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Missed Skeletal Trauma Detected by Whole Body Bone Scan in Patients with Traumatic Brain Injury

  • Seo, Yongsik;Whang, Kum;Pyen, Jinsu;Choi, Jongwook;Kim, Joneyeon;Oh, Jiwoong
    • Journal of Korean Neurosurgical Society
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    • v.63 no.5
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    • pp.649-656
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    • 2020
  • Objective : Unclear mental state is one of the major factors contributing to diagnostic failure of occult skeletal trauma in patients with traumatic brain injury (TBI). The aim of this study was to evaluate the overlooked co-occurring skeletal trauma through whole body bone scan (WBBS) in TBI. Methods : A retrospective study of 547 TBI patients admitted between 2015 and 2017 was performed to investigate their cooccurring skeletal injuries detected by WBBS. The patients were divided into three groups based on the timing of suspecting skeletal trauma confirmed : 1) before WBBS (pre-WBBS); 2) after the routine WBBS (post-WBBS) with good mental state and no initial musculoskeletal complaints; and 3) after the routine WBBS with poor mental state (poor MS). The skeletal trauma detected by WBBS was classified into six skeletal categories : spine, upper and lower extremities, pelvis, chest wall, and clavicles. The skeletal injuries identified by WBBS were confirmed to be simple contusion or fractures by other imaging modalities such as X-ray or computed tomography (CT) scans. Of the six categorizations of skeletal trauma detected as hot uptake lesions in WBBS, the lesions of spine, upper and lower extremities were further statistically analyzed to calculate the incidence rates of actual fractures (AF) and actual surgery (AS) cases over the total number of hot uptake lesions in WBBS. Results : Of 547 patients with TBI, 112 patients (20.4 %) were presented with TBI alone. Four hundred and thirty-five patients with TBI had co-occurring skeletal injuries confirmed by WBBS. The incidences were as follows : chest wall (27.4%), spine (22.9%), lower extremities (20.2%), upper extremities (13.5%), pelvis (9.4%), and clavicles (6.3%). It is notable that relatively larger number of positive hot uptakes were observed in the groups of post-WBBS and poor MS. The percentage of post-WBBS group over the total hot uptake lesions in upper and lower extremities, and spines were 51.0%, 43.8%, and 41.7%, respectively, while their percentages of AS were 2.73%, 1.1%, and 0%, respectively. The percentages of poor MS group in the upper and lower extremities, and spines were 10.4%, 17.4%, and 7.8%, respectively, while their percentages of AS were 26.7%, 14.2%, and 11.1%, respectively. There was a statistical difference in the percentage of AS between the groups of post-WBBS and poor MS (p=0.000). Conclusion : WBBS is a potential diagnostic tool in understanding the skeletal conditions of patients with head injuries which may be undetected during the initial assessment.

Medical Characteristics of the Elderly Pedestrian Inpatient in Traffic Accident (노인 보행자 운수사고 입원환자의 의료적 특성연구)

  • Park, Hye-Seon;Kim, Sang-Mi
    • Journal of Digital Convergence
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    • v.17 no.12
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    • pp.345-352
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    • 2019
  • This study aims to analyze the factors affecting the length of stay in elderly pediatric inpatients in traffic accidents. We used Korean National Hospital Discharge In-depth Injury data on the discharged from 2012 to 2016. Statistically significant factors affecting the length of stay are admission route, Charlson Comorbidity Index(CCI), injury parts, operation, results, hospital area, and beds for hospitals. The length of stay was shorter in the case of the admission route of the outpatient department than the emergency room, the results were not improved or death rather than improved, and the bed size was 500-999 beds or over 1000 beds rather than 100-299 beds. However, the length of stay was longer in the case of CCI score was 1-2 or over 3 rather than 0, injury parts were other parts rather than head/neck, when the operation was yes, and when the hospital area was a province, metropolitan rather than Seoul. This study intends to understand the medical characteristics of inpatient to prevent pedestrian traffic accidents in accordance with the population aging. Based on this finding, we wish to be used as the basic data for the establishment of policies to effectively manage traffic safety and medical resources in consideration of the characteristics of the elderly people.

The Infection Rate in Case of Cranioplasty According to Used Materials and Skull Defect Duration (두개골 성형술의 사용 재료와 수술 시기에 따른 감염율)

  • Kim, Young-Woo;Yoo, Do-Sung;Kim, Dal-Soo;Huh, Pil-Woo;Cho, Kyung-Suck;Kim, Jae-Gun;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.216-220
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    • 2001
  • Objective : Cranioplasty is required to protect underlying brain, to correct major aesthetic deformities, or both. The ideal material for this purpose is autogenous bone. When this is not available, alloplastic or artificial materials may be used. In this study authors compared the infection rate according to the cranioplasty materials(the frozen autologous bone vs. bone cement), and duration of the skull defect. Materials : Between May 1994 and December 1999, 111 patients with skull defect treated with cranioplasty(82 cases of frozen autologous bone and 29 cases of artificial bone material) were included in this study. There were 77 males and 34 females with a mean age of 41.4 years(range 1-85 years). 57 patients had head trauma and 54 had non-traumatic insults. According to the duration of skull defect, there were 28 cases under 1 month, 33 cases of 1-2 months, 15 cases of 2-3 months, 20 cases of 3-6 months and 15 cases over 6 months of duration. Results : Overall infection rate was 9.9%. In cases with frozen autologous bone and artificial bone material, the infection rate was 8.5% and 13.7%, respectively. The infection rate according to the duration of skull defect was 3.6%(among 28 cases) under 1 month of age, while those were 12%(4 among 33 cases) at 1-2 months, 20%(3 among 15 cases) at 2-3 months, 5%(1 among 20 cases) at 3-6 months and 13%(2 among 15 cases) over 6 months. Accoring to the underlying disease, the infection rate in traumatic cases was 12%(7 among 57 cases) and that in non-traumatic one was 3.7%(2 among 54 cases). Conclusion : From this study, it appears that skull defect should be repaired as soon as possible, because early cranioplasty can lower the infection rate. And surgeons could save the patients' cranial bone as possible as they can because autologous bone is not only cost effective in cosmatic purpose but lower the infection rate.

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Design of an Anamorphic Aspherical Prism Lens for the Head Mount Display (HMD용 회전 비대칭 비구면 프리즘 렌즈 설계)

  • Park, Seung-Hwan;Lee, Dong-Hee
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.4
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    • pp.83-88
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    • 2008
  • Purpose: To design an anamorphic aspherical prism lens for the HMD optical system. Methods: First, we get the initial data, needed in design, which are distances between each surface etc., by analyzing user's demended specifications and by drawing geometrically the shape of prism lens by using CAD. Based on these data and using 'ode V' which is an optical design software, we could progress the optimization in which we treat the coefficients of the anamorphic aspherical surface as the principal variables. To reduce the cost in DTM manufacturing, we would optimize the optical system with the transmitting surface, existed in the direction of video device among 3 surfaces of the prism lens, remaining as a plane. Results: we could design one anamorphic aspherical prism lens which has the finite ray aberration of 15 ${\mu}m$, the distortion of 0.5%, and the MTF value of 0.3 over at 36 lp/mm for the video device of 12 mm ${\times}$ 9 mm size. Conclusions: We designed a prism lens used for HMD. This prism lens has the optical capacities of 15 ${\mu}m$ finite ray aberration and 0.5% distortion for the video device of 12 mm ${\times}$ 9 mm size, and become the optical system having the MTF value of 0.3 over at 36 lp/mm.

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Survey and model development of the mechanization for swine farming (양돈농가의 기계화 실태분석 및 모델개발)

  • 이성현;박원규;강창호;오권영
    • Journal of Bio-Environment Control
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    • v.7 no.2
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    • pp.91-108
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    • 1998
  • This study was carried out to survey basic information of swine farms on the machine holdings. facility type. management of manure by farm scale and operation, and then to develop the mechanization model. Manual feeding was common for sows and nursing sows. but automation feeding was normally furnished for weaners. growing pigs and castrated male pigs. Water supplies was completely automated for all of the surveyed swine farms. Fully mechanized and automated system would not be feasible and affordable for the small scale farms breeding less than 500 heads. Because the environmental control for the nursing sows and weaner was important, some swine houses were constructed with the windowless type. However, the furnished rates ranged from 22.2% to 44.4% of the surveyed nursing sow and weaner houses at the farm scales. In the future, a computerized ventilation system would be commended for the efficient use of heat energy and to maintain the desirable temperature of swine buildings. Over-investment for large scale farm and over-crowded pigpen of small farm would cause wasting construction expenses and spreading epidermic diseases Hence, the size of swine building should follow the recommended scale. The fermentation drier was recommended for the manure management. Urine could be recycled or discharged after treating by the activated sludge process.

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A development of bivariate regional drought frequency analysis model using copula function (Copula 함수를 이용한 이변량 가뭄 지역빈도해석 모형 개발)

  • Kim, Jin-Guk;Kim, Jin-Young;Ban, Woo-Sik;Kwon, Hyun-Han
    • Journal of Korea Water Resources Association
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    • v.52 no.12
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    • pp.985-999
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    • 2019
  • Over the last decade, droughts have become more severe and frequent in many regions, and several studies have been conducted to explore the recent drought. Copula-based bivariate drought frequency analysis has been widely used to evaluate drought risk in the context of point frequency analysis. However, the relatively significant uncertainties in the parameters are problematic when available data are limited. For this reason, the primary purpose of this study is to develop a regional drought frequency model based on the Copula function. All parameters, including marginal and copula functions in the regional frequency model, were estimated simultaneously. Here, we present a case study of recent drought 2013-2015 over the Han-River watershed where severe drought risk is consistently found to increase. The proposed model provided a reliable way to significantly reduce the uncertainty of parameters with a Bayesian modeling framework. The uncertainty of the joint return period in the regional frequency analysis is nearly three times lower than that of the point frequency analysis. Accordingly, DIC values in the regional frequency analysis model are significantly decreased by 15. The results confirm that the proposed model is not only reliably representing characteristics of historical droughts and dependencies between drought variables, but also providing the efficacy of understanding regional drought characteristics.

Stereo-based Robust Human Detection on Pose Variation Using Multiple Oriented 2D Elliptical Filters (방향성 2차원 타원형 필터를 이용한 스테레오 기반 포즈에 강인한 사람 검출)

  • Cho, Sang-Ho;Kim, Tae-Wan;Kim, Dae-Jin
    • Journal of KIISE:Software and Applications
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    • v.35 no.10
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    • pp.600-607
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    • 2008
  • This paper proposes a robust human detection method irrespective of their pose variation using the multiple oriented 2D elliptical filters (MO2DEFs). The MO2DEFs can detect the humans regardless of their poses unlike existing object oriented scale adaptive filter (OOSAF). To overcome OOSAF's limitation, we introduce the MO2DEFs whose shapes look like the oriented ellipses. We perform human detection by applying four different 2D elliptical filters with specific orientations to the 2D spatial-depth histogram and then by taking the thresholds over the filtered histograms. In addition, we determine the human pose by using convolution results which are computed by using the MO2DEFs. We verify the human candidates by either detecting the face or matching head-shoulder shapes over the estimated rotation. The experimental results showed that the accuracy of pose angle estimation was about 88%, the human detection using the MO2DEFs outperformed that of using the OOSAF by $15{\sim}20%$ especially in case of the posed human.

Part I Advantages re Applications of Slab type YAG Laser PartII R&D status of All Solid-State Laser in JAPAN

  • Iehisa, Nobuaki
    • Proceedings of the Korean Society of Laser Processing Conference
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    • 1998.11a
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    • pp.0-0
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    • 1998
  • -Part I- As market needs become more various, the production of smaller quantities of a wider variety of products becomes increasingly important. In addition, in order to meet demands for more efficient production, long-term unmanned factory operation is prevailing at a remarkable pace. Within this context, laser machines are gaining increasing popularity for use in applications such as cutting and welding metallic and ceramic materials. FANUC supplies four models of $CO_2$ laser oscillators with laser power ranging from 1.5㎾ to 6㎾ on an OEM basis to machine tool builders. However, FANUC has been requested to produce laser oscillators that allow more compact and lower-cost laser machines to be built. To meet such demands, FANUC has developed six models of Slab type YAG laser oscillators with output power ranging from 150W to 2㎾. These oscillators are designed mainly fur cutting and welding sheet metals. The oscillator has an exceptionally superior laser beam quality compared to conventional YAG laser oscillators, thus providing significantly improved machining capability. In addition, the laser beam of the oscillator can be efficiently transmitted through quartz optical fibers, enabling laser machines to be simplified and made more compact. This paper introduces the features of FANUC’s developed Slab type YAG laser oscillators and their applications. - Part II - All-solid-state lasers employing laser diodes (LD) as a source of pumping solid-state laser feature high efficiency, compactness, and high reliability. Thus, they are expected to provide a new generation of processing tools in various fields, especially in automobile and aircraft industries where great hopes are being placed on laser welding technology for steel plates and aluminum materials for which a significant growth in demand is expected. Also, in power plants, it is hoped that reliability and safety will be improved by using the laser welding technology. As in the above, the advent of high-power all-solid-state lasers may not only bring a great technological innovation to existing industry, but also create new industry. This is the background for this project, which has set its sights on the development of high-power, all-solid-state lasers with an average output of over 10㎾, an oscillation efficiency of over 20%, and a laser head volume of below 0.05㎥. FANUC Ltd. is responsible for the research and development of slab type lasers, and TOSHIBA Corp. far rod type lasers. By pumping slab type Nd: YAG crystal and by using quasi-continuous wave (QCW) type LD stacks, FANUC has already obtained an average output power of 1.7㎾, an optical conversion efficiency of 42%, and an electro-optical conversion efficiency of 16%. These conversion efficiencies are the best results the world has ever seen in the field of high-power all-solid-state lasers. TOSHIBA Corp. has also obtained an output power of 1.2㎾, an optical conversion efficiency of 30%, and an electro-optical conversion efficiency of 12%, by pumping the rod type Nd: YAG crystal by continuous wave (CW) type LD stacks. The laser power achieved by TOSHIBA Corp. is also a new world record in the field of rod type all-solid-state lasers. This report provides details of the above results and some information on future development plans.

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Radiation Absorbed Dose Calculation Using Planar Images after Ho-166-CHICO Therapy (Ho-166-CHICO 치료 후 평면 영상을 이용한 방사선 흡수선량의 계산)

  • 조철우;박찬희;원재환;왕희정;김영미;박경배;이병기
    • Progress in Medical Physics
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    • v.9 no.3
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    • pp.155-162
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    • 1998
  • Ho-l66 was produced by neutron reaction in a reactor at the Korea Atomic Energy Institute (Taejon, Korea). Ho-l66 emits a high energy beta particles with a maximum energy of 1.85 MeV and small proportion of gamma rays (80 keV). Therefore, the radiation absorbed dose estimation could be based on the in-vivo quantification of the activity in tumors from the gamma camera images. Approximately 1 mCi of Ho-l66 in solution was mixed into the flood phantom and planar scintigraphic images were acquired with and without patient interposed between the phantom and scintillation camera. Transmission factor over an area of interest was calculated from the ratio of counts in selected regions of the two images described above. A dual-head gamma camera(Multispect2, Siemens, Hoffman Estates, IL, USA) equipped with medium energy collimators was utilized for imaging(80 keV${\pm}$10%). Fifty-nine year old female patient with hepatoma was enrolled into the therapeutic protocol after the informed consent obtained. Thirty millicuries(110MBq) of Ho-166-CHICO was injected into the right hepatic arterial branch supplying hepatoma. When the injection was completed, anterior and posterior scintigraphic views of the chest and pelvic regions were obtained for 3 successive days. Regions of interest (ROIs) were drawn over the organs in both the anterior and posterior views. The activity in those ROIs was estimated from geometric mean, calibration factor and transmission factors. Absorbed dose was calculated using the Marinelli formula and Medical Internal Radiation Dose (MIRD) schema. Tumor dose of the patient treated with 1110 MBq(30 mCi) Ho-l66 was calculated to be 179.7 Gy. Dose distribution to normal liver, spleen, lung and bone was 9.1, 10.3, 3.9, 5.0 % of the tumor dose respectively. In conclusion, tumor dose and absorbed dose to surrounding structures were calculated by daily external imaging after the Ho-l66 therapy for hepatoma. In order to limit the thresholding dose to each surrounding organ, absorbed dose calculation provides useful information.

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Seedling Plug and Cutting Method for Multi-propagation of Ornamental Miscanthus Spp. (조경용 억새의 대량번식을 위한 플러그묘와 삽목번식법)

  • Hwang, Kyung Sik;Joo, Song Tak;Ha, Soo Sung;Kim, Ki Dong;Joo, Young Kyoo
    • Weed & Turfgrass Science
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    • v.7 no.3
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    • pp.275-282
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    • 2018
  • Miscanthus species are known as a genus of eco-friendly and low-maintenance cost ornamental grasses. Plug and cutting methods were tested for multi-propagation of most promising ornamental Miscanthus species in greenhouse and field plot. The plug formation period with three different cell sizes with four cultivars (M. sinensis 'Andersson', 'Strictus', 'Gracillimus', 'Variegatus') were evaluated the seedling development stages with two irrigation types of the over-head and the bottom watering in greenhouse and field plot afterward during 2015-2016 season. In seedling plug test, the size of tray cell affected the plug formation. Bottom irrigation resulted positively on plant height, weight, root and tiller development compared with the over-head irrigation. Plug cell size affected the plant growth in the field after transplanting. All of the 3 Miscanthus species showed higher rates of successful propagation at the lower nodes before inflorescence formation (vegetative growth stage). To analyze the survival factors of M. xgiganteus cutting, the cutting time, node part, and culm diameter were tested as independent variables with the binary logistic model. The survival probability was influenced by node part and culm diameter significantly. The third and fifth node parts showed 0.12 (8X higher failure probability) and 0.02 (50X higher failure probability) times less survival probability. It means the survival probability will be increased by using older and lower part of cuttings during a vegetative growth stage before inflorescences of M. xgiganteus.