Bone age assessments are a complicated and lengthy process, which are prone to inter- and intra-observer variabilities. Despite the great demand for fully automated systems, developing an accurate and robust bone age assessment solution has remained challenging. The rapidly evolving deep learning technology has shown promising results in automated bone age assessment. In this review article, we will provide information regarding the history of automated bone age assessments, discuss the current status, and present a literature review, as well as the future directions of artificial intelligence-based bone age assessments.

Bone age assessments are a complicated and lengthy process, which are prone to inter- and intra-observer variabilities. Despite the great demand for fully automated systems, developing an accurate and robust bone age assessment solution has remained challenging. The rapidly evolving deep learning technology has shown promising results in automated bone age assessment. In this review article, we will provide information regarding the history of automated bone age assessments, discuss the current status, and present a literature review, as well as the future directions of artificial intelligence-based bone age assessments.

Plasma renin activity (ORA) was determined by radioimmunoassay in 55 normal controls and 121 hypertensive patients in basal state and after double stimulation with furosemide administration and upright posture of 4 hrs. The results were obtained as follows, 1) Mean value of PRA of normal control was 2.2+/-1.41ng/ml/hr in basal state and 2.9+/-1.39ng/ml/hr after double stimulation, respectively. The latter was elevated significantly as compaired to the former. 2) PRA in males was significantly higher than in females, and PRA tend to be decreased as age become old. 3) Normal value of PRA after double stimulation was ranged from 1.0 to 5.0 ng/ml/hr. Of total 121 hypertensive patients(55 males and 66 females), PRA was low in 33 cases(27.3%), normal in 77 cases (63.6%), and high in 11 cases(9.1%). 4) Of 55 male hypertensive patients, PRA was low in 13 cases(23.6%), normal in 35 cases (63.7%), and high in 7 cases(12.7%). Of 66 female hypertensive patients,, PRA was low in 20 cases (30.3%), normal in 42 cases(63.6%), and high in 4 cases(6.1%). High renin group was observed more frequently in male hypertensive patients than in female hypertensive patients, while low renin group more frequently in famale than in male patients. 5) Low renin group was observed more frequently in older age group than in younger age group, while high renin group more frequently in younger age than in older age group.
Female ; Furosemide ; Humans ; Hypertension* ; Korea* ; Male ; Plasma* ; Posture ; Radioimmunoassay ; Reference Values ; Renin*

Transient left ventricular apical ballooning is characterized by transient wall motion abnormalities involving the left ventricular apex and mid-ventricle in the absence of coronary arterial occlusion. A 66-year-old woman presented to the emergency department with chest pain that mimicked acute myocardial infarction. An aortogram showed akinesis from the mid to apical left ventricle with sparing of the basal segments. Four days later, she underwent MRI, which demonstrated characteristic apical contractile dysfunction, the same as the aortogram, without evidence of myocardial infarction on the MRI. Two weeks later, her symptoms were resolved and follow-up echocardiography showed normal ventricular function.
Ventricular Dysfunction, Left/*diagnosis/*etiology ; Stress, Psychological/*complications ; Myocardial Infarction/diagnosis ; Magnetic Resonance Imaging/*methods ; Humans ; Female ; Electrocardiography ; Echocardiography ; Diagnosis, Differential ; Aged

BACKGROUND: High-dose cytarabine (HDAC) and etoposide, two of the most active drugs in relapsed acute myeloid leukemia (AML), have shown synergistic activity with platinum analogues in both preclinical and clinical studies. The present study was undertaken to assess the efficacy and toxicity of a combination regimen of HDAC, etoposide and cisplatin (HAEP) in adult patients with relapsed AML. METHODS: Between 1990 and 1998, 16 patients with relapsed AML were treated with HAEP salvage therapy, which consisted of HDAC (2.0g/m2, q12hr x2/d), etoposide (100mg/m2/d) and cisplatin (20mg/m2/d, 2-hr infusion) for 5 days. RESULTS: Ten of 16 patients (62.5%) achieved a complete remission (CR). Six patients who could not attain CR died either of infection (5 patients) or CNS hemorrhage (1 patient). The median overall survival (OS) for all patients was 63 (range, 6~253) weeks. Median disease free survival (DFS) for those who achieved CR was 57 weeks. At the time of analysis, 6 patients were alive with a median follow-up of 68 (range, 22~152) months. All patients experienced fever in the setting of grade IV neutropenia. The median length of neutropenia and thrombocytopenia was 36 and 41 days, respectively. The median period of neutropenic fever in complete responders was 20 days. The main non-hematologic grade III~IV toxicities were mucositis(25%) and hepatic dysfunction (40%). CONCLUSIONS: The HAEP salvage regimen appears highly effective in obtaining high CR rate and possibly long-term survival in relapsed AML. The results suggest that the addition of cisplatin may enhance the activity of HDAC and etoposide. Hematologic toxicity was high, but there was no excessive or cumulative non-hematologic toxicity. Further evaluation of this novel combination in AML is indicated.
Adult* ; Cisplatin* ; Cytarabine* ; Disease-Free Survival ; Drug Therapy* ; Etoposide* ; Fever ; Follow-Up Studies ; Hemorrhage ; Humans ; Leukemia, Myeloid, Acute* ; Neutropenia ; Platinum ; Salvage Therapy ; Thrombocytopenia

The gastrointestinal rnanifestations associated with antiphospholipid antibodies include Budd-Chiari syndroame, hepatic infarction, portal hypertension, pancreatitis, intestinal infarction, perforation, bleeding and ulceration. A 40-year old man, without prior thrombotic event, presented with severe abdominal pain for 3 days and septic shock. Multiple mesenteric venous thrombosis and colonic congestion were suggested by abdominal CT and angiography. Gastroendoscopy revealed esophageal varix and congestive gastropathy. Laboratory tests disclosed postive antiphospholipid antibodies, anti-HCV antibodies, HCV-PCR, prolonged PT, aPTT, thrombocytopenia and had no evidences of SLE and other connective tissue diseases. He was diagnosed as mutiple mesenteric thrombosis and portal hypertension associated with antiphospholipid antibodies in hepatitis C virus infection. He was improved with the antibiotics and intravenous vasopressors. He have had no other thrombotic events until one year after discharge.
Abdominal Pain ; Adult ; Angiography ; Anti-Bacterial Agents ; Antibodies, Antiphospholipid ; Colon ; Connective Tissue Diseases ; Esophageal and Gastric Varices ; Estrogens, Conjugated (USP) ; Hemorrhage ; Hepacivirus ; Hepatitis C Antibodies ; Hepatitis C* ; Hepatitis* ; Humans ; Hypertension* ; Hypertension, Portal ; Infarction ; Pancreatitis ; Shock, Septic ; Thrombocytopenia ; Thrombosis* ; Tomography, X-Ray Computed ; Ulcer ; Venous Thrombosis

Rhabdomyolysis is a syndrome involving the breakdown of skeletal muscle that causes myoglobin and other intracellular proteins to leak into the circulatory system, resulting in organ injury including acute kidney injury. We report a case of statin-induced rhabdomyolysis and acute kidney injury that developed in a 63-year-old woman with previously undiagnosed hypothyroidism. Untreated hypothyroidism may have caused her hypercholesterolemia requiring statin treatment, and it is postulated that statin-induced muscle injury was aggravated by hypothyroidism resulting in her full-blown rhabdomyolysis. Although this patient was successfully treated with continuous venovenous hemofiltration and L-thyroxin replacement, rhabdomyolysis with acute kidney injury is a potentially life-threatening disorder. Physicians must pay special attention to the possible presence of subclinical hypothyroidism when administering statins in patients with hypercholesterolemia.
Acute Kidney Injury* ; Female ; Hemofiltration ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors* ; Hypercholesterolemia ; Hypothyroidism* ; Middle Aged ; Muscle, Skeletal ; Muscles ; Myoglobin ; Rhabdomyolysis*

Rhabdomyolysis is a syndrome involving the breakdown of skeletal muscle that causes myoglobin and other intracellular proteins to leak into the circulatory system, resulting in organ injury including acute kidney injury. We report a case of statin-induced rhabdomyolysis and acute kidney injury that developed in a 63-year-old woman with previously undiagnosed hypothyroidism. Untreated hypothyroidism may have caused her hypercholesterolemia requiring statin treatment, and it is postulated that statin-induced muscle injury was aggravated by hypothyroidism resulting in her full-blown rhabdomyolysis. Although this patient was successfully treated with continuous venovenous hemofiltration and L-thyroxin replacement, rhabdomyolysis with acute kidney injury is a potentially life-threatening disorder. Physicians must pay special attention to the possible presence of subclinical hypothyroidism when administering statins in patients with hypercholesterolemia.
Acute Kidney Injury* ; Female ; Hemofiltration ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors* ; Hypercholesterolemia ; Hypothyroidism* ; Middle Aged ; Muscle, Skeletal ; Muscles ; Myoglobin ; Rhabdomyolysis*

BACKGROUND: In breast surgery, regional anesthesia rather than primary anesthesia has been mainly used for postoperative analgesia. Serratus anterior plane block is a new method for ultrasound-guided thoracic wall block. It is less invasive and relatively safer than conventional regional anesthetic techniques.CASE: We report a case of breast surgery under serratus anterior plane block as primary anesthesia with monitored anesthesia for a 78-year-old patient with a medical history of cardiopulmonary resuscitation due to stress-induced cardiomyopathy caused by pneumonia. CONCLUSIONS Serratus anterior plane block might be simple and effective technique for breast surgery when a lesion is located on lateral side.

OBJECTIVES: Common genetic SNPs in two genes, encoding catechol-O-methyltransferase (COMT) and methylenetetrahydrofolate reductase (MTHFR), which are interconnected with COMT gene regulation, have been reported to contribute to schizophrenia risk. In this study, we evaluated the association between functional polymorphisms in COMT and MTHFR and schizophrenia risk with a case-control study in a Korean population. METHODS: We performed a case-control study by genotyping analysis using 360 cases and 348 controls in Korean subjects to determine the association between functional polymorphisms in COMT and MTHFR and schizophrenia risk. RESULTS: Four functional SNPs in COMT (Val158Met and rs165599) and MTHFR (C677T and A1298C) were genotyped by primer extension assay. None of the genotype distributions for the four SNPs was significantly different between cases and controls. Stratified analysis did not show any significant gender difference for any polymorphism. In addition, we found no evidence of a gene-gene interaction in the analysis of combined genotypes. CONCLUSION: Our results suggest no significant association between the selected functional polymorphisms of COMT or MTHFR in Korean schizophrenia subjects. However, further studies are required to confirm our findings in a larger number of subjects.
Case-Control Studies ; Catechol O-Methyltransferase ; Genotype ; Methylenetetrahydrofolate Reductase (NADPH2) ; Polymorphism, Single Nucleotide ; Schizophrenia