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Deep Learning-Assisted Diagnosis of Pediatric Skull Fractures on Plain Radiographs
Choi Jae Won,조연진,Ha Ji Young,Lee Yun Young,Koh Seok Young,Seo June Young,Choi Young Hun,Cheon Jung-Eun,Phi Ji Hoon,Kim Injoon,Yang Jaekwang,Kim Woo Sun 대한영상의학회 2022 Korean Journal of Radiology Vol.23 No.3
Objective: To develop and evaluate a deep learning-based artificial intelligence (AI) model for detecting skull fractures on plain radiographs in children. Materials and Methods: This retrospective multi-center study consisted of a development dataset acquired from two hospitals (n = 149 and 264) and an external test set (n = 95) from a third hospital. Datasets included children with head trauma who underwent both skull radiography and cranial computed tomography (CT). The development dataset was split into training, tuning, and internal test sets in a ratio of 7:1:2. The reference standard for skull fracture was cranial CT. Two radiology residents, a pediatric radiologist, and two emergency physicians participated in a two-session observer study on an external test set with and without AI assistance. We obtained the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity along with their 95% confidence intervals (CIs). Results: The AI model showed an AUROC of 0.922 (95% CI, 0.842–0.969) in the internal test set and 0.870 (95% CI, 0.785–0.930) in the external test set. The model had a sensitivity of 81.1% (95% CI, 64.8%–92.0%) and specificity of 91.3% (95% CI, 79.2%–97.6%) for the internal test set and 78.9% (95% CI, 54.4%–93.9%) and 88.2% (95% CI, 78.7%– 94.4%), respectively, for the external test set. With the model’s assistance, significant AUROC improvement was observed in radiology residents (pooled results) and emergency physicians (pooled results) with the difference from reading without AI assistance of 0.094 (95% CI, 0.020–0.168; p = 0.012) and 0.069 (95% CI, 0.002–0.136; p = 0.043), respectively, but not in the pediatric radiologist with the difference of 0.008 (95% CI, -0.074–0.090; p = 0.850). Conclusion: A deep learning-based AI model improved the performance of inexperienced radiologists and emergency physicians in diagnosing pediatric skull fractures on plain radiographs.
Pregnancy Rates and Outcomes of HIV-Infected Women in Korea
Choi, Heun,Kim, Moo Hyun,Lee, Se Ju,Kim, Eun Jin,Lee, Woonji,Jeong, Wooyong,Jung, In Young,Ahn, Jin Young,Jeong, Su Jin,Ku, Nam Su,Baek, Ji Hyeon,Choi, Young Hwa,Kim, Hyo Youl,Kim, June Myung,Choi, Ju KOREAN ACADEMY OF MEDICAL SCIENCE 2018 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.33 No.47
<P><B>Background</B></P><P>Antepartum, intrapartum, and postpartum preventive measures with antiretroviral drugs, appropriate delivery methods, and discouraging breastfeeding significantly decrease the risk of mother-to-child transmission of human immunodeficiency virus (HIV) infection. Herein, we investigated the pregnancy outcomes in HIV-infected Korean women.</P><P><B>Methods</B></P><P>We retrospectively reviewed medical records of childbearing-age HIV-infected women between January 2005 and June 2017 at four tertiary care hospitals in Korea.</P><P><B>Results</B></P><P>Among a total of 95 HIV infected women of child-bearing age with 587.61 years of follow-up duration, 15 HIV-infected women experienced 21 pregnancies and delivered 16 infants. The pregnancy rate was 3.57 per 100 patient-years. Among the 21 pregnancies, five ended with an induced abortion, and 16 with childbirth including two preterm deliveries at 24 and 35 weeks of gestation, respectively. The two preterm infants had low birth weight and one of them died 10 days after delivery due to respiratory failure. Among the 14 full-term infants, one infant was small for gestational age. There were no HIV-infected infants.</P><P><B>Conclusion</B></P><P>The pregnancy rate of HIV-infected women in Korea is lower than that of the general population. Although several adverse pregnancy outcomes were observed, mother-to-child transmission of HIV infection was successfully prevented with effective preventive measures.</P>
Choi, Gi-Hong,Ju, Man-Ki,Kim, June-Young,Kang, Chang-Moo,Kim, Kyung-Sik,Choi, Jin-Sub,Han, Kwang-Hyub,Park, Mi-Suk,Park, Young-Nyun,Lee, Woo-Jung,Kim, Byong-Ro The Korean Academy of Medical Sciences 2008 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.23 No.2
<P>We report on a case of hepatic splenosis. A 32-yr-old man underwent a splenectomy due to trauma at the age of 6. He had been diagnosed as being a chronic hepatitis B-virus carrier 16 yr prior to the surgery. The dynamic computer tomography (CT) performed due to elevated serum alpha-fetoprotein (128 ng/mL) demonstrated two hepatic nodules, which were located near the liver capsule. A nodule in Segment IVa had a slight enhancement during both the arterial and portal phases, and another nodule in Segment VI showed a slight enhancement only in the portal phases. Dynamic magnetic resonance imaging (MRI) of the mass in Segment VI showed enhanced development in the arterial phases and slight hyperintensivity to the liver parenchyma in the portal phases. These imaging findings suggested a hypervascular tumor in the liver, which could be either focal nodular hyperplasia, adenoma, or hepatocellular carcinoma (HCC). Even though these lesions were diagnosed as HCC, some of the findings were not compatible with typical HCC. On dynamic CT and MRI, all lesions showed a slight arterial enhancement and did not show early venous washout. All lesions were located near the liver capsule. These findings, along with a history of splenectomy, suggested a diagnosis of hepatic splenosis.</P>
Choi Naye,Choe Seung-Ah,Ahn Yo Han,Choe Young June,신주영,Choi Nam-Kyong,Kim Seong Heon,강희경 대한소아신장학회 2023 Childhood kidney diseases Vol.27 No.1
Purpose: This article was to collect data on the safety of coronavirus disease 2019 (COVID-19) vaccines in children with underlying medical conditions. Methods: We constructed a prospective cohort of children and adolescents aged 5 to 19 years who had received at least one dose of COVID-19 vaccine. Patients diagnosed with and treated for chronic kidney disease, autoimmune disease, or other chronic conditions at the Seoul National University Children’s Hospital were recruited from June to December 2022. A mobile survey questionnaire was sent to their guardians. The presence of adverse events on the day (day 0), 3 weeks (day 21), and 6 months (day 180) after the 1st dose of COVID-19 vaccine was recorded by the guardians. Results: A total of 73 children participated. The median age was 14 years, and 64.4% of the patients were male. On the day of immunization, 65.8% of the patients reported at least one adverse event. Pain at the injection site, fatigue, headache, arthralgia, and myalgia were the most common symptoms. The prevalence of adverse events decreased over time (65.8% on day 0, 27.4% between days 0 and 21, and 24.6% between days 21 and 180). Severe acute respiratory syndrome coronavirus 2 infection after the 1st dose occurred in 17 patients (23.3%) and one of the patients (5.88%) was hospitalized due to infection. Conclusions: Adverse events after COVID-19 vaccination were generally mild in children and adolescents with underlying medical conditions. Our findings provide evidence for the safety of COVID-19 vaccination in the vulnerable pediatric population.
Choi, Se-Joon,Kim, Ki-Jung,Choi, Hyeong-Seok,Kim, Seong-Yun,Yim, Dong-Seok,Cho, Young-Jin,Hahn, Sang-June,Sung, Ki-Wug The Korean Society of Pharmacology 2006 The Korean Journal of Physiology & Pharmacology Vol.10 No.6
The effects of ethanol on corticostriatal synaptic transmission were examined, using extracellular recording and analysis of population spike amplitudes in rat brain slices, to study how acute ethanol intoxication impairs striatal function. Ethanol caused a decrease in population spike amplitudes in a dose dependent manner ($50{\sim}200mM$). Pretreatment with picrotoxin, a ${\gamma}-amino$ butyric acid $(GABA)_{A}$ receptor antagonist, increased the population spikes but ethanol (100 mM) was still effective in decreasing the population spikes under this condition. In the presence of $_{(DL)}-2-amino-5-phosphonovaleric$ acid (APV), N-methyl-D-aspartate (NMDA) receptor antagonist, the inhibitory action of ethanol on population spikes was not shown. These results suggest that ethanol inhibits the glutamatergic corticostriatal synaptic transmission through blockade of NMDA receptors.
Choi, Suk Hoon,Chin, Bum Sik,Han, Sang Hoon,Lee, Han Sung,Kim, Chang Oh,Jeong, Su Jin,Choi, Hee Kyung,Kim, Myung Soo,Choi, Jun Yong,Song, Young Goo,Kim, June Myung 대한감염학회 2008 감염과 화학요법 Vol.40 No.6
Background : The aim of the present study was to assess the contribution of a QuantiFERON-TB Gold In-Tube test (QFT-IT) in differentiating active tuberculosis (TB) from latent tuberculosis infection (LTBI) by quantifying interferon-r levels. Materials and Methods : We retrospectively reviewed clinical records of 314 patients older than 15 years who had performed QFT-IT between July 2006 and August 2007 at a tertiary care teaching hospital. Results : Subjects with active TB (n=81, culture confirmed active TB in 40 subjects) and LTBI (n=76) were included. Mean±SD IFN-r levels were 4.961±3.98 lU/mL (range -0.08-10) for all subjects with active TB, 4.54±4.05 lU/mL (range -0.08-10) for culture confirmed active TB, and 4.11±3.57 lU/mL (range 0.35-10) for subjects with LTBI. The quantitative results of QFT-IT on IFN-7 levels between all the subjects with active TB and those with LTBI were not statistically significant (P=0.16). The result was similar when compared between those with culture confirmed active TB and those with LTBI, showing little statistical significance (P=0.554). Conclusion : The production of IFN-7 measured by QFT-IT showed no correlation between its level and the activity of Mycobacterium tuberculosis infection. These results suggest that measuring IFN-r using QFT-IT might not be useful for distinguishing active TB from LTBI.
Choi, Ji Ho,Kim, Eun Joong,Choi, June,Kwon, Soon Young,Lee, Heung Man,Kim, Tae Hoon,Lee, Sang Hag,Shin, Chol,Lee, Seung Hoon Annals Pub. Co 2011 The Annals of otology, rhinology & laryngology Vol.120 No.2
<P>The purpose of this study was to evaluate the changes of position during sleep as determined by polysomnography before and after upper airway surgery for obstructive sleep apnea syndrome in patients with no response to surgery ('nonresponse group') and in those who did have a response to surgery ('response group').</P>