• 대한치과교정학회지
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• 제52권1호
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• pp.3-19
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• 2022

Objective: The purpose of this study was to investigate the accuracy of one-step automated orthodontic diagnosis of skeletodental discrepancies using a convolutional neural network (CNN) and lateral cephalogram images with different qualities from nationwide multi-hospitals. Methods: Among 2,174 lateral cephalograms, 1,993 cephalograms from two hospitals were used for training and internal test sets and 181 cephalograms from eight other hospitals were used for an external test set. They were divided into three classification groups according to anteroposterior skeletal discrepancies (Class I, II, and III), vertical skeletal discrepancies (normodivergent, hypodivergent, and hyperdivergent patterns), and vertical dental discrepancies (normal overbite, deep bite, and open bite) as a gold standard. Pre-trained DenseNet-169 was used as a CNN classifier model. Diagnostic performance was evaluated by receiver operating characteristic (ROC) analysis, t-stochastic neighbor embedding (t-SNE), and gradient-weighted class activation mapping (Grad-CAM). Results: In the ROC analysis, the mean area under the curve and the mean accuracy of all classifications were high with both internal and external test sets (all, > 0.89 and > 0.80). In the t-SNE analysis, our model succeeded in creating good separation between three classification groups. Grad-CAM figures showed differences in the location and size of the focus areas between three classification groups in each diagnosis. Conclusions: Since the accuracy of our model was validated with both internal and external test sets, it shows the possible usefulness of a one-step automated orthodontic diagnosis tool using a CNN model. However, it still needs technical improvement in terms of classifying vertical dental discrepancies.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권2호
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• pp.145-153
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• 2022

Background: Postoperative analgesia (POA) is an important determinant of successful treatment. Dexmedetomidine (DEX) has recently gained attention as a promising adjuvant to local anesthetics (LA). The present study aimed to evaluate the efficacy and safety of levobupivacaine (LB) as an adjuvant during inferior alveolar nerve block (IANB) in the extraction of lower impacted third molars (LITM). Methods: A prospective, randomized, placebo-controlled, triple-blind, parallel-arm, and clinical study was performed on 50 systemically healthy participants who required removal of an asymptomatic LITM. Using a 1:1 distribution, the participants were randomized into two groups (n = 25). Group L (control group) received 1.8 mL of 0.5% LB and 0.2 mL normal saline (placebo) and Group D (study group) received a blend of 1.8 mL of 0.5% LB and 0.2 mL (20 ㎍) DEX. The primary outcome variable was the duration of POA and hemodynamic stability, and the secondary variable was the total number of analgesics required postoperatively for up to 72 h. The participants were requested to record the time of rescue analgesic use and the total number of rescue analgesics taken. The area under the curve was plotted for the total number of analgesics administered. The pain was evaluated using the visual analog scale. Data analysis was performed using paired students and unpaired t-test, Mann-Whitney U test, Chi-square test, and receiver operating characteristic analysis. Statistical significance was set at P < 0.05. Results: The latency, profoundness of anesthesia, and duration of POA were statistically significant (P < 0.05). The differences between mean pain scores at 6, 12, 24, 48, and 72 h were found to be significant (each P = 0.0001). Fewer analgesics were required by participants in group D (2.12 ± 0.33) than in L (4.04 ± 0.67), with a significant difference (P = 0.0001). Conclusion: Perineurally administered LA with DEX is a safe, effective, and therapeutic approach for improving latency, providing profound POA, and reducing the need for postoperative analgesia.

• Journal of Gastric Cancer
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• 제21권4호
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• pp.379-391
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• 2021

Purpose: Promoter DNA methylation of various genes has been associated with metachronous gastric cancer (MGC). The cancer-specific methylation gene, cysteine dioxygenase type 1 (CDO1), has been implicated in the occurrence of residual gastric cancer. We evaluated whether DNA methylation of CDO1 could be a predictive biomarker of MGC using specimens of MGC developing on scars after endoscopic submucosal dissection (ESD). Materials and Methods: CDO1 methylation values (TaqMeth values) were compared between 33 patients with early gastric cancer (EGC) with no confirmed metachronous lesions at >3 years after ESD (non-MGC: nMGC group) and 11 patients with MGC developing on scars after ESD (MGCSE groups: EGC at the first ESD [MGCSE-1 group], EGC at the second ESD for treating MGC developing on scars after ESD [MGCSE-2 group]). Each EGC specimen was measured at five locations (at tumor [T] and the 4-point tumor-adjacent noncancerous mucosa [TAM]). Results: In the nMGC group, the TaqMeth values for T were significantly higher than that for TAM (P=0.0006). In the MGCSE groups, TAM (MGCSE-1) exhibited significantly higher TaqMeth values than TAM (nMGC) (P<0.0001) and TAM (MGCSE-2) (P=0.0041), suggesting that TAM (MGCSE-1) exhibited CDO1 hypermethylation similar to T (P=0.3638). The area under the curve for discriminating the highest TaqMeth value of TAM (MGCSE-1) from that of TAM (nMGC) was 0.81, and using the cut-off value of 43.4, CDO1 hypermethylation effectively enriched the MGCSE groups (P<0.0001). Conclusions: CDO1 hypermethylation has been implicated in the occurrence of MGC, suggesting its potential as a promising MGC predictor.

• Investigative Magnetic Resonance Imaging
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• 제25권4호
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• pp.313-322
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• 2021

Purpose: To find diagnostic image features, to compare diagnostic performance of multiphase CT versus gadoxetic acid disodium-enhanced MRI (GAD-MRI), and to evaluate the impact of analyzing Liver Imaging Reporting and Data System (LI-RADS) imaging features, for distinguishing combined hepatocellular-cholangiocarcinoma (CHC) from hepatocellular carcinoma (HCC). Materials and Methods: Ninety-six patients with pathologically proven CHC (n = 48) or HCC (n = 48), diagnosed June 2008 to May 2018 were retrospectively analyzed in random order by three radiologists with different experience levels. In the first analysis, the readers independently determined the probability of CHC based on their own knowledge and experiences. In the second analysis, they evaluated imaging features defined in LI-RADS 2018. Area under the curve (AUC) values for CHC diagnosis were compared between CT and MRI, and between the first and second analyses. Interobserver agreement was assessed using Cohen's weighted κ values. Results: Targetoid LR-M image features showed better specificities and positive predictive values (PPV) than the others. Among them, rim arterial phase hyperenhancement had the highest specificity and PPV. Average sensitivity, specificity, and AUC values were higher for MRI than for CT in both the first (P = 0.008, 0.005, 0.002, respectively) and second (P = 0.017, 0.026, 0.036) analyses. Interobserver agreements were higher for MRI in both analyses (κ = 0.307 for CT, κ = 0.332 for MRI in the first analysis; κ = 0.467 for CT, κ = 0.531 for MRI in the second analysis), with greater agreement in the second analysis for both CT (P = 0.001) and MRI (P < 0.001). Conclusion: Rim arterial phase hyperenhancement on GAD-MRI can be a good indicator suggesting CHC more than HCC. GAD-MRI may provide greater accuracy than CT for distinguishing CHC from HCC. Interobserver agreement can be improved for both CT and MRI by analyzing LI-RADS imaging features.

• 한국방사선학회논문지
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• 제16권3호
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• pp.309-317
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• 2022

본 연구는 코로나 펜데믹에 의한 사회적 거리두기는 신체활동 감소를 가져왔고 이로 인한 근육량 감소는 혈관질환의 위험도가 높아진다고 보고되고 있다. 이에 본 연구는 경동맥 내중막두께 측정을 통해 두께 증가에 따른 여러 변수들의 차이를 분석하였으며 사지근육량지수가 경동맥 내중막두께 위험도 예측을 위한 효과적 표지자로서의 유용성을 알아보고자 하였다. 2022년 1월부터 2022년 5월까지 부산지역 H병원 건강검진센터에 검진을 목적으로 방문하여 혈청학적 검사, 경동맥초음파, 체성분검사를 시행한 남자 121명, 여자 99명 총 220명을 연구대상으로 하였다. 성별에 따른 위험인자의 유의미한 차이는 카이제곱검정을 통해 분석하였다. 동맥경화를 예측할 수 있는 변수의 Cut-off value를 구하였으며 곡선하면적, 민감도, 특이도를 산출하여 정확도를 평가하였다. 그 결과 남자는 총콜레스테롤이 높을수록 여자는 사지근육량지수가 낮을수록 경동맥 내중막두께 위험도가 높게 나타났다. 경동맥 내중막두께 위험도를 예측할 수 있는 Cut-off value는 남성그룹에서 총콜레스테롤 199 mg/dL 이상, 여성그룹에서 사지근육량지수 5.9 kg/m² 이하로 산출되었다. 따라서 사지근육량지수는 쉽게 접근이 가능한 비침습적인 검사로 성인여성의 경우 혈관변화를 조기 예측하고 예방할 수 있는 표지자 역할이 가능할 것으로 기대된다.

• 대한지역사회영양학회지
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• 제27권3호
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• pp.205-222
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• 2022

Objectives: This study examined the characteristics of patients according to nutritional status assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 were included. The patients were categorized into malnutrition and normal status according to five nutritional screening tools one month after surgery. The Spearman partial correlation, Cohen's Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each two screening tools were calculated. Results: Malnutrition was observed in 86.24% of patients based on the PG-SGA and 85.82% based on the NUTRISCORE. When NRI or CONUT were applied, the proportions of malnutrition were < 30%. Patients with malnutrition had lower intakes of energy and protein than normal patients when assessed using the PG-SGA, NUTRISCORE, or NRI. Lower levels of albumin, hemoglobin, total lymphocyte count, and total cholesterol and longer postoperative hospital stays were observed among patients with malnutrition compared to normal patients when NRI, PNI, or CONUT were applied. Relatively high agreement for NUTRISCORE relative to PG-SGA was found; the sensitivity was 90.86%, and the AUC was 0.78. When NRI, PNI, and CONUT were compared, the sensitivities were 23.72% for PNI relative to NRI, 44.53% for CONUT relative to NRI, and 90.91% for CONUT relative to PNI. The AUCs were 0.95 for NRI relative to PNI and 0.91 for CONUT relative to PNI. Conclusions: NUTRISCORE had a high sensitivity compared to PG-SGA, and CONUT had a high sensitivity compared to PNI. NRI had a high specificity compared to PNI. This relatively high sensitivity and specificity resulted in 77.00% agreement between PNI and CONUT and 77.94% agreement between NRI and PNI. Further cohort studies will be needed to determine if the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

• 한국임상수의학회지
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• 제39권5호
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• pp.199-206
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• 2022

Postpartum diseases should be predicted to prevent productivity loss before calving especially in organic dairy farms. This study was aimed to investigate the incidence of postpartum metabolic diseases in an organic dairy farm in Korea, to confirm the association between diseases and prepartum blood biochemical parameters, and to evaluate the accuracy of these parameters with a receiver operating characteristic (ROC) analysis for identifying vulnerable cows. Data were collected from 58 Holstein cows (16 primiparous and 42 multiparous) having calved for 2 years on an organic farm. During a transition period from 4 weeks prepartum to 4 weeks postpartum, blood biochemistry was performed through blood collection every 2 weeks with a physical examination. Thirty-one (53.4%) cows (9 primiparous and 22 multiparous) were diagnosed with at least one postpartum disease. Each incidence was 27.6% for subclinical ketosis, 22.4% for subclinical hypocalcemia, 12.1% for retained placenta, 10.3% for displaced abomasum and 5.2% for clinical ketosis. Between at least one disease and no disease, there were significant differences in the prepartum levels of parameters like body condition score (BCS), non-esterified fatty acid (NEFA), total bilirubin (T-bil), direct bilirubin (D-bil) and NEFA to total cholesterol (T-chol) ratio (p < 0.05). The ROC analysis of each of these prepartum parameters had the area under the curve (AUC) <0.7. However, the ROC analysis with logistic regression including all these parameters revealed a higher AUC (0.769), sensitivity (71.0%), and specificity (77.8%). The ROC analysis with logistic regression including the prepartum BCS, NEFA, T-bil, D-bil, and NEFA to T-chol ratio can be used to identify cows that are vulnerable to postpartum diseases with moderate accuracy.

• 대한본초학회지
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• 제29권3호
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• pp.59-70
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• 2014

Objectives : The purpose of this study was to evaluate boiled rice made from unpolished rice, Job's Tears, and extract from medicinal herbs mixture (HGMCJE) for hypoglycemic effect on STZ-induced diabetic rats. Methods : In the response of glucose tolerance, control and diabetic rats groups was intubated with glucose and HGMCJE. Furthermore, boiled 100% polished rice (P rice), boiled unpolished rice mixed with white rice and Job's tears (polished rice:unpolished rice:Job's tears=60:25:15, UPJ-rice), and UPJ rice made from HGMCJE (HUPJ-rice) were intubated to control and diabetic rats groups, respectively. Then, blood glucose concentration, incremental blood glucose, and area under the curve (${\Delta}AUC$) were analyzed in every experimental groups, and these data were used to evaluate glycemic response. Results : When glucose and p rice were intubated in control and diabetic rats, blood glucose concentration, incremental blood glucose, and incremental response ${\Delta}AUC$ of diabetic groups were significantly increase than control groups. But administraion of a single dose of extract from medicinal herbs mixture and HUPJ-rice in control and diabetic rats inhibited the remarkable increase the level of postprandial blood and ${\Delta}AUC$ at 60, 90, and 120 min Conclusions : These results indicate that when intubation of glucose and P rice were out of control on postprandial glycemic response in diabetic rats. But postprandial glycemic response was well-modulated by administrating a single oral dose of HGMCJE and HUPJ-rice. Therefore, HGMCJE can be developed as an effective hypoglycemic agent.

• Journal of Chest Surgery
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• 제55권2호
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• pp.143-150
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• 2022

Background: The effectiveness of extracorporeal membrane oxygenation (ECMO) for patients with refractory cardiogenic shock or cardiac arrest is being established, and serum lactate is well known as a biomarker of end-organ perfusion. We evaluated the efficacy of pre-ECMO lactate for predicting 6-month survival in patients with acute coronary syndrome (ACS) undergoing ECMO. Methods: We reviewed the medical records of 148 patients who underwent veno-arterial (VA) ECMO for ACS between January 2015 and June 2020. These patients were divided into survivors and non-survivors based on 6-month survival. All clinical data before and during ECMO were compared between the 2 groups. Results: Patients' mean age was 66.0±10.5 years, and 116 (78.4%) were men. The total survival rate was 45.9% (n=68). Cox regression analysis showed that the pre-ECMO lactate level was an independent predictor of 6-month mortality (hazard ratio, 1.210; 95% confidence interval [CI], 1.064-1.376; p=0.004). The area under the receiver operating characteristic curve of pre-ECMO lactate was 0.64 (95% CI, 0.56-0.72; p=0.002; cut-off value=9.8 mmol/L). Kaplan-Meier survival analysis showed that the cumulative survival rate at 6 months was significantly higher among patients with a pre-ECMO lactate level of 9.8 mmol/L or less than among those with a level exceeding 9.8 mmol/L (57.3% vs. 31.8%, p=0.0008). Conclusion: A pre-ECMO lactate of 9.8 mmol/L or less may predict a favorable outcome at 6 months in ACS patients undergoing VA-ECMO. Further research aiming to improve the accuracy of predictions of reversibility in patients with high pre-ECMO lactate levels is essential.

• 한국산업융합학회 논문집
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• 제24권6_2호
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• pp.729-735
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• 2021

Recently Artificial Intelligence(AI) has been developed and used in various fields. Especially AI recognition technology can perceive and distinguish images so it should plays a significant role in quality inspection process. For stability of autonomous driving technology, semiconductors inside automobiles must be protected from external electromagnetic wave(EM wave). As a shield film, a thin polymeric material with hole shaped micro-patterns created by a laser processing could be used for the protection. The shielding efficiency of the film can be increased by the hole structure with appropriate pitch and size. However, since the sensitivity of micro-machining for some parameters, the shape of every single hole can not be same, even it is possible to make defective patterns during process. And it is absolutely time consuming way to inspect all patterns by just using optical microscope. In this paper, we introduce a AI inspection system which is based on web site AI tool. And we evaluate the usefulness of AI model by calculate Area Under ROC curve(Receiver Operating Characteristics). The AI system can classify the micro-patterns into normal or abnormal ones displaying the text of the result on real-time images and save them as image files respectively. Furthermore, pressing the running button, the Hardware of robot arm with two Arduino motors move the film on the optical microscopy stage in order for raster scanning. So this AI system can inspect the entire micro-patterns of a film automatically. If our system could collect much more identified data, it is believed that this system should be a more precise and accurate process for the efficiency of the AI inspection. Also this one could be applied to image-based inspection process of other products.