• Advances in pediatric surgery
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• v.7 no.2
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• pp.105-111
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• 2001

To investigate the diagnostic accuracy and applicability of barium enema(BE) and rectal suction biopsy with acetyl cholinesterase(AChE) histochemistry in the diagnosis of neonatal Hirschsprung's disease(HD), we retrospectively reviewed the findings of BE and AChE staining in 96 neonates with suspected HD during a 10-year period from January 1991 to December 2000. Sixty-nine cases of HD(58 males and 11 females) and 27 cases of non-HD are included in this study. In regard to BE, HD was based on definite transitional zone, suspicious HD on reversed rectosigmoid index(RSI <1), and non-HD on normal RSI(RSI>1). The histochemical criterion used for the diagnosis of HD was that of Chow et al(1977), i.e., the presence of many coarse discrete cholinergic nerve fibers in the muscularis mucosae and in the immediately subjacent submucosa regardless of infiltration of cholinergic nerve fibers in the lamina propria. Of 66 neonates with HD who underwent BE, transitional zone was identified in 33 cases(50 %) and reversed RSI in 19 cases(21 %), microcolon in 4 cases and normal finding in 10 cases(15 %) while of 27 neonates with non-HD, there was normal finding in 16 cases and reversed RSI in 9 cases(41 %). Thus diagnostic accuracy based on transitional zone was 64 %. The positive predictive value of reversed RSI for the diagnosis of HD was 68 %. Of 42 neonates with HD who underwent AChE histochemistry, there were 41 AChE-positive reactions and one AChE-negative reaction in a neonate with total colonic aganglionosis, while of 27 cases of non-HD, there were one equivocal AChE-positive reaction and 26 AChE-negative reactions. Thus AChE histochemical study showed a 97 % diagnostic accuracy with a 98 % sensitivity and a 96 % specificity. In conclusion, we believe that BE is valuable as a first diagnostic step since about 80 % of neonates with HD show significant radiologic findings such as a transitional zone or reversed RSI. AChE histochemical study was a more reliable diagnos tic tool showing a 97 % diagnostic accuracy, and is part.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.2
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• pp.96-101
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• 2007

Laryngopharyngeal reflux (LPR) is the retrograde movement of gastric contents into the larynx, pharynx, and upper aero-digestive tract. LPR differs from gastroesophageal reflux in that it is often not associated with heartburn and regurgitation symptoms. Otolaryngological manifestations of acid reflux include a wide range of pharyngeal and laryngeal symptoms. Belafsky et al. developed a useful self-administered tool, the reflux symptom index (RSI), for assessing the degree of LPR symptoms. Patients are asked to use a 0 to 5 point scale to grade the following symptoms: 1) hoarseness or voice problems; 2) throat clearing; 3) excess throat mucus or postnasal drip ; 4) difficulty swallowing; 5) coughing after eating or lying down; 6) breathing difficulties ; 7) troublesome or annoying cough; 8) sensation of something sticking or a lump in the throat; 9) heartburn, chest pain, indigestion or stomach acid coming up. A RSI score greater than 13 is considered abnormal. As there is no validated instrument to document the physical findings and severity of LPR, Belafsky et al. developed an eight-item clinical severity scale for judging laryngoscopic finding, the reflux finding score (RFS). They rated eight LPR-associated findings on a scale from 0 to 4 : subglottic edema, ventricular obliteration, erythema/hyperemia, vocal-fold edema, diffuse laryngeal edema, posterior commissure hypertrophy, granuloma/granulation tissue, and thick endolaryngeal mucus. A RFS score of greater than 7 was found to suggest LPR-associated laryngitis. Although both indices (RSI and RFS) are widely used, there is some controversy about their validity (sensitivity and specificity) and reliability (intra-rater and inter-rater) in LPR diagnosis and treatment. We discuss the validity and reliability of RSI and RFS with literature review.

• Proceedings of the KIEE Conference
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• 1998.07g
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• pp.2284-2289
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• 1998

The Rotor Stress Indicator is an integrated system of hardware and program components which has been designed to read an assortment of turbine temperature and speed input devices, perform an analysis of the temperature induced stresses and output pertinent temperature and stress information to guide the turbine operator during turbine prewarming, start-ups, load changes, and shut-downs. The purpose of the RSI is to provide guidance to the plant operator during startup, shutdown, loading, and unloading of the turbine. Since the stresses are a function of the temperature changes to which the turbine is exposed, the RSI also provides guidance for operation of the boiler main steam and reheat steam temperatures as they affect the rotor stresses. This may permit more efficient overall boiler turbine start-ups. In this paper, new rotor stress analysis algorithm for RSI is introduced and compared with present system which has been used in thermal power plant.

• Journal of the Korean Geotechnical Society
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• v.15 no.4
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• pp.57-67
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• 1999

In conventional stability analysis of embankment on soft clay ground, an averaged undrained shear strength$(s_u)$ for the depth of clay layer is usually used. Also, all applied load is assumed to an immediate load for simplicity of analysis. The load in the field, however, increases gradually. Undrained shear strength increases during loading due to consolidation of clay ground. In this study, the stability analysis program(RSI-SLOPE) is developed. By using this program, it is possible to consider the rate of strength increase according to the elapsed time of consolidation and the depth of clay ground. And the rested duration for consolidation and gradually increased load can also be considered. Using the examples of some embankments, the critical embankment heights calculated by RSI-SLOPE program are compared with those by PCSTABL without the considerations of gradually increased load and rate of strength increase. In addition, this study contains analysis and comparison about the influence of coefficient of consolidation$(c_u)$ and drainage distance$(H_{DR})$ in the embankment design. RSI-SlOPE program may be useful for more effective and accurate embankment design.

• Investigative Magnetic Resonance Imaging
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• v.19 no.3
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• pp.162-167
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• 2015

Purpose: To evaluate the usefulness of quantitative analysis of the facial nerve using contrast-enhanced three-dimensional (CE 3D) fluid-attenuated inversion recovery-volume isotopic turbo spin echo acquisition (FLAIR-VISTA) for the diagnosis of Bell's palsy in pediatric patients. Materials and Methods: Twelve patients (24 nerves) with unilateral acute facial nerve palsy underwent MRI from March 2014 through March 2015. The unaffected sides were included as a control group. First, for quantitative analysis, the signal intensity (SI) and relative SI (RSI) for canalicular, labyrinthine, geniculate ganglion, tympanic, and mastoid segments of the facial nerve on CE 3D FLAIR images were measured using regions of interest (ROI). Second, CE 3D FLAIR and CE T1-SE images were analyzed to compare their diagnostic performance by visual assessment (VA). The sensitivity, specificity, and accuracy of RSI measurement and VA were compared. Results: The absolute SI of canalicular and mastoid segments and the sum of the five mean SI (total SI) were higher in the palsy group than in the control group, but with no significant differences. The RSI of the canalicular segment and the total SI were significantly correlated with the symptomatic side (P = 0.028 and 0.015). In 11/12 (91.6%) patients, the RSI of total SI resulted in accurate detection of the affected side. The sensitivity, specificity, and accuracy for detecting Bell's palsy were higher with RSI measurement than with VA of CE 3D FLAIR images, while those with VA of CE T1-SE images were higher than those with VA of CE 3D FLAIR images. Conclusion: Quantitative analysis of the facial nerve using CE 3D FLAIR imaging can be useful for increasing the diagnostic performance in children with Bell's palsy when difficult to diagnose using VA alone. With regard to VA, the diagnostic performance of CE T1-SE imaging is superior to that of CE 3D FLAIR imaging in children. Further studies including larger populations are necessary.

• Proceedings of the KSRS Conference
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• 2005.10a
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• pp.142-145
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• 2005

Since the successful launch of FORMOSAT -2 satellite by National Space Organization of Taiwan in May 2004, the Remote Sensing Instrument (RSI) on- board the FORMOSAT -2 has continuously acquired images at one panchromatic and four multi-spectral bands (http://www.nspo.org.tw). In general, the RSI performs well and receives high quality images which proved to be very useful for various applications. However, some RSI panchromatic products exhibit obvious trembling artifact that must be removed. Preliminary study reveals that the trembling artifact is caused by the instability of the spacecraft attitude. Though the magnitude of this artifact is actually less than half of a pixel, it affects the applicability of panchromatic products. A procedure removing this artifact is therefore needed for providing image products of consistent quality. Due to the nature of trembling artifact, it is impossible to describe the trembling amount by employing an analytic model. Relied only on image itself, an algorithm determining trembling amount and removing accordingly the trembling artifact is proposed. The algorithm consists of 3 stages. First, a cross-correlation based scheme is used to measure the relative shift between adjacent scan lines. Follows, the trembling amount is estimated from the measured value. For this purpose, the Fourier transform is utilized to characterize random shifts in frequency domain. An adaptive estimation method is then applied to deduce the approximate trembling amount. In the subsequent stage, image re-sampling operation is applied to restore the trembling-free product. Experimental results show that by applying the proposed algorithm, the unpleasant trembling artifact is no longer evident.

• Journal of Trauma and Injury
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• v.33 no.3
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• pp.195-203
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• 2020

The following key questions and recommendations are presented herein: when is airway intubation initiated in severe trauma? Airway intubation must be initiated in severe trauma patients with a GCS of 8 or lower (1B). Should rapid sequence intubation (RSI) be performed in trauma patients? RSI should be performed in trauma patients to secure the airway unless it is determined that securing the airway will be problematic (1B). What should be used as an induction drug for airway intubation? Ketamine or etomidate can be used as a sedative induction drug when RSI is being performed in a trauma patient (2B). If cervical spine damage is suspected, how is cervical protection achieved during airway intubation? When intubating a patient with a cervical spine injury, the extraction collar can be temporarily removed while the neck is fixed and protected manually (1C). What alternative method should be used if securing the airway fails more than three times? If three or more attempts to intubate the airway fail, other methods should be considered to secure the airway (1B). Should trauma patients maintain normal ventilation after intubation? It is recommended that trauma patients who have undergone airway intubation maintain normal ventilation rather than hyperventilation or hypoventilation (1C). When should resuscitative thoracotomy be considered for trauma patients? Resuscitative thoracotomy is recommended for trauma patients with penetrating injuries undergoing cardiac arrest or shock in the emergency room (1B).

• International Journal of Fluid Machinery and Systems
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• v.10 no.3
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• pp.287-295
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• 2017

The most detrimental pressure pulsations in high-head pump-turbines is caused by the rotor-stator interaction (RSI) between the guide vanes and runner blades. When the pump-turbine operates in the S-shaped region of the characteristic curves, the deteriorative flow structures may significantly strengthen RSI, causing larger pressure pulsations and stronger vibration with an increased risk of mechanical failure. CFD simulations were carried out to analyze the impacts of flow evolution on the pressure pulsations in the S-shaped region of a model pump-turbine. The results show that the reverse flow vortex structures (RFVS) at the runner inlet have regular development and transition patterns when discharge reduces from the best efficiency point (BEP). The RFVS first occur at the hub side, and then shift to the mid-span near the no-load point, which cause the strongest pressure pulsations. The locally distributed RFVS at hub side enhance the local RSI and makes the pressure fluctuations at the corresponding sections stronger than those at the rest sections along the spanwise direction. Under the condition of RFVS at the mid-span, the smaller flow rate make the smaller difference of pressure pulsation amplitudes in the spanwise direction. Moreover, the rotating stall, rotating at 35.7%-62.5% of the runner rotational frequency, make the low frequency components of pressure pulsations distribute unevenly along the circumference in the vaneless space. However, it have little influence on the distributions of high components.

• The Plant Pathology Journal
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• v.37 no.6
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• pp.566-579
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• 2021

Ralstonia syzygii subsp. indonesiensis (Rsi, former name: Ralstonia solanacearum phylotype IV) PW1001, a causal agent of potato wilt disease, induces hypersensitive response (HR) on its non-host eggplant (Solanum melongena cv. Senryo-nigou). The disaccharide trehalose is involved in abiotic and biotic stress tolerance in many organisms. We found that trehalose is required for eliciting HR on eggplant by plant pathogen Rsi PW1001. In R. solanacearum, it is known that the OtsA/OtsB pathway is the dominant trehalose synthesis pathway, and otsA and otsB encode trehalose-6-phosphate (T6P) synthase and T6P phosphatase, respectively. We generated otsA and otsB mutant strains and found that these mutant strains reduced the bacterial trehalose concentration and HR induction on eggplant leaves compared to wild-type. Trehalose functions intracellularly in Rsi PW1001 because addition of exogenous trehalose did not affect the HR level and ion leakage. Requirement of trehalose in HR induction is not common in R. solanacearum species complex because mutation of otsA in Ralstonia pseudosolanacearum (former name: Ralstonia solanacearum phylotype I) RS1002 did not affect HR on the leaves of its non-host tobacco and wild eggplant Solanum torvum. Further, we also found that each otsA and otsB mutant had reduced ability to grow in a medium containing NaCl and sucrose, indicating that trehalose also has an important role in osmotic stress tolerance.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.692-696
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• 2018

Background and Objectives This study investigated the relationship between reflux symptom index (RSI) and psychiatric problems such as depression, somatization, and anxiety. Subjects and Method We prospectively analyzed 231 patients with symptoms with laryngopharyngeal reflux (LPR) using the RSI and the reflux finding score. Results Seventy nine patients (34.2%) were diagnosed with LPR. A significant correlation was detected between the RSI and depression ($18.4{\pm}8.3$ vs. $12.3{\pm}7.0$, p<0.001), anxiety ($19.5{\pm}8.5$ vs. $13.0{\pm}7.3$, p<0.001), and somatization ($19.2{\pm}9.1$ vs. $13.6{\pm}7.5$, p<0.001). A multivariate analysis confirmed a significant association between heartburn and depression [odds ratio (OR): 1.241, 95% confidence interval (CI): 1.003-1.537, p=0.047], choking and anxiety (OR: 1.747, 95% CI: 1.297-2.352, p<0.001), and choking and somatization (OR: 1.707, 95% CI: 1.248-2.336, p=0.001). Conclusion Our preliminary results suggest that patients with high RSI may need to be carefully evaluated for psychiatric problems.