[Show abstract][Hide abstract] ABSTRACT: Ultrasound examination (US) does a key role in the diagnosis and management of the patients with clinically suspected appendicitis which is the most common abdominal surgical emergency. Among the various sonographic findings of appendicitis, outer diameter of the appendix is most important. Therefore, clear delineation of the appendix on US images is essential. In this paper, we propose a new intelligent method to extract appendix automatically from abdominal sonographic images as a basic building block of developing such an intelligent tool for medical practitioners. Knowing that the appendix is located at the lower organ area below the bottom fascia line, we conduct a series of image processing techniques to find the fascia line correctly. And then we apply fuzzy ART learning algorithm to the organ area in order to extract appendix accurately. The experiment verifies that the proposed method is highly accurate (successful in 38 out of 40 cases) in extracting appendix.
Computational and Mathematical Methods in Medicine 06/2015; 2015:1-10. DOI:10.1155/2015/389057 · 0.77 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To investigate the effects of Korean red ginseng (KRG) on semen parameters in male infertility patients in a randomized, double-blind, placebo-controlled study.
A total of 80 male infertility patients with varicocele were recruited from April 2011 to February 2012. The subjects were then divided into the following four groups: non-varicocelectomy (V)+placebo (P) group, V+P group, non-V+KRG group (1.5-g KRG daily), and V+KGR group (1.5-g KRG daily). Semen analysis was performed and hormonal levels were measured in each treatment arm after 12 weeks.
All groups but not the non-V+P group, showed significant improvements in sperm concentrations, motility, morphology, and viability at the end of the study. However, there were no significant differences in serum follicle-stimulating hormone, luteinizing hormone, and testosterone among groups. The incidence of adverse events was low, and all events were assumed to be unrelated to the treatments administered.
Although the exact mechanism by which KRG improves spermatogenesis remains unclear, KRG may be a useful agent for the treatment of male infertility. Nevertheless, additional studies to evaluate the optimal dose and duration of treatment are needed.
Chinese Journal of Integrative Medicine 05/2015; DOI:10.1007/s11655-015-2139-9 · 1.22 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study evaluated the demographics and semen parameters of males with cancer who banked their sperm prior to chemotherapy.
This is a retrospective study of 66 cases referred for sperm banking prior to initiation of chemotherapy over a 15-year period (1999~2014). Patients who had previously received cancer treatment including chemotherapy or radiotherapy were not included in this study.
We studied a total of 66 cancer patients referred for cryopreservation of sperm prior to chemotherapy. The mean age of the patients at the time of banking was 32.0±7.9 years (range, 19~58 years). The types of cancer were testicular cancer (31 cases, 47.0%), non-Hodgkin's disease (10 cases, 15.1%), Hodgkin's disease (5 cases, 7.6%), leukemia (8 cases, 12.1%), gastrointestinal malignancy (5 cases, 7.6%), and musculoskeletal malignancy (5 cases, 7.6%). There were significant differences in sperm concentration and viability among the various types of cancer, but no significant difference in semen volume or sperm motility and morphology.
In this study we found that sperm quality could decrease even before chemotherapy. Because chemotherapy can also negatively affect spermatogenesis, sperm cryopreservation prior to treatment should be strongly recommended for cancer patients of reproductive age.
[Show abstract][Hide abstract] ABSTRACT: In the ultrasound image, the gallbladder has a wide variety of shape, type, size, and slope, so the existing researches into contour-based gallbladder detection cannot be applied to the various types of gallbladder. Therefore, in this paper, we present a new approach to locate the gallbladder from ultrasound image using ends-in search stretching and self organizing map (SOM)-based color quantization. We use the ends-in search stretching technique to emphasize the difference in brightness among the structures, and SOM-based color quantization is used to classify pixels into the gallbladder and gallbladder wall. After SOM-based color quantization, we extract gallbladder candidates. To verify the gallbladder candidates, we define five morphologic characteristics-based rough conditions. We experiment using 30 ultrasound images. Experiment results shows the proposed method locates the gallbladder excellently despite gallbladders have a variety of shapes.
Current Medical Imaging Reviews 02/2015; 11(1). DOI:10.2174/157340561101150423105447 · 0.73 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Color quantization is an important process for image processing and various applications. Up to now, many color quantization methods have been proposed. The self-organizing maps (SUM) method is one of the most effective color quantization methods, which gives excellent color quantization results. However, it is slow, so it is not suitable for real-time applications. In this paper, we present a color importance based SUM color quantization method. The proposed method dynamically adjusts the learning rate and the radius of the neighborhood using color importance. This makes the proposed method faster than the conventional SUM-based color quantization method. We compare the proposed method to 10 well-known color quantization methods to evaluate performance. The methods are compared by measuring mean absolute error (MAE), mean square error (MSE), and processing time. The experimental results show that the proposed method is effective and excellent for color quantization. Not only does the proposed method provide the best results compared to the other methods, but it uses only 67.18% of the processing time of the conventional SUM method.
Neural Network World 01/2015; 25(2):121-137. DOI:10.14311/NNW.2015.25.006 · 0.48 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to investigate the efficacy of mirodenafil in middle-aged male patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
Eighty-eight males with CP/CPPS were randomized to receive either levofloxacin (500 mg/d) (group L, 40 patients) or levofloxacin (500 mg/d) and mirodenafil (50 mg/d) (group ML, 48 patients) for six weeks. The International Prostate Symptom Score (IPSS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and erectile function (EF) domain scores of the International Index of Erectile Function (IIEF) questionnaire were used to grade symptoms at baseline and 6 weeks after treatment.
The mean change in total IPSS from baseline was higher in group ML than that in group L (group L, -1.1 vs. group ML, -4.3; p<0.05). Significant improvements were also seen in the IPSS voiding subscore (group L, -0.7 vs. group ML, -3.0; p<0.05). Changes observed in the NIH-CPSI of group ML at six weeks were greater than those at baseline (group L, -3.2 vs. group ML, -7.2; p<0.05). Significant improvements were seen in the NIH-CPSI voiding (group L, -0.5 vs. group ML, -1.7; p<0.05) and quality of life domains (group L, -1.0 vs. group ML, -1.8; p<0.05). Group ML showed a significantly greater increase in the IIEF-EF score than did group ML (group L, +0.2 vs. group ML, +7.8; p<0.05).
Mirodenafil (50 mg once daily) was well tolerated and resulted in significant symptomatic improvement in middle-aged males with CP/CPPS.
[Show abstract][Hide abstract] ABSTRACT: A sequence alignment algorithm is a basic building block for protein analysis and nucleic acid analysis in bioinformatics. Such alignment represents the similarities and differences of two or more compared sequences. Thus, there have been many algorithms and tools studied and developed. In this paper, we focus on the PHRED based sequence alignment algorithm using Needleman-Wunsch dynamic programming. Although it is well known and proven to be reliable to some extent, it suffers from the heavy computation of producing scoring matrix based on dynamic programming whose time complexity is O(mn). We propose a method applying quadrant method in that process to reduce the computational loads. Also, PHRED based algorithms suffer from the environment when low quality bases are frequently in tips of DNA fragments. Thus, we designed a fuzzy logic system to control the gap cost dynamically to improve the quality of the alignment. In the experiment using real genome data from NCBI (National Center for Biotechnology Information), we verify that the proposed method reduces the computational loads by half in producing scoring matrix and thus the alignment quality is also improved by our fuzzy inference system.
Current Bioinformatics 11/2014; 9(5). DOI:10.2174/1574893609666140523000227 · 0.92 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Lymphangioma is a rare, benign mesenchymal neoplasm, which is characterized by numerous intercommunicating cystic spaces containing lymphatic fluid. It is considered a congenital disease resulting from the obstruction of regional lymph drainage during the developmental period. Lymphangioma may be focal/unilateral or diffuse/bilateral, and in the latter case, it is referred to as lymphangiomatosis. Here, we report a case of a 38-year-old man with perirenal lymphangiomatosis. The patient's chief complaint was left flank pain, and left pleural effusion was found on radiological examination. After radical nephrectomy, the pathological examinations revealed that the kidney was enclosed by a multicystic mass with intrarenal cystic dilatations. We report the case and discuss the management of perirenal lymphangiomatosis with a literature review.
[Show abstract][Hide abstract] ABSTRACT: In this paper, we propose a method to extract sternocleidomastoid and longus capitis/colli automatically and measure the thickness of those muscles from cervical vertebrae ultrasound images. Extracting sternocleidomastoid is relatively easy but for longus capitis/colli case, due to the brightness sensitivity, it requires much more computationally burdensome procedures. In the binarization process, instead of simple and cheap thresholding method, we apply fuzzy sigma binarization to mitigate the sensitivity. Since that binarization procedure is computationally expensive we keep thresholding method for sternocleidomastoid case. With considerate image processing processes such as 4-directional contour analysis and Cubic Spline interpolation, we can successfully analyze features like muscle thickness. In experiment, the efficacy of the proposed method is verified as having 73 ~ 87% of real world cervical vertebrae images successfully analyzed meaning that only a small magnitude of errors in measuring thickness from medical expert's own measurement (less than 0.1 cm for sternocleidomastoid and less than 0.3 cm for longus capitis/colli). We hope such result encourages the use of automatic ultrasound analysis system for cervical vertebrae in rehabilitation practices.
Current Medical Imaging Reviews 07/2014; 10(2). DOI:10.2174/157340561002140715101740 · 0.73 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In this paper, we propose a new fully computerized image analysis method for measuring the thickness of muscles from ultrasound image obtained by muscle endurance test using morphological information of fascia and thoracic vertebra. Firstly, we divide the image into lumbar region and thoracolumbar region by the difference of density in image for measuring the thickness of muscles. In lumbar region, we notice that the intensity of fascia is relatively higher than other parts. Thus, we measure the thickness of muscles surrounding the fascia area. In the process, we apply median filter to candidate fascia areas for extracting candidate muscle layers between fascias. Then, the thickness of muscles we measure is that of the third layer. In thoracolumbar region, we apply region expansion method for classifying the region into subcutaneous fat part and part including thoracic vertebra. Then, we apply counting method and evolutionary computation search model to find the measuring location that is in between subcutaneous fat area and thoracic vertebra. In experiment, the proposed method is effective in measuring the thickness of muscles and avoids failures of previous studies. The performance of this approach is sufficiently comparable to that of medical experts.
[Show abstract][Hide abstract] ABSTRACT: Objective:
To investigate the reasons for prescription change of α1-blockers in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.
The ratio and interval of prescription change were assessed in 3200 patients who were eligible for the study and took 1 of 4 different α1-blockers (doxazosin, alfuzosin, tamsulosin, or silodosin). The reasons for prescription change and evaluation of efficacy were analyzed in 444 patients whose medical records were complete.
Prescription change to another α1-blocker occurred in 694 of 3200 patients (21.7%), and the mean duration of taking their first α1-blocker was 10.8 ± 8.2 weeks. Lack of efficacy (52.7%) was the main reason for changing α1-blockers, followed by adverse events (33.1%), relatively high cost compared with other α1-blockers (7.0%), inconvenience of taking drugs (4.1%), and cardiovascular comorbidity (3.2%). The mean duration of treatment according to each reason is as follows: increased adverse events: 6.3 ± 5.2 weeks, relatively high cost compared with other α1-blockers: 8.7 ± 4.5 weeks, cardiovascular comorbidity: 10.5 ± 6.8 weeks, inconvenience of taking drugs: 10.8 ± 3.9 weeks, and lack of efficacy: 14.8 ± 6.8 weeks. The proportion of prescription change (16.3%) and prescription change because of hemodynamic adverse events (2.4%) in the silodosin group were low compared with those in the other groups (P <.05 and P <.006, respectively), but prescription change because of a ejaculation disorder was high in the silodosin group (30.1%, P <.001).
Major reasons for prescription change in patients taking α1-blockers were lack of efficacy and adverse events. In the silodosin group, the proportion of prescription change was significantly low compared with that in the other 3 groups.
[Show abstract][Hide abstract] ABSTRACT: Phosphodiesterase type 5 (PDE5) inhibitors are the most commonly used treatment for erectile dysfunction (ED). Since the launch of sildenafil, several drugs-including mirodenafil, sildenafil citrate (sildenafil), tadalafil, vardenafil HCL (vardenafil), udenafil, and avanafil-have become available. Mirodenafil is a newly developed pyrrolopyrimidinone compound, which is a potent, reversible, and selective oral PDE5 inhibitor. Mirodenafil was launched in Korea in 2007, and an orally disintegrating film of mirodenafil was developed in 2011 for benefitting patients having difficulty in swallowing tablets. This study aimed to review the pharmacokinetic characteristic profile of mirodenafil and report evidence on its efficacy in the case of ED. In addition, we reviewed randomized controlled studies of mirodenafil's daily administration and efficacy for lower urinary tract symptoms.
[Show abstract][Hide abstract] ABSTRACT: Purpose
This post hoc integrated analysis assessed the efficacy and safety of tadalafil 5 mg once daily in a large Korean population with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH-LUTS).
Materials and Methods
Individual Korean participant data were integrated from three 12-week, randomized, double-blind, placebo-controlled studies in Asian men with BPH-LUTS, wherein 177 Korean men received placebo and 177 received tadalafil 5 mg once daily. The primary objective was to compare the change from baseline to week 12 in total International Prostate Symptom Score (IPSS) after treatment with tadalafil versus placebo.
A significantly greater improvement (p<0.001) in total IPSS from baseline to week 12 was observed for tadalafil compared to placebo (least squares mean: tadalafil=-5.97; placebo=-3.94 ). Total IPSS at weeks 4 and 12, IPSS voiding and storage subscores at weeks 4, 8, and 12, and IPSS quality of life index at weeks 8 and 12 were also significantly improved (p<0.05) for tadalafil compared to placebo. There was significant improvement (p<0.001) in the patient global Impression of improvement responses and numerical improvement in the clinician global impression of improvement responses with tadalafil compared to placebo. There were no significant treatment differences for peak urine flow rate or postvoid residual volume. Few participants had treatment-emergent adverse events and there were no unexpected safety findings.
This integrated analysis of three randomized, placebo-controlled Asian studies confirmed tadalafil 5 mg once daily as an efficacious and well-tolerated treatment for Korean men with BPH-LUTS.
[Show abstract][Hide abstract] ABSTRACT: In rehabilitation, ultrasonography is a popular diagnostic tool. However, it could be subjective to the medical expert's experience. Thus, it is necessary to develop an objective automatic procedure for ultrasonographic image analysis. A disadvantage of the existing automatic analytic
procedure in musculoskeletal systems is the designation of an incorrect muscle area when the figure of fascia is vague. In this study, we propose a new procedure to more accurately extract muscle area in abdominal ultrasonographic images. After removing unnecessary noise from the input image,
we apply the End-in search algorithm to enhance the contrast between the fascia and muscle area. Then after extracting the initial muscle area using an up-down search, we trace the fascia area with a mask based on morphological and directional information. By this tracing of mask movements,
we can emphasize the fascia area to extract more accurate muscle area as a result. This new procedure is proven to be more effective than existing methods based on experiments using convex ultrasound images which are used in the practical diagnostic field of rehabilitation.
Journal of Medical Imaging and Health Informatics 03/2014; 4(1):8-13. DOI:10.1166/jmihi.2014.1218 · 0.50 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Infertile couples interested in nonspouse artificial insemination by donor (AID) not only require a thorough understanding of the medical procedure but also must scrutinize the effects it will have on family relationships, including those on the infant to be born. We conducted a series of surveys in couples with male infertility to collect information necessary for AID counseling.
A total of 384 cases with noncurable male infertility were enrolled in this inquiry survey. The questionnaire consisted of 18 items that assessed demographic characteristics, background information concerning the choice to use AID, subjective experiences, long-term effects, and an overall evaluation.
A total of 126 surveys were returned (32.8%). AID was first suggested by the husband in about half of the cases. The major reason for considering the procedure was to form a complete family. Two-thirds of the couples were anxious about the procedure, most often about possible congenital or acquired deformities in the infant. After the birth of the child, most couples were positive about their decision to have used AID. About half of the couples felt that the child was their own and expected not to tell the child about AID. Overall, about 50% of the couples were satisfied with the procedure.
Those who underwent AID experienced various psychological effects, including anxiety about the child to be born. To overcome these problems, sufficient medical information and consultation about the process of selecting the donor and about AID procedures should be provided before the procedure is used.
Korean journal of urology 02/2014; 55(2):134-9. DOI:10.4111/kju.2014.55.2.134
[Show abstract][Hide abstract] ABSTRACT: A nationwide survey was conducted of Korean urologists to illustrate physicians' perceptions and real practical patterns regarding Peyronie disease (PD).
A specially designed questionnaire exploring practice characteristics and attitudes regarding PD, as well as patient satisfaction with each treatment modality, was e-mailed to 2,421 randomly selected urologists.
Responses were received from 385 practicing urologists (15.9%) with a median time after certification as an urologist of 12 years. Regarding the natural course, 87% of respondents believed that PD is a progressive disease, and 82% replied that spontaneous healing in PD occurred in fewer than 20% of patients. Regarding diagnosis of PD, the methods used were, in order, history taking with physical examination (98%), International Index of Erectile Function questionnaires (40%), intracavernous injection and stimulation (35%), and duplex sonography (28%). Vitamin E was most preferred as an initial medical management (80.2%), followed by phosphodiesterase-5 inhibitors (27.4%) and Potaba (aminobenzoate potassium, 20.1%). For urologists who administered intralesional injection, the injected agent was, in order, corticosteroid (72.2%), verapamil (45.1%), and interferon (3.2%). The most frequently performed surgical procedure was plication (84.1%), followed by excision and graft (42.9%) and penile prosthesis implantation (14.2%). Among the most popular treatments in each modality, the urologists' perceptions regarding the suitability of treatment and patient satisfaction were significantly different, favoring plication surgery.
The practice pattern of urologists depicted in this survey is in line with currently available Western guidelines, which indicates the need for development of further local guidelines based on solid clinical data.
Korean journal of urology 01/2014; 55(1):57-63. DOI:10.4111/kju.2014.55.1.57
[Show abstract][Hide abstract] ABSTRACT: We studied the relative importance of high-sensitivity C-reactive protein (hs-CRP) concentrations in patients with erectile dysfunction (ED) and diabetes and determined whether the hs-CRP level predicts the response to treatment with 5 mg tadalafil once daily.
We enrolled 102 men (aged 40-60 years) with diabetes and ED. All patients completed the International Index of Erectile Function (IIEF) questionnaire and were given 5 mg tadalafil daily. The IIEF and serum hs-CRP levels in patients and healthy controls and in patient responders and nonresponders to 5 mg tadalafil once daily were compared.
Median age was 53.2 years (range, 45 to 62 years) in patients and 55.6 years (range, 47 to 64 years) in healthy controls (p=0.158). The median duration of diabetes was 54.3 months (range, 34 to 70 months). The median IIEF and hs-CRP level were 12.1 (range, 5 to 20) and 0.21 mg/dL (range, 0.05 to 0.6 mg/dL) in patients and 28.2 (range, 13 to 31) and 0.09 mg/dL (range, 0.04 to 0.2 mg/dL) in the controls, respectively (pIIEF=0.000, pCRP=0.031). After tadalafil treatment, 71 patients (69.6%) achieved an erection sufficient for sexual intercourse, whereas 31 (30.4%) did not. The median age of the tadalafil nonresponders was 56.2 years (range, 45 to 64 years) and that of the responders was 51.3 years (range, 42 to 62 years; p=0.065). Median hs-CRP levels were 0.31 mg/dL (range, 0.18 to 0.62 mg/dL) in nonresponders and 0.14 mg/dL (range, 0.09 to 0.4 mg/dL) in responders, respectively (p=0.028).
Serum hs-CRP was significantly higher in patients with ED and diabetes mellitus than in patients without ED. A significant correlation was observed between serum hs-CRP levels, the degree of ED, and responsiveness to tadalafil.
Korean journal of urology 12/2013; 54(12):858-64. DOI:10.4111/kju.2013.54.12.858
[Show abstract][Hide abstract] ABSTRACT: According to previous studies, the prevalence of premature ejaculation (PE) in Korea ranges from 11.3% to 33%. However, the actual practice patterns in managing patients with PE is not well known. In this study, we have endeavored to determine how contemporary urologists in Korea manage patients with PE.
The e-mailing list was obtained from the Korean Urological Association Registry of Physicians. A specifically designed questionnaire was e-mailed to the 2,421 urologists in Korea from May 2012 to August 2012.
UROLOGISTS IN KOREA DIAGNOSED PE USING VARIOUS CRITERIA: the definition of the International Society for Sexual Medicine (63.4%), Diagnostic and Statistical Manual of Mental Disorders (43.8%), International Statistical Classification of Disease, 10th edition (61.7%), or perceptional self-diagnosis by the patient himself (23.5%). A brief self-administered questionnaire, the Premature Ejaculation Diagnostic Tool, was used by only 42.5% of the urologists. Selective-serotonin reuptake inhibitor (SSRI) therapy was the main treatment modality (91.5%) for PE patients. 40.2% of the urologists used phosphodiesterase type 5 inhibitors, 47.6% behavior therapy, and 53.7% local anesthetics. Further, 286 (54.3%) urologists managed PE patients with a surgical modality such as selective dorsal neurotomy (SDN).
A majority of Korean urologists diagnose PE by a multidimensional approach using various diagnostic tools. Most urologists believe that medical treatment with an SSRI is effective in the management of PE. At the same time, surgical treatment such as SDN also investigated as one of major treatment modality despite the lack of scientific evidence.
[Show abstract][Hide abstract] ABSTRACT: This review assesses lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with or without erectile dysfunction (ED) and related therapies focusing on tadalafil. A literature search was obtained and reviewed for the epidemiology, treatment therapies, pathophysiology, and efficacy and safety of phosphodiesterase type 5 inhibitor (PDE5i) tadalafil in patients with LUTS/BPH. Approximately 42% of men aged 51 to 60 years have BPH. Approximately 90% of men aged 45 to 80 years have LUTS. Occurrence of LUTS increases with age for almost all racial/ethnic groups (range, 32% to 56%) with prevalence of LUTS highest among Hispanic men, then Blacks, Caucasians, and Asians. There is an independent relationship with LUTS/BPH and ED, with approximately 70% of men with LUTS/BPH having ED with severity of one disease often correlating with the other. The European Urological Association guidelines include the use of the PDE5i tadalafil. Tadalafil is the only therapy recommended for treatment of co-existing BPH and ED, while other therapies have unwanted ED side effects. The mode of action of tadalafil may involve different areas of the lower urinary tract such as smooth muscle cell relaxation in the bladder neck, prostate, and urethra, but there may also be resulting modulation of the afferent nerve activity. Tadalafil (5 mg) in Asian men with LUTS/BPH, similar to global studies, is efficacious and safe. Tadalafil (5 mg) improves co-existing LUTS/BPH and ED, independently. Men with LUTS/BPH likely also have ED. Asian men with LUTS/BPH have similar incidence rates, co-existing ED, comorbid diseases, and risks as non-Asian men. Tadalafil can improve co-existing LUTS/BPH and ED.