• Healthcare Informatics Research
• /
• v.24 no.4
• /
• pp.346-358
• /
• 2018

Objectives: The association between obstructive sleep apnea (OSA) and mortality or serious cardiovascular events over a long period of time is not clearly understood. The aim of this observational study was to estimate the clinical effectiveness of continuous positive airway pressure (CPAP) treatment on an outcome variable combining mortality, acute myocardial infarction (AMI), and cerebrovascular insult (CVI) during a follow-up period of 15.5 years ($186{\pm}58$ months). Methods: The data set consisted of 978 patients with an apnea-hypopnea index (AHI) ${\geq}5.0$. One-third had used CPAP treatment. For the first time, a data-driven causal Bayesian network (DDBN) and a hypothesis-driven causal Bayesian network (HDBN) were used to investigate the effectiveness of CPAP. Results: In the DDBN, coronary heart disease (CHD), congestive heart failure (CHF), and diuretic use were directly associated with the outcome variable. Sleep apnea parameters and CPAP treatment had no direct association with the outcome variable. In the HDBN, CPAP treatment showed an average improvement of 5.3 percentage points in the outcome. The greatest improvement was seen in patients aged ${\leq}55$ years. The effect of CPAP treatment was weaker in older patients (>55 years) and in patients with CHD. In CHF patients, CPAP treatment was associated with an increased risk of mortality, AMI, or CVI. Conclusions: The effectiveness of CPAP is modest in younger patients. Long-term effectiveness is limited in older patients and in patients with heart disease (CHD or CHF).

• Archives of Craniofacial Surgery
• /
• v.23 no.2
• /
• pp.59-63
• /
• 2022

Background: Deformational plagiocephaly is usually managed conservatively, as it tends to improve over time and with the use of conservative measures. However, before the year 2017 we operated on patients with severe plagiocephaly and neurological symptoms at the Helsinki Cleft Palate and Craniofacial Center. Methods: Of the 20 infants with severe deformational plagiocephaly and neurological symptoms referred to us between 2014 and 2016, 10 underwent cranioplasty open reshaping of the posterior cranial vault. The parents of the last 10 patients were given information on the natural history of the condition and the patients were followed up with an outpatient protocol. The aim of this study was to gain information on the brain electrophysiology and recovery of patients after total cranial vault reconstruction by measuring the electroencephalogram (EEG) somatosensory evoked potentials (SEP; median nerve). Results: Of the 10 participants in the operation arm, six had abnormal SEP at least on the affected cerebral hemisphere and all SEPs were recorded as normal when controlled postoperatively. In the follow-up arm, eight out of 10 participants had abnormal SEP at the age of approximately 24 months, and all had normalized SEPs at control visits. Conclusion: Our data suggest that cranioplasty open reshaping of the posterior cranial vault did not affect abnormal SEP-EEG recordings. We have abandoned the operations in deformational plagiocephaly patients due to findings suggesting that expanding cranioplasty is not beneficial for brain function in this patient group.

• The Journal of Korea Institute of Information, Electronics, and Communication Technology
• /
• v.16 no.1
• /
• pp.1-7
• /
• 2023

Convolutional neural networks have already been applied to various fields beyond human visual processing capabilities in the image processing area. However, they are exposed to a severe risk of deteriorating model performance due to the appearance of adversarial attacks. In addition, defense technology to respond to adversarial attacks is effective against the attack but is vulnerable to other types of attacks. Therefore, to respond to an adversarial attack, it is necessary to analyze how the performance of the adversarial attack deteriorates through the process inside the convolutional neural network. In this study, the adversarial attack of the Alexnet and VGG11 models was analyzed using the population sparseness index, a measure of neuronal activity in neurophysiology. Through the research, it was observed in each layer that the population sparsity index for adversarial examples showed differences from that of benign examples.

• Journal of Chest Surgery
• /
• v.56 no.5
• /
• pp.336-345
• /
• 2023

Background: The objective of this study was to demonstrate the safety, efficacy, and feasibility of intraoperative monitoring of the recurrent laryngeal nerves during thoracoscopic and robotic 3-field esophagectomy. Methods: This retrospective analysis details our initial experience using intraoperative nerve monitoring (IONM) during minimally invasive 3-field esophagectomy. Data were obtained from a prospectively maintained database and electronic medical records. The study included all patients who underwent minimally invasive (video-assisted thoracic surgery/robotic) transthoracic esophagectomy with neck anastomosis. The patients were divided into those who underwent IONM during the study period and a historical cohort who underwent 3-field esophagectomy without IONM at the same institution. Appropriate statistical tests were used to compare the 2 groups. Results: Twenty-four patients underwent nerve monitoring during minimally invasive 3-field esophagectomy. Of these, 15 patients underwent thoraco-laparoscopic operation, while 9 received a robot-assisted procedure. In the immediate postoperative period, 8 of 24 patients (33.3%) experienced vocal cord paralysis. Relative to a historical cohort from the same institution, who were treated with surgery without nerve monitoring in the preceding 5 years, a 26% reduction was observed in the nerve paralysis rate (p=0.08). On follow-up, 6 of the 8 patients with vocal cord paralysis reported a return to normal vocal function. Additionally, patients who underwent IONM exhibited a higher nodal yield and a decreased frequency of tracheostomy and bronchoscopy. Conclusion: The use of IONM during minimally invasive 3-field esophagectomy is safe and feasible. This technique has the potential to decrease the incidence of recurrent nerve palsy and increase nodal yield.

• Journal of Korean Neurosurgical Society
• /
• v.61 no.3
• /
• pp.363-375
• /
• 2018

Intraoperative monitoring (IOM) utilizes electrophysiological techniques as a surrogate test and evaluation of nervous function while a patient is under general anesthesia. They are increasingly used for procedures, both surgical and endovascular, to avoid injury during an operation, examine neurological tissue to guide the surgery, or to test electrophysiological function to allow for more complete resection or corrections. The application of IOM during pediatric brain tumor resections encompasses a unique set of technical issues. First, obtaining stable and reliable responses in children of different ages requires detailed understanding of normal age-adjusted brain-spine development. Neurophysiology, anatomy, and anthropometry of children are different from those of adults. Second, monitoring of the brain may include risk to eloquent functions and cranial nerve functions that are difficult with the usual neurophysiological techniques. Third, interpretation of signal change requires unique sets of normative values specific for children of that age. Fourth, tumor resection involves multiple considerations including defining tumor type, size, location, pathophysiology that might require maximal removal of lesion or minimal intervention. IOM techniques can be divided into monitoring and mapping. Mapping involves identification of specific neural structures to avoid or minimize injury. Monitoring is continuous acquisition of neural signals to determine the integrity of the full longitudinal path of the neural system of interest. Motor evoked potentials and somatosensory evoked potentials are representative methodologies for monitoring. Free-running electromyography is also used to monitor irritation or damage to the motor nerves in the lower motor neuron level : cranial nerves, roots, and peripheral nerves. For the surgery of infratentorial tumors, in addition to free-running electromyography of the bulbar muscles, brainstem auditory evoked potentials or corticobulbar motor evoked potentials could be combined to prevent injury of the cranial nerves or nucleus. IOM for cerebral tumors can adopt direct cortical stimulation or direct subcortical stimulation to map the corticospinal pathways in the vicinity of lesion. IOM is a diagnostic as well as interventional tool for neurosurgery. To prove clinical evidence of it is not simple. Randomized controlled prospective studies may not be possible due to ethical reasons. However, prospective longitudinal studies confirming prognostic value of IOM are available. Furthermore, oncological outcome has also been shown to be superior in some brain tumors, with IOM. New methodologies of IOM are being developed and clinically applied. This review establishes a composite view of techniques used today, noting differences between adult and pediatric monitoring.

• Korean Journal of Cognitive Science
• /
• v.21 no.2
• /
• pp.309-338
• /
• 2010

In this paper, we studied the brain-computer interface (BCI). BCIs help severely disabled people to control external devices by analyzing their brain signals evoked from motor imageries. The findings in the field of neurophysiology revealed that the power of $\beta$(14-26 Hz) and $\mu$(8-12 Hz) rhythms decreases or increases in synchrony of the underlying neuronal populations in the sensorymotor cortex when people imagine the movement of their body parts. These are called Event-Related Desynchronization / Synchronization (ERD/ERS), respectively. We implemented a BCI-based mouse interface system which enabled subjects to control a computer mouse cursor into four different directions (e.g., up, down, left, and right) by analyzing brain signal patterns online. Tongue, foot, left-hand, and right-hand motor imageries were utilized to stimulate a human brain. We used a non-invasive EEG which records brain's spontaneous electrical activity over a short period of time by placing electrodes on the scalp. Because of the nature of the EEG signals, i.e., low amplitude and vulnerability to artifacts and noise, it is hard to analyze and classify brain signals measured by EEG directly. In order to overcome these obstacles, we applied statistical machine-learning techniques. We could achieve high performance in the classification of four motor imageries by employing Common Spatial Pattern (CSP) and Linear Discriminant Analysis (LDA) which transformed input EEG signals into a new coordinate system making the variances among different motor imagery signals maximized for easy classification. From the inspection of the topographies of the results, we could also confirm ERD/ERS appeared at different brain areas for different motor imageries showing the correspondence with the anatomical and neurophysiological knowledge.

• Journal of the Korean Institute of Intelligent Systems
• /
• v.22 no.4
• /
• pp.429-434
• /
• 2012

This paper presents a technology for manipulating external devices by Brain Computer Interface (BCI) system. Recently, BCI based rehabilitation and assistance system for disabled people, such as patient of Spinal Cord Injury (SCI), general paralysis, and so on, is attracting tremendous interest. Especially, electroencephalogram (EEG) signal is used to organize the BCI system by analyzing the signals, such as evoked potential. The general findings of neurophysiology support an availability of the EEG-based BCI system. We concentrate on the event-related synchronization of motor imagery EEG signal, which have an affinity with an intention for moving control of external device. To analyze the brain activity, short-time Fourier transform and particle swarm optimization are used to optimal feature selection from the preprocessed EEG signals. In our experiment, we can verify that the power spectral density correspond to range mu-rhythm(${\mu}8$~12Hz) have maximum amplitude among the raw signals and most of particles are concentrated in the corresponding region. Result shows accuracy of subject left hand 40% and right hand 38%.

• The Journal of the Acoustical Society of Korea
• /
• v.35 no.1
• /
• pp.63-73
• /
• 2016

It is widely acknowledged that the human auditory system is organized tonotopically and people generally listen to sounds as a function of frequency distribution through the auditory system. However, it is still unclear how acoustic features of speech sounds are indicated to the human brain in terms of speech perception. Thus, the purpose of this study is to investigate whether two sounds with similar high-frequency characteristics in the acoustic analysis show similar results at the level of auditory brainstem. Thirty three young adults with normal hearing participated in the study. As stimuli, two Korean monosyllables (i.e., /ja/ and /cha/) and four frequencies of toneburst (i.e., 500, 1000, 2000, and 4000 Hz) were used to elicit the auditory brainstem response (ABR). Measures of monosyllable and toneburst were highly replicable and the wave V of waveform was detectable in all subjects. In the results of Pearson correlation analysis, the /ja/ syllable had a high correlation with 4000 Hz of toneburst which means that its acoustic characteristics (i.e., 3671~5384 Hz) showed the same results in the brainstem. However, the /cha/ syllable had a high correlation with 1000 and 2000 Hz of toneburst although it has acoustical distribution of 3362~5412 Hz. We concluded that there was disagreement between acoustic features and physiology outcomes at the auditory brainstem level. This finding suggests that an acoustical-perceptual mapping study is needed to scrutinize human speech perception.

• Journal of Korean Ophthalmic Optics Society
• /
• v.10 no.1
• /
• pp.41-46
• /
• 2005

The aim of the study was performed the wave analysis of P-VEP on the normal monocular vision and amblyopia in binocular. The P-VEP of three channels were recorded by the Nicolet system. Five adults (three males, two females, mean=22 years, range=19 to 24) subjects were recorded The subjects were researched the history including the systemic health, medication, genetics, allergy and ocular disease. Visual acuity and stereopsis were recorded for each subject monocularly and binocularly. Also subjects viewed the P-VEP stimulus both monocularly and binocularly through the corrected visual acuity during the VEP were recorded. The results of study suggest that the visual acuity of binocularly is better than with monocularly and the stereopsis was about over 140 sec. On the other hand, the analysis of P-VEP suggest that the amplitude of wave is larger when the monocular eye receives the P-VEP stimulus compared with the binocular eye. However the amplitude of wave in amblyopia had more smaller than the normal monocular The latency period of P-VEP was similar to results between the normal eye and binocular vision. But the amblyopia was a long period compared with the normal monocular and binocular vision. In conclusion, this study indicated that the visual acuity of binocularly have a better than the normal monocular vision, But in the P-VEP test, the amplitude of wave on normal monocularly vision appears to be better through the binocularly. But the amblyopia appeared the low amplitude wave of P-VEP and decreased the visual acuity.

• Science of Emotion and Sensibility
• /
• v.8 no.4
• /
• pp.365-374
• /
• 2005

Pain has at least two dimensions such as somatosensory qualities and affect and patients are frequently asked to score the intensity of their pain on a numerical pain rating scale. However, the use of a undimensional scale is questionable in view of the belief, overwhelmingly supported by clinical experience as well as by empirical evidence from multidimensional scaling and other sources, that pain has multidimensions such as sensory-discrimitive, motivational-affective and cognitive-evaluative The study of pain has recently received much attention, especially in understanding its neurophysiology by using new brain imaging techniques, such as positron emission tomography(PET) and functional magnetic resonance imaging (fMRI), both of which allow us to visualize brain function in vivo. Also the new brainimaging devices allow us to evaluate the patients pain status and plan To treat patients objectively. Base4 on our findings we presented what are the new brain imaging devices and the results of study by using brain imaging devices.