• Imaging Science in Dentistry
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• 제53권1호
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• pp.69-75
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• 2023

Purpose: Maxillofacial trauma predominantly affects young adults between 20 and 40 years of age. Although radioprotection is a legal requirement, the significant potential of dose reduction in computed tomography (CT) is still underused in the clinical routine. The objective of this study was to evaluate whether maxillofacial fractures can be reliably detected and classified using ultra-low-dose CT. Materials and Methods: CT images of 123 clinical cases with maxillofacial fractures were classified by two readers using the AOCOIAC software and compared with the corresponding results from post-treatment images. In group 1, consisting of 97 patients with isolated facial trauma, pre-treatment CT images at different dose levels (volumetric computed tomography dose index: ultra-low dose, 2.6 mGy; low dose, <10 mGy; and regular dose, <20 mGy) were compared with post-treatment cone-beam computed tomography (CBCT). In group 2, consisting of 31 patients with complex midface fractures, pre-treatment shock room CT images were compared with post-treatment CT at different dose levels or CBCT. All images were presented in random order and classified by 2 readers blinded to the clinical results. All cases with an unequal classification were re-evaluated. Results: In both groups, ultra-low-dose CT had no clinically relevant effect on fracture classification. Fourteen cases in group 2 showed minor differences in the classification code, which were no longer obvious after comparing the images directly to each other. Conclusion: Ultra-low-dose CT images allowed the correct diagnosis and classification of maxillofacial fractures. These results might lead to a substantial reconsideration of current reference dose levels.

• Gut and Liver
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• 제12권6호
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• pp.674-681
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• 2018

Background/Aims: The cumulative surgery rate and postoperative relapse of intestinal Behçet's disease (BD) have been reported to be high. This study aimed to establish a scoring system based on follow-up endoscopic findings that can predict intestinal BD recurrence after surgery. Methods: Fifty-four patients with intestinal BD who underwent surgery due to bowel complications and underwent follow-up colonoscopy were retrospectively investigated. Their clinical data, including colonoscopic findings, were retrieved. Classification and regression tree analysis was used to develop an appropriate endoscopic classification model that can explain the postsurgical recurrence of intestinal BD most accurately based on the following classification: e0, no lesions; e1, solitary ulcer <20 mm in size; e2, solitary ulcer ${\geq}20mm$ in size; and e3, multiple ulcers regardless of size. Results: Clinical relapse occurred in 37 patients (68.5%). Among 38 patients with colonoscopic recurrence, only 29 patients had clinically relapsed. Multivariate analysis identified higher disease activity index for intestinal BD at colonoscopy (hazard ratio [HR], 1.013; 95% confidence interval [CI], 1.005 to 1.021; p=0.002) and colonoscopic recurrence (HR, 2.829; 95% CI, 1.223 to 6.545; p=0.015) as independent risk factors for clinical relapse of intestinal BD. Endoscopic findings were classified into four groups, and multivariate analysis showed that the endoscopic score was an independent risk factor of clinical relapse (p=0.012). The risk of clinical relapse was higher in the e3 group compared to the e0 group (HR, 6.284; 95% CI, 2.036 to 19.391; p=0.001). Conclusions: This new endoscopic scoring system could predict clinical relapse in patients after surgical resection of intestinal BD.

• 대한한의학원전학회지
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• 제36권3호
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• pp.89-128
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• 2023

Objectives : This study aims to diachronically examine the classification systems of all materia medica, followed by categorization and analysis of each category to deduce each category's characteristic. This will provide foundation for further examining classifications of bencao in contemporary herbology. Methods : Classification systems from a total of 93 bencao related texts were collected and categorized. Each category's classification system was analyzed to determine its meaning. The classification systems were compared from a diachronic perspective, to further deduce each system's problem from a historical context. Results : The classification systems of materia medica could be summarized as following three standards: quality, origin, and medical application. In reality, bencao could be generally classified according to origin and medical application. The origin-based classification system provided a stable and flexible classification outline in the expansion process of bencao. The medical application-based classification strengthened the relationship between bencao and illness pattern, improving clinical applicability. Conclusions : In the history of herbology, the two classification systems created the current of herbology through mutual contribution and conflict. We hope that further discussion on the direction towards which classification system of bencao in contemporary herbology should head will proceed based on this study.

• 대한한의학회지
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• 제35권3호
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• pp.93-102
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• 2014

Objectives: This study aimed at revising the Korean Out-patient Groups for Korean Medicine (KOPG-OM, version 1.0) based on clinical similarity and resource use, by using the accumulated claims data, and evaluating the validity of the revised classification system. Methods: A clinical specialist panel involving 19 specialists from 8 Korean medicine (KM) specialty areas reviewed the classification tree, diagnosis groups and procedure groups in terms of clinical similarity. Several models of outpatient grouping were formulated, with the validity of each tested based on the $R^2$ coefficient of determination for the treatment costs of all visits. To add age splits, the variances of treatment costs by age groups were also analyzed. These statistical analyses were performed using KM claims data of National Health Insurance from 2010 to 2012. Results: The classification tree designed via panel discussions was used to allocate outpatient cases to 26 diagnosis groups, with cases involving procedures such as acupuncture, moxibustion and cupping, then allocated to 9 procedure groups in each diagnosis group. The cases without procedures were categorized into the visit index - medication group. This process resulted in 298 outpatient groups. The $R^2$ values for treatment costs of all visits ranged from 0.38 to 0.69 depending on the providers' types. Conclusions: The revised model of KOPG-KM has a higher validity for outpatient classification than the current system and can provide better management of the costs of outpatient care in KM.

• 대한본초학회지
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• 제33권4호
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• pp.53-58
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• 2018

Objectives : Kaempferia parviflora Rhizome is black ginger indigenous to Laos and Thailand. It has been used as a folk medicine to improve blood flow and promote vitality and longevity with good health and well being. For these reasons, Kaempferia parviflora Rhizome has been focused on developing it as a food or food supplement. In addition, Kaempferia parviflora Rhizome could be under consideration of new prescription based on its characteristic compounds, polymethoxyflavonoids. However, it needs to be certified as safe before it can be used. Here, a single-oral toxicity test and safety classification was carried out to identity acute information of the toxicity of Kaempferia parviflora Rhizome powder and to make sure of its safety in clinical applications. Methods : Test substance was orally administered to male and female SD-rat at dose levels of 5000 mg/kg to estimate approximate lethal dose(ALD). Based on the acute information of the toxicity, the safety classification was estimated using the HED(human equivalent dose)-based MOS(margin of safety). Results : At 14 days after treatment with test substance. there were no of test substance related with mortalities and clinical signs. In addition, no changes in the body or organ weights and no gross or histopathological findings were observed. Thus, the ALD of Kaempferia parviflora Rhizome powder was considered over 5,000 mg/kg in both female and male mice. Conclusions : Based on the single oral toxicity test using the highest and limit dose, 5,000 mg/kg and the decision guideline for safety classification based on HED-based MOS, it was estimated that Kaempferia parviflora Rhizome powder is classified as "Specified class B" indicating that clinical dose is not limited to patients as safe as food.

• Journal of Periodontal and Implant Science
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• 제53권1호
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• pp.38-53
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• 2023

Purpose: The current Classification of Periodontal and Peri-Implant Diseases and Conditions, published and disseminated in 2018, involves some difficulties and causes diagnostic conflicts due to its criteria, especially for inexperienced clinicians. The aim of this study was to design a decision system based on machine learning algorithms by using clinical measurements and radiographic images in order to determine and facilitate the staging and grading of periodontitis. Methods: In the first part of this study, machine learning models were created using the Python programming language based on clinical data from 144 individuals who presented to the Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University. In the second part, panoramic radiographic images were processed and classification was carried out with deep learning algorithms. Results: Using clinical data, the accuracy of staging with the tree algorithm reached 97.2%, while the random forest and k-nearest neighbor algorithms reached 98.6% accuracy. The best staging accuracy for processing panoramic radiographic images was provided by a hybrid network model algorithm combining the proposed ResNet50 architecture and the support vector machine algorithm. For this, the images were preprocessed, and high success was obtained, with a classification accuracy of 88.2% for staging. However, in general, it was observed that the radiographic images provided a low level of success, in terms of accuracy, for modeling the grading of periodontitis. Conclusions: The machine learning-based decision system presented herein can facilitate periodontal diagnoses despite its current limitations. Further studies are planned to optimize the algorithm and improve the results.

• Journal of Digestive Cancer Research
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• 제10권2호
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• pp.56-64
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• 2022

Narrow-band imaging (NBI) is the most widely used image-enhanced endoscopic technique. The superficial microanatomy of gastric mucosa can be visualized when used with a magnifying endoscopy with narrow-band imaging (ME-NBI). The diagnostic criteria for early gastric cancer (EGC), using the classification system for microvascular and microsurface pattern of ME-NBI, have been developed, and their usefulness has been proven in the differential diagnosis of small depressed cancer from focal gastritis and in lateral extent delineation of EGC. Some studies reported on the prediction of histologic differentiation and invasion depth of gastric cancer using ME-NBI; however, its application is limited in clinical practice, and further well-designed studies are necessary. Clinicians should understand the ME-NBI classification system and acquire appropriate diagnostic skills through various experiences and training to improve the quality of endoscopy for EGC diagnosis.

• 대한상한금궤의학회지
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• 제14권1호
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• pp.41-50
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• 2022

Objective : The purpose of this study is to explore the most suitable machine learning model algorithm for Shanghanlun diagnostic system classification using natural language processing (NLP). Methods : A total of 201 data items were collected from 『Shanghanlun』 and 『Clinical Shanghanlun』, 'Taeyangbyeong-gyeolhyung' and 'Eumyangyeokchahunobokbyeong' were excluded to prevent oversampling or undersampling. Data were pretreated using a twitter Korean tokenizer and trained by logistic regression, ridge regression, lasso regression, naive bayes classifier, decision tree, and random forest algorithms. The accuracy of the models were compared. Results : As a result of machine learning, ridge regression and naive Bayes classifier showed an accuracy of 0.843, logistic regression and random forest showed an accuracy of 0.804, and decision tree showed an accuracy of 0.745, while lasso regression showed an accuracy of 0.608. Conclusions : Ridge regression and naive Bayes classifier are suitable NLP machine learning models for the Shanghanlun diagnostic system classification.

• 대한한방내과학회지
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• 제25권4호
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• pp.34-44
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• 2004

Objective : The purpose of this study is to investigate clinical characteristics with 25 patients who have suffered from headache and were treated. Methods : We classified 25 patients into several groups by IHS classification and evaluated the effects of oriental medical therapy on headache. Results : 1. According to the statistics, instances of migraine were more prevalent than tension headache, especially among women. 2. 28% of patient had entered for treatment within one month of onset. 3. Common associated symptoms included dizziness, nausea, dyspepsia, palpitation and insomnia. 4. In classification by the oriental medical differentiation of symptoms and signs, the rate of stagnation of the humid dam and deficiency of qi, these two types were highest. 5. 56% of patients said they were satisfied with the treatment, reporting half the frequency of headache or better from before treatment. Conclusions : The present results suggest that oriental medical therapy has effects on headache. Further clinical comparative studies on herb-medication versus acupuncture therapy for headache are urged.

• The Journal of Advanced Prosthodontics
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• 제3권4호
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• pp.229-235
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• 2011

PURPOSE. The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR. MATERIALS AND METHODS. A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), replace tooth type (incisor, canine, premolar or molar) Kennedy classification, prosthodontic type, prosthodontic design, opposite dentition, abutment type, occlusal material, occlusal unit, splint to tooth, cantilever, other surgery). Clinical examination (mobility, percussion, screw loosening, discomfort, etc.) and radiographic examination data were collected from patient records including all problems during follow-up period according to protocols described earlier. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR. RESULTS. Five of 249 implants were failed. Four of these were lost before loading. The 5-year implant cumulative survival rate was 97.37%. Cox regression analysis demonstrated a significant predictive association between overall CSR and systemic disease, smoking, reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The screw related complication was rare. Two abutment screw fractures were found. Another complications of prosthetic components were porcelain fracture, resin facing fracture and denture fracture (n=19). CONCLUSION. The 5-year CSR of Implantium implants was 97.37 %. Implant survival may be dependent upon systemic disease, smoking reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The presence of systemic diseases and combination of other surgical procedures may be associated with increased implant failure.