• Title/Summary/Keyword: Skin motion

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A Case of the Shoulder-Hand Syndrome Caused by a Crush Injury of the Shoulder (견관절부 외상후 발생된 Shoulder-Hand Syndrome)

  • Jeon, Jae-Soo;Lee, Sung-Keun;Song, Hoo-Bin;Kim, Sun-Jong;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.155-166
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    • 1989
  • Bonica defined, that reflex sympathetic dystrophy (RSD) may develop pain, vasomotor abnoramalities, delayed functional recovery, and dystrophic changes on an affected area without major neurologic injury following trauma, surgery or one of several diseased states. This 45 year old male patient had been crushed on his left shoulder by a heavily laden rear car, during his job street cleaning about 10 years ago (1978). At first the pain was localizea only to the site of injury, but with time, it spreaded from the shoulder to the elbow and hand, with swelling. X-ray studies in the local clinic, showed no bone abnormalities of the affected site. During about 10 years following the injury, the had recieved several types of treatments such as nonsteroidal analgesics, steroid injections into the glenoidal cavity (10 times), physical therapy, some oriental herb medicines, and acupuncture over a period of 1~3 months annually. His shoulder pain and it's joint dysfunction persisted with recurrent paroxysmal aggrevation because of being mismanaged or neglected for a sufficiently long period these fore permiting progression of the sympathetic imbalance. On July 14 1988 when he visited our clinic. He complained of burning, aching and had a hyperpathic response or hyperesthesia in touch from the shoulder girdle to the elbow and the hand. Also the skin of the affected area was pale, cold, and there was much sweating of the axilla and palm, but no edema. The shoulder girdle was unable to move due to joint pain with marked weakness. We confirmed skin temperatures $5^{\circ}C$ lower than those of the unaffected axilla, elbow and palm of his hand, and his nails were slightly ridged with lateral arching and some were brittle. On X-ray findings of both the shoulder AP & lateral view, the left humerus and joint area showed diffuse post-traumatic osteoporosis and fibrous ankylozing with an osteoarthritis-like appearance. For evaluating the RSD and it's relief of pain, the left cervical sympathetic ganglion was blocked by injecting 0.5% bupivacaine 5 ml with normal saline 5 ml (=SGB). After 15 minutes following the SGB, the clinical efficacy of the block by the patients subjective score of pain intensity (=PSSPI), showed a 50% reduction of his shoulder and arm pain, which was burning in quality, and a hyperpathic response against palpation by the examiner. The skin temperatures of the axilla and palm rose to $4{\sim}5^{\circ}C$ more than those before the SGB. He felt that his left face and upper extremity became warmer than before the SGB, and that he had reduced sweating on his axilla and his palm. Horner's sign was also observed on his face and eyes. But his deep shoulder joint pain was not improved. For the control of the remaining shoulder joint pain, after 45 minutes following the SGB, a somatic sensory block was performed by injecting 0.5% bupivacaine 6 ml mixed with salmon calcitonin, $Tridol^{(R)}$, $Polydyn^{(R)}$ and triamcinolone into the fossa of the acromioclavicular joint region. The clinical effect of the somatic block showed an 80% releif of the deep joint pain by the PSSPI of the joint motion. Both blocks, as the above mentioned, were repeated a total of 28 times respectively, during 6 months, except the steroid was used just 3 times from the start. For maintaining the relieved pain level whilst using both blocks, we prescribed a low dose of clonazepam, prazocin, $Etravil^{(R)}$, codeine, etodolac micronized and antacids over 6 months. The result of the treatments were as follows; 1) The burning, aching and hyperpathic condition which accompanied with vaosmotor and pseudomotor dysfunction, disappeared gradually to almost nothing, within 3 weeks from the starting of the blocks every other day. 2) The joint disability of the affected area was improved little by little within 6 months. 3) The post-traumatic osteoporosis, fibrous ankylosis and marginal sclerosis with a narrowed joint, showed not much improvement on the X-ray findings (on April 25, 1989) 10 months later in the follow-up. 4) Now he has returned to his job as a street cleaner.

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The Clinical Effect and Construction of a Stereotactic Whole Body Immobilization Device (전신 정위 고정장치 제작과 임상효과에 대한 연구)

  • 정진범;정원균;서태석;최경식;진호상;지영훈
    • Progress in Medical Physics
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    • v.15 no.1
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    • pp.30-38
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    • 2004
  • Purpose: To develop a whole body frame for the purpose of reducing patient motion and minimizing setup error for extra-cranial stereotactic radiotherapy, and to evaluate the repositioning setup error of a patient in the frame. Materials and Methods: The developed whole body frame is composed of a base plate, immobilizer, vacuum cushion, ruler and belts. The dimension of the base plate is 130 cm in length, 50 cm in width and 1 cm in thickness. The material used in the base plate of the frame was bakelite and the immobilizer was made of acetal. In addition, Radiopaque angio-catheter wires were engraved on the base plate for a coordinate system to determine the target localization. The measurement for radiation transmission and target localization is peformed in order to test the utilization of the frame. Also, a Matlab program analyzed the patients setup error by using the patient's setup images obtained from a CCTV camera and digital record recorder (DVR). Results: A frame that is useful for CT simulation and radiation treatment was fabricated. The frame structure was designed to minimize collisions from the changes in the rotation angle of the gantry and to maximize the transmission rate of the Incident radiation at the lateral or posterior oblique direction. The lightening belts may be used for the further reduction of the patient motion, and the belts can be adjusted so that they are not in the way of beam direction. The radiation transmission rates of this frame were measured as 95% and 96% at 10 and 21 MV, respectively. The position of a test target on the skin of a volunteer is accurately determined by CT simulation using the coordinate system in the frame. The estimated setup errors by Matlab program are shown 3.69$\pm$1.60, 2.14$\pm$0.78 mm at the lateral and central chest, and 7.11 $\pm$2.10, 6.54$\pm$2.22 mm at lateral and central abdomen, respectively. The setup error due to the lateral motion of breast is shown as 6.33$\pm$ 1.55 mm. Conclusion: The development and test of a whole body frame has proven very useful and practical in the radiosurgery for extra-cranial cancers. It may be used in determining target localization, and it can be used as a patient immobilization tool. More experimental data should be obtained in order to improve and confirm the results of the patient setup error.

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Using the fusion of spatial and temporal features for malicious video classification (공간과 시간적 특징 융합 기반 유해 비디오 분류에 관한 연구)

  • Jeon, Jae-Hyun;Kim, Se-Min;Han, Seung-Wan;Ro, Yong-Man
    • The KIPS Transactions:PartB
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    • v.18B no.6
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    • pp.365-374
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    • 2011
  • Recently, malicious video classification and filtering techniques are of practical interest as ones can easily access to malicious multimedia contents through the Internet, IPTV, online social network, and etc. Considerable research efforts have been made to developing malicious video classification and filtering systems. However, the malicious video classification and filtering is not still being from mature in terms of reliable classification/filtering performance. In particular, the most of conventional approaches have been limited to using only the spatial features (such as a ratio of skin regions and bag of visual words) for the purpose of malicious image classification. Hence, previous approaches have been restricted to achieving acceptable classification and filtering performance. In order to overcome the aforementioned limitation, we propose new malicious video classification framework that takes advantage of using both the spatial and temporal features that are readily extracted from a sequence of video frames. In particular, we develop the effective temporal features based on the motion periodicity feature and temporal correlation. In addition, to exploit the best data fusion approach aiming to combine the spatial and temporal features, the representative data fusion approaches are applied to the proposed framework. To demonstrate the effectiveness of our method, we collect 200 sexual intercourse videos and 200 non-sexual intercourse videos. Experimental results show that the proposed method increases 3.75% (from 92.25% to 96%) for classification of sexual intercourse video in terms of accuracy. Further, based on our experimental results, feature-level fusion approach (for fusing spatial and temporal features) is found to achieve the best classification accuracy.

Efficient Intermediate Joint Estimation using the UKF based on the Numerical Inverse Kinematics (수치적인 역운동학 기반 UKF를 이용한 효율적인 중간 관절 추정)

  • Seo, Yung-Ho;Lee, Jun-Sung;Lee, Chil-Woo
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.47 no.6
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    • pp.39-47
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    • 2010
  • A research of image-based articulated pose estimation has some problems such as detection of human feature, precise pose estimation, and real-time performance. In particular, various methods are currently presented for recovering many joints of human body. We propose the novel numerical inverse kinematics improved with the UKF(unscented Kalman filter) in order to estimate the human pose in real-time. An existing numerical inverse kinematics is required many iterations for solving the optimal estimation and has some problems such as the singularity of jacobian matrix and a local minima. To solve these problems, we combine the UKF as a tool for optimal state estimation with the numerical inverse kinematics. Combining the solution of the numerical inverse kinematics with the sampling based UKF provides the stability and rapid convergence to optimal estimate. In order to estimate the human pose, we extract the interesting human body using both background subtraction and skin color detection algorithm. We localize its 3D position with the camera geometry. Next, through we use the UKF based numerical inverse kinematics, we generate the intermediate joints that are not detect from the images. Proposed method complements the defect of numerical inverse kinematics such as a computational complexity and an accuracy of estimation.

Eye Tracking Using Neural Network and Mean-shift (신경망과 Mean-shift를 이용한 눈 추적)

  • Kang, Sin-Kuk;Kim, Kyung-Tai;Shin, Yun-Hee;Kim, Na-Yeon;Kim, Eun-Yi
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.44 no.1
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    • pp.56-63
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    • 2007
  • In this paper, an eye tracking method is presented using a neural network (NN) and mean-shift algorithm that can accurately detect and track user's eyes under the cluttered background. In the proposed method, to deal with the rigid head motion, the facial region is first obtained using skin-color model and con-nected-component analysis. Thereafter the eye regions are localized using neural network (NN)-based tex-ture classifier that discriminates the facial region into eye class and non-eye class, which enables our method to accurately detect users' eyes even if they put on glasses. Once the eye region is localized, they are continuously and correctly tracking by mean-shift algorithm. To assess the validity of the proposed method, it is applied to the interface system using eye movement and is tested with a group of 25 users through playing a 'aligns games.' The results show that the system process more than 30 frames/sec on PC for the $320{\times}240$ size input image and supply a user-friendly and convenient access to a computer in real-time operation.

Treatment of Distal Clavicular Fracture by Reconstruction Plate and Wire Fixation (쇄골 원위부 골절에 대한 재건 금속판과 강선 고정술을 이용한 치료)

  • Suh, Mu-Sam;Kim, Sang-Hyo;Park, Hyeong-Taek
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.58-62
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    • 2006
  • Purpose: To evaluate the result of operative treatment with plate and wire fixation for fractures of the distal clavicle. Materials and Methods: We assessed 9 cases of fractures of the distal clavicle that were treated by plate and wire fixation from March 2001 to July 2003 and followed up over 1year. We used the reconstruction plate as a buttress and performed cerclage wiring to fix comminuted fracture site. The functional result of shoulder was evaluated by the scoring system of Rowe. Results: The average periods of bony union was 9 weeks in all cases. According to Rowe scoring system, the functional result was exellent in 7 cases and good in 2 cases. There was no LOM of shoulder and traumatic arthritis in AC joint. But there was skin irritation in 1 case. Conclusion : The operative method by reconstruction plate and wire fixation for distal clavicular fracture was useful when there were comminuted fracture. This method seems to be simple and satisfactory in terms of improvement of range of motion of shoulder, restoration of function and rare complication.

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Operative Treatment of the Clavicular Midshaft Fractures in Adult - A Comparison between Intramedullary Multiple Steinmann Pins Fixation and Reconstruction Plate Fixation - (성인 쇄골 간부 골절의 수술적 치료-골수강내 다발성 Steinmann핀 고정술과 재구성 금속판 고정술과의 비교-)

  • Lee Young Kuk;Gu Hae Seo
    • Clinics in Shoulder and Elbow
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    • v.2 no.1
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    • pp.14-20
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    • 1999
  • Purpose: Despite of the popular use of the reconstruction plate for the fixation of clavicular shaft fractures, some disadventages have been raised such as long period of immobilization, long skin incision, loosening of plate and screws, and increased chance of nonunion due to severe periosteal injury. Thus, the authors have performed intramedullary multiple Steinmann pins fixation that could reduce the disadvantages of plate fixation in order to compare the treatment results between the two groups. Materials & Methods: From 1994. Jan. to 1997. Dec. the department of orthopaedic surgery of the Kwak's hospital treated operatively for 56 cases of the clavicular shaft fractures in adult. 39 cases of them were treated with the plate fixation and 17 cases with the intramedullary multiple Steinmann pins fixation(SP group). Reconstruction plates(Plate group) were used for 26 out of 39 patients treated with plate fixation. Among the Plate group and SP group, each 15 cases were selected by age and sex and compared each other according to the bone union time, union rate, complication, and functional results. The follow-up period was 12 months at the shortest and 48 months at the longest and the average was 16 months. Results: The Plate group showed that the bone union time was 7 weeks and the bone union rate was 93%. The SP group showed 6.5 weeks and 100% respectively. In complication, the Plate group had 1 case of loosening of plate and screws and delayed union; SP group had 1 case of pin migration. The functional results according to Kang's criteria, 87% of the Plate group and 93% of the SP group showed good or excellent. Conclusion : The SP group showed very comparable results in terms of the bone union time, bone union rate, complication, and functional results comparing to the Plate group. The intramedullary multiple Steinmann pins fixation showed several advantages over the reconstruction plate fixation, which were simple operative technique, easy removal of pins, being able to perform immediate postoperative full range of motion exercise. Therefore, the intramedullary multiple Steinmann pins fixation is thought to be one of the useful operative techniques in treatment of the clavicular shaft fractures in adult.

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Single Incision Flexible Endoscopic Cholecystectomy in Dogs : Feasibility Study (개에서 단일 통로 유연 내시경 담낭 절제술 : 유용성 연구)

  • Lee, So-Yeon;Shin, Beom-Jun;Jeong, Seong-Mok
    • Journal of Veterinary Clinics
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    • v.28 no.6
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    • pp.555-561
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    • 2011
  • Laparoscopic surgery is a well-established alternative to open surgery across disciplines. However, in veterinary medicine, laparoscopic surgery in dogs was rarely reported because of small abdominal size for multiple ports insertion. The concept of single-incision laparoscopic surgery (SILS) is to perform the entire laparoscopic operation through a single incision rather than conventional multiple small skin incisions. Indirect evidence of potential benefits of SILS, decreases operative morbidity related to reduction in port size, already exists. Therefore, this study was performed to evaluate the safety and feasibility of the modified form of SILS using flexible endoscope in Cholecystectomy before clinical adoption. A 2 cm single periumbilical incision was performed, and flexible endoscope was introduced into the abdominal cavity. A laparoscopic grasper was inserted into the abdominal cavity for the traction of gall bladder. Cystic duct and artery were ligated by 5 mm Hem-o-lok$^{(R)}$. Then, gall bladder was dissected and resected from the liver with 5 mm Autonomy Laparo-Angle Maryland dissector and endoscopic needle knife. Resected gall bladder was wrapped by using specimen pouch and was retrieved through abdominal incision from the cavity. All three gall bladders were successfully removed. Hematological changes were not observed during examination periods. No leakage sign was identified at necropsy. The flexible endoscope, as distinct from conventional rigid laparoscope, allows the visualization from various angles and the wide range of motion, result in less crowding.

Vision-based Motion Control for the Immersive Interaction with a Mobile Augmented Reality Object (모바일 증강현실 물체와 몰입형 상호작용을 위한 비전기반 동작제어)

  • Chun, Jun-Chul
    • Journal of Internet Computing and Services
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    • v.12 no.3
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    • pp.119-129
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    • 2011
  • Vision-based Human computer interaction is an emerging field of science and industry to provide natural way to communicate with human and computer. Especially, recent increasing demands for mobile augmented reality require the development of efficient interactive technologies between the augmented virtual object and users. This paper presents a novel approach to construct marker-less mobile augmented reality object and control the object. Replacing a traditional market, the human hand interface is used for marker-less mobile augmented reality system. In order to implement the marker-less mobile augmented system in the limited resources of mobile device compared with the desktop environments, we proposed a method to extract an optimal hand region which plays a role of the marker and augment object in a realtime fashion by using the camera attached on mobile device. The optimal hand region detection can be composed of detecting hand region with YCbCr skin color model and extracting the optimal rectangle region with Rotating Calipers Algorithm. The extracted optimal rectangle region takes a role of traditional marker. The proposed method resolved the problem of missing the track of fingertips when the hand is rotated or occluded in the hand marker system. From the experiment, we can prove that the proposed framework can effectively construct and control the augmented virtual object in the mobile environments.

Gracilis Muscle Transplantation in Neglected Brachial Plexus Palsy (진구성 상완 신경총 마비에 대한 유리박근이식술)

  • Chung, Duke-Whan;Han, Chung-Soo;Ok, Jae-Chul;Cho, Chang-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.6 no.1
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    • pp.73-79
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    • 1997
  • Complete denervation after severe brachial plexus injury make significant muscle atrophy with loss of proper function. It is much helpful to reconstruct the essential function of the elbow flexion movement in patient with total loss of elbow flexion motion after brachial plexus lesion which was not recovered with nerve surgery or long term conservative treatment from onset. In whole arm type brachial plexus injury, if there were no response to neurotization or neglected from injury, the volume of the denervated muscle is significantely reduced month by month. About 18 months most of the muscle fibers change to fibrous tissues and markedly atrophied irreversibly, further waiting is no more meaningful from that period. Authors performed 14 cases of functioning gracilis muscle transfer from 1981 to 1995 with microneurovascular technique, neuromusculocutaneous free flaps were performed for reconstruction of lost elbow flexion function. Average follow-up period was 5 years and 6 months. We used couple of intercostal nerves as a recipient nerve which were anastomosed to muscular nerve from obturator nerve in all cases. Recipient vessels were three deep brachial artery and eleven brachial artery which were anastomosed to medial femoral circumflex artery with end to end or end to side fashion. Average resting length of the transplanted gracilis were 24 cm. We can get average 54 degree flexion range of elbow with fair muscle power from flail elbow. There were one case of muscle necrosis with lately developed thrombosis of microvascular anastomosed site which comes from insufficient recipient arterial condition, 3 cases of partial marginal necrosis of distal skin of the transplanted part which were not significant problem with spontaneously solved with time goes by gracilis muscle has constant neurovascular pattern with relatively easy harvesting donor with minimal donor morbidity. Especially it has similar length and shape with biceps brachii muscle of upper arm and longer nerve pedicle which can neurorrhaphy with intercostal nerve without nerve graft if sufficient mobilization of the nerves from both sides of gracilis and intercostal region. Authors can propose gracilis muscle transplantation with intercostal nerves neurotization is helpful method with minimal donor morbidity for neglected brachial plexus palsy patients.

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