• 제목/요약/키워드: clinical grading

검색결과 295건 처리시간 0.026초

Determination of the stage and grade of periodontitis according to the current classification of periodontal and peri-implant diseases and conditions (2018) using machine learning algorithms

  • Kubra Ertas;Ihsan Pence;Melike Siseci Cesmeli;Zuhal Yetkin Ay
    • Journal of Periodontal and Implant Science
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    • 제53권1호
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    • pp.38-53
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    • 2023
  • Purpose: The current Classification of Periodontal and Peri-Implant Diseases and Conditions, published and disseminated in 2018, involves some difficulties and causes diagnostic conflicts due to its criteria, especially for inexperienced clinicians. The aim of this study was to design a decision system based on machine learning algorithms by using clinical measurements and radiographic images in order to determine and facilitate the staging and grading of periodontitis. Methods: In the first part of this study, machine learning models were created using the Python programming language based on clinical data from 144 individuals who presented to the Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University. In the second part, panoramic radiographic images were processed and classification was carried out with deep learning algorithms. Results: Using clinical data, the accuracy of staging with the tree algorithm reached 97.2%, while the random forest and k-nearest neighbor algorithms reached 98.6% accuracy. The best staging accuracy for processing panoramic radiographic images was provided by a hybrid network model algorithm combining the proposed ResNet50 architecture and the support vector machine algorithm. For this, the images were preprocessed, and high success was obtained, with a classification accuracy of 88.2% for staging. However, in general, it was observed that the radiographic images provided a low level of success, in terms of accuracy, for modeling the grading of periodontitis. Conclusions: The machine learning-based decision system presented herein can facilitate periodontal diagnoses despite its current limitations. Further studies are planned to optimize the algorithm and improve the results.

Acceptable Values of Kappa for Comparison of Two Groups

  • Seigel Daniel G.;Podgor Marvin J.;Remaley Nancy A.
    • 대한예방의학회:학술대회논문집
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    • 대한예방의학회 1994년도 교수 연수회(역학)
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    • pp.129-136
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    • 1994
  • A model was developed for a simple clinical trial in which graders had defined probabilities of misclassifying pathologic material to disease present or absent. The authors compared Kappa between graders, and efficiency and bias in the clinical trial in the presence of misclassification. Though related to bias and efficiency, Kappa did not predict these two statistics well. These results pertain generally to evaluation of systems for encoding medical information, and the relevance of Kappa in determining whether such systems are ready for use in comparative studies. The authors conclude that, by itself, Kappa is not informative Enough to evaluate the appropriateness of a grading scheme for comparative studies. Additional, and perhaps difficult, questions must be addressed for such evaluation.

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재발 벨마비의 임상 분석 (The Clinical Analysis of Recurrent Bell's Palsy)

  • 김경집;석정임;이동국
    • Annals of Clinical Neurophysiology
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    • 제10권1호
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    • pp.38-42
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    • 2008
  • Background: Idiopathic facial nerve palsy, or Bell's palsy (BP), is a common and important disease. Recurrent Bell's palsy has been known as a rare entity with only a few cases in the literature. Methods: A total of 111 consecutive patients with acute BP patients were enrolled at Daegu Catholic University Hospital from July 2005 to March 2007. We classified the patients into two groups - single BP and recurrent BP - and compared them by demographic data, clinical features, MRI findings and prognosis. The degree of BP was graded according to the House and Brackmann facial nerve grading system. Results: Recurrent BP was observed in 10 (9%) patients. The number of recurrence was varied from 2 to 5. The mean age of first attack in recurrent BP was $35.70{\pm}23.65$ years old and was earlier than that of the single BP ($50.94{\pm}16.21$ year). The larger proportion of the single BP had an abnormal enhancement of affected facial nerve (91.3%) than the recurrent BP (50%). The recurrent BP showed worse prognosis than the single BP. The associated conditions, etiology, and clinical features were similar between two groups. Conclusions: In comparison with single BP, recurrent BP showed earlier onset of first BP attack, less frequent abnormal enhancement of facial nerve on MRI, and worse prognosis.

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정상압수두증에 의한 보행장애 환자 치험 1례 (A case study of normal pressure hydrocephalus patient with gait disturbance using conservative Korean medical treatment)

  • 정민호;이미림;이유리;조기호;문상관;정우상
    • 대한중풍순환신경학회지
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    • 제17권1호
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    • pp.45-54
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    • 2016
  • A case of a 75-year-old Korean female with gait disturbance due to Normal pressure hydrocephalus (NPH) is presented. She was treated with acupuncture, electroacupuncture and herbal medicine - 柴苓湯(Shirhyung-Tang, Chai-ling-tang, Sairei-to) We used iNPH grading scale, and specified further the grade of gait disturbance category. After Korean medical treatment, there was notable improvement in gait disturbance on our specified scale. Cognitive impairment, tremor and rigidity were improved on each scale alongside. Korean medical treatment may be effective in treating NPH patients.

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소아 IgA 신병증의 추적 관찰 (Clinical Course of IgA Nephropathy in Children)

  • 홍인희;이준화;고철우;곽정식;구자훈
    • Childhood Kidney Diseases
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    • 제3권2호
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    • pp.153-160
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    • 1999
  • 목적 : 소아 IgA 신병증을 Haas에 의한 조직 병리학적 분류로 분류하고 이들의 임상 소견과 수년간의 추적 관찰을 통하여 임상 경과, 신기능저하의 빈도 및 위험인자를 알아보고자 본 조사를 시행하였다. 방법 : 대상 환아는 과거 11년간 경북대학교병원 소아과에 입원하여 신생검 소견상 IgA 신병증으로 진단된 60례로 하였으며 이들을 Haas의 subclass로 분류하고 임상 소견과 각종 검사실 성적을 비교 관찰하였고 또한 3-4년간의 추적 관찰을 통하여 각 subclass의 임상 경과, 신기능저하의 빈도 등을 알아보았다. 결과 : Haas의 조직학적 분류에 의한 subclass는 I 10례, III 36례, IV 12례, V 2례였으며 subclass II는 한 례도 없었다. 성별 분포는 남아 45례 여아 15례로 남아에 호발하였으며 (남 : 여 = 3 : 1) 평균 발병 연령은 $10.4{\pm}2.8$세로서 subclass에 따른 차이는 없었다. 육안적 혈뇨가 71.7%를 차지하였으며 진단 당시 고혈압이 2례, 질소혈증이 3례에서 관찰되었다. 혈청 단백과 알부민치는 subclass IV 및 V에서 각각 $6.3{\pm}1.1,\;3.3{\pm}0.9$$4.5{\pm}1.1,\;2.1{\pm}0.3g/dL$로서 subclass가 증가함에 따라 감소하였으며 24시간 뇨단백 배설양 ($mg/m^2/day$)은 subclass가 증가함에 따라 배설양도 증가하여 subclass IV는 $1338{\pm}1031$, subclass V는 $4500{\pm}1500$의 심한 단백뇨를 보여주었다. 혈청 IgA치는 28.3%에서 증가되어 있었으며 subclass의 정도 및 환아의 임상 경과와는 무관하였다. 추적 관찰 기간중 첫 1-2년에 14%, 3-4년에는 37.1%에서 정상 뇨소견(혈뇨의 소실)이 관찰되었으며 subclass에 따른 차이는 없었다. 점진적인 신기능 저하를 보인 경우는 3례로서 이들은 Haas의 subclass III, IV 및 V가 각각 1례씩이였다. 결론 : 소아에서의 IgA신병증의 예후는 지금까지 알려져 온 것보다 만성 신부전으로의 진행이 높은 것으로 생각되며 Haas의 조직학적 분류가 예후 판정에 도움이 된다고 생각한다. 그러나 본 연구는 대상 환아 및 추적 관찰 기간이 짧았기 때문에, 앞으로는 다 기관 공동 연구에 의하여 더 많은 예 수와 10년 이상의 장기 추적관찰에 의한 광범위한 연구가 이루어져야 할 것으로 생각한다.

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한 대학병원에서 분석한 재발 벨마비 환자의 임상양상 (Clinical Analysis of Recurrent Bell's Palsy in One University Hospital)

  • 김창형;이동국
    • Annals of Clinical Neurophysiology
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    • 제15권1호
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    • pp.1-6
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    • 2013
  • Background: Bell's palsy (BP) is the most common cause of unilateral lower motor facial palsy. Recurrent paralysis of the facial nerve is unusual and reported in only 7-8%. Methods: A total of 394 consecutive patients with acute BP patients were enrolled at Daegu Catholic University Hospital from July 2005 to September 2012. We classified the patients into two groups-single BP and recurrent BP-and compared them by patient characteristics, clinical features, MRI findings, electrophysiologic findings and prognosis. The degree of BP was graded according to the House and Brackmann facial nerve grading system. Results: Recurrent BP was observed in 31 (7.9%) patients. The number of recurrence was varied from 2 to 5. The recurrent BP (9.7%) had more incidence of family history and MRI enhancement than those of single BP (2.2%, p=0.047). The single BP (63.4%) had better recovery than recurrent BP (45.2%, p=0.045). Conclusions: The recurrent BP had more incidence of family history, MRI enhancement and poor prognosis than the single BP.

Correlation Between Accompanying Symptoms of Facial Nerve Palsy, Clinical Assessment Scales and Surface Electromyography

  • Gyu Hui, Kim;Jung Hyeon, Park;Tae Kyung, Kim;Eun Ju, Lee;Su Eun, Jung;Jong Cheol, Seo;Cheol Hong, Kim;Yoo Min, Choi;Hyun Min, Yoon
    • Journal of Acupuncture Research
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    • 제39권4호
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    • pp.297-303
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    • 2022
  • Background: This retrospective study aimed to determine whether there were correlations between the number and type of accompanying symptoms of peripheral facial nerve palsy, and surface electromyography (SEMG) and clinical assessment scales to help diagnosis. Methods: There were 30, cases of peripheral facial nerve palsy at Visit 1 to the Korean Medicine Hospital, Dong-eui University, 22 cases at Visit 2 and 10 cases at Visit 3. The study period was from July 19, 2021 to November 31, 2021. Symptoms were evaluated three times (with two-week intervals which began 7 days from onset) using SEMG, clinical assessment scales and accompanying symptoms. In this study, the House-Brackmann grading system (HBGS), and the Yanagihara's unweighted grading system (Y-score) clinical assessment scales were used. The Pearson or Spearman correlation was used for statistical analysis. Results: On Visit 1, the number of accompanying symptoms of peripheral facial nerve palsy had no significant correlation with other measures. On Visits 1-3, the HBGS score had a significant negative correlation with the Y-score. On Visit 2, most of the mean values measured had significant correlations with each other although not between SEMG-Z and SEMG-O that Z means a zygomaticus muscle and O means a orbicularis oris muscle. On Visit 3, the number of accompanying symptoms significantly correlated with the clinical assessment scales. The HBGS score, Y-score, and SEMG measurements (except SEMG-Z) had significant correlations with each other. A significant positive correlation between SEMG-Z and SEMG-T was noted. Conclusion: We predict accompanying symptoms can be used to diagnose the peripheral facial nerve palsy including both clinical assessment scales and SEMG measurements at 2-5 weeks after onset.

안면신경마비 후유증 정안침 증례보고 (Case Study of a Patient with Sequelae of Facial Palsy)

  • 이은지;김성태;권민구;신현권;고용준;강수우;나재일;설재욱;조현정;정필선;현민경;정민영
    • 동의생리병리학회지
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    • 제29권4호
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    • pp.347-351
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    • 2015
  • This study examines a clinical progress of treatment for the sequelae of facial palsy through Jung-ahn acupuncture. The patient in this case was diagnosed with facial paralysis a few years ago. The patient was treated with Korean medicine and Western medicine, but was given up without improvement. The paretic symptom was found out in left side of the face. Also facial spasm and epiphora caused by blepharoptosis were existed. The patient got 8 times Jung-ahn acupuncture treatment from September 18th, 2014 to September 26th, 2014. House-Brackmann facial nerve grading system(H-B scale) was implemented. On the first time of the treatment, H-B scale was Grade Ⅴ and facial nerve grading was 2/8. Facial spasm and epiphora caused by blepharoptosis in lower eyelid were appeared on facial expressions and conversation. After total 8 treatments(therapies), H-B scale was Grade Ⅲ and facial nerve grading was 5/8. The symptoms of facial paralysis and blepharoptosis were improved. Jung-ahn acupuncture is estimated to be effective in facial palsy sequela. More cases are required to develop treatment of facial palsy sequela.

Diffusion tensor imaging of the C1-C3 dorsal root ganglia and greater occipital nerve for cervicogenic headache

  • Wang, Lang;Shen, Jiang;Das, Sushant;Yang, Hanfeng
    • The Korean Journal of Pain
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    • 제33권3호
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    • pp.275-283
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    • 2020
  • Background: Previous studies showed neurography and tractography of the greater occipital nerve (GON). The purpose of this study was determining diffusion tensor imaging (DTI) parameters of bilateral GONs and dorsal root ganglia (DRG) in unilateral cervicogenic headache as well as the grading value of DTI for severe headache. The correlation between DTI parameters and clinical characteristics was evaluated. Methods: The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in bilateral GONs and cervical DRG (C2 and C3) were measured. Grading values for headache severity was calculated using a receiver operating characteristics curve. The correlation was analyzed with Pearson's coefficient. Results: The FA values of the symptomatic side of GON and cervical DRG (C2 and C3) were significantly lower than that of the asymptomatic side (all the P < 0.001), while the ADC values were significantly higher (P = 0.003, P < 0.001, and P = 0.003, respectively). The FA value of 0.205 in C2 DRG was considered the grading parameter for headache severity with sensitivity of 0.743 and specificity of 0.999 (P < 0.001). A negative correlation and a positive correlation between the FA and ADC value of the GON and headache index (HI; r = -0.420, P = 0.037 and r = 0.531, P = 0.006, respectively) was found. Conclusions: DTI parameters in the symptomatic side of the C2 and C3 DRG and GON were significantly changed. The FA value of the C2 DRG can grade headache severity. DTI parameters of the GON significantly correlated with HI.