Scale-attentional U-Net for the segmentation of the median nerve in ultrasound images

Purpose@#The aim of this study was to develop a neural network that accurately and effectively segments the median nerve in ultrasound (US) images. @*Methods@#In total, 1,305 images of the median nerve of 123 normal subjects were used to train and evaluate the model. Four datasets from two measurement regions (wrist and forearm) of the nerve and two US machines were used. The neural network was designed for high accuracy by combining information at multiple scales, as well as for high efficiency to prevent overfitting. The model was designed in two parts (cascaded and factorized convolutions), followed by selfattention over scale and channel features. The precision, recall, dice similarity coefficient (DSC), and Hausdorff distance (HD) were used as performance metrics. The area under the receiver operating characteristic curve (AUC) was also assessed. @*Results@#In the wrist datasets, the proposed network achieved 92.7% and 90.3% precision, 92.4% and 89.8% recall, DSCs of 92.3% and 89.7%, HDs of 5.158 and 4.966, and AUCs of 0.9755 and 0.9399 on two machines. In the forearm datasets, 79.3% and 87.8% precision, 76.0% and 85.0% recall, DSCs of 76.1% and 85.8%, HDs of 5.206 and 4.527, and AUCs of 0.8846 and 0.9150 were achieved. In all datasets, the model developed herein achieved better performance in terms of DSC than previous U-Net-based systems. @*Conclusion@#The proposed neural network yields accurate segmentation results to assist clinicians in identifying the median nerve.

A Case of Kimura’s Disease Without Eosinophilia / 대한두경부종양학회지

Kimura's disease is a rare disease of unknown etiology, commonly presenting with slow-growing head and neck subcutaneous nodules. It primarily involves the head and neck region, presenting as deep subcutaneous masses and is often accompanied by regional lymphadenopathy and salivary gland involvement. Clinically it is often confused with a parotid tumor or lymph node metastasis. It is difficult to diagnose before surgery, and fine needle aspiration cytology has only limited value. Even though this disease has not shown any malignant transformation, it is often difficult to cope with because of its high recurrence rate. Surgery, steroids, and radiotherapy have been used widely as the first-line recommendation, but none of them is standard procedure until now because of high recurrence rates. The recurrence of the disease reported up to 62%. We recently experienced a case of Kimura's disease, not accompanying peripheral eosinophilia, on the parotid gland treated by surgical resection in an 82-year-old woman with polycythemia vera. Here, we report this case with a review of the literature.

A Case of Kimura’s Disease Without Eosinophilia / 대한두경부종양학회지

Kimura's disease is a rare disease of unknown etiology, commonly presenting with slow-growing head and neck subcutaneous nodules. It primarily involves the head and neck region, presenting as deep subcutaneous masses and is often accompanied by regional lymphadenopathy and salivary gland involvement. Clinically it is often confused with a parotid tumor or lymph node metastasis. It is difficult to diagnose before surgery, and fine needle aspiration cytology has only limited value. Even though this disease has not shown any malignant transformation, it is often difficult to cope with because of its high recurrence rate. Surgery, steroids, and radiotherapy have been used widely as the first-line recommendation, but none of them is standard procedure until now because of high recurrence rates. The recurrence of the disease reported up to 62%. We recently experienced a case of Kimura's disease, not accompanying peripheral eosinophilia, on the parotid gland treated by surgical resection in an 82-year-old woman with polycythemia vera. Here, we report this case with a review of the literature.

Public Safety Communication and Networking Technologies for Disaster Response and Medical Assistance / 한양의대학술지

Future major disasters require the development of socially transparent and rational-decision-making procedures. Recent reports indicate that the frequency of human disasters are decreasing while natural disasters and social disasters are becoming more frequent. The creation of a disaster communication network, which is essential in protecting the life and property as well as providing a sense of societal security. Standards for a modern disaster communication network must be developed at the national level, with national state support for a 3rd generation partnership project such as a Public Safety-LTE that allows the construction of an effective national disaster network plan. Compliance and certification standards to ensure interoperability of communications and other equipment are necessary for the creation of a modern national disaster network that allows more efficient management of disaster situations. It can be expected that our efforts and example can help other countries to build a standard protocol for managing the national disasters.

Effect of Shock Wave Therapy on Upper Limb Spasticity in Chronic Stroke

OBJECTIVE: To investigate the effect and optimal therapeutic frequency of extracorporeal shock wave therapy (ESWT) on upper limb spasticity in chronic stroke patients. METHOD: Total 16 patients with chronic stroke were evaluated. Patients were divided into 2 groups, one group applied with 4 Hz stimulation, and the other group applied with 8 Hz stimulation. All patients were applied with sham stimulation (0 mj/cm2) at the initial time and with active stimulation (0.030 mj/cm2) 4 weeks later. Target muscles were dorsal interossei and flexor digitorum profundus. The primary outcome was the finger flexor spasticity using the modified Ashworth scale (MAS), which was serially measured before, after 1 week and after 4 week respectively. RESULTS: Before the study, the MAS of 4 Hz group was 3.90±0.87 and 8 Hz group was 3.89±0.93, which showed no significant difference. After 1 week of active stimulation, the MAS of 4 Hz group (2.90±0.81) was significantly smaller than the MAS of 8 Hz group (3.33±0.88). Treatment effects had been continued to 4 weeks. There were no complications associated with ESWT. CONCLUSION: ESWT could be used to reduce spasticity of the upper limb muscles in chronic stroke patients.

Chemical inhibitors destabilize HuR binding to the AU-rich element of TNF-alpha mRNA

Hu protein R (HuR) binds to the AU-rich element (ARE) in the 3'UTR to stabilize TNF-alpha mRNA. Here, we identified chemical inhibitors of the interaction between HuR and the ARE of TNF-alpha mRNA using RNA electrophoretic mobility gel shift assay (EMSA) and filter binding assay. Of 179 chemicals screened, we identified three with a half-maximal inhibitory concentration (IC(50)) below 10 micrometer. The IC(50) of quercetin, b-40, and b-41 were 1.4, 0.38, and 6.21 micrometer, respectively, for binding of HuR protein to TNF-alpha mRNA. Quercetin and b-40 did not inhibit binding of tristetraprolin to the ARE of TNF-alpha mRNA. When LPS-treated RAW264.7 cells were treated with quercetin and b-40, we observed decreased stability of TNF-alpha mRNA and decreased levels of secreted TNF-alpha. From these results, we could find inhibitors for the TNF-alpha mRNA stability, which might be used advantageously for both the study for post-transcriptional regulation and the discovery of new anti-inflammation drugs.