Purpose: The present study aimed to develop 2 deep learning (DL) systems incorporating detection functions for the diagnosis of carotid artery calcifications (CACs) on panoramic radiographs and to compare their diagnostic performances using CAC-based, side-based, and patient-based evaluations. Materials and Methods: Panoramic radiographs from 290 patients with CACs and 290 control patients without CACs were used to develop 2 detection models: one designed to detect individual CACs across the entire radiograph (System 1) and another designed to detect CACs within the limited bilateral cervical areas (System 2). CAC-based performance was evaluated using recall, precision, and F1-score. Side-based and patient-based performances were assessed usingsensitivity, specificity, positive predictive value, negative predictive value, accuracy, and the area under the receiveroperating characteristic curve (AUC). Results: For System 1, CAC-based recall, precision, and F1-score were 0.81, 0.68, and 0.74, respectively. For System 2,the corresponding values were 0.90, 0.67, and 0.77. Side-based sensitivity, specificity, and AUC were 0.87, 0.80, and 0.83 for System 1, and 0.93, 0.84, and 0.89 for System 2. Patient-based sensitivity, specificity, and AUC were 0.93, 0.73,and 0.83 for System 1, and 0.95, 0.70, and 0.83 for System 2. Although a relatively large number of false positives were observed in CAC-based assessments, side-based and patient-based performances showed improvement. Conclusion Side-based and patient-based performances were sufficient when calculated on the basis of CAC-basedevaluations for diagnosing CACs on panoramic radiographs. When conducting studies of this type, performance assessments should include side-based and patient-based evaluations in addition to CAC-based analyses.

Background: In the era of nucleoside analogs (NA), we investigated the safety of using hepatitis B surface antigen (HBsAg)-positive grafts in liver transplantation (LT) using nationwide KOTRY data. Methods: Among 4,265 adult LTs in the KOTRY registry (April 2014–January 2020), 20 (0.5%) used HBsAg(+) grafts. The S(+) group was compared with HBsAg-nega-tive groups, both HBcAb(+) (C[+]) and HBcAb(−) (SC[−]), using 1:1 propensity scorematching. Patient and graft survival were evaluated using Kaplan–Meier analysis.Cox regression was used to identify prognostic factors. Results: No significant differences were observed in patient or graft survival be-tween S(+) and C(+) or SC(−) groups. Key prognostic factors for patient survivalincluded age, HCC, MELD score, ascites, and encephalopathy. For graft survival, HCC, preoperative HCC treatment, MELD score, ascites, and encephalopathy were significant. HBV recurrence occurred in the S(+) group, but did not compromise outcomes. Conclusion In HBV-endemic regions, HBsAg(+) liver grafts can be safely used to expand the donor pool without compromising LT outcomes when combined with appropriate prophylaxis.

Purpose: In this study, we aimed to classify an implant system by comparing the types of implant thread shapes shown on radiographs using various Convolutional Neural Networks (CNNs), particularly Xception, InceptionV3, ResNet50V2, and ResNet101V2. The accuracy of the CNN based on the implant site was compared. Materials and Methods: A total of 1000 radiographic images, consisting of eight types of implants, were preprocessed by resizing and CLAHE filtering, and then augmented. CNNs were trained and validated for implant thread shape prediction. Grad-CAM was used to visualize class activation maps (CAM) on the implant threads shown within the radiographic image. Results: Averaged over 10 validation folds, each model achieved an AUC of over 0.96: AUC of 0.961 (95% CI 0.952–0.970) with Xception, 0.973 (95% CI 0.966-0.980) with InceptionV3, 0.980 (95% CI 0.974-0.988) with ResNet50V2, and 0.983 (95% CI 0.975-0.992) with ResNet101V2. Accuracy was higher in the posterior region than in the anterior area in all four models. Most CAMs highlighted the implant surface where the threads were present; however, some showed responses in other areas. Conclusion The CNN models accurately classified implants in all areas of the oral cavity according to the thread shape, using radiographic images.

Purpose: In this study, we aimed to classify an implant system by comparing the types of implant thread shapes shown on radiographs using various Convolutional Neural Networks (CNNs), particularly Xception, InceptionV3, ResNet50V2, and ResNet101V2. The accuracy of the CNN based on the implant site was compared. Materials and Methods: A total of 1000 radiographic images, consisting of eight types of implants, were preprocessed by resizing and CLAHE filtering, and then augmented. CNNs were trained and validated for implant thread shape prediction. Grad-CAM was used to visualize class activation maps (CAM) on the implant threads shown within the radiographic image. Results: Averaged over 10 validation folds, each model achieved an AUC of over 0.96: AUC of 0.961 (95% CI 0.952–0.970) with Xception, 0.973 (95% CI 0.966-0.980) with InceptionV3, 0.980 (95% CI 0.974-0.988) with ResNet50V2, and 0.983 (95% CI 0.975-0.992) with ResNet101V2. Accuracy was higher in the posterior region than in the anterior area in all four models. Most CAMs highlighted the implant surface where the threads were present; however, some showed responses in other areas. Conclusion The CNN models accurately classified implants in all areas of the oral cavity according to the thread shape, using radiographic images.

Purpose: In this study, we aimed to classify an implant system by comparing the types of implant thread shapes shown on radiographs using various Convolutional Neural Networks (CNNs), particularly Xception, InceptionV3, ResNet50V2, and ResNet101V2. The accuracy of the CNN based on the implant site was compared. Materials and Methods: A total of 1000 radiographic images, consisting of eight types of implants, were preprocessed by resizing and CLAHE filtering, and then augmented. CNNs were trained and validated for implant thread shape prediction. Grad-CAM was used to visualize class activation maps (CAM) on the implant threads shown within the radiographic image. Results: Averaged over 10 validation folds, each model achieved an AUC of over 0.96: AUC of 0.961 (95% CI 0.952–0.970) with Xception, 0.973 (95% CI 0.966-0.980) with InceptionV3, 0.980 (95% CI 0.974-0.988) with ResNet50V2, and 0.983 (95% CI 0.975-0.992) with ResNet101V2. Accuracy was higher in the posterior region than in the anterior area in all four models. Most CAMs highlighted the implant surface where the threads were present; however, some showed responses in other areas. Conclusion The CNN models accurately classified implants in all areas of the oral cavity according to the thread shape, using radiographic images.

Background: Purse-string suture is a simple technique to reduce wound size and to achieve complete or partial closure of skin defects. Objective: To classify situations in which purse-string sutures can be utilized and to assess the long-term size reduction and cosmetic outcome of the final scar. Methods: Patients (93 from Severance hospital and 12 from Gangnam Severance hospital) in whom purse-string sutures were used between January 2015 and December 2019 were retrospectively reviewed. Wound site, final reconstruction method, repair duration, final wound size, and Vancouver scar scale were assessed. Results: A total of 105 patients were reviewed. Lesions were located on the trunk (48 [45.7%]), limbs (32 [30.5%]), and face (25 [23.8%]). Mean ratio of wound length/primary defect length was 0.79±0.30. Multilayered purse-string suture showed the shortest duration from excision to final repair (p<0.001) and most effectively minimized the scar size (scar to defect size ratio 0.67±0.23, p=0.002). The average Vancouver scar scale measured at the latest followup visit at least 6 months postoperatively was 1.62, and the risk of hypertrophic scarring was 8.6%. There was no significant difference in the Vancouver scar scale and the risk of hypertrophic scarring between the different surgical method groups. Conclusion Purse-string sutures can be utilized in many stages of reconstruction to effectively reduce scar size without compromising the final cosmetic outcome.

Background: Dental evaluation and protection are important for preventing traumatic dental injuries when patients are under general anesthesia. The objective of the present study was to develop a questionnaire based on dentition-related risk factors that could serve as a valuable tool for dental evaluation and documentation. Methods: We developed a questionnaire for dental evaluation before administration of general anesthesia, investigated the association between patient-and-dentist responses and mouthguard fabrication, and assessed response agreement between 100 patients. Results: Protective mouthguards were fabricated for 27 patients who were identified as having a high risk of dental injury. There was a strong association between dentists’ responses and mouthguard fabrication, depending on the general oral health status, use of ceramic prosthesis, presence of masticatory pain related to periodontal diseases, gingival edema, and implants (P < 0.05). Response agreement between patients and dentists for items related to dental pain, loss of dental pulp vitality, root canal therapy, dental trauma, aesthetic prosthesis, tooth mobility, and implant prosthesis was high (Cohen’s kappa coefficient κ ≥ 0.6). Conclusions A high agreement was observed between patient-dentist responses and a strong association with mouthguard fabrication for items pertaining to ceramic prosthesis, masticatory pain, and dental implants. Patients with a “yes” response to these items are recommended to undergo a dental evaluation and use a dental protective device while under general anesthesia.

Background: Pathological gambling is associated with several adverse outcomes, including depression, suicide, divorce, loss of employment, and debt. However, studies on the prevalence of pathological gambling are limited in South Korea. We assessed the prevalence of pathological gambling and its related factors. Methods: Data were obtained from 500 community-dwelling adults aged 20–59 years living in Jeju, Korea. This study assessed pathological/problem gambling using the Korean version of the Diagnostic Interview Schedule. We used the Patient Health Questionnaire-9 to obtain information about depression. Results: Lifetime prevalence rates of pathological gambling and problem gambling were 1.2% and 7.2%, respectively. The association between pathological/problem gambling and depression was highly significant (p<0.001). Multivariate analysis revealed significant relationships between men gender (odds ratio [OR], 2.62; 95% confidence interval [CI], 1.18–5.84; p=0.018) and depression (OR, 2.84; 95% CI, 1.42–5.68; p<0.001) and pathological/problem gambling. Conclusion Pathological/problem gambling is highly associated with depression, indicating that clinicians should carefully evaluate and treat depression among gamblers.

Background: Spine-hip discordance (SHD) increases fracture risk. However, its prevalence and clinical implications have not been investigated in patients with hip fractures. This study determined the prevalence and association of SHD with mortality and investigated the cause of SHD in patients with hip fractures. Methods: This study included patients admitted for fragility hip fractures between 2011 and 2020. All patients underwent dual energy X-ray absorptiometry and anteroposterior and lateral views of the lumbosacral spine during admission. Data on demographics, diagnosis, American Society of Anesthesiologists score, and mortality were collected. A T-score difference of more than 1.5 between L1-4 and the femur neck was considered discordant, and 3 groups (lumbar low [LL] discordance, no discordance [ND], and femur neck low [FL] discordance) were compared. In the discordance group, lumbar radiographs were reviewed to determine the cause of discordance. Results: Among 1,220 eligible patients, 130 were excluded due to patient refusal or bilateral hip implantation; therefore, this study included 1,090 patients (271 male and 819 female). The prevalence of LL, ND, and FL was 4.4%, 66.4% and 29.2% in men and 3.9%, 76.1%, and 20.0% women. Mortality was not associated with discordance. The most common causes of discordance were physiological in the LL group and pathological in the FL group for both sexes. Conclusions Patients with hip fractures showed lower rates of ND and higher rates of FL compared to the general population. True discordance should be carefully judged for pathological and artifact reasons. The clinical implications of SHD require further investigation.