Analysis of Watson for oncology and clinicians� treatment recommendations for patients with breast cancer in Korea: A single center experience

Background: Various clinical applications have been attempted using artificial intelligence (AI) clinical decision support system (CDSS), and it has become a starting point for personalized cancer treatment. We aimed to identify the degree of agreement between the AI?CDSS, Watson for Oncology (WFO), and the clinician in treatment recommendations for Korean breast cancer patients and to provide guidelines for future improvement. Methods: One hundred and eighty?three breast cancer patients who underwent treatment at the Pusan National University Hospital between January 1, 2016 and May 31, 2017 were enrolled in this study. The concordance between WFO抯 and clinicians� treatment recommendations were examined according to various factors. Results: WFO gave the same treatment option recommendations as clinicians in 74 (40.4%) of the cases. According to the logistic regression, the difference in recommendation concordance between stage I and stage III was statistically significant (P = 0.004), and there was no difference among other factors. Conclusion: The concordance of treatment recommendations was low overall. However, this is largely attributable to the differences of medical insurance system and healthcare environment between the United States and Korea. In the future, region?specific features should be considered or reflected during the development of AI?CDSS.

Genomic epidemiology cohorts in Korea: present and the future.

Human genome epidemiology involves the application of genetic technology to assess the impact of variations at the DNA level on health and disease. Recent developments in molecular biology allow epidemiologists to use biomarkers to determine an individuals predisposition to disease and to detect disease at an early stage. Moreover, advances in genomics and proteomics could play a central role in research into disease prediction and prevention. Large scale population-based cohort prospective studies offer the most comprehensive approach to the delineation of gene function, the effects of the environment, and their interactions. The Korean Multi-center Cancer Cohort (KMCC), under construction since 1993, is the first multi-center prospective cohort to identify risk factors for cancer in Korea. Data on general lifestyle, physical activity, diet, reproductive factors, and agricultural exposure are obtained through direct interview using a structured questionnaire. Anthropometric measurements and clinical laboratory findings are also collected using a web-based data entry system. Moreover, biological materials have been banked [blood (serum, plasma, buffy coat, packed erythrocytes) is stored at -70 degrees C and urine at -20 degrees C] for future analysis. Several other cohorts including the Korean National Cancer Center (KNCC) Cohort, the Korean Health Examinees (KOEX) Cohort, the Korean Health and Genome Epidemiologic Study (KHGES), and the Yang Pyeong Cohort have also been launched since the KMCC cohort was initiated. Even though these cohorts have collected similar data and biospecimen, questionnaires and protocols used have not been standardized. However, these cohort studies are of increased scope and have been designed to detect risk factors for cardiovascular disease, metabolic syndrome, and cancer. Subjects have been followed up actively by health personnel in different regions and by using record linkages with the central cancer registry, and the national death certificate and national health insurance claim databases. As of August 2004, the total number of subjects enrolled in all cohorts with archived biologic specimens was around 80,000. A new genomic cohort has been launched since 2001 in Korea, for which the target number of subjects is 250,000 men and women over the next 5 years. This article describes the goals and the designs of each of the above-mentioned cohorts.

Estrutura e organização dos genes da superfamília TS(trans-sialidase) de Trypanosoma cruzi / Structure and organization of genes from tge TS(trans-sialidase) gene superfamily of Trypanosoma cruzi

A seqüência de uma região intersticial de 30 Kb do genoma de T. cruzi (clone Silvio X10.6) foi determinada completamente. Este fragmento foi isolado de uma genoteca de T. cruza construída no cosmídio pcosTL (Kelly et ai. 1994). Os fragmentos do cosmídio C2 obtidos por nebulização foram clonados em plasmídio pUC18 e sequenciados, gerando seqüências de alta qualidade. A seqüência contém 62 fases de leitura aberta (ORF) maiores que 285 pb, entre as quais a maior tem 2679 pb. Entre as maiores ORFs, nove apresentam seqüências similares aos genes de T cruzi e de Leishmania, depositados nos bancos de dados. Cerca de 70 por cento das ORFs não apresentam similaridade ao nível de nucleotídeos e de proteínas com as seqüências depositadas nos bancos de dados GenBank e EMBL. Os genes parasitários identificados incluem cópias de transcriptase reversa, trans-sialidase, sialidase, GP85 e mucina do T. cruza; e proteofosfoglicana, fosfatase ácida e proteína rica em leucina de Leishmania. O contig apresenta vários elementos repetidos. As regiões intergênicas são pobres em repetições de di - e trinucleotídeos e apresentam várias seqüências repetitivas de T cruzi, tais como, TcIRE (Agüero et al. 2000) e C6 (Araya et al. 1997). Uma característica interessante da seqüência foi presença de duas repetições diretas de 664 pb (similar ao elemento E12 do T cruza) flanqueando o gene TS. A comparação das seqüências mostrou que a repetição RD664 é similar ORF-3 do retrotransposon L1 Tc do tipo não-LTR (Olivares et al. 2002) que codifica uma proteína similar à RNase H. A associação do elemento RD664 com o gene TS foi confirmada por hibridização do DNA de T cruza digerido com várias enzimas de restrição e das bandas cromossômicas com as sondas RD664 e TS. Quatro bandas cromossômicas hibridizaram com as duas sondas, sugerindo que o gene TS e o elemento RD664 estão associados em diferentes regiões do genoma. Esta organização foi confirmada em uma pesquisa no banco de dados do Projeto Genoma de T cruza(http://www.genedb.org/genedb/tcruzi). Entre 17 contigs que apresentavam uma cópia completa do gene TS, três apresentaram duas repetições RD664 flanqueando o gene TS na mesma organização encontrada no cosmídio C2. O elemento RD664 pode ser também encontrado flanqueando os genes de mucina. Ensaio de PCR utilizando os…(au)

Reproducibility of a food frequency questionnaire in koreans.

Objective : The present study was conducted to report upon the reproducibility of a 98-item food frequency questionnaire among Koreans. Subjects : The study subjects were recruited from among those who visited for a regular health check-up at the health centers from Samsung Hospital and Hallym University Hospital. Setting : The FFQ was administered first in April to June of 2002 to 145 Korean adults aged 40 and over residing in Seoul and its vicinity and was then re-administered to 126 three months later between July and September of 2002 (FFQ 1 and FFQ 2). Methods : Reproducibility was evaluated using the Pearson correlation coefficients of log-e and the calorie-adjusted nutrient score. Weighted kappa (k) statistics with 95% confidence limits were calculated to assess the chance adjusted level of agreement between the FFQ 1 and the FFQ 2. The proportions of correctly categorized subjects in the same or adjacent quintiles were calculated. Results : The average intake in FFQ 1 was no more than 12 percent different from the average intake in FFQ 2. Correlations varied between 0.47 for sodium and 0.72 for vitamin C. All k values exceeded 0.5 except that of fiber. The average k for all nutrients was 0.67. The percentage agreement varied from 62% for energy and potassium to 82% for vitamin B(2) and cholesterol. The average of the agreement was 72%. Conclusion : The results of this study verify that it is possible to use tailored, relatively simple, but comprehensive, self-administered food frequency questionnaires to study nutrient consumption in large-scale epidemiological studies.