• Title/Summary/Keyword: Treatment Grade

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IPMN-LEARN: A linear support vector machine learning model for predicting low-grade intraductal papillary mucinous neoplasms

  • Yasmin Genevieve Hernandez-Barco;Dania Daye;Carlos F. Fernandez-del Castillo;Regina F. Parker;Brenna W. Casey;Andrew L. Warshaw;Cristina R. Ferrone;Keith D. Lillemoe;Motaz Qadan
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.195-200
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    • 2023
  • Backgrounds/Aims: We aimed to build a machine learning tool to help predict low-grade intraductal papillary mucinous neoplasms (IPMNs) in order to avoid unnecessary surgical resection. IPMNs are precursors to pancreatic cancer. Surgical resection remains the only recognized treatment for IPMNs yet carries some risks of morbidity and potential mortality. Existing clinical guidelines are imperfect in distinguishing low-risk cysts from high-risk cysts that warrant resection. Methods: We built a linear support vector machine (SVM) learning model using a prospectively maintained surgical database of patients with resected IPMNs. Input variables included 18 demographic, clinical, and imaging characteristics. The outcome variable was the presence of low-grade or high-grade IPMN based on post-operative pathology results. Data were divided into a training/validation set and a testing set at a ratio of 4:1. Receiver operating characteristics analysis was used to assess classification performance. Results: A total of 575 patients with resected IPMNs were identified. Of them, 53.4% had low-grade disease on final pathology. After classifier training and testing, a linear SVM-based model (IPMN-LEARN) was applied on the validation set. It achieved an accuracy of 77.4%, with a positive predictive value of 83%, a specificity of 72%, and a sensitivity of 83% in predicting low-grade disease in patients with IPMN. The model predicted low-grade lesions with an area under the curve of 0.82. Conclusions: A linear SVM learning model can identify low-grade IPMNs with good sensitivity and specificity. It may be used as a complement to existing guidelines to identify patients who could avoid unnecessary surgical resection.

To Assess Whether Lee's Grading System for Central Lumbar Spinal Stenosis Can Be Used as a Decision-Making Tool for Surgical Treatment (요추 중심 신경관 협착에 있어서 Lee's Grade를 통한 MRI 평가방법이 수술적 치료 결정에 유용한가에 대한 연구)

  • Do Yeon Ahn;Hee Jin Park;Jung Woo Yi;Ji Na Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.102-111
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    • 2022
  • Purpose To evaluate the correlation between Lee's grades and surgical intervention for central lumbar spinal stenosis (CLSS) and to assess whether this grading system can be used as a decision-making tool for the surgical treatment of this condition. Materials and Methods This retrospective study included 290 patients (M:F = 156:134; mean age, 46 ± 16 years). Radiologists assessed the presence and grade of CLSS at the stenosis point according to Lee's grading system, in which CLSS is classified into four grades according to the shape of the cauda equina. Correlation coefficients (rs) between Lee's grades and the operation were calculated with Spearman rank correlation. Results Among the operated patients, grade 2 was the most commonly assigned grade (50%-58%), grade 3 was less common (35%), and grade 0 was the least common (2%-3%). Among the non-operated patients, grade 1 was the most common (63%-65%), grade 0 was less common (15%-16%), and grade 3 was the least common (8%). The distribution of grades differed between the operated and non-operated groups (p < 0.001). Less than 25% of patients who underwent surgery were assigned grades 0 and 1, and more than 88% were assigned grades 2 and 3. A moderate correlation was found between the grade and surgical intervention (rs = 0.632 and rs = 0.583). Conclusion Lee's grade was moderately correlated with surgical intervention. Lee's grading system can be a decision-making tool for the surgical treatment of CLSS.

Case Study of Treating Acne Scar Using Scar Regeneration Acupuncture Therapy and Micro-needle Therapy (흉터재생침과 미세피부침을 이용한 여드름 흉터의 치험례)

  • Lee, Ki-Su;Kim, You-Ra;Choi, Hyeong-Seok
    • Journal of Acupuncture Research
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    • v.29 no.4
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    • pp.81-91
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    • 2012
  • Objectives : There are numerous methods in treating acne scar. On the contrary there are hardly any cases on treating acne scars through Korean medicine. By observing we compared how much acne scar was treated by scar regeneration acupuncture therapy and micro-needle therapy treatment through observing pre and post case photos, KAGS, KCADI and patient satisfaction. Results : By comparing pre and post procedure through acne scar grade criteria, total of 5 patients showed improvement and could see distinct change in skin comparing case photos. After comparing pre and post procedures, total of 5 patients showed improvements in figures of Korean acne index. 4 patients replied very satisfied and 1 replies satisfied on patient satisfaction survey. Conclusions : After observing patients satisfaction, and comparing case photos, acne scar grade criteria, korean acne index, it can be considered that scar regeneration acupuncture therapy and micro-needle therapy done in our clinic to be valid treatment.

Fabrics Dyeing using Natural dyestuff Manufactured from Squid Ink (오징어 먹물 색소를 이용한 직물에의 염색)

  • 이혜자;반성의;유혜자
    • Journal of the Korean Society of Clothing and Textiles
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    • v.22 no.8
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    • pp.1011-1019
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    • 1998
  • The natural dyestuff(squid ink) was manufactured from squid ink by boiling in 0.1% NaOH solution and powdering in freeze dryer. Cotton, wool, silk and nylon fabrics were dyed under several conditions using the manufactured squid ink to investigate the dyeability and color fastness. Dyeing was operated in acidic dyebath of pH 4 because the squid ink is anionic. Dyeabilities on wool, silk and nylon fabrics were good, especially silk fabrics were dyed deeper than others because of being amine group. But dyeability on cotton fabrics was low and developed with chitosan treatment. All the dyed fabrics showed excellent in color fastness to crocking and laundering. Also light fastness of them were excellent except nylon. The light fastness of dyed-nylon fabrics was as poor as grade 1, but they could be improved to grade 4 by aftertreatment with gallicacid. Useing the natural dyestuff-squid ink powder, we could execute whenever we want to dye fabrics in the adequate concentration. Dyeabilities were developed according to repeating times of dyeing and the increased dye concentration. We could recycle the wasting sources.

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Mucoepidermoid Carcinoma of the Soft Palate in a Child (소아에서 발생한 연구개 점액표피양 종양 1례)

  • Jung, Hoon;Eun, Young-Gyu;Kwon, Kee-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.2
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    • pp.207-210
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    • 2008
  • The purpose of this paper is to review our experience with mucoepidermoid carcinoma(MEC), a rare tumour in minor salivary glands, in a paediatric patients. 15-year-old boy was noted to have a irregular round mass appearing atthe soft palate just to the right of the mid-line. A computed tomographic(CT) scan showed a palatal mass limited to soft palate with no bony erosion. The lesion was curetted and debulked. Pathology was reported as an intermediate-grade mucoepidermoid carcinoma, and the patient was considered to radiation therapy institution for further treatment. To date, patients remain free of disease. Wide local excision is the treatment of choice for low to intermediate grade MEC of the minor salivary glands in paediatric patients.

One Case Report of Peptic ulcer Patient Who was Administered by Anjungsan (안중산 투여 후 증상호전을 보인 급성 소화성 궤양 환자 1례 증례보고)

  • Kim, Min-Chul
    • Herbal Formula Science
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    • v.19 no.1
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    • pp.253-261
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    • 2011
  • Objectives : The prevalence of peptic ulcer disease is estimated about 10% in Korea, and has declined due to Helicobacter pylori eradication therapy. Symptoms of peptic ulcer are postprandial epigastric pain, hunger pain, anorexia, nauea, vomiting, soreness, postprandial fullness, postparandial discomfort. The purpose of the study was to evaluate the effectiveness of the Anjungsan in the improvement of the symptoms in patients with peptic ulcer. Methods : After taking Anjungsan to patient with peptic ulcer, Examined to assess the improvemnet by Ordinal Scale VI grade and VAS. Results : Patients with symptoms of the appeal was taking Anjungsan gets better after 3 dyas appeared to be more than half. And 11 days after treatment all symptoms were improved under the VAS 1-2 except for epigastric lump sensation. Conclusions : After treatment with Anjungsan, patient showed improvement in all symptoms associated with peptic ulcer.

Pap Smear Combined with HPV Testing: A Reasonable Tool for Women with High-grade Cervical Intraepithelial Neoplasia Treated by LEEP

  • Mo, Ling-Zhao;Song, Hong-Lin;Wang, Jian-Li;He, Qing;Qiu, Zhang-Can;Li, Fei
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4297-4302
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    • 2015
  • Background: To evaluate HPV testing by Hybrid Capture II (HCII) in conjunction with cytology in detecting the residual/recurrence disease after treatment of high-grade cervical intraepithelial neoplasia (CIN II-III) with loop electrosurgical excision procedure (LEEP). Materials and Methods: A retrospective review of 158 patients with histologically confirmed CIN II-III who underwent LEEP between January 2011 and October 2012 was conducted. Post-treatment control was scheduled at the 3rd, 6th, 12th and 18th month. All patients were followed up by Pap smear and HR-HPV genotype and viral load testing. Results: Pre-treatment, HR-HPV DNA, was detected in all specimens of the patients. At follow-up, 25 patients were diagnosed as the residual/recurrent disease during the FU visit, among whom, 16 patients with positive margin: 13 patients (52%) with HR-HPV DNA+/cytology+, 2 patients (8%) with HR-HPV DNA+/cytology-, 1 patient (4%) with cytology+/HR-HPV DNA-; 9 patients with clean margin - 5 patients (55.6%) with HR-HPV DNA+/cytology+; 2 patients (22.2%) with HRHPV DNA+/cytology-, 2 patients (22.2%) with cytology+/HR-HPV DNA-. None of them persisting HR-HPV DNA-/cytology-with positive or negative margin was identified as the residual/recurrent disease. The majority of residual/recurrent disease was detected at the 12th and 18th month FU, and there was almost no difference in the sensitivity and negative predictive value (NPV) between at the 3rd month and the 6th month FU visits. 14 residual/recurrence disease (14/46:30.4%) had pre-treatment high viral load (>5 000 RUL/PC) and 11 (11/112, 9.8%) with pre-treatment low viral load, P<0.05. Conclusions: (1) The persistence HR-HPV DNA is the root cause of the residual/recurrent disease for the women treated for high-grade CIN; the pre-treatment viral load and margin can be seen as the predictor. (2) The FU visit beginning at the 6th month post-treatment and lasting at least 24 months with the combination of cytology and HPV testing. (3) Patients with high pre-treatment HPV load, which is considered as one risk of developing the residual/recurrent disease, should be paid more attention (especially above 500RUL/PC) to by clinicians.

Physical symptoms generated by internet game addiction and relationship between physical symptom and game addiction grade. (인터넷 게임 중독으로 발생하는 신체증상과 중독성 사이의 상관성 연구)

  • Cho, Sung-Min;Yoon, Kyung-Hee;Koh, Duck-Jae;You, Han-Jung;Lee, Jin-Yong;Kim, Deog-Gon
    • The Journal of Pediatrics of Korean Medicine
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    • v.20 no.3
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    • pp.143-160
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    • 2006
  • Objectives : As the side effect brought up by internet game addiction, many reports come out, but most of past articles are for middle or high school students. There is seldom a poisoning game treatise to a primary school student, if there is treatise, it is real condition that treatise for lead pipe with psychological reasons is seldom discussion about physical symptoms. This research searches high grade elementary students' game use actual conditions and when divide to general user group, latent danger use group, high dangerous use group, according to serious illness degree of game poisoning, three groups and game poisoning happens, recognized about body symptoms that happen much. Methods : Target population of these questionnaire are fifth and sixth grade elementary student of Seoul city 2 school. Chose 263 elementary students, 144 men, 119 women who understand purpose of research and admit participation is 25 October, 2006 since 1 September, 2006 Results : As poisoning serious illness degree is high, there are many number of game times, much more boys are addicted to internet game than girs, insomnia is apt to happen frequently in game poisoning danger group, and correlation is high by megrim, shoulder ache, digestive trouble. Insomnia, symptoms that show next even if some symptoms show first because there is high correlation between megrim, shoulder ache, digestive trouble is high possibility to happen among four symptoms. Insomnia, megrim, shoulder ache, digestive trouble that happen by internet game poisoning, is apt to increase by increasing addiction. Symptoms treatment can divide by internal treatment that treat insomnia, megrim, digestive trouble, external treatment that is typical symptoms of VDT syndrome shoulder ache, headache, fatigue persimmon. Root treatment is mind symptoms treatment. Game addiction treatment is relationship method 'seven emotions injury treatment' in oriental medicine. 'promote the normal flow of qi' and 'adjustment of suitable emotion' can talk as pivotal point of treatment.

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Helicobacter pylori Infection in Children with Recurrent Abdominal Pain (소아에서 만성 반복성 복통(Recurrent Abdominal Pain)과 Helicobacter pylori 감염과의 연관성에 대한 연구)

  • Na, So Young;Seo, Jeong Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.1-11
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    • 2005
  • Purpose: The aim of this study was to evaluate the relationship between H. pylori infection and recurrent abdominal pain (RAP) in children and to evaluate the effects of eradication therapy on RAP. Methods: From January 1998 to January 2005, 166 children with RAP (61 male, 105 female) aged $10.0{\pm}3.3$ years were included. Upper gastrointestinal endoscopies were performed for all the patients. All H. pylori infected children (n=70) received the eradication therapy and were divided into two groups: Group Ia (n=52); eradicated, Group Ib (n=18); non-eradicated. H. pylori-negative children (n=96) were divided into three groups according to the medication: Group IIa (n=67); no medication, Group IIb (n=13); acid-suppressant, Group IIc (n=16); both acid-suppressant and antibiotics. Questionnaire for symptoms were asked at the first, 6th, 12th, 24th, and 36th months following the treatment (grade 0; completely resolved, grade 1; definitely improved, but there are occasional episodes of mild abdominal pain, grade 2; no change in the frequency and intensity of abdominal pain). Results: In about 90% of H. pylori positive children, RAP improved in the both H. pylori-eradicated and non-eradicated children in a follow-up survey. In about 75% of H. pylori-negative children, RAP also improved among in the three groups of patients regardless of medication. Conclusion: These results suggest that there was no correlations between improvement of RAP and eradication of H. pylori, and between improvement of RAP and medication. Consequently the reassurance that the children with RAP have no serious organic cause was important to improvement of RAP.

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