• Journal of Biomedical Engineering Research
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• v.45 no.2
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• pp.95-100
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• 2024

Vitiligo is a condition characterized by the destruction or dysfunction of melanin-producing cells in the skin, resulting in a loss of skin pigmentation. Facial vitiligo, specifically affecting the face, significantly impacts patients' appearance, thereby diminishing their quality of life. Evaluating the efficacy of facial vitiligo treatment typically relies on subjective assessments, such as the Facial Vitiligo Area Scoring Index (F-VASI), which can be time-consuming and subjective due to its reliance on clinical observations like lesion shape and distribution. Various machine learning and deep learning methods have been proposed for segmenting vitiligo areas in facial images, showing promising results. However, these methods often struggle to accurately segment vitiligo lesions irregularly distributed across the face. Therefore, our study introduces a framework aimed at improving the segmentation of vitiligo lesions on the face and providing an evaluation of vitiligo lesions. Our framework for facial vitiligo segmentation and lesion evaluation consists of three main steps. Firstly, we perform face detection to minimize background areas and identify the face area of interest using high-quality ultraviolet photographs. Secondly, we extract facial area masks and vitiligo lesion masks using a semantic segmentation network-based approach with the generated dataset. Thirdly, we automatically calculate the vitiligo area relative to the facial area. We evaluated the performance of facial and vitiligo lesion segmentation using an independent test dataset that was not included in the training and validation, showing excellent results. The framework proposed in this study can serve as a useful tool for evaluating the diagnosis and treatment efficacy of vitiligo.

• Tuberculosis and Respiratory Diseases
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• v.87 no.4
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• pp.483-493
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• 2024

Background: The use of immune checkpoint inhibitors (ICIs) in patients with advanced lung cancer is increasing. Despite ongoing studies to predict the efficacy of ICIs, its use in clinical practice remains difficult. Thus, we aimed to discover a predictive marker by analyzing blood cell characteristics and developing a scoring system for patients treated with ICIs. Methods: This was a prospective multicenter study in patients with advanced non-small cell lung cancer (NSCLC) who received ICIs as second-line treatment from June 2021 to November 2022. Blood cell parameters in routine blood samples were evaluated using an automated hematology analyzer. Immune checkpoint inhibitor score (IChIS) was calculated as the sum of neutrophil count score and immature granulocyte score. Results: A total of 143 patients from four institutions were included. The treatment response was as follows: partial response, 8.4%; stable disease, 37.1%; and progressive disease, 44.8%. Median progression-free survival and overall survival after ICI treatment was 3.0 and 8.3 months, respectively. Median progression-free survival in patients with an IChIS of 0 was 4.0 months, which was significantly longer than 1.9 months in patients with an IChIS of 1 and 1.0 month in those with an IChIS of 2 (p=0.001). The median overall survival in patients with an IChIS of 0 was 10.2 months, which was significantly longer than 6.8 and 1.8 months in patients with an IChIS of 1 and 2, respectively (p<0.001). Conclusion: Baseline IChIS could be a potential biomarker for predicting survival benefit of immunotherapy in NSCLC.

• Journal of the Korean Arthroscopy Society
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• v.12 no.2
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• pp.139-146
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• 2008

Purpose: The purpose of this study is to introduce the double bundle posterior cruciate ligament(PCL) reconstruction using Achilles allograft by the tibial inlay method and evaluate the clinical results of 11 cases who had PCL reconstruction using this method and were followed for more than 2 years after surgery. Materials and Methods: Our series consists of 11 cases of PCL reconstruction due to chronic posterior instability of knee and acute PCL rupture. The clinical results were assessed using the IKDC(International Knee Documentation Committee) scoring system, posterior stress radiographs and the maximum posterior displacement using a KT-1000TM arthrometer. Results: The average preoperative posterior displacement in 90 degree flexion stress radiograph was measured 13.4 mm and in 10 degree flexion the average posterior displacement using the KT-1000TM arthrometer was measured 11.4 mm. Postoperatively the 13.4 mm reduced to 4.4 mm and the 11.4 mm reduced to 3.9 mm. According to IKDC scoring system, 9 cases(81.8%) were satisfied. One case showed limitation of flexion with mild stiffness in the knee and another one case was not improved the posterior instability sufficiently and no complication of allograft was noticed. Conclusion: The double bundle PCL reconstruction using Achilles allograft by the tibial inlay method is a useful method for acute PCL rupture and chronic posterior instability of the knee including failed PCL reconstruction, because it will also make the posterior stability in the extension and 90 degree flexion position, and avoid the grafted tendon abrasion by acute turn of tibial tunnel.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.6 no.1
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• pp.1-9
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• 2013

Purpose: The purpose is to perform objective evaluation for rotator cuff using ultrasonography and validate factors influencing cuff integrity as well as efficacy of follow-up ultrasonography after unreamed antegrade intramedullary nailing for humerus fracture. Materials and Methods: Seventeen patients with an average age of $55.7{\pm}18.6$ years underwent antegrade intramedullary nailing for humerus fracture and follow-up ultrasonography of shoulder joint. Mean follow-up period was $43.5{\pm}32.2$ months. Intraoperative evaluation for preoperative cuff tear was performed, of which four cuffs were repaired by single row repair technique. Clinical evaluation included visual analogue scale (VAS), range of motion, Korean Shoulder Scoring System (KSS) and American Shoulder and Elbow Society (ASES) score. Ultrasonographic evaluation was performed on cuff integrity and protrusion of proximal nail tip as well. Radiographic evaluation included time to union, protrusion of proximal nail tip and migration of proximal interlocking screw which could affect shoulder joint function. Results: Mean VAS at last follow-up was $1.65{\pm}1.84$ points. Range of motion showed forward flexion of $137.0{\pm}33.5^{\circ}$, external rotation of $43.5{\pm}12.7^{\circ}$ and internal rotation of $16.4{\pm}2.0^{\circ}$ while KSS score and ASES score were $79.6{\pm}20.7$ and $83.7{\pm}17.0$ points, respectively. Bone union was demonstrated in all cases and average time to union was $3.4{\pm}1.3$ months. Migration of proximal interlocking screw was shown in 6 cases (35%). On ultrasonographic evaluation, there were normal in 8 (47%), weaving in 4 (24%), partial tear in 5 cases (29%), but no complete tear. Protrusion of proximal nail tip was demonstrated in 8 cases (47%) on plain radiographs whereas in 11 cases (65%) on ultrasonography and was associated with increasing age (p=0.038). Ultrasonographic weaving and partial tear was associated with protrusion of proximal nail tip (p=006), but not with repair of preoperative tear (p>0.05). Conclusion: Because weaving and partial tear on ultrasonography originated from protrusion of proximal nail tip, careful insertion of nail and meticulous repair of cuff during operation lead to stable fixation with satisfactory recovery of shoulder function follow-up ultrasonography can be a useful tool for evaluating protrusion of nail tip and rotator cuff tear, of which diagnosis is difficult on plain X-ray after antegrade intramedullary nailing for humerus fracture.

• Tuberculosis and Respiratory Diseases
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• v.53 no.2
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• pp.136-147
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• 2002

Background : Interstitial lung disease has various manifestations that are differentiated by their pathology, progress and treatment. However, all manifestations eventually progresses to pulmonary fibrosis. Recent studies have shown that apoptosis of pulmonary epithelial cells might be related to pulmonary fibrosis. The correlation of the apoptotic index with the clinical manifestations, pathological findings, HRCT findings and the response to treatment were examined. Materials and Methods : Twenty subjects (14 men, 16 women), who had been diagnosed with interstitial lung disease through an open lung biopsy, were enrolled in this study. The subtypes were one AIP, two NIP, eight BOOP, and seven UIP cases. The apoptotic index was scaled from 0-2 depending on the fraction of positive staining cells by TUNEL method. The clinical severity was assessed by a modification of a previously developed CRP scoring system. The pathologic scores were based on 4 components: fibrosis, cellularity, desquamation, and granulation. In the HRCT study, each lobe was scored by the radiologists on a scale for both fibrosis and ground-glass attenuation. The treatment response was assessed by an increase in more than 10% of the CRP score, and comparing the results 3 months before and after treatment. Results : The apoptotic index showed no correlation with the CRP and HRCT scoring system. The apoptotic index correlated with the pathologic elements including fibrosis, cellularity and the desquamation score (p<0.05). Of the 16 patients who received corticosteroid therapy, 9 patients (56.3%) responded to therapy. There was no correlation between the response to corticosteroid and the apoptotic index. In the case of patients with acute and subacute ILD, the apoptotic index showed a correlation with the cellularity, desquamation, and the total histological score (p<0.05). In the case of patients with chronic ILD, the apoptotic index correlated with the fibrosis and cellularity score (p<0.05). Conclusion : Apoptosis of the pulmonary epithelial cells is implicated in the pathogenesis of interstitial lung disease particularly on a pathological basis.

• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.135-142
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• 2020

Purpose: This paper presents the long term follow-up results of arthroscopic partial repair for massive irreparable rotator cuff tears using a biceps long head auto graft. Materials and Methods: Forty-one patients with massive irreparable rotator cuff tear, who underwent arthroscopic repair, were reviewed retrospectively. Patients who underwent arthroscopic partial repair using a biceps long head auto graft were assigned to group 1, and patients in group 2 underwent arthroscopic partial repair alone. Patients with a less than 50% partial tear of the long head biceps tendon were included in this study. The clinical scores were measured using a visual analogue pain scale (VAS) for pain, range of motion (ROM), The University of California, Los Angeles shoulder score (UCLA), American Shoulder and Elbow Surgeons Shoulder Score (ASES), and Korean Shoulder Scoring System (KSS) scores preoperatively and at the final follow-up. The acromiohumeral interval (AHI) was measured using plain radiographs taken preoperatively and at the final follow-up, and re-tear was evaluated using postoperative ultrasound or magnetic resonance imaging at the last follow-up. Results: The mean age of the patients was 62.1±12.7 years, and the mean follow-up period was 90.3±16.8 months. No significant differences in the VAS and ROM (forward flexion, external rotation, internal rotation) were found between the two groups (p=0.179, p=0.129, p=0.098, p=0.155, respectively). The UCLA (p=0.041), ASES (p=0.023), and KSS (p=0.019) scores showed functional improvements in group 1 compared to group 2. At the last follow-up, the measured AHI values were 9.46±0.41 mm and 6.86±0.64 mm in group 1 and 2, respectively (p=0.032). Re-tear was observed in six out of 21 cases (28.6%) in group 1 and nine out of 20 cases (45.0%) in group 2; the retear rate was significantly lower in group 1 than in group 2 (p=0.011). Conclusion: Arthroscopic partial repair for a massive irreparable rotator cuff tear using a biceps long head auto graft has significant clinical usefulness in functional recovery and decreases the re-tear rates after surgery than arthroscopic partial repair alone, showing favorable results after a long-term follow-up.

• Journal of Korean Neurosurgical Society
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• v.57 no.3
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• pp.174-177
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• 2015

Objective : For improving the drawbacks of previous thoracolumbar spine trauma classification, the Spine Trauma Study Group was developed new classification, Thoracolumbar Injury Classification and Severity Score (TLICS). The simplicity of this scoring system makes it useful clinical application. However, considering criteria of Korean Health Insurance Review and Assessment Service (HIRA), the usefulness of TLICS system is still controversial in the treatment decision of thoracolumbar spine injury. Methods : Total 100 patients, who admitted to our hospital due to acute traumatic thoracolumbar injury, were enrolled. In 45, surgical treatment was performed and surgical treatment was decided following the criteria of HIRA in all patients. With assessing of TLICS score and Denis's classification, the treatment guidelines of TLICS and Denis's classification were applied to the criteria of Korean HIRA. Results : According to the Denis's three-column spine system, numbers of patients with 2 or 3 column injuries were 94. Only 45 of 94 patients (47.9%) with middle column injury fulfilled the criteria of HIRA. According to TLICS system, operation required fractures (score>4) were 31 and all patients except one fulfilled the criteria of HIRA. Conservative treatment required fractures (score<4) were 52 and borderline fracture (score=4) were 17. Conclusion : The TLICS system is very useful system for decision of surgical indication in acute traumatic thoracolumbar injury. However, the decision of treatment in TLICS score 4 should be carefully considered. Furthermore, definite criteria of posterior ligamentous complex (PLC) injury may be necessary because the differentiation of PLC injury between TLICS score 2 and 3 is very difficult.

• Clinics in Shoulder and Elbow
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• v.11 no.1
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• pp.41-45
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• 2008

Purpose: To review the clinical and radiological results after an open reduction and internal fixation with a T-shaped LCP for unstable distal clavicle fractures. Materials and Methods: From February 2005 to June 2006, ten patients with distal clavicle Neer type II fractures were treated with an open reduction and internal fixation with a T-shaped LCP. Bony union was identified by plain radiography. The clinical results were analyzed according to the UCLA scoring system. Results: The mean time to fracture union was 9weeks and union was achieved in all cases. The mean UCLA score was 33.4 (30-35); excellent in 8 cases and good in 2 cases. In one case, loosening of one distal screw was occured and mild AC joint subluxation was observed in another case. Conclusion: 3.5 mm T-shaped LCP fixation is a useful technique for treating unstable distal clavicle fractures. This procedure provide stable fixation with no further AC joint injury.

• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.89-95
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• 2006

Purpose: Arthroscopic repair of rotator cuff tears are many techniques that have been developed to improve the initial postoperative strength of the repair. There was a doubt that current arthroscopic cuff repairs using a single row of suture anchors reproduce insufficient area of the anatomic cuff insertion, and concerns about failure of fixation often lead surgeons to limit early motion. Newer technique of double-row repair in arthroscopic treatment may provide initial stronger fixation and more contact with bone at the repair site than single-row repair did. We studied the comparison between clinical outcomes of arthroscopic single- and double-row repair in cuff tears at 1year postoperatively. Materials and methods: We retrospectively analyzed 40 shoulders with single-row repair and 38 shoulders with double-row repair of full-thickness rotator cuff tears between May 2002 and October 2004. Out of total 78 shoulders, 42 (54%) were male patients and 36 (46%) were female patients and the mean age at surgery was 56 years. All patients were diagnosed by physical examination and MRI. At 1year' follow-up after operation, we evaluated with the ASES and the Constant scoring system, and measured muscle power of abduction, internal and external rotation of the affected shoulder then compared with each other. Results: Mean ASES scores and Constant scores in double-row repair group improved more than single-row repair group significantly at 1year postoperatively. Muscle power of abduction and internal rotation, especially abduction power, improved more significantly in double-row repair group than in single-row repair. Conclusion: Arthroscopic double-row repair for the full thickness rotator cuff tear may be a superior technique, which showed better clinical outcomes and restoration of muscle power compared with single-row repair at relatively short period of postoperative follow-up. Restoration of footprint close to normal anatomy by double-row repair seems to play an important role in the recovery of muscle strength.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.115-122
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• 2013

Purpose: The purpose of this study is to analyze the results of acute acromioclavicular joint dislocation treatment with coracoclavicular ligament augmentation using Tight-Rope$^{(R)}$ (Arthrex). Materials and Methods: From October 2009 to March 2011, 30 patients with acute acromioclavicular joint dislocation underwent coracoclavicular ligament augmentation using Tight-Rope$^{(R)}$ and were followed up for at least 12 months after surgery. The radiologic results were qualified according to serial plain radiographs, and the clinical results according to University of California - Los Angeles (UCLA) Shoulder Scale, Constant score, and VAS pain score. Results: Using the UCLA scoring system, excellent results were observed in 22 cases (73%), good results in five cases (17%), fair results in two cases (7%), and a poor result in one case (3%). The average Constant score was $92.5{\pm}7.5$. According to radiologic results, anatomical reduction was achieved in 26 cases, and two cases showed a moderate loss of reduction, and two cases showed complete re-dislocation. Clinical results for patients with re-dislocation were unsatisfactory and reoperation was required. Conclusion: Coracoclavicular ligament augmentation using Tight-Rope$^{(R)}$ is a good option providing reliable functional results in patients with acute acromioclavicular joint dislocation.