fracture: a report of two cases

Clinical limitations following closed reduction of an intracapsular condylar fracture include a decrease in maximum mouth opening, reduced range of mandibular movements such as protrusion/lateral excursion, and reduced occlusal stability. Anteromedial and inferior displacement of the medial condyle fragment by traction of the lateral pterygoid muscle can induce bone overgrowth due to distraction osteogenesis between the medial and lateral condylar fragments, causing structural changes in the condyle. In addition, when conventional maxillomandibular fixation (MMF) is performed, persistent interdental contact sustains masticatory muscle hyperactivity, leading to a decreased vertical dimension and premature contact of the posterior teeth. To resolve the functional problems of conventional closed reduction, we designed a novel method for closed reduction through protrusive MMF for two weeks. Two patients diagnosed with intracapsular condylar fracture had favorable occlusion after protrusive MMF without premature contact of the posterior teeth. This particular method has two main advantages. First, in the protrusive position, the lateral condylar fragment is moved in the anterior-inferior direction closer to the medial fragment, minimizing bone formation between the two fragments and preventing structural changes. Second, in the protrusive position, posterior disclusion occurs, preventing masticatory muscle hyperactivity and the subsequent gradual decrease in ramus height.

Protrusive maxillomandibular fixation for intracapsular condylar fracture: a report of two cases

Clinical limitations following closed reduction of an intracapsular condylar fracture include a decrease in maximum mouth opening, reduced range of mandibular movements such as protrusion/lateral excursion, and reduced occlusal stability. Anteromedial and inferior displacement of the medial condyle fragment by traction of the lateral pterygoid muscle can induce bone overgrowth due to distraction osteogenesis between the medial and lateral condylar fragments, causing structural changes in the condyle. In addition, when conventional maxillomandibular fixation (MMF) is performed, persistent interdental contact sustains masticatory muscle hyperactivity, leading to a decreased vertical dimension and premature contact of the posterior teeth. To resolve the functional problems of conventional closed reduction, we designed a novel method for closed reduction through protrusive MMF for two weeks. Two patients diagnosed with intracapsular condylar fracture had favorable occlusion after protrusive MMF without premature contact of the posterior teeth. This particular method has two main advantages. First, in the protrusive position, the lateral condylar fragment is moved in the anterior-inferior direction closer to the medial fragment, minimizing bone formation between the two fragments and preventing structural changes. Second, in the protrusive position, posterior disclusion occurs, preventing masticatory muscle hyperactivity and the subsequent gradual decrease in ramus height.

MRI Findings of Cavernous Hemangioma of the Uterus: A Case Report

Hemangioma is the most common soft tissue tumor in the body. Though it may occur anywhere in the body, hemangioma of the uterus is a very rare tumor. Hemangioma is almost asymptomatic, but it is sometimes clinically important because it can cause massive hemorrhage and this is a life-threatening condition. We report here on the magnetic resonance imaging and pathologic findings of cavernous hemangioma of the uterus in a 32-year-woman with menorrhagia.

The effect of labial inclination on intrusion of the upper and lower incisors by three-dimensional finite element analysis / 대한치과교정학회지

This study was designed to investigate the position of anteroposterior center of resistance for genuine intrusion and the mode of change of the minimum distal force for simultanous intrusion and retraction of the upper and lower incisors according to the increase of labial inclination. For this purpose, we used the three-piece intrusion arch appliance and three-dimensional finite element models of upper and lower incisors. 1. Positions of the center of resistance in upper incisors according to the increase of the labial inclination were as follows; 1) In normal inclination situation, the center of resistance was located in 6mm behind the distal surface of the lateral incisor bracket. 2) In 10degrees increase of the labial inclination situation, the center of resistance was located in 9mm behind the distal surface of the lateral incisor bracket. 3) In 20degrees increase of the labial inclination situation, the center of resistance was located in 12m behind the distal surface of the lateral incisor bracket. 4) In 30degrees increase of the labial inclination situation, the center of resistance was located in 16m behind the distal surface of the lateral incisor bracket. 2. Positions of the center of resistance in lower incisors according to the increase of the labial inclination were as follows; 1) In normal inclination situation, the center of resistance was located in 10mm behind the distal surface of the lateral incisor bracket. 2) In 10degrees increase of the labial inclination situation, the center of resistance was located in 13mm behind the distal surface of the lateral incisor bracket. 3) In 20degrees increase of the labial inclination situation, the center of resistance was located in 15m behind the distal surface of the lateral incisor bracket. 4) In 30degrees increase of the labial inclination situation, the center of resistance was located in 18m behind the distal surface of the lateral incisor bracket. 3. The patterns of stress distribution were as follows; 1) There were even compressive stresses in and periodontal ligament when intrusion force was applied through determined center of resistance. 2) There were gradual increase of complexity in compressive stress distribution pattern with increase of the labial inclination when intrusion and retraction force were applied simultaneously.

The new approach to maxillary and mandibular anterior dental arch forms: The prediction to maxillary and mandibular anterior occlusal relationship by computer program / 대한치과교정학회지

When we deal with maxillary and mandibular anterior dental arches showing problems in occlusal relation and aesthetics caused by malformations of teeth and congenital missing, et al during the orthodontic treatment, we could not often decide the functional occlusion by only relying on the orthodontic treatment. If orthodontists can predict what kinds of treatments are needed for functional occlusion in maxillary and mandibular anterior dental arches, they can not only effectively treat patients but also facilitate the cooperation with other field during the treatment. Our previous research showed the correlation among intercanine width, segment depth and arch perimeter by using the Korean normal occlusion model. At this time, we produced the computer application program by taking advantage of this correlation. And then, we applied this program to setting up the treatment plans for 2 patients with the damaged maxillary and mandibular dentures. With the help of this program, we could not only easily acquire the information about the change of variables required by treatment plans but also understand the change of the anterior dental occlusion corresponding to the change of each variables such as the intercanine width, segment depth and arch perimeter. Later, if we can have the information about the relationship between the change of the angle of incisors depending on facial types and arch forms and, in addition, can acquire the appropriate intercanine width, we can have the ability to produce the 3 dimensional occlusogram for the anterior dental arch forms.

Role of Adenosine in the Activation of Myocardial Catalase Induced by Brief Regional Ischemia

The activities of myocardial antioxidant enzymes are known to increase in the hearts preconditioned with the brief episodes of ischemia. This study was undertaken to elucidate the possible involvement of adenosine in the stimulation of myocardial catalase induced by the brief regional ischemia in rabbit hearts. Coronary artery descending the middle anterior wall of left ventricle was occluded for 15 min, followed by 1 hr of reperfusion. Upon reperfusion after the brief ischemia, the activity of catalase increased significantly in both ischemic and non-ischemic parts of myocardium. Pretreatment of the heart with theophylline, a non-specific adenosine receptor blocker, completely abolished the increase of catalase activity in both the ischemic and non-ischemic regions of myocardium. On the other hand, the administration of exogenous adenosine instead of the ischemia failed to increase the catalase activity in in vivo hearts. Moreover, adenosine infusion did not affect the catalase activity in the isolated, perfused hearts either. These results suggest that the endogenous adenosine released from the ischemic myocardium is involved in the activation of catalase induced by brief ischemia, but that adenosine may not be a final direct activator of cellular catalase in the myocardium.

Involvement of adenosine in cardioprotective effect of catecholamine preconditioning in ischemia-reperfused heart of rat

Preconditioning of a heart with small doses of catecholamines induces a tolerance against the subsequent lethal ischemia. The present study was performed to find a specific receptor pathway involved with the catecholamine preconditioning and to test if adenosine plays a role in this cardioprotective effect. Isolated rat hearts, pretreated with small doses of alpha- or beta-adrenergic agonists/antagonists, were subjected to 20 minutes ischemia and 20 minutes reperfusion by Langendorff perfusion method. Cardiac mechanical functions, lactate dehydrogenase and adenosine release from the hearts were measured before and after the drug treatments and ischemia. In another series of experiments, adenosine A1 or A2 receptor blockers were treated prior to administration of adrenergic agonists. Pretreatments of a beta-agonist, isoproterenol(10-9 ~ 10-7 M) markedly improved the post-ischemic mechanical function and reduced the lactate dehydrogenase release. Similar cardioprotective effect was observed with an alpha-agonist, phenylephrine pretreatment, but much higher concentration(10-4 M) was needed to achieve the same degree of cardioprotection. The cardioprotective effects of isoproterenol and phenylephrine pretreatments were blocked by a beta1-adrenergic receptor antagonist, atenolol, but not by an alpha1-antagonist, prazosin. Adenosine release from the heart was increased by isoproterenol, and the increase was also blocked by atenolol, but not by prazosin. A selective A1-adenosine receptor antagonist, 1,3-dipropyl-8-cyclopentyl xanthine (DPCPX) blocked the cardioprotection by isoproterenol pretreatment. These results suggest that catecholamine pretreatment protects rat myocardium against ischemia and reperfusion injury by mediation of beta1-adrenergic receptor pathway, and that adenosine is involved in this cardioprotective effect.