• Journal of Trauma and Injury
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• 제33권4호
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• pp.207-218
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• 2020

The following recommendations are presented herein: All trauma patients admitted to the resuscitation room should be constantly (or periodically) monitored for parameters such as blood pressure, heart rate, respiratory rate, oxygen saturation, body temperature, electrocardiography, Glasgow Coma Scale, and pupil reflex (1C). Chest AP and pelvic AP should be performed as the standard initial trauma series for severe trauma patients (1B). In patients with severe hemodynamically unstable trauma, it is recommended to perform extended focused assessment with sonography for trauma (eFAST) as an initial examination (1B). In hemodynamically stable trauma patients, eFAST can be considered as the initial examination (2B). For the diagnosis of suspected head trauma patients, brain computed tomography (CT) should be performed as an initial examination (1B). Cervical spine CT should be performed as an initial imaging test for patients with suspected cervical spine injury (1C). It is not necessary to perform chest CT as an initial examination in all patients with suspected chest injury, but in cases of suspected vascular injury in patients with thoracic or high-energy damage due to the mechanism of injury, chest CT can be considered for patients in a hemodynamically stable condition (2B). CT of the abdomen is recommended for patients suspected of abdominal trauma with stable vital signs (1B). CT of the abdomen should be considered for suspected pelvic trauma patients with stable vital signs (2B). Whole-body CT can be considered in patients with suspicion of severe trauma with stable vital signs (2B). Magnetic resonance imaging can be considered in hemodynamically stable trauma patients with suspected spinal cord injuries (2B).

• 스마트미디어저널
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• 제11권5호
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• pp.48-55
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• 2022

토마토 작물은 병해에 노출이 쉽고 단시간에 퍼지므로 병해에 대한 늦은 조치로 인한 피해는 생산량과 매출에 직접적인 영향을 끼친다. 따라서, 토마토의 병해에 대해 누구나 현장에서 간편하고 정확하게 진단하여 조기 예방을 가능하게 하는 서비스가 요구된다. 본 논문에서는 사전에 ImageNet 전이 학습된 딥러닝 기반 모델을 적용하여 토마토의 9가지 병해 및 정상인 경우의 클래스를 분류하고 서비스를 제공하는 시스템을 구성한다. Plant Village 데이터 셋으로부터 토마토 병해 및 정상을 분류한 잎의 이미지 셋을 합성곱을 사용하여 조금 더 가벼운 신경망을 구축한 딥러닝 기반 CNN구조를 갖는 MobileNet, ResNet의 입력을 사용한다. 2가지 제안 모델의 학습을 통해 정확도와 학습속도가 빠른 MobileNet를 사용하여 빠르고 편리한 서비스를 제공할 수 있다.

• Journal of Trauma and Injury
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• 제35권3호
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• pp.209-214
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• 2022

We describe a case of hyperbaric oxygen therapy (HBOt) as an adjunct to treatment of a crush injury to the hand. A 34-year-old male paramedic was involved in a motor vehicle accident and admitted for diagnosis and surgical treatment. He sustained a crush injury to his right hand and presented with significant muscle damage, including multiple fractures and dislocations, an avulsion injury of the flexor tendons, and amputation of the distal phalanx of the little finger. He underwent reconstructive surgery and received HBOt over the following days. In the following 2 months, he lost the distal and middle phalanges of the little finger and recovered hand function. Posttraumatic compartment syndrome responds well to HBOt, which reduces edema and contributes to angiogenesis, as well as promoting the cascade of healing events. High-energy trauma causes massive cell destruction, and the blood supply is usually not sufficient to meet the oxygen demands of viable tissues. Hyperbaric oxygenation by diffusion through interstitial and cellular fluids increases tissue oxygenation to levels sufficient for the host's responses to injury to work and helps control the delayed inflammatory reaction. HBOt used as an adjunct to surgical treatment resulted in early healing and rehabilitation, accelerating functional recovery. The results suggest that adjunctive HBOt can be beneficial for the treatment of crush injuries of the hand, resulting in better functional outcomes and helping to avoid unnecessary amputations.

• 적정기술학회지
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• 제7권2호
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• pp.206-210
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• 2021

고빌리루빈혈증은 신생아기에 가장 흔히 볼 수 있는 질환으로 전세계적으로 생후 일주일내 신생아 중 약 80%에서 관찰된다. 고빌리루빈혈증을 치료하지 않을 경우 핵황달 및 사망에 이르게 되므로 신속하고 정확하게 진단하는 것이 매우 중요하다. 본 연구에서는 상용 스마트폰을 사용하여 휴대가 편리하고 전처리 과정없이 사용이 간편한 총빌리루빈 측정시스템을 개발하였다. 본 시스템은 추가의 장치가 필요없이 스마트폰의 LED와 카메라를 이용하여 측정하며 전처리 없이 소량의 혈액을 주입하면 되므로 현장에서 누구나 쉽게 측정이 가능하다. Cobas c111의 측정값과 비교한 결과 3 mg/dL 이하 ±0.4 mg/dL 이내 94%(17/18), 3 mg/dL 이상 ±20% 이내 98%(276/282)로 CLIA 가이드라인의 정확도 기준을 만족함을 확인하였다. 이는 의료 시설 및 훈련된 인력 부족한 현장에서 신속하게 영유아의 황달 상태를 확인하는 방법으로 사용할 수 있을 것으로 보여진다.

• 한국건축시공학회지
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• 제21권3호
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• pp.189-194
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• 2021

본 연구에서는 Lab. 스케일 LIBS 장치를 제작하여 모르타르 내 염화물 분석에서의 LIBS 적용성과 재현성 검토를 수행하였다. 염화물 함량을 조절한 모르타르를 대상으로 기존의 분석방법(XRF, 전위차 적정법)과 LIBS 분석을 동시에 진행하였다. LIBS 분석 결과, 염소이온은 837.59nm 파장에서 검출되었고, 다양한 농도 구간에서의 정밀도를 향상시키기 위하여 전기장 강화를 통한 약 50배의 LIBS 신호증폭을 구현하였다. 수용액 기반의 재현성을 검증을 통하여 LIBS 신호 강도와 Cl농도 사이의 높은 상관관계를 확인할수 있었으며, 콘크리트 염해 내구성 진단에 LIBS적용 가능성을 확인하였다.

• 보존과학회지
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• 제38권1호
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• pp.45-54
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• 2022

This study examined the production technique of bracket murals in Daeungjeon Hall, Gaeamsa Temple by conducting a analysis of their wall structure, material characteristics, and painting layers. Wall was a single-branch structure with support layer, middle layer, finishing layer, and painting layer. The support layer, middle layer and finishing layer, were produced by mixing sand (quartz, feldspars etc.), and loess. The ratio of above medium sand to below fine sand was approximately 0.7 : 9.3 in the support layer, 4 : 6 in the middle layer and 6 : 4 in the finishing layer, which had a more percentage of above medium sand than the support layer. The analysis of the painting layer showed that natural soil pigment was used to establish a relatively ground layer of up to 50 ㎛, and pigments such as Lead sulfate, atacamite and mercury sulfide were painted on top of the layer. This study's results confirmed that the bracket mural paintings in Gaeamsa Temple are within the category of the production style of murals during the Joseon period. However, the points that the middle layer was formed several times, the significant difference in particle size distribution between the wall, and the absence of chopped straw in the support layer are a feature of bracket mural paintings in Gaeamsa Temple. These properties of murals as material and structure may be viewed for correlation with the degree of damage to wall structure of mural painting and would serve as an important reference to diagnosis the conservation conditions of murals or prepare conservation treatments.

• Journal of Korean Neurosurgical Society
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• 제65권5호
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• pp.652-664
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• 2022

The Kernohan-Woltman notch phenomenon (KWNP) refers to an intracranial lesion causing massive side-to-side mass effect which leads to compression of the contralateral cerebral peduncle against the free edge of the cerebellar tentorium. Diagnosis is based on "paradoxical" motor deficit ipsilateral to the lesion associated with radiologic evidence of damage to the contralateral cerebral peduncle. To date, there is scarce evidence regarding KWNP associated neuroimaging patterns and motor function prognostic factors. A systematic review was conducted on Medline database from inception to July 2021 looking for English-language articles concerning KWNP, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The research yielded 45 articles for a total of 51 patients. The mean age was 40.7 years-old and the male/female sex ratio was 2/1. 63% of the patients (32/51) suffered from head trauma with a majority of acute subdural hematomas (57%, 29/51). 57% (29/51) of the patients were in the coma upon admission and 47% (24/51) presented pupil anomalies. KWNP presented the neuroimaging features of compression ischemic stroke located in the contralateral cerebral peduncle, with edema in the surrounding structures and sometimes compression stroke of the cerebral arteries passing nearby. 45% of the patients (23/51) presented a good motor functional outcome; nevertheless, no predisposing factor was identified. A Glasgow coma scale (GCS) of more than 3 showed a trend (p=0.1065) toward a better motor functional outcome. The KWNP is a regional compression syndrome oftentimes caused by sudden and massive uncal herniation and leading to contralateral cerebral peduncle ischemia. Even though patients suffering from KWNP usually present a good overall recovery, patients with a GCS of 3 may present a worse motor functional outcome. In order to better understand this syndrome, future studies will have to focus on more personalized criteria such as individual variation of tentorial notch width.

• 대한두개안면성형외과학회지
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• 제23권2호
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• pp.89-92
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• 2022

Post-traumatic pseudoaneurysms of internal maxillary artery are rare, but may be life-threatening. When arterial damage leads to pseudoaneurysm formation, delayed intractable epistaxis can occur. We report our experience with the diagnosis and management of a ruptured internal maxillary arterial pseudoaneurysm that was discovered preoperatively in a patient with a zygomaticomaxillary complex (ZMC) fracture. He presented to the emergency room with epistaxis, which ceased shortly, and sinus hemorrhage was observed with a fracture of the posterior maxillary wall. The patient was scheduled for open reduction and internal fixation (ORIF) of the ZMC fracture. However, immediately before surgery, uncontrolled epistaxis of unknown origin was observed. Angiography indicated a pseudoaneurysm of the posterior superior alveolar artery. Selective endovascular embolization was performed, and hemostasis was achieved. After radiologic intervention, ORIF was successfully implemented without complications. Our case shows that in patients with a posterior maxillary wall fracture, there is a risk of uncontrolled bleeding in the perioperative period that could be caused by pseudoaneurysms, which should be considered even in the absence of typical symptoms.

• 대한통합의학회지
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• 제10권3호
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• pp.73-84
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• 2022

Background : Lymphedema is a progressive disorder characterized by the impairment of lymph flow from tissues to the blood circulation system. This occurs as a result of damage to the lymphatic system. Complex decongestive therapy (CDT) is a multimodal, conservative therapeutic approach that is used for the management of lymphedema. CDT consists of a combination of compression therapy, manual lymphatic drainage, exercise, and skin care. Purpose : This study aimed to provide a review of available physical therapy interventions as well as general care guidelines for patients with lymphedema. Methods : The recommendations and guidelines for physical therapy management, medical management, and general information were reviewed from the following sources: 1) The American Physical Therapy Association, 2) The Norton School of Lymphatic Therapy, and 3) The International Society of Lymphology. This review contains general information, including the medical management and the importance of physical therapy in lymphedema. Physical therapy management should be based on an assessment of the patients' presenting impairments, including based on inclusion or exclusion of physical therapy interventions. This review also outlines a step-by-step approach that starts with disease diagnosis and progression all the way through to rehabilitation as an outpatient. Conclusion : Depending on the patients' journey to recovery and the requirement for rehabilitation, physical therapy interventions should focus on the patients' needs including pain, appearance, physical function and general rehabilitation. We hope that this review will provide information on evidence-based physical therapy and general care to patients with lymphedema.

• 대한방사성의약품학회지
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• 제9권1호
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• pp.3-8
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• 2023

Parkinson's disease is a neurodegenerative disease caused by damage to brain neurons related to dopamine. Non-clinical animal models mainly used in Parkinson's disease research include drug-induced models of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and 6-hydroxydopamine, and genetically modified transgenic animal models. Parkinson's diagnosis can be made using brain imaging of the substantia nigra-striatal dopamine system and using a radiotracer that specifically binds to the dopamine transporter. In this study, ¹⁸F-N-(3-fluoropropyl)-2β-carboxymethoxy-3β-(4-iodophenyl) nortropane was used to confirm the image evaluation cutoff between normal and parkinson's disease models, and to confirm model persistence over time. In addition, the efficacy of single or combined administration of clinically used therapeutic drugs in parkinson's animal models was evaluated. Image analysis was performed using the PMOD software. Converted to standardized uptake value, and analyzed by standardized uptake value ratio by dividing the average value of left striatum by the average value of right striatum obtained by applying positron emission tomography images to the atlas magnetic resonance template. The image cutoff of the normal and the parkinson's disease model was calculated as SUVR=0.829, and it was confirmed that it was maintained during the test period. In the three-drug combination administration group, the right and left striatum showed a high symmetry of more than 0.942 on average and recovered significantly. Images using ¹⁸F-N-(3-fluoropropyl)-2β-carboxymethoxy-3β-(4-iodophenyl) nortropane are thought to be able to diagnose and evaluate treatment efficacy of non-clinical Parkinson's disease.