OBJECTIVES: This paper proposes a measurement method to quantify the abnormal characteristics of the broken parts of ribs using local texture and shape features in chest radiographs. METHODS: Our measurement method comprises two steps: a measurement area assignment and sampling step using a spline curve and sampling lines orthogonal to the spline curve, and a fracture-ness measurement step with three measures, asymmetry and gray-level co-occurrence matrix based measures (contrast and homogeneity). They were designed to quantify the regional shape and texture features of ribs along the centerline. The discriminating ability of our method was evaluated through region of interest (ROI) analysis and rib fracture classification test using support vector machine. RESULTS: The statistically significant difference was found between the measured values from fracture and normal ROIs; asymmetry (p < 0.0001), contrast (p < 0.001), and homogeneity (p = 0.022). The rib fracture classifier, trained with the measured values in ROI analysis, detected every rib fracture from chest radiographs used for ROI analysis, but it also classified some unbroken parts of ribs as abnormal parts (8 to 17 line sets; length of each line set, 2.998 +/- 2.652 mm; length of centerlines, 131.067 +/- 29.460 mm). CONCLUSIONS: Our measurement method, which includes a flexible measurement technique for the curved shape of ribs and the proposed shape and texture measures, could discriminate the suspicious regions of ribs for possible rib fractures in chest radiographs.
Decision Support Techniques ; Rib Fractures ; Ribs ; Thorax

PURPOSE: Ischiofemoral impingement (IFI)-primarily diagnosed by magnetic resonance imaging (MRI)-is an easily overlooked disease due to its low incidence. The purpose of this study was to evaluate the usefulness of false profile view as a screening test for IFI. MATERIALS AND METHODS: Fifty-eight patients diagnosed with IFI between June 2013 and July 2017 were enrolled in this retrospective study. A control group (n=58) with matching propensity scores (age, gender, and body mass index) were also included. Ischiofemoral space (IFS) was measured as the shortest distance between the lateral cortex of the ischium and the medial cortex of lesser trochanter in weight bearing hip anteroposterior (AP) view and false profile view. MRI was used to measure IFS and quadratus femoris space (QFS). The receiver operating characteristics (ROC), area under the ROC curve (AUC) and cutoff point of the IFS were measured by false profile images, and the correlation between the IFS and QFS was analyzed using the MRI scans. RESULTS: In the false profile view and hip AP view, patients with IFI had significantly decreased IFS (P < 0.01). In the false profile view, ROC AUC (0.967) was higher than in the hip AP view (0.841). Cutoff value for differential diagnosis of IFI in the false profile view was 10.3 mm (sensitivity, 88.2%; specificity, 88.4%). IFS correlated with IFS (r=0.744) QFS (0.740) in MRI and IFS (0.621) in hip AP view (P < 0.01). CONCLUSION: IFS on false profile view can be used as a screening tool for potential IFI.
Area Under Curve ; Diagnosis, Differential ; Femur ; Hip ; Humans ; Incidence ; Ischium ; Magnetic Resonance Imaging ; Mass Screening ; Propensity Score ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Weight-Bearing

The prevalence of cheek lymphoma, especially a mucosa-associated lymphoid tissue lymphoma (MALT), is very rare. Non-specific symptoms and image findings of cheek lymphoma may mimic benign entities and make it difficult to diagnose. In this case report, we present a case of MALT lymphoma of the cheek mimicking benign entities on computed tomography and magnetic resonance imaging.

The prevalence of cheek lymphoma, especially a mucosa-associated lymphoid tissue lymphoma (MALT), is very rare. Non-specific symptoms and image findings of cheek lymphoma may mimic benign entities and make it difficult to diagnose. In this case report, we present a case of MALT lymphoma of the cheek mimicking benign entities on computed tomography and magnetic resonance imaging.

Objective: Patients are taken to the emergency department (ED) via a variety of transport systems. Proper ambulance use is important for improving patients’ transport quality and using limited resources allotted by the system effectively. Korea is a country with a well-developed public ambulance system established by the government. Therefore, this study was conducted to analyze the overuse or underuse of the ambulance system by patients who visited the ED. Methods: This study was conducted at the ED in three hospitals. A total of 459,647 patients visited these EDs over the three-year study period from 2016 to 2018. Medical records were investigated retrospectively. The study subjects were divided into three groups based on their triage score and ambulance use. Patients were classified into adequacy (Korean Triage and Acuity Scale [KTAS] 1-3, ambulance use or KTAS 4-5, non-ambulance use), underuse (KTAS 1-3, non-ambulance use) and overuse (KTAS 4-5, ambulance use) groups. Results: The mean age of patients was 46.7±26.0 years, and 237,118 (51.6%) were male. The adequacy group included 269,046 patients (58.5% of the patients). The underuse group had 162,575 patients (35.4%), and the overuse group included 328,026 patients (6.1%). Despite having KTAS level 1 or 2, the number of patients who did not use an ambulance was 14,792. Ambulances were used by 5,154 patients at KTAS 5 level. Conclusion Many patients use ambulances appropriately, but overuse and underuse of ambulances can still be observed. Guidelines on ambulance use are necessary for the efficient use of emergency medical resources and the safety of patients.

Thyroid surgery, characterized by its high risk due to the vascular nature of the thyroid gland, often leads to significant postoperative bleeding. This study assesses the efficacy of using drains to prevent complications such as hematomas, seromas, and bleeding, and their impact on infection rates and hospitalization duration post-thyroidectomy. Following the PRISMA guidelines, a systematic search was conducted across PubMed, Embase, and the Cochrane Library, including randomized controlled trials and published prospective studies on patients undergoing thyroidectomy by November 15, 2023. The analysis focused on postoperative complications and the length of hospital stay as primary outcomes. Thirty-five studies with 4283 participants (2162 with drains and 2121 without) were analyzed. The meta-analysis showed no significant reduction in hematomas, bleeding, or seroma formation in the drain group. However, drain usage was correlated with a higher infection rate (odds ratio 3.31; 95% confidence interval [CI] 1.92-5.70, p<0.001) and longer hospital stays (mean difference=1.38 days, 95% CI 1.00-1.76, p<0.001). The employment of drains in thyroid surgery does not significantly impact the prevention of typical surgical complications but is linked to increased infection risks and extended hospitalization. These findings challenge the conventional practice of utilizing drains in thyroidectomy, highlighting the necessity for a tailored approach based on individual patient assessments.

Thyroid surgery, characterized by its high risk due to the vascular nature of the thyroid gland, often leads to significant postoperative bleeding. This study assesses the efficacy of using drains to prevent complications such as hematomas, seromas, and bleeding, and their impact on infection rates and hospitalization duration post-thyroidectomy. Following the PRISMA guidelines, a systematic search was conducted across PubMed, Embase, and the Cochrane Library, including randomized controlled trials and published prospective studies on patients undergoing thyroidectomy by November 15, 2023. The analysis focused on postoperative complications and the length of hospital stay as primary outcomes. Thirty-five studies with 4283 participants (2162 with drains and 2121 without) were analyzed. The meta-analysis showed no significant reduction in hematomas, bleeding, or seroma formation in the drain group. However, drain usage was correlated with a higher infection rate (odds ratio 3.31; 95% confidence interval [CI] 1.92-5.70, p<0.001) and longer hospital stays (mean difference=1.38 days, 95% CI 1.00-1.76, p<0.001). The employment of drains in thyroid surgery does not significantly impact the prevention of typical surgical complications but is linked to increased infection risks and extended hospitalization. These findings challenge the conventional practice of utilizing drains in thyroidectomy, highlighting the necessity for a tailored approach based on individual patient assessments.

Thyroid surgery, characterized by its high risk due to the vascular nature of the thyroid gland, often leads to significant postoperative bleeding. This study assesses the efficacy of using drains to prevent complications such as hematomas, seromas, and bleeding, and their impact on infection rates and hospitalization duration post-thyroidectomy. Following the PRISMA guidelines, a systematic search was conducted across PubMed, Embase, and the Cochrane Library, including randomized controlled trials and published prospective studies on patients undergoing thyroidectomy by November 15, 2023. The analysis focused on postoperative complications and the length of hospital stay as primary outcomes. Thirty-five studies with 4283 participants (2162 with drains and 2121 without) were analyzed. The meta-analysis showed no significant reduction in hematomas, bleeding, or seroma formation in the drain group. However, drain usage was correlated with a higher infection rate (odds ratio 3.31; 95% confidence interval [CI] 1.92-5.70, p<0.001) and longer hospital stays (mean difference=1.38 days, 95% CI 1.00-1.76, p<0.001). The employment of drains in thyroid surgery does not significantly impact the prevention of typical surgical complications but is linked to increased infection risks and extended hospitalization. These findings challenge the conventional practice of utilizing drains in thyroidectomy, highlighting the necessity for a tailored approach based on individual patient assessments.

Thyroid surgery, characterized by its high risk due to the vascular nature of the thyroid gland, often leads to significant postoperative bleeding. This study assesses the efficacy of using drains to prevent complications such as hematomas, seromas, and bleeding, and their impact on infection rates and hospitalization duration post-thyroidectomy. Following the PRISMA guidelines, a systematic search was conducted across PubMed, Embase, and the Cochrane Library, including randomized controlled trials and published prospective studies on patients undergoing thyroidectomy by November 15, 2023. The analysis focused on postoperative complications and the length of hospital stay as primary outcomes. Thirty-five studies with 4283 participants (2162 with drains and 2121 without) were analyzed. The meta-analysis showed no significant reduction in hematomas, bleeding, or seroma formation in the drain group. However, drain usage was correlated with a higher infection rate (odds ratio 3.31; 95% confidence interval [CI] 1.92-5.70, p<0.001) and longer hospital stays (mean difference=1.38 days, 95% CI 1.00-1.76, p<0.001). The employment of drains in thyroid surgery does not significantly impact the prevention of typical surgical complications but is linked to increased infection risks and extended hospitalization. These findings challenge the conventional practice of utilizing drains in thyroidectomy, highlighting the necessity for a tailored approach based on individual patient assessments.

Thyroid surgery, characterized by its high risk due to the vascular nature of the thyroid gland, often leads to significant postoperative bleeding. This study assesses the efficacy of using drains to prevent complications such as hematomas, seromas, and bleeding, and their impact on infection rates and hospitalization duration post-thyroidectomy. Following the PRISMA guidelines, a systematic search was conducted across PubMed, Embase, and the Cochrane Library, including randomized controlled trials and published prospective studies on patients undergoing thyroidectomy by November 15, 2023. The analysis focused on postoperative complications and the length of hospital stay as primary outcomes. Thirty-five studies with 4283 participants (2162 with drains and 2121 without) were analyzed. The meta-analysis showed no significant reduction in hematomas, bleeding, or seroma formation in the drain group. However, drain usage was correlated with a higher infection rate (odds ratio 3.31; 95% confidence interval [CI] 1.92-5.70, p<0.001) and longer hospital stays (mean difference=1.38 days, 95% CI 1.00-1.76, p<0.001). The employment of drains in thyroid surgery does not significantly impact the prevention of typical surgical complications but is linked to increased infection risks and extended hospitalization. These findings challenge the conventional practice of utilizing drains in thyroidectomy, highlighting the necessity for a tailored approach based on individual patient assessments.