Esophagogastroduodenoscopy (EGD) is generally a safe procedure, but adverse events often occur. This highlights the necessity of the quality control of EGD. Complete visualization and photo documentation of upper gastrointestinal (UGI) tracts are important measures in quality control of EGD. To evaluate these measures in large scale, we developed an AI-driven quality control system for EGD through convolutional neural networks (CNNs) using archived endoscopic images.
We retrospectively collected and labeled images from 250 EGD procedures, a total of 2599 images from eight locations of the UGI tract, using the European Society of Gastrointestinal Endoscopy (ESGE) photo documentation methods. The label confirmed by five experts was considered the gold standard. We developed a CNN model for multi-class classification of EGD images to one of the eight locations and binary classification of each EGD procedure based on its completeness.
Our CNN model successfully classified the EGD images into one of the eight regions of UGI tracts with 97.58% accuracy, 97.42% sensitivity, 99.66% specificity, 97.50% positive predictive value (PPV), and 99.66% negative predictive value (NPV). Our model classified the completeness of EGD with 89.20% accuracy, 89.20% sensitivity, 100.00% specificity, 100.00% PPV, and 64.94% NPV. We analyzed the credibility of our model using a probability heatmap.
We constructed a CNN model that could be used in the quality control of photo documentation in EGD. Our model needs further validation with a large dataset, and we expect our model to help both endoscopists and patients by improving the quality of EGD procedures.
We constructed a CNN model that could be used in the quality control of photo documentation in EGD. Our model needs further validation with a large dataset, and we expect our model to help both endoscopists and patients by improving the quality of EGD procedures.
Doppler-guided hemorrhoidal laser procedure consists of sutureless closure of terminal branches of the superior hemorrhoidal artery by laser energy. Clinical results of patients treated with this procedure were analyzed at the completion of 2-year follow-up. Primary endpoint was resolution of symptoms and secondary endpoints were recurrence rate, type of recurrences, re-operation rate, and potential predictive factors for failure.
Bleeding was assessed on a score from 0 to 4 (none = 0; < 1/month = 1; 1/week = 2; > 1/week = 3; 3-4/week = 4), frequency of hemorrhoid-related symptoms with a score of 0-3 (2/year = 1; 3-5/year = 2; < 5/year = 3). Constipation and fecal incontinence were assessed by means of validated scores. Quality of life and pain at defecation were assessed using a visual analog scale of 0-10 (0 = worst possible-10 = best possible quality of life and 0 = no pain-10 = worst pain imaginable, respectively). Recurrence rate and need for re-operation were reported. Potential predictive n be considered as 'first-line' treatment in patients with low-grade hemorrhoids suffering from bleeding, pain and recurrent acute symptoms in whom conservative treatment failed.
The Doppler-guided hemorrhoidal laser procedure showed efficacy at long-term follow-up. It can be considered as 'first-line' treatment in patients with low-grade hemorrhoids suffering from bleeding, pain and recurrent acute symptoms in whom conservative treatment failed.
To determine the frequency and predictive factors for alcohol recidivism following transjugular intrahepatic portosystemic shunts (TIPS) placed in patients with alcoholic cirrhosis.
One hundred ninety-nine patients who had a TIPS placed at a single institution for different indications in the setting of alcoholic cirrhosis were reviewed. Length of sobriety prior to TIPS placement and maintained sobriety at 1, 3 and 6-12months after TIPS placement were recorded. Smoking history, substance abuse and psychiatric comorbidities were also recorded as was ascitic response to TIPS at 1, 3 and 6-12months.
At 1month 11/199 (5.5%) patients had experienced a relapse while, 20/199 (10.1%) had at 3months, and 44/199 (22.1%) had at 12months. There was no difference in ascitic response in those who did and did not relapse at 1month (p = 0.57), 3months (p = 1.00) or 1year (p = 0.44). The mean time of sobriety at the time of TIPS placement for those who relapsed by 12months was significantly less than those who did not relapse (5.11 (1.10-7.90) months vs 18.32 (8.63-48.12) months, p < 0.001). https://www.selleckchem.com/products/protokylol-hydrochloride.html Concurrent psychiatric comorbidity (p < 0.001), substance abuse (p < 0.001), age less than 40 (p = 0.004) and smoking history at the time of procedure (p < 0.001) were also associated with alcohol relapse.
Recidivism is a frequent issue for patients following TIPS placement; those who have concurrent psychiatric comorbidity, substance abuse, smoking history are younger than 40 and shorter sobriety duration prior to TIPS may be at increased risk.
Recidivism is a frequent issue for patients following TIPS placement; those who have concurrent psychiatric comorbidity, substance abuse, smoking history are younger than 40 and shorter sobriety duration prior to TIPS may be at increased risk.
To examine physiochemical characteristics and drug release properties of cisplatin powder and lipiodol mixtures formed by a glass membrane emulsification device compared with a 3-way stopcock.
Seven different types of mixtures were evaluated cisplatin powder and lipiodol directly mixed (suspension), complete cisplatin solution and lipiodol mixed by a 3-way stopcock or the device (emulsion), incomplete cisplatin solution and lipiodol mixed by a 3-way stopcock or the device (solid-in-water emulsion), and contrast material and cisplatin suspension mixed by a 3-way stopcock or the device (solid-in-oil emulsion).
The percentages of water-in-oil were 98.08 ± 0.27% in the emulsion formed by the device, while 70.3 ± 4.63% in the emulsion formed by a 3-way stopcock (P = 0.037). Solid-in-water and solid-in-oil emulsions formed by the device showed 98.09 ± 0.38% and 98.70 ± 0.40% of water-in-oil, respectively, whereas both solid-in-water and solid-in-oil emulsions formed by a 3-way stopcock showed 0.00%. Homogenous droplet sizes were shown by using the device.
Esophagogastroduodenoscopy (EGD) is generally a safe procedure, but adverse events often occur. This highlights the necessity of the quality control of EGD. Complete visualization and photo documentation of upper gastrointestinal (UGI) tracts are important measures in quality control of EGD. To evaluate these measures in large scale, we developed an AI-driven quality control system for EGD through convolutional neural networks (CNNs) using archived endoscopic images.
We retrospectively collected and labeled images from 250 EGD procedures, a total of 2599 images from eight locations of the UGI tract, using the European Society of Gastrointestinal Endoscopy (ESGE) photo documentation methods. The label confirmed by five experts was considered the gold standard. We developed a CNN model for multi-class classification of EGD images to one of the eight locations and binary classification of each EGD procedure based on its completeness.
Our CNN model successfully classified the EGD images into one of the eight regions of UGI tracts with 97.58% accuracy, 97.42% sensitivity, 99.66% specificity, 97.50% positive predictive value (PPV), and 99.66% negative predictive value (NPV). Our model classified the completeness of EGD with 89.20% accuracy, 89.20% sensitivity, 100.00% specificity, 100.00% PPV, and 64.94% NPV. We analyzed the credibility of our model using a probability heatmap.
We constructed a CNN model that could be used in the quality control of photo documentation in EGD. Our model needs further validation with a large dataset, and we expect our model to help both endoscopists and patients by improving the quality of EGD procedures.
We constructed a CNN model that could be used in the quality control of photo documentation in EGD. Our model needs further validation with a large dataset, and we expect our model to help both endoscopists and patients by improving the quality of EGD procedures.
Doppler-guided hemorrhoidal laser procedure consists of sutureless closure of terminal branches of the superior hemorrhoidal artery by laser energy. Clinical results of patients treated with this procedure were analyzed at the completion of 2-year follow-up. Primary endpoint was resolution of symptoms and secondary endpoints were recurrence rate, type of recurrences, re-operation rate, and potential predictive factors for failure.
Bleeding was assessed on a score from 0 to 4 (none = 0; < 1/month = 1; 1/week = 2; > 1/week = 3; 3-4/week = 4), frequency of hemorrhoid-related symptoms with a score of 0-3 (2/year = 1; 3-5/year = 2; < 5/year = 3). Constipation and fecal incontinence were assessed by means of validated scores. Quality of life and pain at defecation were assessed using a visual analog scale of 0-10 (0 = worst possible-10 = best possible quality of life and 0 = no pain-10 = worst pain imaginable, respectively). Recurrence rate and need for re-operation were reported. Potential predictive n be considered as 'first-line' treatment in patients with low-grade hemorrhoids suffering from bleeding, pain and recurrent acute symptoms in whom conservative treatment failed.
The Doppler-guided hemorrhoidal laser procedure showed efficacy at long-term follow-up. It can be considered as 'first-line' treatment in patients with low-grade hemorrhoids suffering from bleeding, pain and recurrent acute symptoms in whom conservative treatment failed.
To determine the frequency and predictive factors for alcohol recidivism following transjugular intrahepatic portosystemic shunts (TIPS) placed in patients with alcoholic cirrhosis.
One hundred ninety-nine patients who had a TIPS placed at a single institution for different indications in the setting of alcoholic cirrhosis were reviewed. Length of sobriety prior to TIPS placement and maintained sobriety at 1, 3 and 6-12months after TIPS placement were recorded. Smoking history, substance abuse and psychiatric comorbidities were also recorded as was ascitic response to TIPS at 1, 3 and 6-12months.
At 1month 11/199 (5.5%) patients had experienced a relapse while, 20/199 (10.1%) had at 3months, and 44/199 (22.1%) had at 12months. There was no difference in ascitic response in those who did and did not relapse at 1month (p = 0.57), 3months (p = 1.00) or 1year (p = 0.44). The mean time of sobriety at the time of TIPS placement for those who relapsed by 12months was significantly less than those who did not relapse (5.11 (1.10-7.90) months vs 18.32 (8.63-48.12) months, p < 0.001). https://www.selleckchem.com/products/protokylol-hydrochloride.html Concurrent psychiatric comorbidity (p < 0.001), substance abuse (p < 0.001), age less than 40 (p = 0.004) and smoking history at the time of procedure (p < 0.001) were also associated with alcohol relapse.
Recidivism is a frequent issue for patients following TIPS placement; those who have concurrent psychiatric comorbidity, substance abuse, smoking history are younger than 40 and shorter sobriety duration prior to TIPS may be at increased risk.
Recidivism is a frequent issue for patients following TIPS placement; those who have concurrent psychiatric comorbidity, substance abuse, smoking history are younger than 40 and shorter sobriety duration prior to TIPS may be at increased risk.
To examine physiochemical characteristics and drug release properties of cisplatin powder and lipiodol mixtures formed by a glass membrane emulsification device compared with a 3-way stopcock.
Seven different types of mixtures were evaluated cisplatin powder and lipiodol directly mixed (suspension), complete cisplatin solution and lipiodol mixed by a 3-way stopcock or the device (emulsion), incomplete cisplatin solution and lipiodol mixed by a 3-way stopcock or the device (solid-in-water emulsion), and contrast material and cisplatin suspension mixed by a 3-way stopcock or the device (solid-in-oil emulsion).
The percentages of water-in-oil were 98.08 ± 0.27% in the emulsion formed by the device, while 70.3 ± 4.63% in the emulsion formed by a 3-way stopcock (P = 0.037). Solid-in-water and solid-in-oil emulsions formed by the device showed 98.09 ± 0.38% and 98.70 ± 0.40% of water-in-oil, respectively, whereas both solid-in-water and solid-in-oil emulsions formed by a 3-way stopcock showed 0.00%. Homogenous droplet sizes were shown by using the device.
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