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Diagnostic Classification of Chest X-ray Pneumonia using Inception V3 Modeling (Inception V3를 이용한 흉부촬영 X선 영상의 폐렴 진단 분류)

  • Kim, Ji-Yul;Ye, Soo-Young
    • Journal of the Korean Society of Radiology
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    • v.14 no.6
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    • pp.773-780
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    • 2020
  • With the development of the 4th industrial, research is being conducted to prevent diseases and reduce damage in various fields of science and technology such as medicine, health, and bio. As a result, artificial intelligence technology has been introduced and researched for image analysis of radiological examinations. In this paper, we will directly apply a deep learning model for classification and detection of pneumonia using chest X-ray images, and evaluate whether the deep learning model of the Inception series is a useful model for detecting pneumonia. As the experimental material, a chest X-ray image data set provided and shared free of charge by Kaggle was used, and out of the total 3,470 chest X-ray image data, it was classified into 1,870 training data sets, 1,100 validation data sets, and 500 test data sets. I did. As a result of the experiment, the result of metric evaluation of the Inception V3 deep learning model was 94.80% for accuracy, 97.24% for precision, 94.00% for recall, and 95.59 for F1 score. In addition, the accuracy of the final epoch for Inception V3 deep learning modeling was 94.91% for learning modeling and 89.68% for verification modeling for pneumonia detection and classification of chest X-ray images. For the evaluation of the loss function value, the learning modeling was 1.127% and the validation modeling was 4.603%. As a result, it was evaluated that the Inception V3 deep learning model is a very excellent deep learning model in extracting and classifying features of chest image data, and its learning state is also very good. As a result of matrix accuracy evaluation for test modeling, the accuracy of 96% for normal chest X-ray image data and 97% for pneumonia chest X-ray image data was proven. The deep learning model of the Inception series is considered to be a useful deep learning model for classification of chest diseases, and it is expected that it can also play an auxiliary role of human resources, so it is considered that it will be a solution to the problem of insufficient medical personnel. In the future, this study is expected to be presented as basic data for similar studies in the case of similar studies on the diagnosis of pneumonia using deep learning.

Efficacy of Mitral Valve Surgery in Moderate Ischemic Mitral Regurgitation (MR) (중등도의 허혈성 승모판막 폐쇄부전증 환자에서 승모판막 수술의 유용성)

  • Jung Sung Ho;Lee Jae Won;Choi Jun Young
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.357-365
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    • 2005
  • Background: Patients with mitral regurgitation (MR) in the setting of coronary artery disease have a dismal long-term prognosis whether treated medically or surgically. Moreover, the optimal management of moderate ischemic MR at the time of coronary artery bypass grafting (CABG) remains the subjects of controversy. Thus, the present retrospective study was undertaken to determine whether mitral valve surgery for moderate ischemic MR at the time of CABG would be preferable to CABG alone in terms of clinical outcome. Material and Method: Between January 1997 and December 2003, 34 patients with moderate (Gr 3/4) ischemic MR underwent CABG alone (Group I, n=23) or CABG plus mitral valve surgery (Group II, n=11). Operative mortality, long-term survival and echocardiographic parameters were used to evaluate the efficacy of mitral valve surgery in patients with moderate ischemic MR. The mean follow-up durations of each group were $69.3\pm4.3$ months and $53.1\pm4.9$ months respectively. Result: There was no hospital mortality in both groups. There was one case of late mortality in Group I. The mean number of bypass graft was similar ($3.8\pm1.2\;vs\;3.7\pm1.3$ respectively). Cardiopulmonary bypass time was longer in group II (p=0.014). In group II, all of the patients received mitral annuloplasty using ring. On immediate postoperative echo-cardiogram, mitral regurgitation was reduced more in group II (p=0.002). Echocardiogram performed at last follow-up state showed no difference except the grade of MR between the two groups. Actuarial survival of both groups at 5 years was similar ($95.5\%\;vs\;100\%$, p=0.48). Conclusion: This study shows that in selected patients with moderate ischemic MR, CABG without mitral valve surgery might be sufficient. However, patients with low EF and NYHA functional class pre-operatively had tendency of significant residual MR, so mitral valve surgery should be necessary in these patients, and moreover, MR severity and left ventricle volume decreased more in mitral valve surgery group. Therefore, more large-scale studies are necessary to determine these effects on the ventricular function and long-term survival.

Mid-Term Results of Mitral Valve Repair Using a Partial Flexible Band and a Completely Rigid Ring in Patients with Degenerative Mitral Regurgitation (퇴행성 승모판막역류 환자에서 Partial Flexible Band와 Complete Rigid Ring을 이용한 승모판막 성형술의 중기 결과 비교)

  • Kim, Kyung-Hwan;Ahn, Hyuk;Hwang, Ho-Young;Choi, Jin-Ho;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.475-481
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    • 2010
  • Background: We evaluated mid-term results of mitral annuloplasty using a flexible band and a completely rigid ring for mitral valve repair in patients with degenerative mitral regurgitation (MR). Material and Method: From January 2004 to September 2008, 71 patients (M:F=36:35, $55{\pm}13$ years) underwent mitral valve repair with mitral annuloplasty for degenerative MR. Ring annuloplasty was done using a Cosgrove-Edwards flexible band (Group I, n=43) or a Carpentier-Edwards classic ring (Group II, n=28). There were no differences in preoperative characteristics of the participants. Average duration of follow-up was 36 months (range: 2~69 mos). Result: There was no in-hospital mortality. Postoperative morbidity, which included atrial fibrillation (n=7) and low cardiac output syndrome (n=5) in groups I and II were similar. There was one late death in group II. The proportion exhibiting freedom from recurrent mitral regurgitation ($\geq$moderate) at 4 years in Groups I and II were, respectively, 94.5 and 91.8%, (p=0.695). Left ventricular ejection fraction decreased in the early postoperative period ($7{\pm}2$ days) and recovered by last follow-up ($25{\pm}16$ mos; p=0.002). The pattern was similar in groups I and II (p=0.905). Re-operation was performed in 3 patients (1 in Group I and 2 in Group II, p=0.316). Four-year event-free survival (free of adverse valve-related events) was 95.2% for Group I and 92.6% for Group II; this difference was not significant, p=0.646). Conclusion: The type of technique used in mitral annuloplasty to repair the mitral valve repair after degenerative MR did not affect mid-term clinical and functional results.

Neuroprotective Effect of Phenytoin and Hypothermia on a Spinal Cord Ischemic Injury Model in Rabbits (토끼의 척수 허혈 손상 모델에서 페니토인과 저체온의 신경 보호 효과의 비교)

  • Oh, Sam-Sae;Choe, Ghee-Young;Kim, Won-Gon
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.405-416
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    • 2008
  • Background: Spinal cord ischemic injury during thoracic and thoracoabdominal aortic surgeries remains a potentially devastating outcome despite using various methods of protection. Neuronal voltage-dependent sodium channel antagonists are known to provide neuroprotection in cerebral ischemic models. This study was designed to compare the neuroprotective effects of phenytoin with those of hypothermia in a rabbit model of spinal cord ischemia. Material and Method: Spinal cord ischemia was induced in New Zealand white rabbits by means of infrarenal aortic cross clamping for 25 minutes. Four groups of 8 animals each were studied. The control group and the hypothermia group received retrograde infusion of saline only ($22^{\circ}C$, 2 mL/min); the normothermic phenytoin group and the hypothermicphenytoin group received retrograde infusion of 100 mg of phenytoin at different rectal temperatures ($39^{\circ}C$ and $37^{\circ}C$, respectively) during the ischemic period. The neurologic function was assessed at 24 and 72 hours after the operation with using the modified Tarlov criteria. The spinal cords were harvested after the final neurologic examination for histopathological examination to objectively quantify the amount of neuronal damage. Result: No major adverse effects were observed with the retrograde phenytoin infusion during the aortic ischemic period. All the control rabbits became severely paraplegic, Both the phenytoin group and the hypothermia group had a better neurological status than did the control group (p < 0.05). The typical morphological changes that are characteristic of neuronal necrosis in the gray matter of the control animals were demonstrated by means of the histopathological examination, whereas phenytoin or hypothermia prevented or attenuated these necrotic phenomena (p < 0.05). The number of motor neuron cells positive for TUNEL staining was significantly reduced, to a similar extent, in the rabbits treated with phenytoin or hypothermia. Phenytoin and hypothermia had some additive neuroprotective effect, but there was no statistical significance between the two on the neurological and histopathological analysis. Conclusion: The neurological and histopathological analysis consistently demonstrated that both phenytoin and hypothermia may afford significant spinal cord protection to a similar extent during spinal cord ischemia in rabbits, although no significant additive effects were noticed.

A Proposal on a Management Model Applicable to Visiting Nursing Program for a Low-income Group (저소득층 방문간호 관리를 위한 제안 - 강북구 방문간호 대상자를 중심으로-)

  • Ko Mee-Ja
    • Journal of Korean Public Health Nursing
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    • v.10 no.1
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    • pp.118-138
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    • 1996
  • Because of accelerated urbanization public body visiting nursing project that started according as matter of health on urban class in the lower brackets of income was concentrated on Social interests has a unsatisfied points to propel project efficiently from the lack of rating materials. Therefore centering around written contents in documentary literature of citizen health by household in five years from starting year of project to now. visiting frequency by medical manpower was evaluated quantitatively and qualitatively in aspect of management hereupon. for the sake of giving a basic materials for public health project of this field. This research presents documentary literature of citizen health which become materials is that as one person's charged region of nurse in duty scale. district is Kang-Buck Gu. the object is resident in the lower brackets of income grounded livelihood protection law and who is admitted by the head of organ~chief of health care). and the number of material centering around the head of a household is 415 copy. The result of research is summarized. as follow. 1. Average visiting frequency examinated by medical manpower show difference according to valuables of supervision characteristics namely average visiting. Frequency of nurse has long term residence in case registration season is early and supervision season is the first year and is high incase a kind of house is unlicdnsed mountain town. Average visiting frequency with doctor is high incase supervision season is the first year and the medical insurance system is admitted by chief of health care. That shows that a man of discomfort behavior left alone are yet many in local society. The meaning of this result shows that the continuity of official relation about class in the lowest brackets of income of long term residence goes well between househole who is a user of visiting nursing service of the object according to midway income under management influences a given duty of nurse s and so causes quantitative decrease. 2. In case behavier and condition of health that nurse diagnoses are bad. as the type matter is a lack of health and the number of patient is large. the average visiting frequency of nurse is high. because average visiting frequency with doctor is high as the condition of health is bad and the number of patient is large. That is similar with that of nurse. CD Average visiting frequency of nurse s seen by matter of disease is very high only in apoplexy by 39.50 and is confined within limits from 7.63 to 11.36 in other disease. But average visiting frequency with doctor is double as many as that of nurse but defined in apoplexy hypertension and articulate. (1) Average visiting frequency of nurse by existence in inoculation of hepatitis is low by 6.73 in unidentified group and very high by 26.89 in group of non-inoculation and the case of the antigenic positive man of B type hepatitis or epileptic who can't be inoculated shows 13.00 and that even family nursing service is needed to them. That result shows that though one person nurse of local charge has a large scale of duty. as visting nursing service is given a class who has a large demand preferentially by respectively accurate nursing diagnosis. the number of diagnosis service is similar with it. 3. During five years. average visiting frequency of nurse is 10.84 and average visiting frequency with doctor is 76.50 seeing from the official scale of nurse. visiting by household is performed two more per year to the average. Seeing this by type of service. average visiting frequency of nurse is higher in indirectly nursing than in directly nursing and that suggests that at the time of visiting household nurse performs education of protection lively save patient but at the time of contrastedly visiting with doctor. directly nursing is more contents of service show no difference by man power and medication dressing by demand is 14.3 and 18.6 the aid of hardship term of doctor and nurse is high by 18.7 and 17.00 in the request of hospitalization when seeing by demands. 4. Action by turns exemplified 1994 is well in sequence of 2/4 turn. 3/4 turn. 1/4 turn. 4/4 turn. When seen by average visiting frequency of nurse but gradually is even. Without difference by turns. average visiting frequency of doctor is much higher in 1/4 turn than other turns. Type of service by turns is all even but directly nursing is inactive in 4/4 and indirectly nursing. Very increases in 4/4 and so. Nurse's quantity of duty is plentiful that shows that by evaluation of last turn and plan of project. Contents of service follows that medication and dressing is the highest by' 5.57 in 1/4turn. goes down gradually by turn. becomes 3.57 in 3/4 turn. and increases again by 4.83 in 4/4 turn. the rest service is higher in 2/4 turn than other turns. 5. Total visiting frequency of nurse is explained to total $37.5\%$ by six valuables of visiting frequency of doctor. nursing demand. demand of diagnosis. condition of behavior. year. Special terms and magnitude of influential power is the same as sequence of enumerated valuables. Namely. the higher the visiting frequency of doctor. the bigger nursing and demand of diagnosis is. the worse the condition of behavior is. the older the object is and the more the household of special terms is. the high total visiting frequency of nurse is.

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Effect of Fertigation with Indigenous Microorganism and EM on Soil Chemical and Microbial Properties and Growth of Cherry Tomatoes (토착미생물과 EM 활용 액비 처리가 방울토마토의 토양 화학성과 미생물상 및 생장에 미치는 영향)

  • Choi, Hyun-Sug;Jung, Ji-Sik;Kuk, Yong-In;Choi, In-Young;Jung, Seok-Kyu
    • Journal of the Korea Organic Resources Recycling Association
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    • v.27 no.4
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    • pp.15-24
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    • 2019
  • The study was compared for soil chemical and microbial properties as well as growth of the cherry tomato (Lycopersicon esculentum var. cerasiforme) plants environmentally friendly gown for 3 years and 5 years, which had been fertigated with homemade liquid fertilizer (LF) with indigenous microorganism as an additional fertilizer. Treatment included LF with indigenous microorganism for 3 years (3-year IM-LF) and for 5 years (5-year IM-LF), with an effective microorganism for 10 years (EM-LF), which had been applied with 1,000 times of dilution in the farmhouse. IM-LF and EM-LF materials had increased pH pattern for 16 weeks, in particular for increase of 1.2 for EM-LF. IM-LF material contained slightly higher EC but similar level of 0.2 dS/m to EM-LF. For a pot experiment in the greenhouse, IM-LF treatment increased root dry weight of the cherry tomato plants. In the farmhouse experiment, IM-LF treatment increased to 7.5 of soil pH and 8.4 dS/m of EC, indicating high salt accumulation. EM-LF treatment increased to 62 g/kg of soil OM, which would have affected concentrations of macro essential nutrients, including T-N in the soil. However, the optimum soil chemical levels for growth of cherry tomato plants were observed on the IM-LF plots. EM-LF treatment increased number of bacteria and actinobacteria in the soil. EM-LF treatment increased concentrations of macro essential nutrients in the plants, except for P, with similar nutrient concentrations observed between 3-year IM-LF and 5-year IM-LF-treated plants. Leaf SPAD and PS II levels decreased in the plants treated with 3-year IM-LF. EM-LF treatment increased leaf width and length, number of leaves, canopy area, plant height, and stem diameter in the mid-term stage of growth, which were not significantly different between the treatments. EM-LF treated-plants had two times higher leaf dry weight than those of values observed on the IM-LF plants, which was the opposite result observed on the number of fruit.

Feed Value, Growth and Dry Matter Yield of High Yielding Rice(Oryza sativa L.) for the Twice-cutting System (2회 예취 재배법을 이용한 초다수 벼(Oryza sativa L.) 계통의 생육·수량 및 사료가치 평가)

  • 백진수;이점호;정오영;홍하철;이규성;진일두;이상복;최용환;양창인;김종근;김병완;김홍열;양세준;이영태
    • Journal of Animal Science and Technology
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    • v.48 no.3
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    • pp.443-452
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    • 2006
  • The four rice(Oryza sativa L.) lines, previously demonstrated to have vigorous herbage production at the vegetative growth stage, were investigated for their growth traits, dry matter yield and feed value using the twice-cutting system that 1st-cut is harvested at panicle formation stage and 2nd-cut at the yellow ripen stage. The twice-cutting system is regarded as an effective method in the production of forage rice by escaping lodging and insect damages caused by the overgrowth and typhoon around the heading stage.The feed value of the twice-cut rice plant of there lines were compared with the control of normal, cutting at the yellow ripen stage. The relative feed value(RFV), the total digestible nutrient(TDN) and the crude protein(CP) content of the twice-cut straw were higher the control in every lines. However, the dry matter yield (DMY), represented by the summed forage production of 1st and 2nd cut-rice plant, were lower the control, and the DMY of straws were increase but grains were decrease for twice-cutting system. In addition, TDN yield showed the similar tendency with DMY.Recently, as one of the breeding aims the researches for improving the digestibility of rice straw have been required. In this regard, twice-cutting system is recognized with the fact that it has the effect which raises the digestibility of the straw. Especially, the 2nd cut of IR73111-B-R-15-3-1 line was similar to the control at the TDN yield of straw, and would be used as a breeding material for product the roughage of good quality.

Studies on the Desalinization and Improvement of Physical-chemical Characteristics of Saline and Alkali Soils by CHP Treatment (CHP에 의(依)한 간척지(干拓地) 토양(土壤)의 제염(除鹽) 및 이화학성질개량(理化學性質改良)에 관(關)한 시험연구(試驗硏究))

  • Lee, S.H.;Oh, J.S.;Im, C.N.
    • Applied Biological Chemistry
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    • v.8
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    • pp.65-73
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    • 1967
  • For the study of method for salt elimination aimed at reforming tidal land into normal paddy fields in a short period with reduction of periods requiring for elimination of saline, CHP (a kind of Ca-hum ate), a soil conditioner made of peat as a main material was tried. In the pot experiment, effect on elimination of salt, improvement of physical-chemical characteristics and rice cultivation test were studied. The results of these tests are as follows: 1, CHP treatment somewhat improves aggregation state with some effect on aggregation. 2. CHP treatment is remarkably effective in permeability which increases with 1.0 percent treatment by three times in percolation rate, and by 4.5 times in volume of leached water respectively. 3. With the increase of CHP amounts, salt was eliminated in short period. When 80% of the total Na was leached in 1.0% CHP-A treated pot, control pot begins permeable. 4. CEC and phosphorous absorption capacity are not influenced by CHP treatment. 5. Growing state of rice is greatly influenced by rainfalls. Growth of rice in tidal land however are almost similar to those in normal paddy fields with layer amounts of CHP treatment. With salt content in the soils, saline hazard and numbers of ineffective stems, amounts of unmatured grain are increased. 6. With the treatment of CHP yields of rough rice were increased. With 0.5% CHP treatment the yields were similar to those of the normal paddy fields. With 1.0% CHP-A treatment, the yields were increased by 15 times more than those of none treated soil and by 25 percent more than normal paddy soils.

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The Effects of Packed Red Blood Cell Washing and Circuit Precirculation-Ultrafiltration on the Production of Cytokines by Open Heart Surgery (충전용 농축적혈구의 세척 및 체외순환로의 전순환-초여과법이 개심수술에 의한 사이토카인 형성에 미치는 영향)

  • 전태국;노준량
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.199-208
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    • 2002
  • Background: The washing of packed red blood cells could remove pro-inflammatory mediators, cell debris, and micro-particles contained in packed red blood cells, and the preci-rculation-ultrafiltration (recirculation and ultrafiltration of circuit itself before cardiopulmonary bypass) could attenuate the initial inflammatory reaction and remove the initial proinflam-matory mediators. This study was performed to evaluate whether the washing of packed red blood cells and precirculation-ultrafiltration can reduce the production of cytokines that have an important role in myocardial reperfusion injury. This study investigated the effects of washing the packed red blood cells and precirculation-ultrafiltration on the production of cytokines during and after cardiopulmonary bypass and open heart surgery. Material and Method: Forty eight infants with VSD undergoing open heart surgery under cardiopulmonary bypass were randomized into control group (group C, n=12), washing group (group W, n= 12), precirculation-ultrafiltration group (group F, n: 12), and combined group(washing and precirculation-ultrafiltration, group WF, n=12). Blood samples were obtained before, during, and after the bypass to assess plasma level of tumor necrosis factor-$\alpha$(TNF-$\alpha$), interleukin-6(IL-6), and interleukin-8 (IL-8). Results: Expressions of TNF-$\alpha$ were significantly reduced in combined group (group WF) compared with group C, group W, and group F (p<0.05). Expression of IL-6 were significantly reduced in group W, group F, and group WF compared with group C (p<0.05), but similar among group W, group F, and group WF (p=0.053). Expression of IL-8 were reduced in group W and group WF compared with group C (p<0.05), but similar among group W, group F, and group WF (p=0.067). Conclusion: In conclusion, the washing of packed red blood cells and precirculation-ultrafiltration blunted the increase of TNF-$\alpha$ , IL-6, and IL-8 during and after open heart surgery with cardiopulmonary bypass. However, the clinical benefits of these treatments remains unproven.

Early Hemodynamic Changes and Short-term Outcomes of Mitral Valvuloplasty versus Replacement with Chordal Preservation for Patients with Mitral Regurgitation (승모판막폐쇄부전 환자에서 판막성형술과 판막대치술이 수술 후 혈역학과 단기 예후에 미치는 영향 비교)

  • Choi, Yong-Seon;Kwak, Young-Lan;Chang, Byung-Chul;Kim, Ji-Ho;Hong, Yong-Woo;Bang, Sou-Ouk
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.659-666
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    • 2007
  • Background: Preserving the subvalvular apparatus after mitral valve replacement (MVR) results in better ventricular function and a better outcome. In conjunction, mitral valve repair (MVr) is associated with a better outcome, yet little is known about the hemodynamics and outcomes between patients undergoing MVr and MVR with chordal preservation. We prospectively evaluated the hemodynamic changes and outcomes of patients undergoing MVr and MVR with chordal preservation. Material and Method: Fifty-four patients with mitral regurgitation (MR) who under-went MVR with chordal preservation (n=21) or MVr (n=33) were studied. The patients' characteristics, the intra-and postoperative hemodynamics and the use of cardiac medications, the postoperative outcome and the complications were recorded during the hospital stay. All the patients were followed up for at least 6 months post-operatively for determining their morbidity and mortality. Result: The patients' characteristics were similar between the groups, except for the presence of atrial fibrillation and congestive heart failure which was more frequent in the MVR group. Also, the preoperative left ventricular ejection fraction was lower in the MVR group than in the MVr group ($64{\pm}9%$ versus $69{\pm}5%$, respectively, p=0.043). There were no significant differences of the hemodynamics between the groups. The use of inotropic drugs and pacemakers during the 12hrs postoperatively was more common in the MVR group than in the MVr group (48% versus 24%, p=0.025 and 52% versus 24%, p=0.035, respectively). The other postoperative outcomes were similar in both groups for at least the 6 months follow-up period. Conclusion: MVR with chordal preservation was comparable with regard to the hemodynamics and clinical outcomes, supporting the beneficial effect of preserving the subvalvular apparatus after MVR.