PURPOSE: This paper introduces an improved classification approach which adopts a deterministic relaxation method and an agglomerative clustering technique for the classification of MRI using neural network. The proposed approach can solve the problems of convergency to local optima and computational burden caused by a large number of input patterns when a neural network is used for image classification. MATERIALS AND METHODS: Application of Hopfield neural network has been solving various optimization problems. However, major problem of mapping an image classification problem into a neural network is that network is opt to converge to local optima and its convergency toward the global solution with a standard stochastic relaxation spends much time. Therefore, to avoid local solutions and to achieve fast convergency toward a global optimization, we adopt MFA to a Hopfield network during the classification. MFA replaces the stochastic nature of simulated annealing method with a set of deterministic update rules that act on the average value of the variable. By minimizing averages, it is possible to converge to an equilibrium state considerably faster than standard simulated annealing method. Moreover, the proposed agglomerative clustering algorithm which determines the underlying clusters of the image provides initial input values of Hopfield neural network. RESULTS: The proposed approach which uses agglomerative clustering and deterministic relaxation approach resolves the problem of local optimization and achieves fast convergency toward a global optimization when a neural network is used for MRI classification. CONCLUSION: In this paper, we introduce a new paradigm to classify MRI using clustering analysis and deterministic relaxation for neural network to improve the classification results.
Classification* ; Magnetic Resonance Imaging ; Relaxation*

ols is an effective method for increasing new bone formation in distracted areas.
Osteogenesis* ; Osteogenesis, Distraction* ; Rabbits*

Pilomatricoma, calcifying epithelioma of Malherbe, is a benign skin neoplasm of hair matrix origin that is typically occurred in the head and neck region. It usually presents as a superficial, firm, solitary, slow-growing, and painless mass of less than 3 cm in diameter and most often occurs in young age under 20 years. The tumor does not express an aggressive behavior and surgical excision is the treatment of choice. The purpose of this article is to present a case of pilomatricoma of the preauricular region and to review the literature regarding pilomatricomas of the head and neck region.
Hair ; Head ; Neck ; Pilomatrixoma ; Skin Neoplasms

Pierre Robin sequence as a symptom triad of micrognathia, glossoptosis, and cleft palate results in upper airway obstruction and feeding problems. If mild, it is often managed in the prone position. When positional treatment fails, however, surgical intervention such as tongue-lip adhesion, tracheostomy, and mandibular distraction osteogenesis is mandatory to relieve airway obstruction. There has been growing interest in the application of distraction osteogenesis for the management of craniofacial abnormalities. The mandibular distraction osteogenesis to newborns may prevent the airway obstruction, decrease the potential tracheostomy, and reduce the likehood of orthognathic surgery after growth. We experienced an infant with Pierre Robin sequence who showed mandibular hypoplasia, glossoptosis, incomplete cleft palate, intermittent cyanos is, depression of the chest, and respiratory difficulty associated with airway obstruction. We treated the airway obstruction by tongue-lip adhesion at 2 weeks of age, and treated the mandibular retrognathism and depression of the chest byusing internal mandibular distraction osteogenesis at 7 month of age. The mandible moved forwardly, the upper airway space was enlarged, and the antero-posterior distance of the mandible was elongated after the mandibular distraction. Mandibular distraction osteogenesis may be a promising technique to avoid the need of tracheostomy and orthognathic surgery, and to correct airway obstruction in infants with congenital craniofacial malformation.
Airway Obstruction ; Cleft Palate ; Craniofacial Abnormalities ; Depression ; Humans ; Infant ; Infant, Newborn ; Mandible ; Orthognathic Surgery ; Osteogenesis, Distraction ; Pierre Robin Syndrome ; Prone Position ; Retrognathia ; Songbirds ; Thorax ; Tracheostomy

Hypertension is a frequent complication after organ transplantation and remains risk factor for the development of cardiovascular disease and graft dysfunction after renal transplantation. The prevalence of hypertension after renal transplantation varies from 50% to 93%. There are multiple mechanisms for development of post-transplant hypertension. To examine the effects of hypertension on renal allograft survival, we studied the clinical course of 319 kidney transplant recipients(male:female=231:88, mean age=32.9+/-10.4 yrs) who had functioning graft at least 6 months. The patients were divided into three groups : normotensive groups(n=90), controlled hypertensive groups(n=176) and uncontrolled hypertensive groups(n=53). Among 319 patients, 229(72%) were hypertensive at the time of renal transplantation. The incidence of hypertension decreased progressively to 68%, 65% and 61% at 1, 3 and 5 years after transplantation (p<0.05). The numbers of antihypertensive medication at the time of operation was 1.35+/-1.09, which decreased significantly to 0.98+/-0.76 at 12 months after renal transplantation(p<0.05). Cumulative graft survival at 5 years for normotensive and controlled hypertensive patients were 44% and 50% respectively, 20% for uncontrolled hypertensive patients. The difference of 5 years graft survival between controlled hypertensive and uncontrolled hypertensive patietns was significant (p<0.01), whereas the difference between the normotensive and controlled hypertensive group was not significant. We conclude that hypertension per se may not be an important risk factor for renal graft survival. However, the control of hypertension appear to be a more important risk factor for renal allograft survivial.
Allografts* ; Cardiovascular Diseases ; Graft Survival ; Humans ; Hypertension* ; Incidence ; Kidney Transplantation* ; Kidney* ; Organ Transplantation ; Prevalence ; Risk Factors ; Transplants

Excessive wear causes many complications when untreated, so that accurate diagnosis, analysis and predictive treatment plan should be made, and through evaluation of vertical dimension and stepwise treatment, a stable inter-arch relationship can be set. For the long-term success of implant treatment, ideal position and angle of implant is important, and its importance increases especially in multiple implant cases. Therefore, thorough diagnosis and planning, accurate surgery and prosthodontic procedures are significant. In this case, a 68-year-old male patient with a loss of vertical dimension due to multiple tooth loss and overall tooth wear was planned with systematic analyses from the pre-treatment stage to rehabilitate vertical dimension. Full-mouth fixed rehabilitation with computer tomography guided implant surgery was performed to the newly set vertical dimension and attained satisfactory outcomes both functionally and esthetically.
Aged ; Dentition* ; Diagnosis ; Humans ; Male ; Rehabilitation* ; Tooth Loss ; Tooth Wear ; Tooth* ; Vertical Dimension*

PURPOSE: Spontaneously ruptured hepatocellular carcinoma (srHCC) is known to be a life-threatening complication with poor prognosis. Although there are various treatment modalities, there is no definite treatment guideline. The purpose of this study was to review the surgical outcome and prognosis of srHCC treated with intraoperative radiofrequency ablation (RFA) and distilled water peritoneal lavage (DWPL). METHODS: From March 2012 to October 2018, 9 patients with srHCC who underwent emergent surgery were reviewed. After hematoma removal, intraoperative RFA and DWPL were applied to all patients. Hepatectomy was performed if necessary. Patients with multiple tumors, distant metastasis, and vascular tumor involvement in radiologic imaging were excluded. RESULTS: Six of 9 patients with diameters less than 7 cm were able to obtain hemostasis using RFA alone (RFA group). However, 3 patients with a tumor size of more than 10 cm underwent liver resection because they could not obtain hemostasis with RFA (hepatectomy only group). The RFA group had shorter operation time (148.3 ± 31.7 minutes vs. 251.7 ± 20.2 minutes, P < 0.05) and less red blood cell transfusion (5.8 ± 2.5 packs vs. 24.0 ± 11.5 packs, P < 0.05) than the hepatectomy only group. There was no peritoneal metastasis at long-term follow-up in the RFA group. Five-year recurrence-free survival rate was 0% in both groups. However, 5-year overall survival rate was better in the RFA group (83.3% vs. 0%, P < 0.05). CONCLUSION: Intraoperative RFA and DWPL are easy to perform and theoretically the best methods for managing relatively small srHCC.
Carcinoma, Hepatocellular ; Catheter Ablation ; Erythrocyte Transfusion ; Follow-Up Studies ; Hematoma ; Hemostasis ; Hepatectomy ; Humans ; Liver ; Neoplasm Metastasis ; Peritoneal Lavage ; Prognosis ; Rupture ; Survival Rate ; Water

Subaortic left brachiocephalic vein is a rare congenital anomaly that is sometimes found in the normal population. We report here on a case of subaortic left brachiocephalic vein that was detected incidentally by performing contrast transesophageal echocardiography (TEE) with using agitated saline and computed tomography (CT).
Brachiocephalic Veins* ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Dihydroergotamine ; Echocardiography, Transesophageal

OBJECTIVE: Personal and social performance scale (PSP) has been reported as useful tool for the assessment of functioning in the psychiatric population. The authors wanted to assess the reliability and validity of the Korean version of the PSP (K-PSP). METHODS: One hundred ten patients, including out-patients and in-patients, diagnosed as schizophrenia and schizoaffective disorder according to the DSM-IV criteria were participated in the study. Subjects were assessed with K-PSP, Positive and negative syndrome scale (PANSS), Global assessment functioning scale (GAF),and Clinical global impression-severity (CGI-S) to evaluate cross-validation. Statistical analysis was done by the calculation of Cronbach's alpha, Pearson correlation coefficient. RESUTLS: The Cronbach's alpha coefficient of K-PSP was 0.79. The correlations of each domain of K-PSP with the total score of K-PSP were statistically significant (r= -0.46~-0.84, p<0.001). The inter-rater reliabilities of the total score of K-PSP was 0.79 (p<0.001) and individual score (r=0.775~0.783, p<0.001) relatively high. The total score of K-PSP showed a meaningful correlations with those of PANSS (r=-0.60, p<0.001), GAF (r=-0.71, p<0.001) and CGI-S (r=0.60, p<0.001). CONCLUSION: The K-PSP is the useful tool for assessment of functioning in the psychiatric population. So K-PSP can be widely used in the clinical practice and psychiatric studies.

BACKGROUND/AIMS: We evaluated whether colonic transit time (CTT) can predict the degree of bowel preparation in patients with chronic constipation undergoing scheduled colonoscopy in order to assist in the development of better bowel preparation strategies for these patients. METHODS: We analyzed the records of 160 patients with chronic constipation from March 2007 to November 2012. We enrolled patients who had undergone a CTT test followed by colonoscopy. We defined patients with a CTT > or =30 hours as the slow transit time (STT) group, and patients with a CTT <30 hours as the normal transit time (NTT) group. Boston Bowel Preparation Scale (BBPS) scores were compared between the STT and NTT groups. RESULTS: Of 160 patients with chronic constipation, 82 (51%) were included in the STT group and 78 (49%) were included in the NTT group. Patients with a BBPS score of <6 were more prevalent in the STT group than in the NTT group (31.7% vs. 10.3%, P=0.001). Multivariate analysis showed that slow CTT was an independent predictor of inadequate bowel preparation (odds ratio, 0.261; 95% confidence interval, 0.107-0.634; P=0.003). The best CTT cut-off value for predicting inadequate bowel preparation in patients with chronic constipation was 37 hours, as determined by receiver operator characteristic (ROC) curve analysis (area under the ROC curve: 0.676, specificity: 0.735, sensitivity: 0.643). CONCLUSIONS: Patients with chronic constipation and a CTT >30 hours were at risk for inadequate bowel preparation. CTT measured prior to colonoscopy could be useful for developing individualized strategies for bowel preparation in patients with slow CTT, as these patients are likely to have inadequate bowel preparation.
Colon* ; Colonoscopy ; Constipation* ; Humans ; Multivariate Analysis ; ROC Curve ; Sensitivity and Specificity