Artificial Intelligence in Gastric Cancer Imaging With Emphasis on Diagnostic Imaging and Body Morphometry

Gastric cancer remains a significant global health concern, coercing the need for advancements in imaging techniques for ensuring accurate diagnosis and effective treatment planning. Artificial intelligence (AI) has emerged as a potent tool for gastric-cancer imaging, particularly for diagnostic imaging and body morphometry. This review article offers a comprehensive overview of the recent developments and applications of AI in gastric cancer imaging. We investigated the role of AI imaging in gastric cancer diagnosis and staging, showcasing its potential to enhance the accuracy and efficiency of these crucial aspects of patient management. Additionally, we explored the application of AI body morphometry specifically for assessing the clinical impact of gastrectomy. This aspect of AI utilization holds significant promise for understanding postoperative changes and optimizing patient outcomes. Furthermore, we examine the current state of AI techniques for the prognosis of patients with gastric cancer. These prognostic models leverage AI algorithms to predict long-term survival outcomes and assist clinicians in making informed treatment decisions.However, the implementation of AI techniques for gastric cancer imaging has several limitations. As AI continues to evolve, we hope to witness the translation of cutting-edge technologies into routine clinical practice, ultimately improving patient care and outcomes in the fight against gastric cancer.

A case of generalized tonic seizures related to acute myocarditis

It is challenging to clinically distinguish between convulsive syncope and true seizure. We describe a 7-year-old girl presenting with generalized tonic seizure caused by acquired complete atrioventricular block related to acute myocarditis. After hospitalization following 6 episodes of new-onset fever with seizure, she had a short episode of abrupt complete atrioventricular block followed by another generalized tonic seizure. The concentrations of cardiac enzymes were elevated, and her echocardiogram showed a decreased left ventricular function. This case underlines the necessity of cardiac investigations in children with convulsive syncope.

A case of generalized tonic seizures related to acute myocarditis

It is challenging to clinically distinguish between convulsive syncope and true seizure. We describe a 7-year-old girl presenting with generalized tonic seizure caused by acquired complete atrioventricular block related to acute myocarditis. After hospitalization following 6 episodes of new-onset fever with seizure, she had a short episode of abrupt complete atrioventricular block followed by another generalized tonic seizure. The concentrations of cardiac enzymes were elevated, and her echocardiogram showed a decreased left ventricular function. This case underlines the necessity of cardiac investigations in children with convulsive syncope.

Retraction: Volume Fraction of the Human Pathologic Ossicles Destructed by Cholesteatoma Using Micro-CT / 대한이비인후과학회지

No abstract available.

A Clinical Significance of AAO-HNS guidelines for Meniere's Disease

BACKGROUND AND OBJECTIVES:The guidelines for Meniere's disease recommended from the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) in 1995, provided a basis for reporting results of the treatment used in Meniere's disease. However, these guidelines are sometimes not all inclusive and appropriate for management and reporting for some patients clinically considered having Meniere's disease. The objectives of this study is to review and analyze the symptoms, vertiginous episodes, audiometry, vestibular function test and results of the treatment in Meniere's disease and to evaluate the significance of AAO-HNS guidelines. MATERIALS AND METHOD:This study consisted of the patients with Meniere symptoms who visited the Dizziness Clinic of Ajou University Hospital between 1994 and 2001 were included in this study. The characteristics of dizziness (duration, frequency, and episodes), pure tone audiometry, vestibular function tests, and treatment results were carefully analyzed according to AAO-HNS guidelines. RESULTS:Of 550 patients with Meniere symptoms, 198 patients were in the criteria for Meniere's disease. They were classified to 75 (37.9%) of the "definite", 120 (60.6%) of the "possible", and only 3 (1.5%) of the "probable". In the "definite" group, the pure tone average (PTA) was 54.3 dB and canal paresis (CP) was showed in 33 patients (44%) with a mean CP of 53.6%, and the peak and descending types of the pure tone audiogram were dominant (62%). In the "possible" group, the PTA was 19.4dB and CP was found in 30 patients (25%) with mean CP of 50.1%. CONCLUSION:Even though AAO-HNS guidelines for Meniere's disease are helpful for communication between doctors, they should be considered to have limitations for the diagnosis and treatment in clinical practices.

Treatment Outcome, Prognostic Factors and Patterns of Failure of Nasopharyngeal Carcinoma / 대한이비인후과학회지

PURPOSE: The first treatment of choice for nasopharyngeal carcinoma (NPC) is radiotherapy as NPC is more responsive to radiotherapy than any other head and neck cancer. We analyzed the clinical characteristics and prognostic factors of NPC patients treated at the Severance Hospital. SUBJECTS AND METHOD: Charts of 123 patients diagnosed with NPC at the Severance Hospital from 1995 to 2002 were reviewed and retrospectively analyzed. They were staged according to the 1997 AJCC criteria. According to the WHO classification, the type I included 14 cases, type II 44 cases, and type III 65 cases. Sixty-five cases were treated with radiotherapy only and 58 cases were treated with a combined modality of chemotherapy and radiotherapy. RESULTS: The factors for a poor prognosis were age over 47 years' old, histologic findings of WHO type I and advanced T, N stage. The overall 5 year survival rate was 66.22%. According to treatment modality, only the radiotherapy group was 68.6%, while the chemoradiotherapy group was 63.6%. There was no difference in survival (p>0.05). In chemoradiotherapy group, the survival of induction chemoradiotherapy group was 82.1% and the concurrent chemoradiotherapy group was 36.8%. There was significant difference in survival. CONCLUSIONS: There was no significant difference in the 5 year survival rate between the patients who were treated with radiotherapy only and those who were treated with both radiotherapy and chemotherapy.

Volume Fraction of the Human Pathologic Ossicles Destructed by Cholesteatoma Using Micro-CT / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Conventional studies for the middle ear ossicles destructed by cholesteatoma give relatively limited information on shape, mechanical strength and 3-dimensional relationship. Recently, Micro-CT scanning technology has been applied to analysis of skeletal structure. This study aims to reconstruct the 3-dimensional structure of normal ossicles and destructed ossicles by different cholesteatomas and to compare volume fraction of destructed ossicles with that of normal ossicles. MATERIALS AND METHOD: 13 pathological ossicles obtained during cholesteatoma surgery were used in this study (2 malleuses and 2 incuses from attic cholesteatoma;1 malleus and 2 incuses from sinus cholesteatoma;2 malleuses and 2 incuses from tensa retraction cholesteatoma; 2 incuses from congenital cholesteatoma). As a control, normal ossicles harvested from cadaveric temporal bone specimens were used. The structure of obtained ossicles was analyzed through Micro-CT (SkySan-1072, Belgium) by filming the 2-dimensional cross section image running perpendicular to the long axis of the ossicles. The 3-dimensional images were thereby reconstructed for each, and were analyzed using CT-Analyzer(TM) and ANTTM. Based on the results, the strength of each ossicle were measured. RESULTS: The volume fraction, indicating relative strengths of ossicles, was lower in the portion of destructed surface. The pattern of destructed ossicles by cholesteatoma was different according to pathological status of cholesteatoma. CONCLUSION: Our preliminary data of ossicular structure analyzed by Micro-CT scan will be helpful for elucidation of pathological ossicles in middle ear cholesteatoma and will make a great contribution to research of middle ear cholesteatoma.

Preliminary Results of Steroid Gargle Treatment and Clinical Characteristics of Patients with Burning Mouth Syndrome / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Burning mouth syndrome (BMS) is characterized by a burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory abnormal findings. BMS is not an uncommon disease that ENT doctors can encounter in the OPD clinics. However, the causes, pathophysiology, and treatment of BMS are not known yet, and there are just a few reported articles. The aim of this study was to analyze the characteristics of BMS and to evaluate the effects of steroid gargle treatments. SUBJECTS AND METHOD: We reviewed 18 patients with BMS who visited the Department of Otolaryngology, Ajou University Hospital. The patients were analyzed according to the sites, duration of their burning sensations and associated symptoms. Furthermore, the interview included inquiries regarding current diseases, on-going medications, smoking history and psychological factors. The change of symptoms after steroid gargle treatment with/without other drugs was carefully analyzed. RESULTS: The average age of patients with BMS was 56.4 years old, and the male to female ratio was 8:10. The most frequently involved site was tongue (94.4%), followed by lower lip, gingiva, palate, and floor of mouth. We found that the causes of BMS were psychogenic factors for 4 patients, and diabetes mellitus and hypertension for 2 patients each. Approximately 80.0% (8/10 patients) of the women was menopausal. Six (50.0%) of 12 patients treated only with steroid gargle and 3 (75.5%) of 4 patients treated with steroid gargle and other medications showed relieved symptoms. CONCLUSION: Burning mouth syndrome is not an uncommon disease in the ENT field, and has complex etiology. Although the definitive treatment for BMS is not known yet, we think that steroid gargle may be helpful in the treatment of BMS.

Conservation of Mucous Epithelial Characteristics in the Human Middle Ear Epithelial Cell Line / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The stable cell line system of middle ear epithelial cells is essential for studying molecular pathogenesis of otitis media. Recently, we succeeded in establishing the human middle ear epithelial cell line (HMEEC) using a retrovirus. The cell line retains many of the phenotypic and morphological properties of the non-transformed, parental cultures such as the expression of cytokeratin and tight junctions. We aimed to show the conservation of mucosal characteristics and subcellular mechanisms of transcriptional regulation in this cell line. MATERIALS AND METHOD: RT-PCR was performed using mucin gene specific primers and total RNA extracted from HMEEC. The luciferase-expressing vector containing 5' flanking region of human beta defensin 2 (hBD-2), an inducible antimicrobial peptide, was transfected to HMEEC. After starvation of serum, HMEEC was treated with interleukin 1 alpha (IL-1alpha) and subsequently harvested 10 hrs later. Luciferase activity was measured using luminometer after the corresponding substrate was supplemented to the cell lysate. RESULTS: Expression of mucin genes (MUC1, 2 and 5B) in HMEEC was demonstrated by RT-PCR. Luciferase assay showed that IL-1alpha up-regulates the promoter activity of hBD-2 more than 10 fold. This transcriptional regulatory mechanism was also demonstrated in the well established reference cell lines, HeLa cells and A549 cells. CONCLUSION: We demonstrated the conservation of mucin gene expression and transcriptional regulatory mechanism of hBD-2 in HMEEC. The proposed cell line can serve as a useful experimental model for elucidating the pathogenesis of middle ear mucosa-related diseases.

The Comparison of Benign Paroxysmal Vertigo of Childhood and Migraine Related Vertigo in Children

BACKGROUND AND OBJECTIVES: Benign paroxysmal vertigo of childhood (BPVC) and migraine related vertigo (MRV) are most common causes of vertigo in children. Some authors suggested that BPVC may be an early manifestation of migraine. However there is few articles about relationship between BPVC and MRV. The purpose of this study is to compare the clinical characteristics, audiological and vestibular findings, treatment and prognosis of BPVC and MRV and to provide the helpful information for relationship between BPVC and MRV. MATERIALS AND METHOD: The twenty four children (less than 16 years old) with BPVC and 23 children with MRV, who visited the Dizziness Clinic in the Department of Otolaryngology, Ajou University Hospital, Suwon, Korea between January 2001 and August 2003 were selected for this study. These excluded the patients with abnormal eardrums/tympanograms or those that did not perform questionnaires, audiological, or vestibular evaluations. They were retrospectively analyzed for clinical symptoms, audiograms, vestibular functions, and treatment results. RESULTS: BPVC was frequently detected in younger children than MRV. Spinning sensation was frequently associated with BPVC. Aural symptoms, headache, photophobia, phonophobia, and visual symptoms were frequently associated with MRV. Abnormalities in vestibular function tests were 14 (58%) in BPVC and 15 (62%) in MRV. BPVC & MRV had good prognosis. But medication was sometimes more needed in MRV than in BPVC. CONCLUSIONS: BPVC and MRV show some different features in the age of onset, clinical features, treatment and prognosis, but also have some features of MRV. Further studies are needed to find their relationship between them.

Two Cases of Misdiagnosed Congenital Stapes Fixation / 대한이비인후과학회지

Congenital stapes fixation showing normal finding of external auditory canal and tympanic membrane causes non-progressive conductive hearing loss in the range of 40 to 60 dB since childhood. It is a rare disease, but most commonly found among the isolated ossicular anomalies. Patients with this disease are very suitable candidates for stapes surgery, and successful hearing improvement can be expected by an appropriate surgical procedure. We report 2 cases of congenital stapes fixation which had been operated improperly. One case showed interposed homologous ossicle between the stapes head and the incus, and the other case showed transposed incus between the malleus handle and the stapes head along with the anterior crus fracture. They showed hearing improvements of more than 30 dB after stapedotomy with placement of the Fisch type stapes prosthesis. We are reporting two cases of misdiagnosed congenital stapes fixation with a discussion.