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.

We had experience of 464 cases of anesthesia for repair of cleft lip and cleft palate under 10 years of age. The analyzed results are as follows: 1) The 464 cases were divided into 5 age groups and 165 cases(35.6%) were in the under 2 years age group. Sex distribution was 291 males(66.2%) and 173 females(37.3%) 2) 377 cases(81.3%) were under 20kg of body weight. 3) There were 229 cleft lip cases (29.3%), 233 cleft palate cases, and 1 case each of (50.2%), of naso-ocular fistular correction and oro-ocular correction. 4) There were 386 cases elective surgery and 2 were emergency cases. 5) All cases had general anesthesia by means of endotracheal intubation 377 cases(81.3%) with a non-rebreathing system and 87 cases(18.8%) had a semi-closed absorption system. 6) The main anesthetic was halothane in 462 cases(99.6%) and Valium-Demerol and ether was 1 case each. 7) The mean blood loss in palatoplastry was 10ml/kg of body weight but it was 13.7ml/kg in the 5~10kg of body weight group, 11.6ml/kg in the 10kg~20kg of body weight group and 7.5ml/kg in the 20~30kg of body weight group. 8) Incidence of cleft lip combined with cleft palate was 211 cases(45.5%) among 464 cases and 149 cases(51.2%) were males and 62 cases(35.8%) were females. 9) The most common type of cleft lip was left incomplete lip(30.1%) and of cleft palate it was left complete palate(30.5%). 10) Familial history was found in 56 cases(12%).
Absorption ; Anesthesia* ; Anesthesia, General ; Body Weight ; Child* ; Cleft Lip ; Cleft Palate ; Emergencies ; Ether ; Female ; Halothane ; Humans ; Incidence ; Intubation, Intratracheal ; Male ; Sex Distribution

We performed the interscalene technic of brachial plexus block for an operation of the upper extremity in 94 patients. We used 1%, 1.5% or 2% lidocaine solution with or without 1:200,000 epinephrine. There were paresthesias in all cases of needle puncture with the interscalene approach. The resutls were as follows: 1) Onset of anesthesia was observed in 3~10 minutes(average: 5 min.) 2) Complete anesthesia was observed in 10~30 minutes(average: 18 min.) 3) The mean interval of anesthesia to operation was 22 minutes. 4) We observed satisfactory blocks in 81 cases, unsatisfactory block in 8 cases and failure in 5 cases. 5) There were not any complications such as pneumothorax, dyspnea, convulsions, subarachnoid or epidural injection, etc.
Anesthesia ; Brachial Plexus* ; Dyspnea ; Epinephrine ; Humans ; Injections, Epidural ; Lidocaine ; Needles ; Paresthesia ; Pneumothorax ; Punctures ; Seizures ; Upper Extremity

PURPOSE: We evaluated the expressions of hTERT, Ki-67 and p53 in patients who underwent a curative resection for hepatic colorectal metastasis to see if there was any relationship of these immunohistochemical analyses with the disease free survival. METHODS: Patients who underwent a curative resection for hepatic colorectal metastasis, between 1995 and 2003, were analyzed. For each patient, the clinical prognostic score was derived from the patient's sex, age, tumor size and lymph node status, and serum CEA level. Tumor specimens were analyzed for Ki-67, hTERT and p53 using standard immunohistochemical techniques. RESULTS: The study included 23 patients: 9 and 12 survived without disease for less and more than 12 months, respectively. Ki-67, hTERT (labeling indexes greater than or equal to 50%) and p53 positivities (labeling indexes greater than or equal to 10%) were observed in 5, 17 and 11 patients, respectively. CONCLUSION: In patients undergoing resection of hepatic colorectal metastasis, the expressions of Ki-67, hTERT and p53 did not correlate with the disease free survival.
Colorectal Neoplasms ; Disease-Free Survival ; Hepatectomy ; Humans ; Humans* ; Liver* ; Lymph Nodes ; Neoplasm Metastasis* ; Telomerase*

Body Mass Index ; Child ; Humans ; Insulin ; Non-alcoholic Fatty Liver Disease ; Obesity ; Overweight ; Pediatric Obesity ; Prevalence ; Waist Circumference

Purpose: The aim of this study was to evaluate the pancreatic fat fraction (PFF) using magnetic resonance imaging (MRI) in children with and without obesity and to correlate PFF with body mass index (BMI) z-score, hepatic fat fraction (HFF), and ultrasonography-derived pancreato-perihepatic fat index (PPHFI). Methods: This prospective study included 45 children with obesity and 19 without obesity (control group). PFF and HFF were quantitatively assessed using the abdominal multi-echo Dixon method for MRI. The PPHFI was assessed using transabdominal ultrasonography. Anthropometric, MRI, and ultrasonographic characteristics were compared between the two groups. Correlations between PFF, HFF, PPHFI, and BMI z-scores in each group were also analyzed. Results: The PFF, HFF, PPHFI, and BMI z-score were higher in the group with obesity than in the control group (PFF: 6.65±3.42 vs. 1.78±0.55, HFF: 19.5±13.0 vs. 2.31±1, PPHFI: 3.65 ±1.63 vs. 0.94±0.31, BMI z-score: 2.27±0.56 vs. 0.42±0.54, p<0.01, respectively). PFF was correlated with BMI z-scores, PPHFI, and HFF in the obesity group, and multivariate analysis showed that PFF was strongly correlated with BMI z-score and PPHFI (p<0.05). The BMI z-score was strongly correlated with PFF in the control group (p<0.01). Conclusion These results suggest that MRI-derived PFF measures are associated with childhood obesity. PFF and PPHFI were also highly correlated in the obesity group. Therefore, PFF may be an objective index of pancreatic fat content and has the potential for clinical utility as a non-invasive biomarker for the assessment of childhood obesity.

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

PURPOSE: The variety of outcomes in patients with stage II colorectal carcinomas might be due to understaging caused by an inadequate number of lymph nodes (LNs) being examined. The aim of this study was to determine if any number of examined LNs reflects a reliable node-negative staging for colorectal carcinomas (CRCs). METHODS: Data on 241 patients (132 males) who underwent potentially curative resections for pT3 and pT4 CRC were reviewed. The patients ranged in age from 21 to 87 (mean: 58.2) years with a median follow-up of 43 (range: 7~96) months. The relationship between the number of LNs harvested and both the 5-year disease-free survival (DFS) and the overall survival (OS) rates were assessed for stage II CRCs. RESULTS: A median of 15 LNs (range: 3~104) was harvested per tumor specimen, and lymph-node metastases were present in 107 cases (44.4%). The proportion of lymph-node metastases increased as a function of the number of LNs harvested (P=0.0002; 95% confidence interval, 0.3333~0.8138). The number of LNs revealed to be the best number for dividing stage II patients into subgroups with different DFS and OS rates was ten. The 5-year DFS and OS rates of the 48 patients (35.8%) with nine or fewer LNs harvested were 68.6% and 76.8%, respectively, whereas those of the 86 patients (64.2%) with ten or more LNs harvested were 87.2% and 91.9%, respectively (DFS, P=0.0082; OS, P=0.0303). Moreover, there were no statistical differences between the node-negative patients with nine or fewer LNs harvested and the 67 stage III patients with N1 in respect to the DFS (68.6% vs. 56.7%; P= 0.2031) and the OS (76.8% vs. 68.3%; P=0.2772) rates. CONCLUSIONS: This study suggests that examining a greater number of lymph nodes increases the likelihood of accurate nodal staging and that a minimum of ten LNs per surgical specimen should be harvested and examined to label a pT3 or pT4 CRC as node-negative.
Colorectal Neoplasms* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Neoplasm Metastasis ; Prognosis

Lymphatic malformations in cases with macrocystic lesions can be treated with surgical excision or sclerotherapy using alcohol, bleomycin, doxycycline, or OK-432. We report a case of a 24-year-old woman who underwent percutaneous drainage and povidone-iodine sclerotherapy as primary treatment for cervical lymphatic malformation. The patient underwent povidone-iodine sclerotherapy for 3 consecutive days. After 8 months, ultrasonography of the lesion in the neck revealed complete resolution of the cervical lymphatic malformation without any complication. Povidone-iodine sclerotherapy can be a safe and cost-effective treatment option for cervical lymphatic malformation.
Bleomycin ; Doxycycline ; Drainage* ; Female ; Humans ; Neck ; Picibanil ; Povidone-Iodine* ; Sclerotherapy* ; Ultrasonography ; Young Adult