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Development of Intelligent Severity of Atopic Dermatitis Diagnosis Model using Convolutional Neural Network (합성곱 신경망(Convolutional Neural Network)을 활용한 지능형 아토피피부염 중증도 진단 모델 개발)

  • Yoon, Jae-Woong;Chun, Jae-Heon;Bang, Chul-Hwan;Park, Young-Min;Kim, Young-Joo;Oh, Sung-Min;Jung, Joon-Ho;Lee, Suk-Jun;Lee, Ji-Hyun
    • Management & Information Systems Review
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    • v.36 no.4
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    • pp.33-51
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    • 2017
  • With the advent of 'The Forth Industrial Revolution' and the growing demand for quality of life due to economic growth, needs for the quality of medical services are increasing. Artificial intelligence has been introduced in the medical field, but it is rarely used in chronic skin diseases that directly affect the quality of life. Also, atopic dermatitis, a representative disease among chronic skin diseases, has a disadvantage in that it is difficult to make an objective diagnosis of the severity of lesions. The aim of this study is to establish an intelligent severity recognition model of atopic dermatitis for improving the quality of patient's life. For this, the following steps were performed. First, image data of patients with atopic dermatitis were collected from the Catholic University of Korea Seoul Saint Mary's Hospital. Refinement and labeling were performed on the collected image data to obtain training and verification data that suitable for the objective intelligent atopic dermatitis severity recognition model. Second, learning and verification of various CNN algorithms are performed to select an image recognition algorithm that suitable for the objective intelligent atopic dermatitis severity recognition model. Experimental results showed that 'ResNet V1 101' and 'ResNet V2 50' were measured the highest performance with Erythema and Excoriation over 90% accuracy, and 'VGG-NET' was measured 89% accuracy lower than the two lesions due to lack of training data. The proposed methodology demonstrates that the image recognition algorithm has high performance not only in the field of object recognition but also in the medical field requiring expert knowledge. In addition, this study is expected to be highly applicable in the field of atopic dermatitis due to it uses image data of actual atopic dermatitis patients.

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Occluding Effect of the Application of Fluoride Compounds and Desensitizers on Dentinal Tubules (불소도포 및 지각과민처치제 적용 후 상아세관 폐쇄효과와 지속력 평가)

  • Lee, Ye-Jin;Jeong, Moon-Jin;Ahn, Yong-Soon;Cheun, Su-Kyung;Jeong, Soon-Jeong;Lim, Do-Seon
    • Journal of dental hygiene science
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    • v.16 no.4
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    • pp.272-283
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    • 2016
  • This study compared and analyzed the occluding effects of fluoride compounds and desensitizers, which are commonly used in dental clinics, on dentinal tubules. This study also evaluated the persistence of the active ingredients over time by performing toothbrushing with an electric toothbrush. Thirty-five molar teeth, which had been extracted within the past 3 months from healthy people without tooth decays, amalgam fillings, or dental crowns, were divided into 4 pieces each. Of these, 135 teeth pieces were used as study specimens. These specimens were divided into a control group, an untreated group, and 5 experimental groups (acidulated fluoride gel, fluoride varnish, Gluma, Super Seal, and SE-Bond). The specimens were then subjected to toothbrushing equivalent to 1 week (140 times), 2 weeks (280 times), and 4 weeks (560 times), and the occluding effects on dentinal tubules in 3 regions of each specimen were examined under a scanning electron microscope. The fluoride varnish treated group showed the highest degree of dentinal tubule occlusion effects during the first, second, and fourth weeks of toothbrushing, with the SE-Bond treated group showing the second highest degree and the Gluma treated group showing the lowest degree. After 4 weeks of toothbrushing, the Gluma treated group and the Super Seal treated group showed the lowest degrees of dentinal tubule occlusion effects. In summary, the fluoride varnish treated group and the SE-Bond treated group displayed higher occlusion effects even after 4 weeks of treatment than did the other experimental groups. Therefore, it is the authors' belief that fluoride varnish and SE-Bond are effective for treating dentinal hyperesthesia.

A Study on the Infection Control Attitude of Dental Hygienists (일부 치과위생사의 감염방지 태도에 관한 조사연구)

  • Kim, Ji-Hee;Lee, Kaa-Yean
    • Journal of dental hygiene science
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    • v.9 no.1
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    • pp.129-136
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    • 2009
  • The purpose of this study was to examine the infection control attitude of dental hygienists and the relationship between their attitude and general characteristics. The subjects in this study were 235 dental hygienists who received local in-service education on April 27, 2008. The survey was conducted by this researcher with questionnaires that included 11 items about general characteristics and 41 about attitude of dental infection. The findings of the study were as follows: 1. The dental hygienists investigated got a mean of 2.96 out of possible three points on hand washing, which was a high score. Those who had never been exposed to the blood of patients scored better than the others who hadn't. As for infection control attitude of protective personal devices, they got 2.01 out of possible three points. Those who were at the age of 26 to 30 and who had ever received infection control education got better scores. 2. Concerning attitude toward surface disinfectant, they got 1.95 out of possible three points. whose age was shorter, whose career was shorter, who were in charge of treatment, who served at general hospitals and who had ever received infection control education got better scores. In regard to attitude to surface disinfection methods, they got 1.83 out of possible three points. Those who had ever received infection control education got better scores. 3. As for equipment disinfection, they got 2.43 out of possible three points. Those who worked at dental hospitals and who had ever received infection control education got better scores. Concerning attitude to disposal of scrapped materials, they got 2.92 out of possible three points, and all the intergroup gaps weren't significant. 4. Overall, the dental hygienists got a mean of 2.08 out of possible three points on dental infection control, and those who worked at dental hospitals and who had ever received infection control education took a better attitude to dental infection control.

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Evaluation of the Surgical Treatment for Mitral Stenosis (승모판협착증의 외과적 치료에 대한 평가)

  • Sin, Dong-Geun;Kim, Min-Ho;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1095-1101
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    • 1996
  • From July 1983 to June 1995, 95 consecutive patients with mitral stenosis were treated surgically in the Department of Thoracic and Cardiovascular Surgery, Chonbuk national University Hospital, mitral valve replacement(MVR) in 62 patients and open mitral commissurotomy(OMC) in 33 patients. Mitral stenosis combined with coronary artery disease, with aortic valve disease, or wish mitral valvular Insufficiency, were excluded from this study. Surgical procedures for mitral stenosis were evaluated, according to complication, reoperation, mor- tality, nd functional change at mid- and long-term postoperative period. Cardiothoracic ratio in the MVR group was greater than the OMC group(0.59 $\pm$0.07 in MVR, 0.53 $\pm$0. 07 in OMC, p<0.05), but other variables(age, sex, MYHA functional classification, EKG finding, echocardiographic finding) did not show significant difference between two groups in the preoperative periods. Even though pathologic valvular lesion(Sellor's pathologic type m: 35 in MVR, 13 in OMC) and valvular calcification(35 in MVR, 11 in OMC) were severe in the MVR group(p=0.001) at intraoperative observation, OMC was possible in 11 patients(23.9%) among 46 patients with valvular calcification and in 13 patients(27.1 %) among 61 patients with Sellor's pathologic type IH . There was no significant difference in early and late mortality, actuarial survival(75% in MVR, 87.6% in OMC at 12 year), but early and late hemorrhagic, thromboembolic complications in the MVR group were greater than in the OMC. Functional changes in NYHA functional classification, EKG lEnding, cardiothoraclc ratio, and echocardiographic finding(EF, LVIDS, LWDd, LAD) did not differ between two groups in mid- and long-term postoperative periods. We conclude that our efforts for preservation of the native valve would be continued, because hemorrhagic and thromboembolic complications in the MVR were greater than in the OMC, and OMC was possible even in patients with severely stenotic and calcified mitral valve, although there was no sis-nificant difference in the functional change, mortality, and survival between the M VR and OMC.

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Spatial Structure of Hinterlands and Forelands of Pusan Container Export Port: the Cases of 3 National Flag Carriers (부산 컨테이너 수출항의 배후지와 지향지의 공간구조)

  • Cho, Su-Kyung
    • Journal of the Korean Geographical Society
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    • v.28 no.3
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    • pp.247-267
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    • 1993
  • According to developing international economy since the World War II, the increase and competition of the national business is so empha-sized tht both the interest and the necessity about marine transportation playing the impor-thant role of international transportation are increased. Today, the container transportation, as called the innovation of marine transport has been prevailed since the 1970's. The purpose of this paper is to grasp the spatial structure of the hinterlands and forelands, its object is export container cargo at Pusan Export Port, as known for the transportation node of modern containerlization. In this study, for the purpose of grasping the relation between hinterlands and forelands of Korean export container cargo, first, I researched the transition of carloading about container cargo, the bistribution channel of cargo, the change of the items of container and the carlo-adings about transport route, secondly, I used the cluster analysis so as to group hinterlands according to the items of goods and forelands. The object of the analysis is container cargo of Choyang Line, Hanjin Shipping and Hyundai Merchant Marine of National Frag Carriers. The source materials used in this study are Trucking Data of Hanjin Co., Container Ren-tal Data of Samik Transport Co. and Transpor-ting Present Condition Tables of Hyundai Mer-chant Marine. 1. There are two kinds of the transport classi-fied by its form: FCL and LCL. In Pusan Con-tainer Export, a lot of textile goods, clothings and furniture, compound, electric goods, and so on are dealed with but the rate of occupation of the transport is getting lower while that of occupation of equipment, papers and agricultu-ral, mineral and livestock industry higher. 2. In 1990, the transports of container cargo in Korea consist of 7 services and round-the world lines. We can list North America lines, East-South Asian lines, Japan lines and Inter European lines, in order of the quantity of tran-sport form the largest to the smaller. We can have another list that Japan lines, North Ame-rica lines and East-South lines in order of the rate participation of national flag carriers, be-cacuse Korean foreign trade lay disproportionate emphasis on East-South Asian lines. Japan lines among them is the biggest import-export market. Since the rationlization policy of marine tran-sport in 1984, each of national flag carriers have its own lines. Hanjin Shipping predominates over North America lines, Choyang Line over New Zealand, Inter European and Austria lines and Hyundai Merchant Marine over Center-South America lines, in terms of the volume of transport. And small-to-medium sized shippers are prevailing in lines which are adjacent to Korea, Such as Japan lines and East-South Asian lines. 3. In relation to hinterlands and forelands of Choyang Line, the light industry goods, electric goods and machinary produced in Seoul and Pusan are exported to the major ports in Europe and Japan, the same produces in Suwon, Ulsan, Kumi are exported to European Ports, and those in Incheon and Kwangju Austrian and Japanese ports, and those in the rest regions to the major port in Japan. 4. In relation to hinterlands and forelands of Hanjin Shipping, the light industry goods pro-ducing in Seoul and Pusan, the electric goods and machinary in Incheon and Pyeongteck, are exported to New York and Los Angeles. Electric goods and machinary Masan, Anyang, Cheona, Cheongju and Incheon, Electric goods machinary and light industry goods in Kwangju and non mental goods in Pohang, are exported New York, Los Angeles and Oakland. 5. In relation to hinterlands and forelands of Hyundai Merchant Marine, the region of Seoul, Pusan and Incheon closely related with the main ports in U.S.A. The rest regions with Montreal. The hinterlands of export container cargo can be classified by its export items into three kinds: the large city, industrial city and the rest city. Choyang Line's forelands are European lines, Japan lines and Austria lines, and Hanjin Shipping's forelands are North America lines, and Hyundai Merchant Marine's forelands are North America lines and Japan line. 3 National flag carriers' major forelands are determined by the size of port and the shipper's convenient use of the port terminal.

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A Study of Lung Cancers Without Demonstrable Mass Lesions on Simple Chest X-rays (단순흉부 X-선촬영상 종괴가 보이지 않았던 폐암에 관한 연구)

  • Suh, Gee-Young;Jeong, Ki-Ho;Yoo, Chul-Kyu;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keon-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.1
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    • pp.15-23
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    • 1992
  • Background: The prognosis of lung cancer remains poor and early detection and curative surgery is still the most effective treatment for many. In the early detection of lung cancer, sputum cytology and simple chest x-ray are used, but both of these tests are far from being perfect. So we studied the characteristics of patients diagnosed as lung cancer without demonstrable mass lesion on simple chest x-ray to help in the early diagnosis of lung cancer. Methods: We conducted a retrospective study on 11 subjects who were diagnosed as lung cancer at Seoul National University Hospital between August 1986 and June 1989 and had no demonstrable mass lesion on simple chest x-rays. Results: Ten of 11 patients were male, 8 had a history of smoking, most frequent symptoms were sputum, cough, and hemoptysis, and 3 patients either had wheezing or stridor. In 3 of the cases, although there were no mass lesion, there were ill-defined infiltration, major fissure thickening, and fibrostreaky density mimiking tuberculosis where the tumor was eventually found and in one patient tumor was masked by a rib shadow. Also in one case, lateral chest film demonstrated a retrocardiac mass. Both bronchoscopy and computed tomogram were useful in the localization of the tumor. Seven of 11 had relatively early disease (less than StageII). Four of 11 are still alive without any evidence of recurrence between 2 and a half and 4 years after the operation. Conclusion: We conclude that in patients with respiratory symtoms in whom cancer cannot be ruled out, sputum cytology and lateral chest x-rays should be taken and that if necessary further studies like computed tomogram and bronchoscopy should be done to aid in the early diagnosis of lung cancer.

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Etiologies of Bacterial Pneumonia with Implications for Therapy (세균성 폐렴의 원인균과 그 치료)

  • Woo, Jun-Hee;Lee, Jae-Seok;Kwon, Kwang-Ho;Kim, Kyung-Ho;Choi, Chang-Hyun;Park, Choon-Sik;Lee, Wee-Gyo;Choi, Tae-Youn
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.67-75
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    • 1995
  • Background: Although we gain new knowledge, the problem of pneumonia will not be eliminated. We should understand who is at risk, why these people develop this problem, what causes the pneumonia, and how to manage and prevent respiratory infection. To clarify the alterations of the etiologies of bacterial pneumonia we analysed the recent causative organisms and evaluated the therapeutic implications. Methods: A retrospective four-year study of bacterial pneumonia was conducted in Soon Chun Hyang University Hospital. 190 episodes of bacterial pneumonia was investigated. Results: 1) The causative organisms were isolated in 173 cases on the sputum culture: 154 cases (89%) were gram negative bacilli and 19 cases(11%) were gram positive cocci. The major organisms were Pseudomonas species 49 cases(28%), Klebsiella pneumoniae 29 cases(17%), Enterobacter species 25 cases(14%), and Acinetobacter species 20 cases(12%) in decreasing order. Pseudomonas species(13 cases, 34%) were frequently found in nosocomial pneumonia. 2) The causative organisms were isolated in 16 cases on the blood culture: 7 cases(43%) were gram negative bacilli and 9 cases(57%) were gram positive cocci. The major organisms were Staphylococcus aureus(6 cases, 38%), Pseudomonas species(3 cases, 19%) in decreasing order. 3) In the susceptibility test of causative organisms to antimicrobial drugs, Pseudomonas was susceptible to amikacin, ciprofloxacin, aztreonam, ceftazidime(more than 50%) and resistant to piperacillin, gentamicin, carbenicillin(more than 60%). Klebsiella was susceptible to chloramphenicol, gentamicin, cefotetan(more than 70%) and resistant to carbenicillin, ampicillin(more than 70%). Staphylococcus was susceptible to methicillin(64%), and Streptococcus pneumoniae was susceptible to oxacillin(94%). 4) The response rate after antibiotics therapy was 81% and the mortality rate was 19%. Conclusion: As considering the changes of causative organisms and antibiotic resistance, it behooves us to exercise caution in dispending antibiotics in order to maximize their continued efficacy and to do appropiate antibiotics therapy based on cultures and susceptibility test.

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Jejunal Pouch Interposition (JPI) after Distal Gastrectomy in Patients with Gastric Cancer (위암 환자에서 원위부 위절제 후 공장낭 간치술)

  • Jeon, Hae-Myung;Kim, Wook;Hur, Hoon;Lee, Joon-Hyun;Won, Jong-Man
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.242-251
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    • 2004
  • Purpose: Recently, because of the increasing numbers of early gastric cancer patients and improvements in their survivals, greater attention has been directed towards the quality of life and nutritional status of gastric cancer patients after surgery. However, conventional reconstructions, Billroth- I, -II (B-I and B-II) or Roux-en-Y, have proven to have certain limitations, such as a small reservoir, and a malabsorption for iron, fat, calcium, and carotene. To overcome these limitations, we used a jejunal pouch interposition(JPI) after a distal gastrectomy not only to substitute for the small reservoir but also to maintain a physiologic pathway for ingested foods. Materials and Methods: A total of 196 gastric cancer patients who underwent a distal gastrectomy between March 2001 and February 2004 were divided into 3 groups: JPI group (n=100), B-I group (n=29), and B-II group (n=67). We assessed the patient's nutritional status, gastric emptying time, and gastrofiberscopic findings. Results: The percents of body weight loss at 6 months, 1 year, and 2 years postoperatively in the JPI group ($5.14\%,\;3.01\%,\;2.37\%$) were significantly less than those of the conventional B-I ($8.41\%,\;6.69\%,\;5.90\%$) and B-II groups ($7.50\%,\;7.65\%,\;5.86\%$) (P=0.011, 0.000, 0.013). The laboratory findings showed no significant differences between the 3 groups, except for a higher total protein level in the JPI group after 6 months postoperatively. Especially, stage I and II cancers in the JPI group showed much higher total protein levels after 1 year postoperatively. The gastric emptying times in the $\^{99m}$Tc- semisolid scans at 6 months, 1 year, and 2 years postoperatively were 102.5, 83.1, and 58.1 minutes in the JPI group, 95.5, 92.0, and 58.5 minutes in the B-I group, and 53.9, 69.1, and 50.2 minutes in the B-II group, respectively. Also, the symptomatic gastric stasis detected with a gastrofiberscope during the early postoperative period (6 months) was gradually improved. Conclusion: From a nutritional aspect, a jejunal pouch interposition after a distal gastrectomy could be an alternative reconstruction method, especially in stage I and II gastric cancer patients, in spite of the longer operation time and the probable delayed gastric emptying.

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Establishment of Miniaturized Cultivation Method for Large and Rapid Screening of High-yielding Monascus Mutants, and Enhanced Production of Monacolin-K through Statistical Optimization of Production Medium (Monascus 균사체의 소규모 배양을 통한 고생산성 균주의 대규모 선별방법 확립과 통계적 생산배지 최적화를 통한 Monacolin-K 생산성 향상)

  • Lee, Mi-Jin;Jeong, Yong-Seob;Kim, Pyeung-Hyeun;Chun, Gie-Taek
    • KSBB Journal
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    • v.22 no.5
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    • pp.305-312
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    • 2007
  • It is crucial to develop a miniaturized cultivation method for large and rapid screening of high-yielding mutants of monacolin-K, a powerful anti-hypercholesterolemic secondary metabolite biosynthesized by the fungal cells of Monascus ruber. In order to investigate as many strains as possible in a short time, a miniaturized fermentation method especially suitable for the cultivation of the filamentous Monascus mutants was developed using $50m{\ell}$ culture-tube ($7m{\ell}$ of working volume) instead of the traditional $250m{\ell}$ flask ($50m{\ell}$ of working volume). Generally, in filamentous fungal cell fermentations, morphologies in growth and production cultures should be maintained as thick filamentous and compact-pelleted (usually less than 1 mm in diameter) forms, respectively, for enhanced production of secondary metabolites in final production cultures. In this study, we intended to induce the respective optimal morphologies in the miniaturized culture system for the purpose of rapid screening of overproducers. Miniaturized growth culture system was successfully developed due to the mass production of spores in the statistically optimized solid medium. When large amounts of spores were inoculated into the growth cultures, and brown rice flour (20 g/L) was also supplemented to the growth medium, dense filamentous morphologies were successfully induced in the growth cultures performed with the 50 ml culture tubes. It was implied that the amounts of spores inoculated into the growth tube-cultures and the growth medium components should be the key factors for the induction of the filamentous forms in the growth fermentations. Furthermore, in order to statistically optimize production medium, multiple experiments based on Plackett-Burman design and response surface method (RSM) were carried out, resulting in more than 2 fold enhanced production of monacolin-K in the final production cultures with the optimized production medium. Notably, under the production culture conditions with the statistically optimized medium, optimal pellet sizes below 1 mm in diameter were reproducibly induced, in contrast to the thick and viscous filamentous morphologies observed in the previous production cultures.

Mass Screening of Lovastatin High-yielding Mutants through Statistical Optimization of Sporulation Medium and Application of Miniaturized Fungal Cell Cultures (Lovastatin 고생산성 변이주의 신속 선별을 위해 통계적 방법을 적용한 Sporulation 배지 개발 및 Miniature 배양 방법 개발)

  • Ahn, Hyun-Jung;Jeong, Yong-Seob;Kim, Pyeung-Hyeun;Chun, Gie-Taek
    • KSBB Journal
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    • v.22 no.5
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    • pp.297-304
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    • 2007
  • For large and rapid screening of high-yielding mutants of lovastatin produced by filamentous fungal cells of Aspergillus terreus, one of the most important stage is to test as large amounts of mutated strains as possible. For this purpose, we intended to develop a miniaturized cultivation method using $7m{\ell}$ culture tube instead of traditional $250m{\ell}$ flask (working volume $50m{\ell}$). For obtaining large amounts of conidiospores to be used as inoculums for miniaturized cultures, 4 components i.e., glucose, sucrose, yeast extract and $KH_2PO_4$ were intensively investigated, which had been observed to show positive effect on enhancement of spore production through Plackett-Burman design experimet. When optimum concentrations of these components that were determined through application of response surface method (RSM) based on central composite design (CCD) were used, maximum spore numbers amounting to $1.9\times10^{10}$ spores/plate were obtained, resulting in approximately 190 fold increase as compared to the commonly used PDA sporulation medium. Using the miniaturized cultures, intensive strain development programs were carried out for screening of lovastatin high-yielding as well as highly reproducible mutants. It was observed that, for maximum production of lovastatin, the producers should be activated through 'PaB' adaptation process during the early solid culture stage. In addition, they should be proliferated in condensed filamentous forms in miniaturized growth cultures, so that optimum amounts of highly active cells could be transferred to the production culture-tube as reproducible inoculums. Under these highly controlled fermentation conditions, compact-pelleted morphology of optimum size (less than 1 mm in diameter) was successfully induced in the miniaturized production cultures, which proved essential for maximal utilization of the producers' physiology leading to significantly enhanced production of lovastatin. As a result of continuous screening in the miniaturized cultures, lovastatin production levels of the 81% of the daughter cells derived from the high-yielding producers turned out to be in the range of 80%$\sim$120% of the lovastatin production level of the parallel flask cultures. These results demonstrate that the miniaturized cultivation method developed in this study is efficient high throughput system for large and rapid screening of highly stable and productive strains.