Purpose: Semantic segmentation is a fundamental part of the surgical application of deep learning. Traditionally, segmentation in vision tasks has been performed using convolutional neural networks (CNNs), but the transformer architecture has recently been introduced and widely investigated. We aimed to investigate the performance of deep learning models in segmentation in robot-assisted radical prostatectomy (RARP) and identify which of the architectures is superior for segmentation in robotic surgery. Materials and Methods: Intraoperative images during RARP were obtained. The dataset was randomly split into training and validation data. Segmentation of the surgical instruments, bladder, prostate, vas and seminal vesicle was performed using three CNN models (DeepLabv3, MANet, and U-Net++) and three transformers (SegFormer, BEiT, and DPT), and their performances were analyzed. Results: The overall segmentation performance during RARP varied across different model architectures. For the CNN models, DeepLabV3 achieved a mean Dice score of 0.938, MANet scored 0.944, and U-Net++ reached 0.930. For the transformer architectures, SegFormer attained a mean Dice score of 0.919, BEiT scored 0.916, and DPT achieved 0.940. The performance of CNN models was superior to that of transformer models in segmenting the prostate, vas, and seminal vesicle. Conclusions Deep learning models provided accurate segmentation of the surgical instruments and anatomical structures observed during RARP. Both CNN and transformer models showed reliable predictions in the segmentation task; however, CNN models may be more suitable than transformer models for organ segmentation and may be more applicable in unusual cases. Further research with large datasets is needed.

Full mouth rehabilitation is re-organizing the occlusion of the remaining teeth and missing teeth considering the functions, esthetics, and neuromuscular harmony. With the loss of multiple teeth, the patient’s occlusal plane gradually collapses and the vertical dimension can be reduced. Since reduced vertical dimension can be a potential etiology of the temporomandibular joint and masticatory muscles, prosthetic restoration with increased vertical dimension is required. This case report is about a 68 years old patient with vertical dimension loss due to worn dentition and multiple loss of teeth. In this case, the loss of vertical dimension is assessed carefully using the digital dentistry technology. Using CAD software in digital analysis step, the occlusal plane was established and evaluated using several criteria. Orienting the position of the bone and teeth using CBCT image, patient’s condition was visualized in 3 dimension and treatment planning was possible virtually. The information that matches the patient’s condylar position with the articulator, which is the virtual face bow, is reproduced on the actual articulator, and evaluated again. After the evaluation, provisional prosthesis was fabricated and it was confirmed that the patient adapts without any abnormality. This was implemented as a final prosthesis. As a result, the patient obtained satisfying results, utilizing the benefits of digital dentistry technology and traditional methods.

It is very difficult to achieve denture support, stability and retention in single-maxillary complete denture patients with flabby tissue. A 57-year-old male patient was uncomfortable with the existing denture and wanted treatment. The reduction of flabby tissue was confirmed using the treatment denture. Non-pressure impression was obtained using an intraoral scanner during the definitive denture process. This is reported because the resulting denture improved when observing the retention, support and stability of the denture during occlusion.

Purpose: The purpose of this study is to compare the shear bond strength of 3D printing denture base resin according to surface treatment of artificial teeth. Materials and methods: 3D printing denture base resin was fabricated as specimens using 3D printer. The experimental group divided the surface treatment of artificial teeth into five groups according to the application of sandblasting and primer (n=10). Shear bond strengths between denture base and artificial teeth were measured by universal testing machine. All measurements were analyzed by one-way ANOVA and Turkey test (α=.05). Fracture mode of each specimen was analyzed. Microscopic evaluation was conducted by using a scanning electron microscope. Results: Unsurfaced treated group represented the lowest value. The primer groups had significantly higher result values (P<.05). Most specimens of the primer groups had cohesive failure. Conclusion In 3D printing denture base resin group, mechanical and chemical surface treatment of artificial teeth has increased the shear bond strength. Therefore, if dentures are produced using 3D printing, proper mechanical and chemical treatment of artificial teeth is necessary for adhesion of dentures and artificial teeth.

Excessive tooth wear results in unacceptable damage to the occlusal surface and can cause pulpitis, occlusal disharmony, dysfunction, and unesthetic result. Patients with severe attrition have to be classified as several types relative to the vertical dimension of occlusion (VDO) and the interocclusal distance for the prosthetic space. The patient in this case was a 80 - year - old woman who lost support of posterior occlusion and collapsed of the occlusal plane due to confrontation of the opposing teeth, accompanied by an increase in the number of remaining bristles, resulting in a loss of intermaxillary space for prosthesis. In this case, treatment with increased vertical dimension may have stability if the increase in vertical occlusal height is minimized within the required range, and a stable occlusal contact is provided after an increased vertical occlusal height stabilization period. After the new VDO had been confirmed under interim fixed restorations, definitive fixed restorations were produced. Through these treatment processes, we obtain satisfactory results that are functional and aesthetically pleasing.
Dental Occlusion ; Dentition* ; Female ; Humans ; Prostheses and Implants ; Pulpitis ; Rehabilitation* ; Tooth ; Tooth Wear ; Vertical Dimension

BACKGROUND/AIMS: The aim of this study was to investigate the mortality, bleeding control rate, and their associated predictors in patients treated with Sengstaken-Blakemore (SB) tube for uncontrolled variceal hemorrhage associated with hemodynamic instability or failure of endoscopic treatment. METHODS: The clinical data of 66 consecutive patients with uncontrolled variceal hemorrhage treated with SB tube at Gyeongsang National University Hospital from October 2010 to October 2015 were retrospectively analyzed. RESULTS: The overall success rate of initial hemostasis with SB tube was 75.8%, and the independent factors associated with hemostasis were non-intubated state before SB tube (odds ratio, 8.50; p = 0.007) and Child-Pugh score < 11 (odds ratio, 15.65; p = 0.022). Rebleeding rate after successful initial hemostasis with SB tube was 22.0%, and esophageal rupture occurred in 6.1%. Mortality within 30 days was 42.4%, and the related independent factors with mortality were failure of initial hemostasis with SB tube (hazard ratio, 6.24; p < 0.001) and endotracheal intubation before SB tube (hazard ratio, 2.81; p = 0.018). CONCLUSIONS: Since the era of endoscopic band ligation, SB tube might be a beneficial option as a temporary salvage treatment for uncontrolled variceal hemorrhage. However, rescue therapy had a high incidence of fatal complication and rebleeding.
Hemodynamics ; Hemorrhage* ; Hemostasis ; Humans ; Incidence ; Intubation, Intratracheal ; Ligation ; Mortality ; Retrospective Studies ; Rupture ; Salvage Therapy

Many hospitals experience one or more retained surgical instrument events with risk of patient morbidity and medicolegal problems. Identification of retained surgical instrument is important. The radiologists should be familiar with imaging finding of retained surgical instrument. In a 62-year-old female with a retained plastic tube, localized peritoneal infiltration around air-containing tubular structure mimicked acute appendicitis on abdomen computed tomography (CT), one year after laparoscopic cholecystectomy. We reported CT findings of foreign body reaction related to retained Endoloop ligature plastic tube mimicking acute appendicitis.
Abdomen ; Appendicitis* ; Cholecystectomy, Laparoscopic ; Female ; Foreign Bodies* ; Foreign-Body Reaction* ; Humans ; Ligation* ; Middle Aged ; Peritonitis ; Plastics*

PURPOSE: We evaluated the prognostic significance of T3 subtypes and the role of adjuvant radiotherapy in patients with resected the American Joint Committee on Cancer stage IIB T3N0M0 non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: T3N0 NSCLC patients who underwent resection from January 1990 to October 2009 (n = 102) were enrolled and categorized into 6 subgroups according to the extent of invasion: parietal pleura chest wall invasion, mediastinal pleural invasion, diaphragm invasion, separated tumor nodules in the same lobe, endobronchial tumor <2 cm distal to the carina, and tumor-associated collapse. RESULTS: The median overall survival (OS) and disease-free survival (DFS) were 55.3 months and 51.2 months, respectively. In postoperative T3N0M0 patients, the tumor size was a significant prognostic factor for survival (OS, p = 0.035 and DFS, p = 0.035, respectively). Patients with endobronchial tumors within 2 cm of the carina also showed better OS and DFS than those in the other T3 subtypes (p = 0.018 and p = 0.016, respectively). However, adjuvant radiotherapy did not cause any improvement in survival (OS, p = 0.518 and DFS, p = 0.463, respectively). Only patients with mediastinal pleural invasion (n = 25) demonstrated improved OS and DFS after adjuvant radiotherapy (n = 18) (p = 0.012 and p = 0.040, respectively). CONCLUSION: The T3N0 NSCLC subtype that showed the most favorable prognosis is the one with endobronchial tumors within 2 cm of the carina. Adjuvant radiotherapy is not effective in improving survival outcome in resected T3N0 NSCLC.
Carcinoma, Non-Small-Cell Lung* ; Diaphragm ; Disease-Free Survival ; Humans ; Joints ; Pleura ; Prognosis ; Radiotherapy, Adjuvant* ; Thoracic Wall

Nerve compression syndromes commonly involve the nerves in the upper extremity. High-resolution ultrasonography (US) can satisfactorily assess these nerves and may detect the morphological changes of the nerves. US can also reveal the causes of nerve compression when structural abnormalities or space-occupying lesions are present. The most common US finding of compression neuropathy is nerve swelling proximal to the compression site. This article reviews the normal anatomic location and US appearances of the median, ulnar, and radial nerves. Common nerve compression syndromes in the upper extremity and their US findings are also reviewed.
Median Nerve ; Nerve Compression Syndromes* ; Radial Nerve ; Ulnar Nerve ; Ultrasonography* ; Upper Extremity*

OBJECTIVE: To evaluate magnetic resonance imaging (MRI) observer variability to detect ectopic insertion of the pectoralis minor tendon (EIPMT) and to investigate changes in the rotator interval in patients with EIPMT using MRI. MATERIALS AND METHODS: A total of 507 shoulder MRIs (male:female = 259:248; mean age, 55.4 years) were classified into 1) normal type insertion of the pectoralis minor tendon, 2) complete type EIPMT, and 3) partial type EIPMT independently by two radiologists. Inter-observer agreement was calculated using the kappa coefficient. Thickness of the fibrotic scar tissue in the subcoracoid triangle and humeral side axillary recess was measured. MRIs were reviewed by consensus with regard to the grade of fibrotic scar tissue proliferation in the rotator interval. Comparisons were made between normal and EIPMT and between partial and complete type EIPMT. RESULTS: The incidence of EIPMT was 13.4% (complete type, 7.7%; partial type, 5.7%). Inter-observer agreement was substantial (kappa = 0.775). Fibrotic scar tissue in the subcoracoid triangle was thicker, and the grade of fibrotic scar tissue proliferation in the rotator interval was higher in the EIPMT group than those in the control group. No significant difference was observed in the thickness of humeral side axillary recess. The thicknesses of fibrotic scar tissue in the subcoracoid triangle and humeral side axillary recess as well as the grade of fibrotic scar tissue in the rotator interval were not significantly different between complete and partial type EIPMT. CONCLUSION: MRI enabled detection of EIPMT with substantial observer agreement. Patients with EIPMT show a high tendency for fibrotic scar tissue proliferation in the rotator interval.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Rotator Cuff/pathology/*radiography ; Shoulder/pathology/radiography ; Tendons/pathology/*radiography ; Young Adult