Non-contact diagnosis of sleep breathing disorders using infrared optical gas imaging: a prospective observational study.

Full-night polysomnography (PSG) is the gold standard for diagnosing obstructive sleep apnea (OSA). However, PSG requires several sensors to be attached to the patient's body, which can interfere with sleep. Moreover, non-contact devices that utilize impulse radio ultra-wideband radar have limitations as they cannot directly measure respiratory airflow. This study aimed to detect respiratory events through infrared optical gas imaging and verify its feasibility for the diagnosis of OSA. Data collection through PSG and infrared optical gas imaging was simultaneously conducted on 50 volunteers. Respiratory airflow signal was extracted from the infrared optical gas images using an automated algorithm. We compared the respiratory parameters obtained from infrared optical gas imaging with those from PSG. All respiratory events scored from the infrared optical gas imaging were strongly correlated with those identified with standard PSG sensors. Based on a receiver operating characteristic curve, infrared optical gas imaging was deemed appropriate for the diagnosis of OSA. Infrared optical gas imaging accurately detected respiratory events during sleep; therefore, it may be employed as a screening tool for OSA.

Codeless Deep Learning of COVID-19 Chest X-Ray Image Dataset with KNIME Analytics Platform.

OBJECTIVES: This paper proposes a method for computer-assisted diagnosis of coronavirus disease 2019 (COVID-19) through chest X-ray imaging using a deep learning model without writing a single line of code using the Konstanz Information Miner (KNIME) analytics platform. METHODS: We obtained 155 samples of posteroanterior chest X-ray images from COVID-19 open dataset repositories to develop a classification model using a simple convolutional neural network (CNN). All of the images contained diagnostic information for COVID-19 and other diseases. The model would classify whether a patient was infected with COVID-19 or not. Eighty percent of the images were used for model training, and the rest were used for testing. The graphic user interface-based programming in the KNIME enabled class label annotation, data preprocessing, CNN model training and testing, performance evaluation, and so on. RESULTS: 1,000 epochs training were performed to test the simple CNN model. The lower and upper bounds of positive predictive value (precision), sensitivity (recall), specificity, and f-measure are 92.3% and 94.4%. Both bounds of the model's accuracies were equal to 93.5% and 96.6% of the area under the receiver operating characteristic curve for the test set. CONCLUSIONS: In this study, a researcher who does not have basic knowledge of python programming successfully performed deep learning analysis of chest x-ray image dataset using the KNIME independently. The KNIME will reduce the time spent and lower the threshold for deep learning research applied to healthcare.

Cochlear Implantation via the Transmeatal Approach in an Adolescent with Hunter Syndrome-Type II Mucopolysaccharidosis.

Type II mucopolysaccharidosis (MPS II) commonly known as Hunter syndrome, is a rare X-linked lysosomal storage disorder caused by iduronate-2-sulfatase deficiency, which in turn causes otorhinolaryngological manifestations, including sensorineural hearing loss (SNHL). Previously, the median survival age of patients with MPS was approximately 13.4 years. However, in the era of enzyme replacement therapy and other multidisciplinary care modalities, the life expectancy has increased. Herein, we report a rare case of an adolescent with MPS II who underwent SNHL treatment with cochlear implantation (CI). Based on unexpected findings of mastoid emissary veins and overgrowth of the vessels around the temporal bone, CI was performed using the transmeatal approach instead of the conventional transmastoid method, to avoid damage to the vessels. The average hearing threshold after CI was 35 dB and no surgical complications were encountered. Adolescent MPS II may present vessel abnormalities, which can reduce the success rate of surgery. In patients with MPS II with SNHL, CI should be performed under careful monitoring of vessel overgrowth. Moreover, with regard to feasibility of CI in adolescent patients with MPS II with SNHL, surgical techniques such as the transmeatal approach should be selected based on adequate assessment of the case.

Changes in the prevalence of anemia in Korean adolescents, 1998-2018.

BACKGROUND: Anemia is an important health problem affecting approximately 25% of the global population. Although its prevalence is decreasing worldwide, few studies have examined the prevalence of anemia in Korean adolescents. PURPOSE: This study aimed to determine the prevalence of anemia in Korean adolescents over the past 21 years using data from the Korea National Health and Nutrition Examination Survey. METHODS: We investigated the prevalence of anemia in adolescents aged 10-18 years for the period 1998-2018 according to sex, age, residential area, and household income. The effects of menarche age and menstruation were examined in female adolescents for the period 2001-2018. RESULTS: Among the total 11,782 participants, the weighted prevalence of anemia was 4.0%. The prevalence of anemia in male participants significantly decreased (from 3.0% to 0.5%, P<0.001), whereas that in female participants did not change significantly over time (from 7.9% to 8.5%, P=0.054). The average age at menarche was 12.4±0.0 years; the prevalence of anemia in females increased from age 13 years onward. Multivariate analysis revealed that anemia was more common in female than male participants (odds ratio [OR], 9.88; 95% confidence interval [CI], 7.19-13.57; P<0.001). In female adolescents, the prevalence of anemia increased with age (OR, 1.26; 95% CI, 1.15-1.38, P<0.001) and was 3.6 times higher after than before menarche (OR, 3.65; 95% CI, 2.21-6.05, P<0.001). CONCLUSION: Over the 21-year study period, the prevalence of anemia decreased among male adolescents but did not change in female adolescents. In female adolescents, age and menarche were identified as significant risk factors that require continued attention.

The effectiveness of an enhanced recovery after surgery protocol in head and neck cancer surgery with free-flap reconstruction.

PURPOSE: An enhanced recovery after surgery (ERAS) protocol incorporates up-to-date perioperative care principles; the primary aim in using an ERAS protocol is to reduce issues that delay the recovery and cause the complications. The aim of this study was to compare outcomes associated with head and neck cancer surgery with free-flap reconstruction before and after implementation of an ERAS protocol. METHODS: Outcomes were analyzed by dividing patients into 2 groups: 29 patients in the non-ERAS group and 60 patients in the ERAS group. The ERAS group performed a prospective observational cohort study of patients who underwent a head and neck cancer surgery with free-flap reconstruction in Ajou University Hospital from August 2015 to December 2017. The non-ERAS group retrospectively reviewed the medical records of patients who had undergone the same surgery from August 2012 to July 2015. RESULTS: Demographics, comorbidities, hospital length of stay (LOS), postoperative complications, starting time of rehabilitation, and postoperative periods before radiotherapy for the non-ERAS and ERAS groups were compared. Hospital LOS was significantly lower for patients whose care followed the ERAS protocol than for patients in the non-ERAS group (30.87 ± 20.72 days vs. 59.66 ± 40.43 days, P < 0.0001). CONCLUSION: In this study, hospital LOS was reduced through fast recovery after the implementation of the ERAS protocol. Therefore, the ERAS protocol appeared feasible and safe in head and neck cancer surgery with free-flap reconstruction.

Drugs for hyperlipidaemia may slow down the progression of hearing loss in the elderly: A drug repurposing study.

Hearing loss in the elderly causes communication difficulties, decreased quality of life, isolation, loneliness and frustration. The aim of this study was to identify the modifiable variables that may affect the progression of hearing loss in the elderly. A case-control study was conducted using two data sets. Data were extracted from the health examination survey of Ajou University Hospital (2010-2014) and the Korea National Health and Nutrition Examination Survey (2009-2012) data sets. Audiometry data were evaluated according to variables such as age, sex and drug use for underlying diseases. Logistic regression analysis was performed on the entire study population, and middle-aged and elderly groups using odds ratios (ORs). Factors including older age, female gender and diabetes mellitus were significantly associated with hearing levels in all age groups (OR [95% confidence interval, 95% CI], 0.375 [0.388-0.415], 1.202 [1.195-1.208], and 1.427 [1.183-1.721], respectively). However, when the results from the middle-aged and elderly groups were compared, medication for hyperlipidaemia had a significantly positive effect on the preservation of hearing in the elderly group (OR [95% CI], 0.713 [0.567-0.897]), but not in the middle-aged group (OR [95% CI], 0.967 [0.791-1.183]). People, especially those in the elderly group, exposed to medication for hyperlipidaemia are likely to have better hearing than those not exposed to such drugs. Thus, drugs prescribed for hyperlipidaemia may maintain hearing in the elderly. However, to overcome potential confounding-by unmeasured variables-that is present in this study, further studies must be performed with more elaborate research design and methodology.