ABSTRACT
Purpose@#The purpose of this study was to analyze retinal capillary parameters using optical coherence tomography angiography (OCTA) of the affected eye and the fellow eye of unilateral normal tension glaucoma (NTG) patients and compare the findings with eyes from a normal control group. @*Methods@#A retrospective cross-sectional study was carried out on patients diagnosed with unilateral NTG (24 affected eyes and 24 fellow eyes each) and normal individuals (29 eyes, the control group). OCTA was used to measure the vascular density (VD) and perfusion density (PD) of the macular area and the peripapillary area. @*Results@#In the superficial capillary plexus, the fellow eye group of unilateral NTG patients showed a decrease in VD of the inner-inferior and PD of the inner-inferior and outer-average peripapillary area, compared with the normal control group (p = 0.008, p < 0.001, and p = 0.001). In the affected NTG eye group, the VD (p = 0.014, p = 0.011, p < 0.001, p < 0.001, and p < 0.001) and PD (p = 0.017, p = 0.023, p < 0.001, p = 0.001, and p < 0.001) of the total, inner-average, inner-inferior, and outer-inferior peripapillary area, and the outer-inferior macular area decreased compared to the fellow eye and normal control group, as well as the VD of the outer-average peripapillary area (p = 0.010). The PD of the outer-average peripapillary area (p = 0.003); the VD (p = 0.041, p = 0.008, p = 0.006) and the PD (p = 0.013, p < 0.001, p = 0.001) of the total, inner-inferior, and outer-average macular area; and the PD of the outer-temporal macular area (p = 0.003) were lower than the normal control group. There was no difference in the VD or PD obtained from the deep capillary plexus of the macular area among the groups. @*Conclusions@#It is useful to observe retinal capillary parameters using OCTA for patients with unilateral NTG.
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Background/Aims@#We aimed to develop a deep learning model for the prediction of the risk of advanced colorectal neoplasia (ACRN) in asymptomatic adults, based on which colorectal cancer screening could be customized. @*Methods@#We collected data on 26 clinical and laboratory parameters, including age, sex, smoking status, body mass index, complete blood count, blood chemistry, and tumor marker, from 70,336 first-time colonoscopy screening recipients. For reference, we used a logistic regression (LR) model with nine variables manually selected from the 26 variables. A deep neural network (DNN) model was developed using all 26 variables. The area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of the models were compared in a randomly split validation group. @*Results@#In comparison with the LR model (AUC, 0.724; 95% confidence interval [CI], 0.684 to 0.765), the DNN model (AUC, 0.760; 95% CI, 0.724 to 0.795) demonstrated significantly improved performance with respect to the prediction of ACRN (p < 0.001). At a sensitivity of 90%, the specificity significantly increased with the application of the DNN model (41.0%) in comparison with the LR model (26.5%) (p < 0.001), indicating that the colonoscopy workload required to detect the same number of ACRNs could be reduced by 20%. @*Conclusions@#The application of DNN to big clinical data could significantly improve the prediction of ACRNs in comparison with the LR model, potentially realizing further customization by utilizing large quantities and various types of biomedical information.
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Background/Aims@#We aimed to develop a deep learning model for the prediction of the risk of advanced colorectal neoplasia (ACRN) in asymptomatic adults, based on which colorectal cancer screening could be customized. @*Methods@#We collected data on 26 clinical and laboratory parameters, including age, sex, smoking status, body mass index, complete blood count, blood chemistry, and tumor marker, from 70,336 first-time colonoscopy screening recipients. For reference, we used a logistic regression (LR) model with nine variables manually selected from the 26 variables. A deep neural network (DNN) model was developed using all 26 variables. The area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of the models were compared in a randomly split validation group. @*Results@#In comparison with the LR model (AUC, 0.724; 95% confidence interval [CI], 0.684 to 0.765), the DNN model (AUC, 0.760; 95% CI, 0.724 to 0.795) demonstrated significantly improved performance with respect to the prediction of ACRN (p < 0.001). At a sensitivity of 90%, the specificity significantly increased with the application of the DNN model (41.0%) in comparison with the LR model (26.5%) (p < 0.001), indicating that the colonoscopy workload required to detect the same number of ACRNs could be reduced by 20%. @*Conclusions@#The application of DNN to big clinical data could significantly improve the prediction of ACRNs in comparison with the LR model, potentially realizing further customization by utilizing large quantities and various types of biomedical information.
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Background/Aims@#Risk prediction models using a deep neural network (DNN) have not been reported to predict the risk of advanced colorectal neoplasia (ACRN). The aim of this study was to compare DNN models with simple clinical score models to predict the risk of ACRN in colorectal cancer screening. @*Methods@#Databases of screening colonoscopy from Kangbuk Samsung Hospital (n=121,794) and Kyung Hee University Hospital at Gangdong (n=3,728) were used to develop DNN-based prediction models. Two DNN models, the Asian-Pacific Colorectal Screening (APCS) model and the Korean Colorectal Screening (KCS) model, were developed and compared with two simple score models using logistic regression methods to predict the risk of ACRN. The areas under the receiver operating characteristic curves (AUCs) of the models were compared in internal and external validation databases. @*Results@#In the internal validation set, the AUCs of DNN model 1 and the APCS score model were 0.713 and 0.662 (p0.1). @*Conclusions@#Simple score models for the risk prediction of ACRN are as useful as DNN-based models when input variables are limited. However, further studies on this issue are warranted to predict the risk of ACRN in colorectal cancer screening because DNN-based models are currently under improvement.
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Purpose@#To analyze the choroidal vascularity index (CVI) in an eye with retinal detachment and the fellow eye of a patient with monocular primary rhegmatogenous retinal detachment (RRD). @*Methods@#We retrospectively analyzed optical coherence tomography data of both eyes at the first visit of patients who underwent surgery for monocular RRD from January 2017 to January 2018. The subfoveal CVIs of the RD eye, the fellow eye, and the postoperative 3-months RD eye were analyzed using Image J software by two independent ophthalmologists. @*Results@#Forty-five subjects were included. Of the 45 RD eyes, 25 eyes (55.6%) showed macula invasion. The subfoveal CVI was statistically lower in the RD eye compared with the fellow eye (65.61 ± 3.37 vs. 67.28 ± 3.44, respectively; p = 0.024). In the macula-on RD group, the preoperative subfoveal CVI was statistically higher than the subfoveal CVI of postoperative 3 months (67.62 ± 2.35 vs. 65.84 ± 3.04, respectively; p = 0.009). However, the preoperative subfoveal CVI was statistically lower than the subfoveal CVI of postoperative 3 months in the macula-off RD group (64.01 ± 3.21 vs. 66.69 ± 2.64, respectively; p < 0.001). @*Conclusions@#In primary RRD eyes, the subfoveal CVI was lower in the RD eye compared to the fellow eye. In macula-off RD eyes, the subfoveal CVI was lower in preoperative RD eyes compared to postoperative RD eyes. The subfoveal CVI was higher in the preoperative RD eyes compared to postoperative RD eyes in macula-on RD eyes. Further studies are needed to investigate the effects of RD on changes in the lumina and stoma in the choroid.
ABSTRACT
Purpose@#To analyze the choroidal vascularity index (CVI) in an eye with retinal detachment and the fellow eye of a patient with monocular primary rhegmatogenous retinal detachment (RRD). @*Methods@#We retrospectively analyzed optical coherence tomography data of both eyes at the first visit of patients who underwent surgery for monocular RRD from January 2017 to January 2018. The subfoveal CVIs of the RD eye, the fellow eye, and the postoperative 3-months RD eye were analyzed using Image J software by two independent ophthalmologists. @*Results@#Forty-five subjects were included. Of the 45 RD eyes, 25 eyes (55.6%) showed macula invasion. The subfoveal CVI was statistically lower in the RD eye compared with the fellow eye (65.61 ± 3.37 vs. 67.28 ± 3.44, respectively; p = 0.024). In the macula-on RD group, the preoperative subfoveal CVI was statistically higher than the subfoveal CVI of postoperative 3 months (67.62 ± 2.35 vs. 65.84 ± 3.04, respectively; p = 0.009). However, the preoperative subfoveal CVI was statistically lower than the subfoveal CVI of postoperative 3 months in the macula-off RD group (64.01 ± 3.21 vs. 66.69 ± 2.64, respectively; p < 0.001). @*Conclusions@#In primary RRD eyes, the subfoveal CVI was lower in the RD eye compared to the fellow eye. In macula-off RD eyes, the subfoveal CVI was lower in preoperative RD eyes compared to postoperative RD eyes. The subfoveal CVI was higher in the preoperative RD eyes compared to postoperative RD eyes in macula-on RD eyes. Further studies are needed to investigate the effects of RD on changes in the lumina and stoma in the choroid.
ABSTRACT
Postoperative infection from total knee arthroplasty (TKA) is an issue drawing great attention, which can manifest as a local or general infection. Its development into sepsis has also occasionally been reported. Such sepsis is a critical complication that can spread to various parts of the body, which can ultimately lead to mortality. However, the cases where infection has spread to the spine do not have clear clinical signs, making diagnosis difficult. These cases are not found in the literature. Therefore, this is a case study on both postoperative infection from TKA that has developed into sepsis and spread to the spine.
Subject(s)
Arthroplasty, Replacement, Knee , Diagnosis , Mortality , Paraplegia , Sepsis , SpineABSTRACT
The fabella has been considered to have a minor clinical significance. However, there have been a few reports describing the fabella as one of the causes of peroneal nerve palsy (PNP). This report describes a 66-year-old farmer who complained of acute neurologic symptoms involving the fabella. Surgical extirpation was performed and neurologic function was recovered dramatically. Recently, there have been no published reports on fabella syndrome with common PNP. Here, we report an unusual case of common PNP with the fabella as a cause.
Subject(s)
Aged , Humans , Farmers , Neurologic Manifestations , Paralysis , Peroneal Nerve , Sesamoid BonesABSTRACT
PURPOSE: This study was designed to investigate the clinical and oncological results of the unplanned excision group, and to compare the results with those of the planned excision group. MATERIALS AND METHODS: A total of 41 patients who underwent re-excision of sarcoma in Yeungnam University Medical Center, from January 2000 to December 2012, after unplanned excision in local medical centers were reviewed retrospectively. We analyzed the clinical and oncological results according to age, gender, tumor size, depth, and locations. As a control group of planned excision, 81 patients with a similar state, were selected and reviewed among the group of 480 patients who underwent planned excision during the same period. We then compared the results of the two groups. RESULTS: In the unplanned excision group, only the age factor was statistically significant to survival (p=0.048). In comparison of clinical and oncological results of the unplanned and planned excision groups, recurrence rate was 11.1% in the unplanned group, 10.5% in the planned group and did not show statistical significance (p=0.18). Survival rate was 74% in the unplanned group, 76.6% in the planned group and did not show statistical significance (p=0.06). Necessity of additional surgery for coverage of soft tissue defects was 46% in the unplanned group, 14% in the planned group and showed statistical significance (p=0.00). CONCLUSION: No significant difference in survival and local recurrence rate was observed between the groups of re-excision with microscopic remnant tumor after unplanned excision and planned excision. However, unplanned excision might lead to unnecessary additional surgery like skin-graft, skin-flap if it were planned.
Subject(s)
Humans , Academic Medical Centers , Age Factors , Recurrence , Retrospective Studies , Sarcoma , Survival RateABSTRACT
To control blood glucose level as close to normal is a major goal of treatment of diabetes mellitus. Hyperglycemia and hyperlipidemia are the major risk factors for cardiovascular complications, the major cause of immature death among the patients with type 2 diabetes. The purpose of this study is to determine the hypoglycemic and hypolipidemic effects of Salicornia herbacea in animal model of type 2 diabetes and to investigate the possible mechanisms for the beneficial effects of S. herbacea. S. herbacea was extracted with 70% ethanol and desalted with 100% ethanol. Three week-old db/db mice (C57BL/KsJ, n=16) were fed AIN-93G semipurified diet or diet containing 1% desalted ethanol extract of S. herbacea for 6 weeks after 1 week of adaptation. Fasting plasma glucose, triglyceride, and total cholesterol were measured by enzymatic methods and blood glycated hemoglobin (HbA1C) by the chromatographic method. Body weight and food intake of S. herbacea group were not significantly different from those of the control group. Fasting plasma glucose and blood glycated hemoglobin levels tended to be lowered by S. herbacea treatment. Consumption of S. herbacea extract significantly decreased plasma triglyceride and cholesterol levels (p<0.05). The inhibition of S. herbacea extract against yeast alpha-glucosidase was 31.9% of that of acarbose at the concentration of 0.5 mg/mL in vitro. The inhibitory activity of ethanol extract of S. herbacea against porcine pancreatic lipase was 59.0% of that of orlistat at the concentration of 0.25 mg/mL in vitro. Thus, these results suggest that S. herbacea could be effective in controlling hyperlipidemia by inhibition of pancreatic lipase in animal model of type 2 diabetes.