Evaluation of deep learning-based autosegmentation in breast cancer radiotherapy.

PURPOSE: To study the performance of a proposed deep learning-based autocontouring system in delineating organs at risk (OARs) in breast radiotherapy with a group of experts. METHODS: Eleven experts from two institutions delineated nine OARs in 10 cases of adjuvant radiotherapy after breast-conserving surgery. Autocontours were then provided to the experts for correction. Overall, 110 manual contours, 110 corrected autocontours, and 10 autocontours of each type of OAR were analyzed. The Dice similarity coefficient (DSC) and Hausdorff distance (HD) were used to compare the degree of agreement between the best manual contour (chosen by an independent expert committee) and each autocontour, corrected autocontour, and manual contour. Higher DSCs and lower HDs indicated a better geometric overlap. The amount of time reduction using the autocontouring system was examined. User satisfaction was evaluated using a survey. RESULTS: Manual contours, corrected autocontours, and autocontours had a similar accuracy in the average DSC value (0.88 vs. 0.90 vs. 0.90). The accuracy of autocontours ranked the second place, based on DSCs, and the first place, based on HDs among the manual contours. Interphysician variations among the experts were reduced in corrected autocontours, compared to variations in manual contours (DSC: 0.89-0.90 vs. 0.87-0.90; HD: 4.3-5.8 mm vs. 5.3-7.6 mm). Among the manual delineations, the breast contours had the largest variations, which improved most significantly with the autocontouring system. The total mean times for nine OARs were 37 min for manual contours and 6 min for corrected autocontours. The results of the survey revealed good user satisfaction. CONCLUSIONS: The autocontouring system had a similar performance in OARs as that of the experts' manual contouring. This system can be valuable in improving the quality of breast radiotherapy and reducing interphysician variability in clinical practice.

Association between energy drink consumption, depression and suicide ideation in Korean adolescents.

BACKGROUND: Suicide is the leading cause of death among adolescents in South Korea. Negative influences of the abuse of energy drinks on mental health problems have emerged. AIMS: This study aimed to analyze the relationship between energy drink consumption, depression and suicide ideation. METHODS: We analyzed the data of 26,346 boys and 26,966 girls who participated in the 2015 Korean Youth Risk Behavior Web-Based Survey. The independent variable was the frequency of energy drink consumption per week. Experience of depression and suicide ideation were considered as the dependent variables. Multiple logistic regression was performed. RESULTS: An association was found between energy drink intake per week and depressive mood. Moreover, the most frequent energy drink intake (three times or more per week) group showed the highest association with depressive mood (odds ratios (ORs); boys: ORs = 1.40, 95% confidence interval (CI): 1.25-1.56; girls: ORs = 1.61, 95% CI: 1.44-1.79) and suicide ideation (boys: ORs = 1.46, 95% CI: 1.27-1.69; girls: ORs = 1.36, 95% CI: 1.20-1.55). CONCLUSION: We observed that consumption of excessive amounts of energy drinks is associated with depression and suicide ideation. Therefore, appropriate regulation or education is needed to prevent adolescents from experiencing adverse outcomes.

Mucoepidermoid carcinoma of the lacrimal sac after dacryocystectomy for squamous papilloma.

A mass that recurred after dacryocystectomy for benign squamous papilloma of the lacrimal sac was diagnosed as a high-grade mucoepidermoid carcinoma in a 53-year-old man on histopathology. Local excision to the orbital periosteum was performed and gave a margin free of invasion. Neither local recurrence nor systemic metastasis was found 3 years after local excision. Mucoepidermoid carcinoma of the lacrimal sac is extremely rare and spreads locally in an aggressive manner; a cure typically requires exenteration, radical resection, or adjuvant radiotherapy. In this rare case, despite the high malignancy, the patient underwent successful local excision, achieved an aesthetically satisfying result, and has had a long-term cancer-free period.

Percutaneous temporal wiring method for minimally invasive plate osteosynthesis of distal femoral fractures.

The surgical reduction of distal femoral fractures with minimally invasive plate osteosynthesis is difficult and the maintenance of the reduction can involve high exposures to radiation. We designed an effective fracture reduction method involving a percutaneous temporal wiring technique for the reduction of distal femoral fractures with oblique or spiral fracture components during surgery with minimally invasive plate osteosynthesis. Our method consistently reduced these fractures satisfactorily. The maintenance of reduction and plate fixation were easy with our method and the radiation exposure during the operation was reduced.