• Journal of the Korean neurological association
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• 제36권4호
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• pp.294-301
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• 2018

Background: Neuroimaging can play a crucial role in discovering potential abnormalities to cause secondary headache. There has been a progress in the fields of headache diagnosis and neuroimaging in the past two decades. We sought to investigate neuroimaging findings according to headache disorders, age, sex, and imaging modalities in first-visit headache patients. Methods: We used data of consecutive first-visit headache patients from 9 university and 2 general referral hospitals. The International Classification of Headache Disorders, third edition, beta version was used in headache diagnosis. We finally enrolled 1,080 patients undertook neuroimaging in this study. Results: Among 1,080 patients (mean age: $47.7{\pm}14.3$, female: 60.8%), proportions of headache diagnosis were as follows: primary headaches, n=926 (85.7%); secondary headaches, n=110 (10.2%); and cranial neuropathies and other headaches, n=43 (4.1%). Of them, 591 patients (54.7%) received magnetic resonance imaging (MRI). Neuroimaging abnormalities were found in 232 patients (21.5%), and their proportions were higher in older age groups and male sex. Chronic cerebral ischemia was the most common finding (n=88, 8.1%), whereas 76 patients (7.0%) were found to have clinically significant abnormalities such as primary brain tumor, cancer metastasis, and headache-relevant cerebrovascular disease. Patients underwent MRI were four times more likely to have neuroimaging abnormalities than those underwent computed tomography (33.3% vs. 7.2%, p<0.001). Conclusions: In this study, the findings of neuroimaging differed according to headache disorders, age, sex, and imaging modalities. MRI can be a preferable neuroimaging modality to identify potential causes of headache.

• Journal of the Korea Academia-Industrial cooperation Society
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• 제22권2호
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• pp.659-666
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• 2021

This study aimed to investigate the effect of changes in pressure levels and gaze directions on deep neck flexor muscle thickness. Twenty-seven subjects participated in this study. Ultrasound imaging of the longus colli (LC) and sternocleidomastoid (SCM) were measured in four gaze directions (0°, 20°, 40°, 60°) and five pressure levels (20 mmHg, 22 mmHg, 24 mmHg, 26 mmHg, 28 mmHg) during cranial-cervical flexor (CCF) exercises. Repeated ANOVA was performed for analysis of muscle thickness difference according to gaze direction and pressure levels in LC and SCM. Results: LC showed a significant difference between 0° and 20°, 0° and 40°, and 0° and 60° at pressures of 20 mmHg and 22 mmHg (p<.05). SCM displayed a significant difference between 0° and 20°, 20° and 40°, and 40° and 60° at 28 mmHg (p<.05). In this study, it was found that setting the gaze direction to 20° for the CCF exercise can increase the activation of LC and lower the activity of SCM to obtain the effect of exercise. Based on the results of this study, it is hoped that the beneficial effects of the CCF exercise can be increased by setting an optimal gaze direction in a clinical environment.

• Journal of Veterinary Clinics
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• 제38권3호
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• pp.163-168
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• 2021

A 6-year-old, spayed female, Maltese dog with tachypnea and dry cough was presented to Gyeongsang National University Veterinary Medical Teaching hospital. On physical examination, its respiration rate was 132 per minute. Decreased partial pressure of oxygen, partial pressure of carbon dioxide, and hyperlactatemia were found on arterial blood gas analysis. Its diastolic blood pressure was 80 mmHg. Auscultation revealed arrhythmia. Electrocardiogram revealed P pulmonale, P mitrale, and ventricular premature complexes. Thoracic radiographs revealed mild enlargement of both atrium and moderate enlargement of the left ventricular. There was also a moderate alveolar pattern in the right and caudal part of the left cranial lung lobe. Two-dimensional echocardiography showed enlargement of generalized four chambers without remarkable findings of valvular degeneration. M-mode echocardiography showed decreased left ventricular fractional shortening and enlarged left ventricular internal diameter at both end-systolic and end-diastolic. Color-flow Doppler imaging revealed eccentric turbulent flow starting below the left ventricular outflow tract and extending into the left atrium during systole. Spectral Doppler recordings revealed a high velocity flow through the mitral, tricuspid, aorta, and pulmonic regurgitation. Restrictive transmitral flow revealed high E-wave velocity, short E-wave deceleration time, and reduced A-wave velocity. There was also low ejection velocity thorough left ventricular out tract flow. Based on echocardiographic examination, dilated cardiomyopathy was the tentative diagnosis. The dog was medicated with inotropes, angiotensin converting enzyme inhibitor, and diuretics. At the 10-day following-up, the dog died suddenly. This report describes echocardiographic diagnosis and prognosis of dilated cardiomyopathy rarely reported in small breed dogs.

• Journal of the Korea Computer Graphics Society
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• 제28권3호
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• pp.55-65
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• 2022

Recently, deep learning-based automated systems for identifying and detecting landmarks have been proposed. In order to train such a deep learning-based model without overfitting, a large amount of image and labeling data is required. Conventionally, an experienced reader manually identifies and labels landmarks in a patient's image. However, such measurement is not only expensive, but also has poor reproducibility, so the need for an automated labeling method has been raised. In addition, in the X-ray image, since various human tissues on the path through which the photons pass are displayed, it is difficult to identify the landmark compared to a general natural image or a 3D image modality image. In this study, we propose a geometric data augmentation technique that enables the generation of a large amount of labeling data in X-ray images. In addition, the optimal attention mechanism for landmark detection was presented through the implementation and application of various attention techniques to improve the detection performance of 16 major landmarks in the skull. Finally, among the major cranial landmarks, markers that ensure stable detection are derived, and these markers are expected to have high clinical application potential.

• Animal Bioscience
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• 제35권5호
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• pp.639-647
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• 2022

Objective: This study was conducted to clone and compare the molecular characteristics of the deiodinase 2 (DIO2) gene between Sichuan White geese and Landes geese, and to analyze the association between polymorphisms of the DIO2 gene and head dimensions in Tianfu meat geese. Methods: The coding sequence of the DIO2 gene was cloned by polymerase chain reaction and vector ligation and aligned by DNAMAN software. A total of 350 Tianfu meat geese were used to genotype the polymorphisms of the DIO2 gene and measure the head dimensions. Association analysis between the polymorphisms of the DIO2 gene and head dimensions was carried out. Results: An 840-bp coding sequence of the DIO2 gene was obtained and comparison analysis identified four polymorphic loci between Sichuan White geese and Landes geese. Further analysis showed that the dominant alleles for the four polymorphic loci were G, G, A, and T and the frequency of the heterozygous genotype was higher than that of the homozygous genotype in Tianfu meat geese. Compared to that in the population of non-knob geese of Tianfu meat geese, the head dimensions in the population of knob geese were significantly higher except for nostril height. However, in the non-knob geese, beak width 1, beak width 2, nostril length, cranial width 1, and maxillary length had significant differences among different genotypes or haplotypes/diplotypes. Conclusion: These results suggested that polymorphisms of the DIO2 gene could be considered molecular markers to select larger heads of geese in the population of non-knob geese.

• Journal of Korean Neurosurgical Society
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• 제66권1호
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• pp.72-81
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• 2023

Objective : Ischemia and hemorrhage of pituitary adenomas (PA) caused important clinical syndrome. However, the differences on clinical characteristics and surgical outcomes between these two kinds apoplexy were less reported. Methods : A retrospective analysis was made of patients with pituitary apoplexy between January 2013 and June 2018. Baseline and clinical characteristics before surgery were reviewed. All patients underwent transsphenoidal surgery and were followed up at least 1 year. Results : Total 67 cases (5.8%) among 1147 pituitary tumor patients were enrolled, which consisted of 28 (~2.4%) ischemic PA and 39 (~3.4%) hemorrhagic PA. There were more male patients in the ischemic group compared with hemorrhagic group (78.6% vs 53.8%, p=0.043). However, the mean age, tumor size and functional tumor ratio were significant higher in the hemorrhagic group. Headache was more common in ischemic PA (82.1%) than that of hemorrhagic PA (51.3%, p=0.011). Magnetic resonance imaging findings found that mucosal thickening and enhancement of the sphenoid sinus was observed in 15 ischemic PA patients (n=27, 55.6%), but none in patients with hemorrhagic PA (n=38, p<0.0001). It was worth noting that the rate of pre-surgical hypopituitarism in ischemic PA patients were seemed higher than that in hemorrhagic PA patients, but not significant. The two groups got a total tumor resection rate at 94.1% and 92.9%, independently. No significant difference on the operative time, blood loss in operation and complications in perioperative period was observed in two groups. After operation, cranial nerve symptoms recovered to normal at 81.8% of ischemic PA patients and 82.6% of hemorrhagic PA patients. Importantly, the incidence of postoperative hypopituitarism partially decreased in both groups, among which the rate of hypothyroidism in ischemic PA patients significantly decreased from 46.4% to 18.5% (p=0.044). Conclusion : Patients with ischemic PA presented different clinical characteristics to the hemorrhagic ones. Transsphenoidal surgery should be considered for the patients with neuro-ophthalmic deficits and might benefit for pituitary function recovery of the apoplectic adenoma patients, especially pituitary thyroid axis in ischemic PA patients.

• Journal of Korean Clinical Nursing Research
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• 제29권1호
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• pp.24-41
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• 2023

Purpose: This study aimed to update the previously published nursing practice guideline for prevention of venous thromboembolism (VTE). Methods: The guideline was updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 10. Results: The updated nursing practice guideline for prevention of VTE was consisted of 16 domains, 46 subdomains, and 216 recommendations. The recommendations in each domain were: 4 general issues, 8 assessment of risk and bleeding factors, 5 interventions for prevention of VTE, 18 mechanical interventions, 36 pharmacological interventions, 36 VTE prevention starategies for medical patients, 25 for cancer patients, 13 for pregnancy, 8 for surgical patients, 7 for thoractic and cardiac surgery, 16 for orthopedic surgery, 10 for cranial and spinal surgery, 5 for vascular surgery, 13 for other surgery, 3 educations and information, and 2 documentation and report. For these recommendations, the level of evidence was 32.1% for level I, 51.8% for level II, and 16.1% for level III according to the infectious diseases society of America (IDSA) rating system. A total of 112 new recommendations were developed and 49 previous recommendations were deleted. Conclusion: The updated nursing practice guideline for prevention of VTE is expected to serve as an evidence-based practice guideline for prevention of VTE in South Korea. It is recommended that this guideline will disseminate to clinical nursing settings nationwide to improve the effectiveness of prevention of VTE practice.

• Journal of The Korean Ophthalmological Society
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• 제58권11호
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• pp.1313-1316
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• 2017

Purpose: To report fundus photography using a smartphone in an infant with abusive head trauma. Case summary: An 8-month-old male infant presented to the emergency room with decreased consciousness and epileptic seizures that the parents attributed to a fall from a chair. He had no external wounds or fractures to the skull or elsewhere. However, computerized tomography of the brain revealed an acute subdural hematoma in the right cranial convexity and diffuse cerebral edema, leading to a midline shift to the left and effacement of the right lateral ventricle and basal cistern. The attending neurosurgeon promptly administered a decompressive craniectomy. Immediately after the emergency surgery, a fundus examination revealed numerous multi-layered retinal hemorrhages in the posterior pole extending to the periphery in each eye. He also had white retinal ridges with cherry hemorrhages in both eyes. We acquired retinal photographs using the native camera of a smartphone in video mode. The photographer held the smartphone with one hand, facing the patient's eye at 15-20 cm, and held a 20 diopter condensing lens at 5 cm from the eye in the other hand. Our documentation using a smartphone led to a diagnosis of abusive head trauma and to obtain the criminal's confession, because the findings were specific for repetitive acceleration-deceleration forces to an infant's eye with a strong vitreoretinal attachment. Conclusions: This ophthalmic finding had a key role in the diagnosis of abusive head trauma. This case presented the diagnostic use of a smartphone for fundus photography in this important medicolegal case.

• Journal of Veterinary Clinics
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• 제40권5호
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• pp.336-340
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• 2023

A dog (2-year old, female, Shih-Tzu) presented with hyperthermia and right-sided facial paralysis characterized by the inability to close the right eye and drooling from the right side of the mouth after H3N2 influenza vaccination [A/Canine/Korea/01/07(H3N2) strain; Caniflu-Max, Bionote, Hwaseong, Gyeonggi-do, ROK]. To determine the cause of the fever and neurological symptoms, physical examination, ophthalmic examination, thoracic and abdominal radiography, abdominal ultrasonography, complete blood counts, serum chemistry values, and electrolyte levels were determined. In addition, Cerebrospinal fluid analysis, antinuclear antibody test, fever of unknown origin polymerase chain reaction (PCR) panel, tick-borne pathogen PCR panel were performed. As a result, hyperthermia, leukocytosis, and elevated C-reactive protein were confirmed. In addition, neurological examination revealed decreased right eyelid reflexes, corneal reflexes, threat response, and facial sensation, it was possible to suspect problems with the trigeminal and facial nerves of the cranial nerve. Magnetic resonance imaging revealed a lesion suggestive of myositis in the right muscular lesion at atlanto-occipital junction level on site of vaccine injection. Therefore, right-sided facial paralysis was tentatively determined to be a secondary cause of nerve damage caused by myositis. The patient was treated with immunosuppressants such as prednisolone and mycophenolate mofetil. After 3 months of immunosuppressant therapy, the patient's symptoms improved.

• Korean Journal of Ichthyology
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• 제36권1호
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• pp.30-39
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• 2024

This study examines the osteological development of the Bartail Flathead Platycephalus indicus in the cranial, vertebral, caudal bones and pelvic, sholder grilde bones for the purpose of taxonomic studies. Adult P. indicus were collected from the Yeosu coast and artificially fertilized. Juveniles were reared at 18.5~21.8℃ (average 20.0℃±0.5℃). At 3 days after hatching (total length (TL) 3.49±0.32 mm), the parasphenoid and clavicle began to ossify. At 14 days after hatching (6.34±0.24 mm), the parietal and exoccipital bones of the cranium, the six branchiostegal rays of the hyoid, the urostyle of the caudal bones and the actinost of the shoulder girdle had ossified. At 39 days after hatching (11.39±0.86 mm), the preorbital and suborbital bones of the cranium were ossified, ossification of the pelvis girdle had begun, and the sholuder girdle was fully ossified. The number of vertebral columns were 26. At 45 days after hatching (12.63±0.62 mm), the nasal and supraorbital bones were ossified and the entire skeleton of the juvenile was completely ossified.