• Title/Summary/Keyword: Grading system

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Outcome Analysis of External Neurolysis in Posture-Induced Compressive Peroneal Neuropathy and the Utility of Magnetic Resonance Imaging in the Treatment Process

  • Junmo Kim;Jinseo Yang;Yongjun Cho;Sukhyung Kang;Hyukjai Choi;Jinpyeong Jeon
    • Journal of Korean Neurosurgical Society
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    • v.66 no.3
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    • pp.324-331
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    • 2023
  • Objective : We aimed to analyze the effectiveness of external neurolysis on the common peroneal nerve (CPN) in patients with posture-induced compressive peroneal neuropathy (PICPNe). Further, we aimed to examine the utility of magnetic resonance imaging (MRI) in assessing the severity of denervation status and predicting the postoperative prognosis. Methods : We included 13 patients (eight males and five females) with foot drop who underwent CPN decompression between 2018 and 2020. We designed a grading system for assessing the postoperative functional outcome. Additionally, we performed MRI to evaluate the denervation status of the affected musculature and its effect on postoperative recovery. Results : The median time to surgery was 3 months. The median preoperative ankle dorsiflexion and eversion grades were both 3, while the average functional grade was 1. Posterior crural intermuscular septum was the most common cause of nerve compression, followed by deep tendinous fascia and anterior crural intermuscular septum. There was a significant postoperative improvement in the median postoperative ankle dorsiflexion and eversion grades and average postoperative functional (4, 5, and 2.38, respectively). Preoperative ankle eversion was significantly correlated with denervation status. Additionally, the devernation status on MRI was positively correlated with the outcome favorability. However, denervation atrophy led to a less favorable outcome. Conclusion : Among patients with intractable PICPNe despite conservative management, surgical intervention could clinically improve motor function and functional ability. Additionally, MRI examination of the affected muscle could help diagnose CPNe and assess the postoperative prognosis.

Development of Robust Feature Recognition and Extraction Algorithm for Dried Oak Mushrooms (건표고의 외관특징 인식 및 추출 알고리즘 개발)

  • Lee, C.H.;Hwang, H.
    • Journal of Biosystems Engineering
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    • v.21 no.3
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    • pp.325-335
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    • 1996
  • Visual features are crucial for monitoring the growth state, indexing the drying performance, and grading the quality of oak mushrooms. A computer vision system with neural net information processing technique was utilized to quantize quality factors of a dried oak mushrooms distributed over the cap and gill sides. In this paper, visual feature extraction algorithm were integrated with the neural net processing to deal with various fuzzy patterns of mushroom shapes and to compensate the fault sensitiveness of the crisp criteria and heuristic rules derived from the image processing results. The proposed algorithm improved the segmentation of the skin features of each side, the identification of cap and gill surfaces, the identification of stipe states and removal of the stipe, etc. And the visual characteristics of dried oak mushrooms were analyzed and primary visual features essential to tile quality evaluation were extracted and quantized. In this study, black and white gray images were captured and used for the algorithm development.

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Deep Learning-based Rail Surface Damage Evaluation (딥러닝 기반의 레일표면손상 평가)

  • Jung-Youl Choi;Jae-Min Han;Jung-Ho Kim
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.2
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    • pp.505-510
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    • 2024
  • Since rolling contact fatigue cracks can always occur on the rail surface, which is the contact surface between wheels and rails, railway rails require thorough inspection and diagnosis to thoroughly inspect the condition of the cracks and prevent breakage. Recent detailed guidelines on the performance evaluation of track facilities present the requirements for methods and procedures for track performance evaluation. However, diagnosing and grading rail surface damage mainly relies on external inspection (visual inspection), which inevitably relies on qualitative evaluation based on the subjective judgment of the inspector. Therefore, in this study, we conducted a deep learning model study for rail surface defect detection using Fast R-CNN. After building a dataset of rail surface defect images, the model was tested. The performance evaluation results of the deep learning model showed that mAP was 94.9%. Because Fast R-CNN has a high crack detection effect, it is believed that using this model can efficiently identify rail surface defects.

International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy

  • Seung Joo Kang;Chung Hyun Tae;Chang Seok Bang;Cheol Min Shin;Young-Hoon Jeong;Miyoung Choi;Joo Ha Hwang;Yutaka Saito;Philip Wai Yan Chiu;Rungsun Rerknimitr;Christopher Khor;Vu Van Khien;Kee Don Choi;Ki-Nam Shim;Geun Am Song;Oh Young Lee
    • Clinical Endoscopy
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    • v.57 no.2
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    • pp.141-157
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    • 2024
  • Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

Outcome of Tumor Prosthetic Reconstruction in Osteosarcoma Patient (골육종 환자에서 종양 대치물을 이용한 재건술의 치료결과)

  • Kim, Jae-Do;Kim, Cheung-Kue;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.79-86
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    • 2011
  • Purpose: Modular tumor prosthesis is the most popular recontructive modality after resection of malignat tumor in extremity. Complications and survival of tumor prosthesis reconstruction are well-known. however, reports on the long-term outcome of tumor prosthesis in osteosarcoma patientss are scarece. Materials and Methods: In 158 cases as diagnosed as osteosarcoma from feburary 1989 to December 2006 in a single cancer center. We retrospectively reviewd 48 osteosarcoma patients who under went tumor prosthetic reconstruction. Mean follow up preiod was 75.6 months (range; 60 to 179 months). There were 28 males, 20 females and mean age was 22.4 years (range; 11-71). Pathologic subtypes were conventional central osteosarcoma in 46 cases and periosteal in 2 cases. The location of the tumor was proximal tibia (26 cases), distal femor (20 cases), femor diaphysis (1 case), and tibia diaphysis (1 case). In 41 cases built-up-type tumor prosthesis have been used and 7 cases expansion-type tumor prosthesis have been used. We used Musculoskeletal tumor society (MSTS) grading system to asses post operation function, and we analyzed survival rate of patient and tumor prosthesis and complication. Results: The overall survival rate was 77.7% and disease free survival rate was 68.9%. The survival rate of tumor prosthesis was 73%, in last follow up tumor prosthesis has been removed in 12 cases. All of them, 17 complications occurred, which included infection in 16 cases, Periprosthetic Fracture and Loosening of tumor prosthesis in 4 cases, articular instability in 4 cases. MSTS functional score was 74.1% in post operation. Conclusion: In long term follow up result, Primary tumor prosthesis -a reconstruction method after a wide extensional resecion of a bone tumor- can be a effective treatment method in asepect of survival rate, functional assesment and complication.

A comparison between the modified Brostrom procedure using single and double suture anchor for chronic lateral ankle instability (발목관절 외측 불안정성에서 단일 봉합나사와 이중 봉합나사를 이용한 변형 Brostrom 술식간의 임상결과 비교)

  • Shon, Hyun-Chul;Cho, Byung-Ki;Kim, Yong-Min;Kim, Dong-Soo;Choi, Eui-Sung;Park, Kyoung-Jin;Park, Ji-Kang
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.69-77
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    • 2011
  • Purpose: This study was retrospectively performed to compare the clinical outcomes of modified Brostrom procedures using the single suture anchor and the double suture anchor for chronic lateral ankle instability. Materials and Methods: Thirty-seven patients were followed up for more than 1 year after the modified Brostrom procedures using suture anchor. Single surgeon treated seventeen cases with single suture anchor and 20 cases with double suture anchor. The clinical evaluation was performed according to the Karlsson scale and Sefton grading system. Radiologic measurement of the talar tilt and anterior talar translation was performed through anterior and varus stress radiographs using Telos device. Results: The Karlsson scale had improved significantly from preoperative average of 45.2 points to 89.4 points in single suture anchor group, and from 46.4 points to 90.5 points in double suture anchor group. According to the Sefton grading system, 15 cases (88.2%) in single suture anchor group and 18 cases (90%) in double suture anchor group achieved satisfactory results. The talar tilt angle and anterior talar translation had improved significantly from preoperative average of $13.6^{\circ}$ and 8.6 mm to $5.4^{\circ}$ and 4.1 mm in single suture anchor group, from $14.1^{\circ}$ and 8.4mm to $3.9^{\circ}$ and 4 mm in double suture anchor group. Double suture anchor technique was significantly superior in postoperative talar tilt. Conclusion: Single and double suture anchor techniques produced similar clinical and functional outcomes except for talar tilt, which was significantly superior in double suture anchor group. Both modified Brostrom procedures using the single and double suture anchor appear to be effective treatment methods for chronic lateral ankle instability. Further evaluation of clinical outcomes and biomechanical studies in athletes are needed.

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Treatment Outcomes and Acoustic Rhinometric Results in Endoscopic Sinus Surgery of Adult Chronic Paranasal Sinusitis (성인 말성 부비동염에서 내시경적 부비동 수술 전.후의 증상 호전도와 음향비강통기도 검사 결과)

  • Kim, Yong-Dae;Kim, Jae-Yeul;Chang, Keun-Young;Lee, Hyung-Joong;Song, Si-Youn;Yoon, Seok-Keun
    • Journal of Yeungnam Medical Science
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    • v.19 no.1
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    • pp.28-38
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    • 2002
  • Background: Chronic paranasal sinusitis is one of the most common disease in the otorhinolaryngologic field. Endoscopic sinus surgery is treatment of choice in chronic paranasal sinusitis. The aim of this study was to evaluate objective and subjective treatment outcomes of endoscopic sinus surgery in adult chronic paranasal sinusitis with or without polyp. Materials and Methods: We reviewed 84 adult patients underwent endoscopic sinus surgery by one surgeon from June 1999 to June 2000, prospectively. We analyzed preoperative and postoperative subjective symptom scores and acoustic rhinometric results. Results: Fifty cases were male and thirty four cases female. The average age was of 33 year-old (range: 17 to 66 years). There was significantly improvement of symptom scores in postoperative 3 months and 6 months compared with preoperative symptom scores. There was significantly increased postoperative total volume of nasal cavity. When we compared high score group with low score group, there was statistically significant improvement of symptom scores between preoperative stage and postoperative 3 months in radiologic grading group. Conclusions: Endoscopic sinus surgery is considered to be effective for the treatment of chronic paranasal sinusitis. It seems to be helpful to employ subjective symptom score system and objective total volume change of nasal cavity through acoustic rhinometric test to analyze effectiveness of endoscopic sinus surgery. In this study, the most important preoperative factor of sinus surgery outcomes is radiologic grading system.

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Arthroscopic Treatment for Lateral Discoid Meniscus in Children: Clinical Symptoms & Treatment Results According to Meniscus Type (소아의 외측 원판형 반월상 연골의 슬관절경 치료: 유형에 따른 임상증상 및 치료 결과)

  • Shin, Sung-Il;Hyun, Yoon-Suk;Kang, Jung-Woo;Oh, Bum-Suk
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.7-12
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    • 2011
  • Purpose: We purposed to evaluate clinical results after undergoing arthrocopic surgery of lateral discoid meniscus in children. Materials and Methods: Retrospective evaluation was executed for the 21 cases which showed abnormal findings of knee joint due to lateral discoid meniscus, from Janunary 1 1999 to December 30 2007. Average observation period was 38.4 months (14months~60 months), and average age was 9.5 years old (7~12 years old). The major clinical findings for knee joint extension limitations were the most common with 11 cases, and there were 8 cases of knee joint pain, 6 cases of snapping, and 10 cases of gait abnormality. The forms of lateral discoid meniscus were 14 cases of complete type, 5 cases of incomplete type, and 2 cases of Wrisberg type. All patient had arthroscopic partial menisectomy and some patient who had meniscus tear had arthroscopic meniscus repair. The clinical results were evaluated using Ikeuchi grading system, and the change of knee joint was observed through routine radiography. Results: The peripheral hypermobility of lateral disciform meniscus was observed in 7 cases. The peripheral tear was observed in 4 cases, where partial menisectomy was along with suture at the same time. The final clinical results were 5 cases of Excellent, 12 cases of Good, 4 cases of Fair. Radiologically, there were 5 cases of subchondral sclerosis and narrowness of hardness at the lateral knee joint, and osteochondritis occurred at the joint facet of external femur in 1 case. In clinical result, meanwhile, there were 20 cases of normal or almost normal and only 1 case of abnormal in IKDC score. Conclusion: Knee joint arthroscopic partial menisectomy for treatment of lateral discoid meniscus is useful, and when accompanied by peripheral disruption, suture is thought to be necessary.

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Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach

  • Tae-Han Kim;In-Ho Kim;Seung Joo Kang;Miyoung Choi;Baek-Hui Kim;Bang Wool Eom;Bum Jun Kim;Byung-Hoon Min;Chang In Choi;Cheol Min Shin;Chung Hyun Tae;Chung sik Gong;Dong Jin Kim;Arthur Eung-Hyuck Cho;Eun Jeong Gong;Geum Jong Song;Hyeon-Su Im;Hye Seong Ahn;Hyun Lim;Hyung-Don Kim;Jae-Joon Kim;Jeong Il Yu;Jeong Won Lee;Ji Yeon Park;Jwa Hoon Kim;Kyoung Doo Song;Minkyu Jung;Mi Ran Jung;Sang-Yong Son;Shin-Hoo Park;Soo Jin Kim;Sung Hak Lee;Tae-Yong Kim;Woo Kyun Bae;Woong Sub Koom;Yeseob Jee;Yoo Min Kim;Yoonjin Kwak;Young Suk Park;Hye Sook Han;Su Youn Nam;Seong-Ho Kong;The Development Working Group for the Korean Practice Guidelines for Gastric Cancer 2022 Task Force Team
    • Journal of Gastric Cancer
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    • v.23 no.1
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    • pp.3-106
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    • 2023
  • Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.

A Study on Seaman's Criminal Responsibility of Marine Accidents (해양사고에 따른 해원(海員)의 과실책임에 대한 형사실무적 고찰)

  • Song Yong-Seop;Suh Geo-Suk;Park Yong-Uk
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.11 no.2 s.23
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    • pp.41-49
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    • 2005
  • In general, the criminal responsibility of seaman should always be directly assumed by the seamen, according to the principle of self-incrimination. Therefore, the only possible countermeasures for the criminal responsibility of seamen may be to reduce the responsibility by using criminal procedures (ex. the warrant substance examination system, the review system of legality for confinement as much as possible. Another possibility is to reduce the penalty through the revision of the law. In detail, concerning the problem of fine, the maximum fine for oil spill accidents by criminal negligence is KRW 30,000,000 under the current Ocean Pollution Prevention Act, and when an oil spill occurs, the maximum fine tends to be levied regardless of the amount of the spilled oil; thus, it is judged that grading the fine according to the amount of spilled oil may be worth considering. Regarding P & I's payment of fine, contrary to general belief, it is only possible to make up the loss when P & I takes up the legal responsibility or acknowledges its payment. In order to solve the problem, it is possible to consider the option of introducing new collective insurance program or mutual aid system. Also, as seamen are not specialists in legal issues, the ship owners' association or the marine afficers' association need to develop some program through which they can receive systematic assistance from legal specialists including lawyers when they encounter any legal problems (ex. free legal aid programs for farmers and fishermen). Finally, it may be possible to establish enact new laws or revise the existing Act on Special cases Concerning the Settlement of Traffic Accidents to insert a new section on marine accidents.

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