Purpose: To overcome the difficulty in building a large data set with a high-quality in medical imaging, a concept of 'blended-transfer learning' (BTL) using a combination of both source data and target data is proposed for the target task. Materials and Methods: Source and target tasks were defined as training of the source and target networks to reconstruct cardiac CINE images from undersampled data, respectively. In transfer learning (TL), the entire neural network (NN) or some parts of the NN after conducting a source task using an open data set was adopted in the target network as the initial network to improve the learning speed and the performance of the target task. Using BTL, an NN effectively learned the target data while preserving knowledge from the source data to the maximum extent possible. The ratio of the source data to the target data was reduced stepwise from 1 in the initial stage to 0 in the final stage. Results: NN that performed BTL showed an improved performance compared to those that performed TL or standalone learning (SL). Generalization of NN was also better achieved. The learning curve was evaluated using normalized mean square error (NMSE) of reconstructed images for both target data and source data. BTL reduced the learning time by 1.25 to 100 times and provided better image quality. Its NMSE was 3% to 8% lower than with SL. Conclusion The NN that performed the proposed BTL showed the best performance in terms of learning speed and learning curve. It also showed the highest reconstructed-image quality with the lowest NMSE for the test data set. Thus, BTL is an effective way of learning for NNs in the medical-imaging domain where both quality and quantity of data are always limited.

Purpose: To overcome the difficulty in building a large data set with a high-quality in medical imaging, a concept of 'blended-transfer learning' (BTL) using a combination of both source data and target data is proposed for the target task. Materials and Methods: Source and target tasks were defined as training of the source and target networks to reconstruct cardiac CINE images from undersampled data, respectively. In transfer learning (TL), the entire neural network (NN) or some parts of the NN after conducting a source task using an open data set was adopted in the target network as the initial network to improve the learning speed and the performance of the target task. Using BTL, an NN effectively learned the target data while preserving knowledge from the source data to the maximum extent possible. The ratio of the source data to the target data was reduced stepwise from 1 in the initial stage to 0 in the final stage. Results: NN that performed BTL showed an improved performance compared to those that performed TL or standalone learning (SL). Generalization of NN was also better achieved. The learning curve was evaluated using normalized mean square error (NMSE) of reconstructed images for both target data and source data. BTL reduced the learning time by 1.25 to 100 times and provided better image quality. Its NMSE was 3% to 8% lower than with SL. Conclusion The NN that performed the proposed BTL showed the best performance in terms of learning speed and learning curve. It also showed the highest reconstructed-image quality with the lowest NMSE for the test data set. Thus, BTL is an effective way of learning for NNs in the medical-imaging domain where both quality and quantity of data are always limited.

BACKGROUND AND OBJECTIVES: Endoscopically guided middle meatal culture is recommended to determine organ-specific antibiotic therapy in sinusitis. This study was designed to decrease the chance of contamination in endoscopically guided middle meatal swab through a shielded pathway using a sterile straw to bypass the contaminated area in the nose from the vestibule to the middle meatus. SUBJECTS AND METHOD: Seventeen healthy volunteers underwent endoscopically guided middle meatal culture. With or without the sterilization of the nasal vestibule, endoscopically guided middle meatal culture was performed by using a sterile cotton swab (routine swab) and using a sterile cotton swab through a sterile straw (shielded swab). We compared the contamination rates between the routine swab versus shielded swab. RESULTS: With and without the sterilization of the nasal vestibule, the contamination rates of the routine swab was 11.7% and 64.7%, respectively and the contamination rates of the shielded swab was 5.8% in both. CONCLUSION: In endoscopically guided middle meatal culture, the contamination rates was significantly decreased by using the shielded swab without sterilization of the nasal vestibule. This study suggests that the shielded swab is a new and reliable swab method that can be used easily and simply at the office.
Nose ; Sinusitis ; Sterilization

Anomalous systemic arterial supply to the normal basal segments with normal bronchial connection of the lung without sequestration is a rare anomaly. It was classified as a type of sequestration according to Pryce's terminology, but whether the term - one of the sequestration is appropriate or not, is controversial because of normal bronchial connection. We describe our experience with surgical treatments for anomalous arterial supply to the normal basal segments of the left lower lobe.
Lung ; Pulmonary Artery

Calcific constrictive pericarditis is considered to be a nonspecific response to chronic inflammation. This disease has become rare, because the cause of it is usually tuberculosis, which has the tendency to decrease. Other possible causes of it include radiation, rheumatoid disorders, sarcoidosis, and trauma. Whatever the etiology, it can lead to cardiac tamponade by reducing cardiac diastolic filling. We report, herein, the case of a patient with heart failure by a calcific pericardial ring.
Cardiac Tamponade ; Heart Failure* ; Heart* ; Humans ; Inflammation ; Pericarditis, Constrictive ; Sarcoidosis ; Tuberculosis

PURPOSE: To investigate the spontaneous closing time of PDA in term and preterm infants without respiratory distress syndrome. METHOD: For twenty four term and sixteen preterm infants without RDS, prespective echocardiography was performed within 24hr of birth, which was repeated everyday till spontaneous closure of ductus. At the same time, LA/Ao ratio in M-mode echocardiography and blood pressure were checked. RESULT: In term infants, spontaneous ductal closure rate was 15% in the first day of life, 57.7% in the second day, 88.5% in the third day, and 100% in the fourth day. For the preterm infants without RDS, the spontaneous ductal closure rate was 25%, 73.3%, 86.7%, 93.3% in each day. One preterm infant dided of meningitis at second day of life was excluded. One preterm infant (11,23 who had patent ductus arteiosus at fourth day of llife showed persistent ductus at 6 months of life. CONCLUSION: Spontaneous closure of patent ductus arteriosus will not occur if there is persistent shunt after 4th day of life in term and preterm infants without RDS.
Blood Pressure ; Ductus Arteriosus, Patent ; Echocardiography ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Meningitis ; Parturition

BACKGROUND AND OBJECTIVES: Mutations or overexpression of the p53 gene is believed to play an important role in the progression of various human malignant tumors. The type IV collagenase (matrix metalloproteinase: MMP) initiates the degradation of the extracellular matrix and consequently may play a role in the process of tumor invasion and metastasis. Although MMPs are known to be expressed in a variety of tissues and molecular studies in malignant tumor have shown the high frequency of loss of heterozygosity (LOH) in some specific regions, the study on the MMPs expression along with LOH on p53 gene related to clinicopathological parameters in thyroid tumors is very rare. MATERIALS AND METHOD: In this study, we examined the MMP-2, MMP-9 and tissue inhibitor of metalloproteinase (TIMP) -2 expression in association with p53 gene LOH using immunohistochemical method and molecular polymorphic analysis in 100 cases of thyroid tumors (50 papillary carcinomas, 10 follicular carcinomas, 20 follicular adenomas, 20 nodular hyperplasias). LOH was examined at four p53 gene related microsatellite loci including TP53, D17S796, D17S5, D17S513. RESULTS: By immunohistochemistry, MMP-2 expression was detected in 37 (74%) papillary carcinomas, 4 (40%) follicular carcinomas, 5 (25%) follicular adenomas and 2 (10%) nodular hyperplasia cases. MMP-9 expression was detected in 35 (70%) papillary carcinomas, 4 (40%) follicular carcinomas, 4 (20%) follicular adenomas and 2 (10%) nodular hyperplasia cases. TIMP-2 expression was detected in 32 (64%) papillary carcinomas, 4 (40%) follicular carcinomas, 4 (20%) follicular adenomas and 1 (5%) nodular hyperplasia cases. By PCR-polymorphism study, p53 LOH was detected in 31 (62%) papillary carcinomas, 8 (80%) follicular carcinomas, 6 (30%) follicular adenomas and 0 (0%) nodular hyperplasia cases. The differences in MMP-2, MMP-9 and TIMP-2 expression rates and p53 LOH between malignant and benign tumors were statistically significant. Also, MMP-2, MMP-9, TIMP-2 expression and p53 LOH correlated well with higher tumor histologic grade. Also statistically significant correlation was found between p53 LOH and lymph node metastasis. The MMP-2 expression showed increased tendency of lymphatic emboli formation and lymph node metastasis, but there was not statistically significant. MMP-2 expression was well correlated with MMP-9 expression and p53 LOH, but there is no remarkable correlation of expression of MMP-2 and MMP-9 comparable to TIMP-2 expression. CONCLUSION: We concluded that the expression of MMP-2, MMP-9 and TIMP-2 with p53 LOH may contribute to the malignant transformation and poorly differentiated grade in thyroid tumors. Also, MMP-2 expression may be regulated by p53 gene.
Adenoma ; Carcinoma, Papillary ; Collagenases ; Extracellular Matrix ; Genes, p53* ; Humans ; Hyperplasia ; Immunohistochemistry ; Loss of Heterozygosity ; Lymph Nodes ; Matrix Metalloproteinases ; Microsatellite Repeats ; Neoplasm Metastasis ; Thyroid Gland* ; Thyroid Neoplasms ; Tissue Inhibitor of Metalloproteinase-2*

Neurilemmomas are benign tumors that arise from the nerve sheath. Facial nerve neurilemmomas are uncommon, slow-growing neoplasms that occur anywhere along the course of the facial nerve. The majority of facial nerve neurilemmomas are intratemporal, with a few cases arising from the intraparotid portion. The clinical presentations are generally insidious and the nature of the disease depends on the location and extent of the tumor. They are difficult to diagnose preoperatively and are frequently misdiagnosed because of the variety of their clinical manifestations. Therefore, early and correct diagnosis and evaluation are necessary. Recently, we experienced two cases of facial nerve neurilemmoma with relatively good surgical result, involving the mastoid segment of the facial nerve and the main trunk of the facial nerve in the parotid gland. We reviewed the diagnosis, pathology, and treatement of this case, and report the cases with reviews of literature.
Diagnosis ; Facial Nerve* ; Mastoid ; Neurilemmoma* ; Parotid Gland ; Pathology

BACKGROUND AND OBJECTIVES: It has been suggested that the combination of a leukotriene receptor antagonist with an antihistamine may have beneficial effects in the treatment of allergic rhinitis. The aim of this study were to evaluate the effects of combining a leukotriene receptor antagonist, pranlukast, and an antihistamine, cetirizine, to treat nasal symptoms of allergic rhinitis and the quality of life of the patients. SUBJECTS AND METHOD: Thirty-three patients with allergic rhinitis were enrolled in this study. The control group (n=12) received 5 mg cetirizine plus 120 mg pseudoephedrine twice a day while the study group (n=21) received 5 mg cetirizine plus 225 mg pranlukast twice a day. Patients completed a daily symptom-score list for nasal obstruction, rhinorrhea, sneezing, nasal itching during the 7-day treatment period. They also answered the quality of life questionnaire before and after the completion of 7-day treatment. RESULTS: There were significant improvements in the nasal symptoms after the treatment in the control and the study group. However, there was no significant difference between the control and the study group on the improvement of nasal symptom-scores except for the rhinorrhea symptom-score. There were significant improvements in the quality of life domain after the treatment in the control group and the study group. However, there was no significant difference between the control and the study group on the improvement in quality of life domain except for activity limitations. CONCLUSION: A combination of pranlukast and cetirizine is as effective as a combination of pseudoephedrine and cetirizine in treating allergic rhinitis. Therefore, a combination of pranlukast and cetirizine may be another therapeutic alternative for allergic rhinitis patients who are not tolerable of pseudoephedrine.
Cetirizine* ; Histamine Antagonists ; Humans ; Hypersensitivity ; Leukotrienes ; Nasal Obstruction ; Pruritus ; Pseudoephedrine ; Quality of Life ; Surveys and Questionnaires ; Receptors, Leukotriene ; Rhinitis* ; Sneezing

BACKGROUND AND OBJECTIVES: The tympanosclerosis is an abnormal deposits of collagen materials on the lamina propria of the tympanic membrane or the middle ear mucosa. It usually appears as a whitish plaque on the tympanic membrane through otoscopic examination. The etiology of tympanosclerosis is not known, but there are some theories that attempt to explain the pathogenesis. The aim of this study is to understand the pathogenesis of tympanosclerosis and to find out the methods to minimize the occurrence of tympanosclerosis after ventilation tube insertion. MATERIALS AND METHODS: Otoscopic examination, impedance and pure tone audiometry were performed on 190 patients (306 ears) with serous otitis media, and on those who have undertaken ventilaton tube insertion from 1990 to 1998 at the otolaryngology department in Hanyang University Hospital. Then, the patients' medical and operative records were reviewed and analyzed in view of location and pathogenesis of tympanosclerosis. RESULTS: Incidence rate of tympanosclerosis was 42.5% in non-cleft patients and 61.9% in congenital cleft and palate patients. The rate increased when larger and heavier tube was used and the middle ear fluid was highly viscous. Most common sites for the development of tympanosclerosis were in the posteroinferior and anteroinferior portions of the tympanic membrane. Tympanosclerosis had little effect on hearing but in severe cases, it caused mild degree of hearing loss. CONCLUSION: We consider that tympanosclerosis is an inevitable result of ventilation tube insertion and its pathogenesis is multifactorial. We found that we can minimize the occurrence of tympanosclerosis by using small and light ventilation tubes, and avoid intraoperative bleeding and minimal mechanical trauma on the tympanic membrane by aspiring the middle ear fluid.
Audiometry ; Collagen ; Ear, Middle ; Electric Impedance ; Hearing ; Hearing Loss ; Hemorrhage ; Humans ; Incidence ; Mucous Membrane ; Myringosclerosis* ; Otitis Media with Effusion ; Otolaryngology ; Palate ; Tympanic Membrane ; Ventilation*