Intrahepatic cholangiocarcinomas with IDH1/2 mutation-associated hypermethylation at selective genes and their clinicopathological features.

Intrahepatic cholangiocarcinoma (ICC) is a rare but fatal tumor. The isocitrate dehydrogenase 1 and 2 (IDH1/2) genes are known to be mutated in ICC. IDH1/2 mutations tend to be accompanied by enhanced hypermethylation at a subset of genomic loci. We sought to clarify the clinicopathological features, including prognostic value, of ICCs with IDH1/2 mutation-associated hypermethylation at a subset of genes. The mutation status of IDH1/2 and methylation status of 30 gene CpG island loci were analyzed in 172 cases of ICC using pyrosequencing and the MethyLight assay, respectively. The mutation status of IDH1/2 was correlated with clinicopathological features and the DNA methylation status at 30 gene loci. Then, the clinicopathological characteristics were analyzed regarding three-tiered methylation statuses in genes showing IDH1/2 mutation-associated methylation. IDH1/2 mutations were found in 9.3% of ICCs, and IDH1/2-mutated tumors were associated with the histological subtype, including the bile ductular type and small duct type, and poor differentiation. Eight DNA methylation markers showed associations with IDH1/2 mutations, and ICCs with > 5/8 methylated markers were associated with the bile ductular type or small duct type, absence of mucin production, absence of biliary intraepithelial neoplasia, and presence of chronic liver disease. > 5/8 methylated markers were an independent prognostic marker associated with better survival in both cancer-specific survival and recurrence-free survival. In summary, by analyzing the association between IDH1/2 mutations and DNA methylation in individual genes, we developed a panel of DNA methylation markers that were significantly associated with IDH1/2 mutations and were able to identify a subset of ICC with better clinical outcomes.

Acceptability of the consumer-centric u-health services for patients with chronic obstructive pulmonary disease.

OBJECTIVES: We developed and implemented a system for u-health (ubiquitous healthcare) services for patients with chronic obstructive pulmonary disease (COPD) and studied the level of acceptability by the patients in the context of home visits and telephone education. SUBJECTS AND METHODS: To determine its effectiveness, the u-health service system was used for 2 years with 144 COPD patients in a clinical environment. Patients were provided with the u-healthcare service. RESULTS: Patients with COPD were highly satisfied with the u-healthcare service, which incorporated telemonitoring, teleconsultation, and tele-education along with home visits. The average acceptable fees (in USD) of the service system are as follows: u-health device, $421.28; home visit, $21.53/visit; tele-education, $0.53/min or $26.57/month; and total service fee, $44.26/month. CONCLUSIONS: COPD patients accepted u-health services with a high satisfaction rate, promising a new paradigm of consumer-centric healthcare services.

Development of implementation strategies for u-health services based on the healthcare professionals' experiences.

OBJECTIVES: The study develops strategies for implementing ubiquitous healthcare (u-health) based on previous experiences of the healthcare professionals. MATERIALS AND METHODS: Qualitative content analysis, one of qualitative research methods, was used on in-depth interviews conducted between July 21 and October 4, 2009, with 11 healthcare professionals including medical doctors and community healthcare specialist nurses who have previously provided u-health services. RESULTS: Four primary subjects were addressed: (1) subjective experiences on the usability, (2) the expectations, (3) the business prospects, and (4) the prerequisites for the success of u-health market. CONCLUSION: Based on the results of this study, desirable u-health services from the perspective of healthcare professionals were proposed.

An exploratory study on the health information terms for the development of the consumer health vocabulary system.

This study is to find out the difference between consumer vocabulary and medical vocabulary. The rate of mapping between the consumer vocabulary for health information and the medical vocabulary was not to be high. The terms that consumers use should be researched to understand their morphology and features, so that it will increase the accessibility of consumers to the medical and health information they need.