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Case Report of Korean Medicine Treatment for a Patient with an Aneurysmal Subarachnoid Hemorrhage (뇌동맥류 파열로 인한 지주막하 출혈 환자에서 중재적 치료 후 조절되지 않은 두통 치험 1례)

  • Kim, Eun-mi;Kim, Ki-tae
    • The Journal of Internal Korean Medicine
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    • v.42 no.2
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    • pp.197-206
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    • 2021
  • Subarachnoid hemorrhage (SAH) is a disease that causes bleeding in the subarachnoid space; 70%-80% of nontraumatic subarachnoid hemorrhages are caused by saccular aneurysms. If the patient has already experienced a ruptured aneurysm that causes subarachnoid bleeding, rebleeding can result in a high mortality rate and serious sequelae. Therefore, if the patient can undergo surgical or interventional treatment, it should always be performed. This patient was diagnosed with acute aneurysmal subarachnoid hemorrhage and hydrocephalus. The patient was hospitalized for uncontrolled headache and vertigo after aneurysm coil embolization and ventriculoperitoneal shunting. The patient was treated with Yangkyuksanwha-tang and acupuncture and was observed with a symptom checklist for 25 days. Headache improved, from a visual analog scale (VAS) score of 7 to 0. Vertigo also improved, from a numeric rating scale (NRS) of 6 to 2, and the vertigo pattern changed from rotational to nonrotational. This case suggests that Korean medicine treatment is helpful in managing subarachnoid hemorrhage sequelae.

Association of Type 2 Diabetes Mellitus With Perivascular Spaces and Cerebral Amyloid Angiopathy in Alzheimer's Disease: Insights From MRI Imaging

  • Ozlem Bizpinar Munis
    • Dementia and Neurocognitive Disorders
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    • v.22 no.3
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    • pp.87-99
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    • 2023
  • Background and Purpose: According to the amyloid cascade hypothesis, fibrillary amyloid-beta load in the brain causes Alzheimer's disease (AD) with toxic effects. Recently, perivascular spaces (PVSs), fluid-filled cavities around small penetrating arterioles and venules in the brain, and the glymphatic system relationship with type 2 diabetes mellitus (DM2) and AD has been an important research topic from a physiopathological point of view. There are two types of PVSs that are associated with sporadic atherosclerosis and cerebral amyloid angiopathy. In this study, we evaluated the relationship between the number and localization of enlarged PVSs in AD. Methods: A total of 254 patients with AD and 125 healthy controls were included in this study All the patients were evaluated with neurological and cognitive examinations and magnetic resonance imaging (MRI). PVSs on MRI were graded by recording their number and location. The study was a retrospective study. Results: In our study, the number of white matter convexity-central semiovale localized PVSs was higher in patients than in the control group. In addition, the number of PVSs in this localization score was higher in patients with DM2. Cerebral PVS counts were higher in patients with AD than in the control group. Conclusions: These results suggest the important role of cerebral amyloid angiopathy, one of the vascular risk factors, and the glymphatic system in the pathogenesis of AD. In addition, the results of our study suggest that the evaluation of PVSs levels, especially at the (centrum semiovale), using imaging studies in AD is a potential diagnostic option.

MR Imaging of Carpal Tunnel Syndrome : The Usefulness of MRI in Treatment Decisions (수근관 증후군의 자기공명 영상 : 치료 결정의 유용성)

  • Lee, Kyu-Yong;Lee, Young Joo;Kim, Seung Hyun;Song, Hyoung Gon;Kim, Juhan
    • Annals of Clinical Neurophysiology
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    • v.4 no.2
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    • pp.114-118
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    • 2002
  • Backgrounds : Carpal tunnel syndrome (CTS) is a common condition that is usually diagnosed by electrophysiologic studies. However, CTS provide limited information to determine the causes of CTS and to choose the treatment method. We evaluated diagnostic sensitivity of MR imaging and treatment decisions by MR imaging in electrodiagnosed CTS. Methods : 14 patients (26 wrists) with electrodiagnosed CTS were studied using MR imaging. In 26 wrists for which axial T1 & T2 weighted images were obtained at 1.5T with a decided wrist coil. Previously described MR imaging of CTS such as increased median nerve signal, flattening of median nerve, reticular bowing, tenosynovitis and space occupying lesions were retrospectively evaluated. Degree of improvement was evaluated by global symptom score (GSS). The GSS rated symptoms from 0 (no symptoms) to 10 (severe) in each of five categories: pain, numbness, paresthesia, weakness/clumsiness, and nocturnal awakening. Subjects' GSS was recorded at baseline, 2 weeks, 1 month, 6 months after treatment. We decided to medical treatment that showed mainly inflammatory sign such as increased median nerve signal, tenosinovitis and to surgical treatment such as space occupying lesion, high canal pressure sign. Results : MR imaging showed that increased median nerve signal were in 20 wrists (77%), flattening of median nerve were in 6 wrists (23%), reticular bowing were in 3 wrists (12%), tenosynovitis were in 8 wrists (32%), decreased canal size in 2 wrists (7.6%), space occupying lesion were in 1 wrist (4%). A good outcome was revealed in 21 wrists by medical treatment that showed mainly increased median nerve signal, tenosynovitis. The mean GSS were 27.7 at baseline, 11.2 at 2 weeks, 11.0 at 6 months in medical treatment group. Another 5 wrist had surgical treatment shown by ganglion and high canal pressure sign such as median nerve flattening, reticular bowing, decreased canal size: 3 wrists had good prognosis, but 2 wrists (one patient) had no significant improvement due to small carpal tunnel size. Conclusions : Our results are in agreement with most previously described MR imaging signs of CTS. MR imaging plays an important role in several cases and especially in the assessment of failure of surgical treatment. Knowledge of MR findings may permit more rational choice of treatment.

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Qualitative Equity of Neighborhood Parks in Daegu According to Socioeconomic Status (사회경제적 지위에 따른 대구시 근린공원 질적 가치 형평성)

  • Jung, Mijeong;Jung, Taeyeol
    • Journal of the Korean Institute of Landscape Architecture
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    • v.48 no.2
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    • pp.45-55
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    • 2020
  • In terms of environmental justice, urban parks play a pivotal role in imperative amenities allowing for physical activity. The reasonable distribution of urban park services must be considered in terms of community demand and the context of the park. The purpose of this study is to analyze the inequity of qualitative park service according to the socioeconomic status(SES) in Daegu. The qualitative service was assessed for 82 neighborhood and walking-distance parks by utilizing the NGST(Neighborhood Green Space Tool). The inequity was analyzed by SES variables(ratio of basic living recipients, ratio of single-parent families, average housing sales, dilapidated dwelling ratio, and park area per capita). The features of the qualitative equity in Daegu is as follows. First, urban park planning in Daegu is in parallel with the development of residential areas rather than the local policy. The development pattern of parks stretching from center of the city to outskirts clearly dissociates the city based on socioeconomic status. The parks in the center are relatively old and poorly managed. Second, overall neighborhood parks lacked recreational facilities. The facilities are significantly influenced by the housing values around them. The lower the recreation facility score, the higher the floor gradient of the urban parks constraining physical activities. Third, the quantitative supply of parks has nothing to do with the quality of the urban parks. Green space distribution is highly dependent on natural park areas, so the park area per capita cannot be a standard for assessing qualitative equity.

A Study on the Environmental Improvement of National Parks' Public Space Design - Focusing on Trail Entry Areas - (공공디자인 측면에서의 국립공원 환경개선의 효과성 및 만족도 분석 - 탐방로 진입부 공간을 중심으로 -)

  • Lee, Sook-Hyang;Sim, Kyu-Won;Lee, Ho-Seung;Lee, Jea-Kyu;Jeong, Jeong-Kwon
    • Journal of Korean Society of Rural Planning
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    • v.22 no.3
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    • pp.49-61
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    • 2016
  • This study examined the effectiveness of and satisfaction of visitors with the Environmental Improvement Project on national parks' trail entry areas. A survey was conducted to improve the proposal framework based on the data. Data for the study were obtained from 6400 respondents who used 28 national park offices at 32 national park trail entry areas. The field research was collected in 3200 surveys, divided between pre- and post-implementation of the Environmental Improvement Project. The study variables consisted of socio-demographics, visitors' perceptions on the environmental improvement of trail entries, effects of the environmental improvement, and visitor satisfaction. Several important results were found. First, the environment of trail entries has a significant impact on the formation of images and user satisfaction of national parks. Second, the influence of the trail entry improvement showed that 71.8% of visitors rated the trail entry as environmentally friendly after the Environmental Improvement Project, compared to 48.5% of visitors rated the trail entry as environmentally friendly before the Environmental Improvement Project. The findings indicated that a top priority of environmental improvement of the trail entries needs to be the installation of convenience facilities such as rest areas, restrooms, and direction boards (pre: 34.5%, post: 32.6%). Third, functionality and the other nine variables were shown to enhance the effect of the environmental improvement of the trail entries at the 1% statistical significance level. Finally, results indicated that the overall satisfaction of the visitors with the park was significantly higher after the environmental improvement (t-value=25.741, p=.000), showing the satisfaction score was higher after the environmental improvement (pre: 3.51, post: 4.12), with a statistically significant difference at the 1 % level. This study helps to understand trail entries, which have influenced the image of the national park and satisfaction. These findings can be utilized to manage and design a national park as a public space.

Need Survey of Home Modification on Outpatient with Stroke and Spinal Cord Injury in Rehabilitation Center (재활치료를 받는 뇌졸중과 척추손상 외래환자들의 주거환경개선에 대한 요구도 조사)

  • Lim, Kyung-Min;Lee, Yu-Na
    • The Journal of the Korea Contents Association
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    • v.13 no.8
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    • pp.324-333
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    • 2013
  • The purpose of this study was to investigate the need of home modification for outpatient with stroke and spinal cord injury. The subjects of this study were 54 outpatients who have experience in rehabilitation therapy at hospitals in Seoul and Gyeonggi-do. A questionnaire was distributed and collected form January 2th to February 4th, 2012. Descriptive statistics and $x^2$-test were used to analyze data. There were statistically significant difference in stairs of access, in width of front door, in bathroom, space of room according diagnosis. There were statistically significant difference in light of sensor, tissue holder and socket cover in bathroom for the comparison of demands for home modification by living type. There were statistically significant difference in width and threshold of front door, tissue holder and towel bar, nonslip floor in bathroom, space and table, chair of kitchen, space and threshold of porch, light for the comparison of demands for home modification according score of MBI. Based on the results of the survey, needs of home modification is different according disability level, diagnosis, living type, ADL performance. The results of this study show a need for the further occupational therapy of home modification and supporting policies in home modification.

Outcome of Suture Suspension Arthroplasty for Thumb Carpometacarpal Joint Arthritis (무지 수근중수 관절염에 대한 현수 봉합 관절성형술의 결과)

  • Kim, Sehun;Gong, Hyun Sik;Lee, Se Yeon;Lee, Minho;Kim, Jihyeung;Baek, Goo Hyun
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.223-229
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    • 2018
  • Purpose: A number of procedures were introduced to stabilize the 1st metacarpal bone after resection of the trapezium in the thumb carpometacarpal joint (CMCJ) arthroplasty. However, some surgical procedures may inevitably damage normal structures, such as harvesting tendons or drilling of a bone for tendon passage. Suture suspension arthroplasty is relatively less invasive and easier to perform than the previously described surgical methods. The purpose of this study was to report the therapeutic efficiency of the suture suspension arthroplasty. Methods: We retrospectively reviewed 12 patients who underwent suture suspension arthroplasty for the treatment of thumb CMCJ arthritis. Pain visual analogue scale (VAS), satisfaction about surgical outcomes, and the disabilities of the arm, shoulder and hand (DASH) scores were measured to evaluate the functional outcomes and the Trapezial Space Ratios were measured. Satisfaction was measured in the range of "very dissatisfied" (0) to "very satisfied" (10). Results: The mean follow-up period was 23 months. Pain VAS score improved significantly from 7.0 to 2.9 (p<0.05). And mean satisfaction scale was 6.9. However, there was no significant difference in DASH scores between before and after surgery (p=0.06). The mean trapezial space ratio was calculated to be 0.45 before surgery, 0.33 immediately after surgery, 0.23 at the last follow-up. Conclusion: Suture suspension arthroplasty is a satisfactory surgical procedure. And compared with other procedures, there is no significant difference in the reduction of the trapezial space. It may be useful in advanced thumb CMCJ arthritis.

Selective Word Embedding for Sentence Classification by Considering Information Gain and Word Similarity (문장 분류를 위한 정보 이득 및 유사도에 따른 단어 제거와 선택적 단어 임베딩 방안)

  • Lee, Min Seok;Yang, Seok Woo;Lee, Hong Joo
    • Journal of Intelligence and Information Systems
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    • v.25 no.4
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    • pp.105-122
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    • 2019
  • Dimensionality reduction is one of the methods to handle big data in text mining. For dimensionality reduction, we should consider the density of data, which has a significant influence on the performance of sentence classification. It requires lots of computations for data of higher dimensions. Eventually, it can cause lots of computational cost and overfitting in the model. Thus, the dimension reduction process is necessary to improve the performance of the model. Diverse methods have been proposed from only lessening the noise of data like misspelling or informal text to including semantic and syntactic information. On top of it, the expression and selection of the text features have impacts on the performance of the classifier for sentence classification, which is one of the fields of Natural Language Processing. The common goal of dimension reduction is to find latent space that is representative of raw data from observation space. Existing methods utilize various algorithms for dimensionality reduction, such as feature extraction and feature selection. In addition to these algorithms, word embeddings, learning low-dimensional vector space representations of words, that can capture semantic and syntactic information from data are also utilized. For improving performance, recent studies have suggested methods that the word dictionary is modified according to the positive and negative score of pre-defined words. The basic idea of this study is that similar words have similar vector representations. Once the feature selection algorithm selects the words that are not important, we thought the words that are similar to the selected words also have no impacts on sentence classification. This study proposes two ways to achieve more accurate classification that conduct selective word elimination under specific regulations and construct word embedding based on Word2Vec embedding. To select words having low importance from the text, we use information gain algorithm to measure the importance and cosine similarity to search for similar words. First, we eliminate words that have comparatively low information gain values from the raw text and form word embedding. Second, we select words additionally that are similar to the words that have a low level of information gain values and make word embedding. In the end, these filtered text and word embedding apply to the deep learning models; Convolutional Neural Network and Attention-Based Bidirectional LSTM. This study uses customer reviews on Kindle in Amazon.com, IMDB, and Yelp as datasets, and classify each data using the deep learning models. The reviews got more than five helpful votes, and the ratio of helpful votes was over 70% classified as helpful reviews. Also, Yelp only shows the number of helpful votes. We extracted 100,000 reviews which got more than five helpful votes using a random sampling method among 750,000 reviews. The minimal preprocessing was executed to each dataset, such as removing numbers and special characters from text data. To evaluate the proposed methods, we compared the performances of Word2Vec and GloVe word embeddings, which used all the words. We showed that one of the proposed methods is better than the embeddings with all the words. By removing unimportant words, we can get better performance. However, if we removed too many words, it showed that the performance was lowered. For future research, it is required to consider diverse ways of preprocessing and the in-depth analysis for the co-occurrence of words to measure similarity values among words. Also, we only applied the proposed method with Word2Vec. Other embedding methods such as GloVe, fastText, ELMo can be applied with the proposed methods, and it is possible to identify the possible combinations between word embedding methods and elimination methods.

Objective in Vivo Quantification of Emphysema by Thin-Section CT: Correlation with Physiologic Findings (고해상 전산화단층촬영을 이용한 폐기종의 정량적 분석: 폐기능 검사와의 비교)

  • Lee, Jee-Young;Lee, Kye-Young;Choi, Eun-Kyoung;Kim, Sang-Joon;Choi, Young-Hi
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.992-999
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    • 1998
  • Background: To correlate the emphysema score for quantification of the overall extent of emphysema in both lungs by CT with physiologic fingings and to get more objective and simple method to assess the extent of emphysema. Method: Thin-section CT and pulmonary function test(PFT) were performed in 17 patients with emphysema (all males, mean age, 62 years). Emphysema score was obtained as percentage of emphysematous lung area, dividing the total area of the emphysema(voxels with attenuation value less than -880, -900, -920HU, respectively) by the overall area of both lungs(voxels with attenuation value less than -400HU) with highlighting voxels using "Density mask" program. Emphysema score was calculated from whole lung(ESV) and 5 representative scans(ESR) using "Density mask", Visual emphysema score(ESV) was obtained by visual assessment from 5 representative scans. Correlation of these emphysema scores(ESW, ESR, ESV) and physiologic findings were performed, comparing the ESW with ESR and ESV. Results: ESW had correlation with DLCO(r=0.53-0.64) and $FEV_1/FVC$(r=0.42-0.57) among PFT parameters. ESR had good correlation with ESW and with PFT parameters as well. ESV did not correlate with PFT parameters except DLCO. Conclusion: CT quantification of emphysema using "density mask" correlated well with physiologic findings. To assess the severity of emphysema, both ESW and ESR are more reliable than ESV, and ESR is recommended in routine practice as it is objective, simple and reliable.

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A Feasibility Study on the Infrastructure Project of Femto Fusion Technology (펨토 융합기술 기반구축사업 타당성 분석 연구)

  • Kim, Dae Ho;Kim, Tae Hyung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.8 no.1
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    • pp.1-11
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    • 2013
  • The femto fusion technology refers to not only the technology for femtosecond($10^{-15}$ second) laser and but also the fusion technology of its application. This technology is comparable to the nano technology, the extreme technology on the space, and is of extreme time-domain technology. Now, we need to develop the hyperfine and high-precision femto fusion process technology which allows to miniaturize and highly integrate the products of mobile, semiconductor and display industries, the national main focusing growth industries. However, The femtosecond laser fabrication technology is essential in the development of fusion technology, but only a few of domestic researchers can handle the former. Under this condition, our government plans to develop the "femto fusion technology infrastructure project" as one of the ICT research infrastructure. So the purpose of this study is to analyze the feasibility of this project. We applied AHP(analytic hierarchy process) for this study. The final result shows that all the repondent's score is over 0.55 and the aggregated score is 0.846. And as a consequence, we can conclude that to do this project is feasible.

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