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.

Background: Data illustrating the impact of atopic dermatitis (AD) on lives of adults with AD in South Korea are limited. Objective: To assess the AD disease severity and its impact on quality of life (QoL) in patients with AD from South Korea. Methods: Patients with AD utilizing the specialist dermatology services of major hospitals in South Korea were assessed for disease severity using Eczema Area and Severity Index (EASI) score, for QoL using Dermatology Life Quality Index (DLQI) (for QoL), and for comorbidities and treatment experience via retrospective review of 12-month medical records. Clinical and sociodemographic characteristics were also measured. Results: Of the 1,163 patients, 695 (59.8%) were men (mean age [years]±standard deviation: 31.6±12.1). Overall, 52.9% (n=615) patients had moderate-to-severe disease (EASI>7).The QoL of 72.3% (n=840) patients was affected moderately-to-severely (DLQI score: 6~30).Systemic immunosuppressants were used ≥1 over past 12 months in 51.9% (n=603) patients, and the most commonly used were cyclosporines (45.7%, n=531) and systemic corticosteroids (40.5%, n=471). Approximately, 10.8% (n=126) patients consulted or received treatment for AD-related eye problem. Of these, 40% (n=50) patients reported poor, very poor, or completely blind status; approximately, 16.7% patients (n=192) reported having depression or anxiety; and 35.5% (n=410) reported suicidal ideation or suicidal attempt. Conclusion A large proportion of patients had moderate-to-severe AD, a compromised QoL, and ocular or mental health comorbidities, indicating a high disease burden despite systemic treatment. These findings highlight the importance of a holistic approach for the evaluation and treatment of patients with AD.

An ectopic pancreas rarely transforms into a malignancy, and the symptoms vary from patient to patient. The most commonly observed site of an ectopic pancreas is the antrum of the stomach. A 59-year-old male patient with severe abdominal pain underwent CT. A 9.6 cm-sized well-defined exophytic huge mass with heterogenic density was located between the stomach distal antrum and duodenum. A malignant submucosal tumor was suspected because of the exophytic dirty huge mass. Initially, surgery was considered to confirm the histological evaluation. After 2 months, the abdominal pain disappeared, and the follow-up MRI scan showed a decrease in size, which contained a necrotic component inside. It was confirmed that the parenchymal tissue was the pancreas. The pathology through EUS-guided fine needle aspiration (EUS-FNA) was normal pancreatic acinar cells, smooth muscle fragments, squamous cyst, and some neutrophils (abscess). Walled-off necrosis occurs as a complication of acute pancreatitis with parenchymal tissues and surrounding tissues, but complications of ectopic pancreatitis occurred in this case. Abdominal pain due to ectopic pancreas leading to the formation of a giant abscess has been reported as a very rare case. Diagnosis through biopsy is most important when a malignant submucosal tumor is suspected. In addition, it is important to determine the clinical features, examination findings, such as EUS, CT, and MRI, and the changes according to the follow-up period. This paper reports a case of ectopic pancreas, resulting in necrotic tissue and walled-off necrosis, abdominal pain, and spontaneous improvement.