TISNet-Enhanced Fully Convolutional Network with Encoder-Decoder Structure for Tongue Image Segmentation in Traditional Chinese Medicine.

Extracting the tongue body accurately from a digital tongue image is a challenge for automated tongue diagnoses, as the blurred edge of the tongue body, interference of pathological details, and the huge difference in the size and shape of the tongue. In this study, an automated tongue image segmentation method using enhanced fully convolutional network with encoder-decoder structure was presented. In the frame of the proposed network, the deep residual network was adopted as an encoder to obtain dense feature maps, and a Receptive Field Block was assembled behind the encoder. Receptive Field Block can capture adequate global contextual prior because of its structure of the multibranch convolution layers with varying kernels. Moreover, the Feature Pyramid Network was used as a decoder to fuse multiscale feature maps for gathering sufficient positional information to recover the clear contour of the tongue body. The quantitative evaluation of the segmentation results of 300 tongue images from the SIPL-tongue dataset showed that the average Hausdorff Distance, average Symmetric Mean Absolute Surface Distance, average Dice Similarity Coefficient, average precision, average sensitivity, and average specificity were 11.2963, 3.4737, 97.26%, 95.66%, 98.97%, and 98.68%, respectively. The proposed method achieved the best performance compared with the other four deep-learning-based segmentation methods (including SegNet, FCN, PSPNet, and DeepLab v3+). There were also similar results on the HIT-tongue dataset. The experimental results demonstrated that the proposed method can achieve accurate tongue image segmentation and meet the practical requirements of automated tongue diagnoses.

Tongue diagnosis indices for gastroesophageal reflux disease: A cross-sectional, case-controlled observational study.

Traditional Chinese medicine tongue diagnosis can mirror the status of the internal organ, but evidence is lacking regarding the accuracy of tongue diagnosis to gastroesophageal reflux disease (GERD). This study was to investigate the association between GERD and tongue manifestation, and whether tongue imaging could be initial diagnosis of GERD noninvasively.We conducted a cross-sectional, case-controlled observational study at Kaohsiung Chang Gung Memorial Hospital in Taiwan from January 2016 to September 2017. Participants aged over 20 years old with GERD were enrolled and control group without GERD were matched by sex. Tongue imaging were acquired with automatic tongue diagnosis system, then followed by endoscope examination. Nine tongue features were extracted, and a receiver operating characteristic (ROC) curve, analysis of variance, and logistic regression were used.Each group enrolled 67 participants. We found that the saliva amount (P = .009) and thickness of the tongue's fur (P = .036), especially that in the spleen-stomach area (%) (P = .029), were significantly greater in patients with GERD than in those without. The areas under the ROC curve of the amount of saliva and tongue fur in the spleen-stomach area (%) were 0.606 ±â€Š0.049 and 0.615 ±â€Š0.050, respectively. Additionally, as the value of the amount of saliva and tongue fur in the spleen-stomach area (%) increased, the risk of GERD rose by 3.621 and 1.019 times, respectively. The tongue fur in the spleen-stomach area (%) related to severity of GERD from grade 0 to greater than grade B were 51.67 ±â€Š18.72, 58.10 ±â€Š24.60, and 67.29 ±â€Š24.84, respectively.The amount of saliva and tongue fur in the spleen-stomach area (%) might predict the risk and severity of GERD and might be noninvasive indicators of GERD. Further large-scale, multi-center, randomized investigations are needed to confirm the results.Trial registration: NCT03258216, registered August 23, 2017.

940-nm Diode Laser-Assisted Management of Tongue Abscess.

The tongue is a muscular organ with a rich blood supply and acts as an immune defence mechanism. The occurrence of a tongue abscess without immune deficiency is rare. The purpose of this report is to present the case of an eight-year-old boy with a spherical, pinkish-yellow, fluctuant, nontender swelling measuring two cm in diameter on the right anterolateral border of the tongue, causing difficulty in swallowing and speaking. Ultrasonography was performed, followed by a 940-nm diode laser-assisted incision and drainage under local anesthesia. Healing was uneventful, with no recurrence for two years now. A tongue abscess can be life-threatening due to its ability to cause respiratory obstruction. The diode laser can be a safe and effective tool for its management.

Familial occurrence of congenital hypothyroidism due to lingual thyroid gland.

Two sisters who presented with midline neck masses proved to be biochemically hypothyroid. Thyroid scintigraphy supplemented with perchlorate discharge testing showed lingual thyroid glands and ruled out the expected autosomal recessive organification defect. The related literature is reviewed.