RESUMEN
Artificial intelligence (AI) in medical care can raise diagnosis accuracy and improve its uniformity. This study developed a diagnostic imaging system for chronic wounds that can be used in medically underpopulated areas. The image identification algorithm searches for patterns and makes decisions based on information obtained from pixels rather than images. Images of 50 patients with pressure sores treated at Kobe University Hospital were examined. The algorithm determined the presence of necrosis with a significant difference (p = 3.39 × 10-5). A threshold value was created with a luminance difference of 50 for the group with necrosis of 5% or more black pixels. In the no-necrosis group with less than 5% black pixels, the threshold value was created with a brightness difference of 100. The "shallow wounds" were distributed below 100, whereas the "deep wounds" were distributed above 100. When the algorithm was applied to 24 images of 23 new cases, there was 100% agreement between the specialist and the algorithm regarding the presence of necrotic tissue and wound depth evaluation. The algorithm identifies the necrotic tissue and wound depth without requiring a large amount of data, making it suitable for application to future AI diagnosis systems for chronic wounds.
RESUMEN
Accurate evaluation of the orbital soft tissue is essential when conducting surgery to remove excess lower eyelid fat. However, the eyelid puffiness decreases in the supine-position intraoperatively and when magnetic resonance imaging is performed preoperatively, compared with the standing/sitting-position in which patients are commonly examined. We investigated the orbital soft tissue difference between standing/sitting and supine positions. The study was conducted on six patients with an average age of 58.5 years. Anterior soft tissue and adipose tissue of eyeball axis, anterior adipose tissue in front of the infraorbital margin, total adipose tissue, and horizontal and vertical orbital positions were determined. Statistical examination by t test showed that soft tissue and adipose tissue, except for total adipose tissue, were significantly reduced in the supine-position compared with the standing/sitting-position. There was a significant difference in eye position only in the vertical direction. Anterior adipose tissue in front of the infraorbital margin, which is important during lower eyelid surgery, appeared 17.5% lower in the supine-position than in the standing/sitting-position. It is necessary to consider this postural discrepancy during the surgical management of lower eyelid fat.
RESUMEN
BACKGROUND: Most patients with facial pigmentary disorders have multiple disorders. However, there is no definitive treatment algorithm improving various pigmentary disorders simultaneously. OBJECTIVES: To investigate the clinical efficacy and safety of the combination of the Q-switched alexandrite and the carbon dioxide lasers with ZO SKIN HEALTHâ for facial pigmentary disorders. PATIENTS/METHODS: This prospective observational study enrolled 251 patients with at least one facial pigmentary disorder. We assessed treatment efficacy and investigated which disorders were most responsive to combination treatment and the relationship between doctors' skills, outcomes, and dropout rates. RESULTS: There were 246 patients with lentigo senilis, 186 with moles, 79 with melasma, 53 with seborrheic keratosis, 17 with acquired dermal melanocytosis (ADM), and 16 with freckles. Overall, 227 patients completed treatment. Post-treatment outcomes were excellent in 97, good in 113, fair in 17, and poor in 0 patients. Freckles were the most responsive, and ADM was the least responsive. Patient withdrawal and treatment outcomes did not differ significantly based on the doctors' skills. Overall, 3.2% of patients had adverse events. CONCLUSIONS: Our combination algorithm improved several pigmentary disorders of the face simultaneously, regardless of the doctors' proficiency level.