• 한국멀티미디어학회논문지
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• 제15권5호
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• pp.595-605
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• 2012

사시 진단을 위해 임상에서는 다양한 사시각 측정 방법들이 개발되어 이용되어 왔다. 그러나 기존 방법들은 대부분 육안 검사에 의해 이루어지므로 사용자의 주관적인 판단이 개입할 가능성이 크며 협조적인 대상에 대해서만 측정이 용이하다는 단점이 있다. 따라서 보다 이를 보완할 수 있는 객관적이고 신뢰성 있는 사시각 측정 방법의 개발이 필요하다. 본 논문에서는 임상 측정 방법의 문제점들을 보완할 수 있는 컴퓨터 기반의 새로운 자동 사시각 측정 소프트웨어의 개발을 소개한다. 먼저 간단하게 촬영된 환자의 전안부 영상을 획득하고 구형 RGB 모델을 이용하여 전처리를 수행하였다. 이후 새롭게 개발된 3차원 안구모델과 수학적인 측정 알고리즘을 이용하여 사시각 측정이 자동적으로 이루어지도록 하였다. 유효성 평가를 위해 10명의 환자 데이터를 대상으로 두 명의 검사자가 임상 측정 방법 중의 하나인 크림스키 테스트 방법을 통해 측정한 결과와 개발 소프트웨어를 이용하여 측정한 결과를 비교하였다. 그 결과, 두 명의 검사자의 상관계수는 각각 0.955, 0.969로 나타났으며, 두 검사자 간의 상관계수는 0.968로 나타나 객관성과 재현성이 매우 높음을 확인하였다. 향후 기존 사시진단 검사 방법들의 보조 수단이나 새로운 대안으로써 폭넓게 활용될 수 있을 것으로 기대한다.

• Journal of Korean Neurosurgical Society
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• 제59권6호
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• pp.637-642
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• 2016

Objective : Although many treatment modalities have been introduced for trigeminal neuralgia (TN), the long-term clinical results remain unsatisfactory. It has been particularly challenging to determine an appropriate treatment strategy for patients who have responded poorly to initial therapies. We analyzed the surgical outcomes in TN patients who failed prior treatments. Methods : We performed a retrospective analysis of 37 patients with recurrent or persistent TN symptoms who underwent surgery at our hospital between January 2010 and December 2014. Patients with follow-up data of at least one year were included. The prior treatment modalities of the 37 patients included microvascular decompression (MVD), gamma knife radiosurgery (GKRS), and percutaneous procedures such as radiofrequency rhizotomy (RFR), balloon compression, and glycerol rhizotomy (GR). The mean follow-up period was 69.9 months (range : 16-173). The mean interval between the prior treatment and second surgery was 26 months (range : 7-123). We evaluated the surgical outcomes using the Barrow Neurological Institute (BNI) pain intensity scale. Results : Among the 37 recurrent or persistent TN patients, 22 underwent MVD with partial sensory rhizotomy (PSR), 8 received MVD alone, and 7 had PSR alone. Monitoring of the surgical treatment outcomes via the BNI pain intensity scale revealed 8 (21.6%) patients with a score of I, 13 (35.1%) scoring II, 13 (35.1%) scoring III, and 3 (8.2%) scoring IV at the end of the follow-up period. Overall, 91.8% of patients had good surgical outcomes. With regard to postoperative complications, 1 patient had transient cerebrospinal fluid rhinorrhea (2.7%), another had a subdural hematoma (2.7%), and facial sensory changes were noted in 8 (21.1%) patients after surgery. Conclusion : Surgical interventions, such as MVD and PSR, are safe and very effective treatment modalities in TN patients who failed initial or prior treatments. We presume that the combination of MVD with PSR enabled us to obtain good short- and long-term surgical outcomes. Therefore, aggressive surgical treatment should be considered in patients with recurrent TN despite failure of various treatment modalities.

• 대한한방내과학회지
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• 제39권3호
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• pp.350-362
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• 2018

Objectives: By analyzing the characteristics and the distribution of diseases of patients who visited the emergency room of a Korean medical hospital, we sought to determine the methods of activating the Korean emergency medical system and to use this analysis as a basis for future research. Methods: We conducted a retrospective review of 959 patients who visited the emergency department of the Dong-Eui University Korean Medical Hospital from January 2016 to December 2016. The review was conducted using electronic medical records created during the emergency department visit. Results & Conclusions: In distribution of sex, the rate of males was 47.9%, and that of females was 52.1%. In distribution of age, the greatest number of patients were in their 50s (27.5%), followed by those in their 60s (19.9%) and 40s (14.8%). In distribution of residence, most patients were from Busan (84.9%). In distribution of week, more patients visited the emergency room on Sundays and holidays (44.3%). September was the busiest month (12.5%). Visits usually occurred during daytime and nighttime, and there were few visits at dawn. In the analysis of the time interval between onset of symptoms and the emergency room visit, most patients visited within 24 hours (46.5%). In the distribution of diseases, facial palsy was the most common (34.6%). In the systematic distribution of diseases, circulatory diseases were the most common (56.7%), followed by diseases of the musculoskeletal system (28.6%). The rate of first emergency room visit was 52.9%, and the rate of revisit was 47.1%. The rate of hospitalization after emergency room treatment was 27.5%, and the rate of discharge was 72.4%. The rate of revisit was 63.4%. In the distribution of treatment before arrival at the emergency room, direct was the most common (51.0%), and the outpatient department of western medicine was next. In the distribution of treatment in the emergency room, acupuncture was the highest (91.4%), followed by herb-med (43.0%).

• 한국정보과학회논문지:소프트웨어및응용
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• 제33권5호
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• pp.481-488
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• 2006

부공간 투영기술(subspace projection)을 이용한 얼굴인식기술의 성능은 이들 기저영상들(basis images)의 특징과 밀접한 관련이 있다. 특히 표정변화와 같은 국부적 왜곡이나 오클루전이 있는 경우의 인식성능은 기저영상들의 특징에 의해 영향을 받게 된다. 부공간 투영기반의 얼굴인식 방법이 오클루전이나 표정변화와 같은 국부적인 왜곡발생에 강인하려면 부분국부적 표현(part-based local representation)의 기저벡터를 갖는 것이 중요하다. 본 연구에서는 국부적 왜곡과 오클루전에 강인한 효과적인 부분국부적 표현방법을 제안한다. 제안한 방법을 LS-ICA(locally salient ICA) 방법이라고 명명하였다. LS-ICA방법은 ICA 구조I의 기저영상을 구하는 과정에서 공간적인 국부성(locality)의 제약조건을 부과함으로써 부분국부적 기저영상(part-based local basis images)을 얻는 방법이다. 결과적으로 공간적으로 현저한 특징만을 포함하는 기저영상을 사용하게 되며, 이는 "Recognition by Parts"의 방법론과 유사하다. LS-ICA방법과 LNMF(Localized Non-negative Matrix Factorization)와 LFA(Local Feature Analysis)와 같은 기존의 부분 표현방법(part-based representation)들에 대해 다양한 얼굴영상 데이타베이스를 사용하여 실험한 결과, LS-ICA방법이 기존의 방법에 비하여 높은 인식성능을 보였으며, 특히 오클루전이나 국부적인 변형이 포함된 얼굴영상에서 뛰어난 인식성능을 보였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권4호
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• pp.324-331
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• 2010

The radial forearm free flap (RFFF) has become a workhorse flap as a means of reconstructing surgical defects in the head and neck region. We have transferred 12 RFFFs with fasciocutaneous type on oral cavity defects in 12 patients after cancer resection and submucous fibrotic lesion ablation from 2005 to 2007 at Department of oral and maxillofacial surgery, Pusan National University Hospital. We reviewed retrospectively patients' charts and followed up the patients. Clinical analysis on the cases with RFFFs focusing on flap morbidity, indications and available vessels was done. The results of study are follows: 1. RFFF could be applied for all kind of defects after resection of tongue, floor of mouth, buccal mucosa, denuded bone of palate, maxilla, and mandible. 2. All free flaps could be used for primary reconstruction. The survival rate of 12 RFFFs was 92%. Partial marginal loss of the flaps was shown as 3 cases among 12 cases. Large size-vessels like superior thyroid artery, facial artery, internal jugular vein were favorable for microvascular anastomosis. 3. Parenteral nutrition instead of nasal L-tube also can be favorable for postoperative a week for better healing of the flap if the patients couldn't be tolerable with nasal tubing. 4. Donor sites with thigh skin graft were repaired with wrist band for 2 weeks. The complications included scarring, abnormal sensation on hand, and reduced grip strength in few patients, but those didn't induce major side effects. 5. Most RFFFs were well healed even if mortality rate of cancer patients was shown as 50% (5/10 persons). The mortality of patients was not correlated with morbidity of the flaps. We could identify the usefulness of RFFF for restoration of oral function, esthetics if the flap design, tissue transfer indications, and well controlled operation are proceeded.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권1호
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• pp.21-26
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• 2006

Considering the skeletal class III malocclusion that complains of mandibular prognathism, there have been some studies of the mandibular change for comparing the changes of pre operative with post operative state. Nowadays it is common to do the orthognathic 2-jaw surgery for the correction of the maxillary deficiency, the post operative stability and the esthetics. We compare and analyze the changes of soft tissue around the nose and the lip with the changes in the direction and the amount of maxilla. Patients who were diagnosed as maxillofacial deformity and received orthognathic surgery of both jaws at Yongdong Severance hospital from 2001 through 2003 were included in this study. Their lateral cephalograms were analyzed, and the post operative change of hard tissue and soft tissue were studied. Upon analyzing the preoperative cephalograms and 6 month post operative cephalograms, there were significant in the vertical change of Labialis superius(Ls) and Stomion(Stm) in soft tissue in relation to the vertical change of skeletal landmarks (Anterior Nasal Spine, Subspinale, Prosthion, Incision Superious). In addition, there were no significance in horizontal movement of the skeletal landmarks among groups. In terms of hard tissue landmarks, group 3(maxillary posterior impaction and advancement surgery group) showed significantly greater change in the vertical movement of Anterior Nasal Spine(ANS), Subspinale(A), Prosthion(Pr), and Incision Superious(Is) compared with other groups. In terms of soft tissue change, group 3 showed more significant change in the vertical movement of Ls and Stm. This study calculated the changes of the skeletal and soft tissue landmarks in order to act as a guide in planning and performing the surgery and as a reference in predicting the postoperative change of facial appearance.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.631-636
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• 2008

Purpose: Adipose tissue-derived stem cells(ADSC) has an osteoconductive potential and demineralized bone matrix(DBM) is an osteoinductive material. A combination of DBM and ADSC wound probably create osteoinductive properties. The purpose of this study is to determine the effect of the combination of DBM and ADSC mixture on healing of rat calvarial defect. Methods: Thirty adult male Sprague-Dawley rats were randomized into 3 groups(n=10) as 1) Control, 2) DBM alone, 3) DBM with ADSC mixture. DBM with ADSC mixture group has had a 3-day preculture of ADSC from groin fat pad. An 6 mm critical size circular calvarial defect was made in each rat. Defect was implanted with DBM alone or DBM with ADSC mixture. Control defect was left unfilled. 6 and 12 weeks after the implantation, the rats were sacrificed and the defects were evaluated by histomorphometric and radiographical studies. Results: Histomorphometric analysis revealed that DBM with ADSC mixture group showed significantly higher bone formation than DBM alone group(p<0.05). Although radiographs from DBM alone group and DBM with ADSC group revealed similar diffuse radiopaque spots dispersed throughout the defect. Densitometric analysis of calvarial defect revealed DBM with ADSC mixture group significantly higher bone formation than DBM alone(p<0.05). There was correlation of densitometry with new bone formation(Spearman's correlation of coefficient=0.804, 6 weeks, 0.802, 12 weeks). Conclusion: The DBM with ADSC mixture group showed the best healing response and the osteoinductive properties of DBM were accelerated with ADSC mixture. It will be clinically applicable that DBM and ADSC mixture in plastic and reconstructive surgery, such as alveolar cleft and congenital facial deformities that bone graft should be required.

• 초등상담연구
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• 제7권1호
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• pp.205-226
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• 2008

The purpose of the study you have seen is to verify the effectiveness of existing quantitative research and to put the Empathy Training Program to practical use for participating children. From looking into this, the changes in empathic understanding that came to light in relationships between teacher and children and children and children are sure to have that effect. For this work, I established the following subject of inquiry: What kind of changing processes can be seen in the empathic understanding of participating children in the Empathy Training Program? To resolve the above line of inquiry, six female sixth grade elementary school students were chosen and they progressed through twelve sessions of the Empathy Training Program. The children were given a sentence completion exam, recognition work, neat writing exam and a school adaptation exam both before and after participation in the program, making data for analysis. To analyze, first, participants had one or two meetings of forty to fifty minutes each. Progress through the program's curriculum was recorded and through the repeating and copying method, to be sure participating children's empathic understanding was revealed, empathic language and behavior was routinely chosen. Next, according the above criteria I looked into visible changes of the participating children's empathic expressions, classifying and analyzing changes in empathic understanding and six instances of common changes in the emphatic understanding of the participants relationships were analyzed and put together. Next I will summarize the findings we have seen in this research: First, if we look into changes in common empathic understanding from the beginning, using the criteria of empathic language, each individual showed understanding at the beginning and passed and progressed through stages of care, insight and emotional expressions. Second, when we looked at the criteria of empathic behavior from the beginning to the end, one's line of vision and ability to concentrate one's attention was connected. Next, the act of nodding one's head looked like a brief nod at first but at the end, it was not just a simple nod but rather they could feel deep empathy. The condition and substance of the facial expression was seen to match and at the very end the child was expressive and stretched out arms to hold and pat the other person and the act of holding hands could also be seen. Among lots of empathic behavior the final stage was shown by half of the children. Third, from the first stage to the last stage there were many cases revealed. The more the children went the more complete their empathic language became. Their vocabulary increased and became more diverse with empathic actions. Also, when comparing actions and expressions from the beginning with the end, visible expressions became more natural and sincere at the end. The result of the research we have seen is that through receiving experience of empathic understanding, participating children showed a sense of self-confidence and they looked to make peaceful expressions while not being aggressive or defensive about problems. In addition, from understanding empathic expressions, participating children's relationships felt closer. This outcome within this group in this case will be applied and the formation of empathic understanding can be used by the children internally to solve their own problems, acquire close relationships with their teachers and others. It will also contribute to smooth classroom management.

• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.25-28
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• 2016

Phelan-McDermid syndrome is a rare genetic disorder caused by the terminal or interstitial deletion of the chromosome 22q13.3. Patients with this syndrome usually have global developmental delay, hypotonia, and speech delays. Several putative genes such as the SHANK3, RAB, RABL2B, and IB2 are responsible for the neurological features. This study describes the clinical features and outcomes of Korean patients with Phelan-McDermid syndrome. Two patients showing global developmental delay, hypotonia, and speech delay were diagnosed with Phelan-McDermid syndrome via chromosome analysis, fluorescent in situ hybridization, and multiplex ligation-dependent probe amplification analysis. Brain magnetic resonance imaging of Patients 1 and 2 showed delayed myelination and severe communicating hydrocephalus, respectively. Electroencephalography in patient 2 showed high amplitude spike discharges from the left frontotemporoparietal area, but neither patient developed seizures. Kidney ultrasonography of both the patients revealed multicystic kidney disease and pelviectasis, respectively. Patient 2 experienced recurrent respiratory infections, and chest computed tomography findings demonstrated laryngotracheomalacia and bronchial narrowing. He subsequently died because of heart failure after a ventriculoperitoneal shunt operation at 5 months of age. Patient 1, who is currently 20 months old, has been undergoing rehabilitation therapy. However, global developmental delay was noted, as determines using the Korean Infant and Child Development test, the Denver developmental test, and the Bayley developmental test. This report describes the clinical features, outcomes, and molecular genetic characteristics of two Korean patients with Phelan-McDermid syndrome.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.173-181
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• 2011

Purpose: Masseter muscle is an important muscle of mastication. Because it has a great influence on the shape of low facial contour, patients who have masseteric hypertrophy show square-shaped jaw appearance. As aesthetic procedures for the reduction of the masseter muscle volume, radiofrequency ablation or botulinum toxin injection is at the center of attention. Authors studied the anatomical measurement of the thickness and width of masseter muscle and the surface mapping of the maximal thickness point using computed tomography (CT) scan to identify the useful guide for the injection of botulinum toxin in masseteric hypertrophy patients. Methods: We analyzed 2 mm-thickness OMU (ostiomeatal unit) CT of 112 normal people (224 masseter muscles) taken from June 2009 to May 2010. First, we measured the thickness, width and depth of the masseter muscle from the skin surface and analysed each by side, sex and age, respectively. The distribution of the thickness of the muscle and the correlation of thickness and width of the muscle were studied also. Second, we underwent surface mapping of the maximal thickness point using CT analysis by means of checking the vertical and horizontal distance from the angle of the mandible. Results: The average thickness and width of the masseter muscle was 17.73 mm and 40.78 mm in the male patients and were 14.33 mm and 37.42 mm in the female patients. Statistically, both figures of the male patients were larger than those of the female patients. However, the depth of the muscle from the skin surface in female patients (7.37 mm) was larger than that of the male patients (6.15 mm). There were no statistical difference in side or age. The width and thickness of the masseter muscle were in the positive correlation. The location of maximal thickness point of the masseter muscle was 27.77 mm vertically and 27.68 mm horizontally in the male patients, and 25.19 mm vertically and 25.42 mm horizontally in the female patients from the angle of mandible. Conclusion: We were able to present statistical evidence of the diagnosis and treatment of the masseteric hypertrophy regarding the anatomical measurements such as the thickness and width. And the maximal thickness point of the masseter muscle may be a useful guide for the clinical procedures of botulinum toxin injection.