• The Transactions of The Korean Institute of Electrical Engineers
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• v.56 no.11
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• pp.2051-2057
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• 2007

In Oriental medicine, the status of a tongue is the important indicator to diagnose one's health like physiological and clinicopathological changes of inner parts of the body. The method of tongue diagnosis is not only convenient but also non-invasive and widely used in Oriental medicine. However, tongue diagnosis is affected by examination circumstances a lot like a light source, patient's posture and doctor's condition. To develop an automatic tongue diagnosis system for an objective and standardized diagnosis, segmenting a tongue is inevitable but difficult since the colors of a tongue, lips and skin in a mouth are similar. The proposed method includes preprocessing, graph-based over-segmentation, detecting positions with a local minimum over shading, detecting edge with color difference and estimating edge geometry from the probable structure of a tongue, where preprocessing performs down-sampling to reduce computation time, histogram equalization and edge enhancement. A tongue was segmented from a face image with a tongue from a digital tongue diagnosis system by the proposed method. According to three oriental medical doctors' evaluation, it produced the segmented region to include effective information and exclude a non-tongue region. It can be used to make an objective and standardized diagnosis.

• Journal of Oral Medicine and Pain
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• v.40 no.1
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• pp.17-27
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• 2015

Purpose: The purpose of this study was to investigate occupational distribution of temporomandibular disorders (TMD) patients and their diagnosis according to occupations and to evaluate the relationship between TMD and occupations. Work-related factors which might aggravate TMD symptoms were also evaluated. Methods: We investigated 316 TMD patients, aged from 13 to 65 years old, who had visited the Department of Oral Medicine in Pusan National University Dental Hospital. The subjects who have a job were assessed using TMD analysis examination and occupation questionnaire. The level of significance was p-value<0.05. Result: This study presented that the diagnoses according to occupations were not significant, but work-related factors such as verbal work and poor posture were related with TMD symptoms. Conclusions: Proper education is essential to prevent aggravation of TMD symptoms because TMD symptoms were more related to work environment than a specific occupation.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.457-460
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• 2010

Purpose: The great toe presents a reconstructive challenge for plastic surgeons. The big toe has much importance not only for the gait and the stability, but also for appearance aspects. Few reports have documented the reconstruction of big toe defects and we report a unique case of free flap reconstruction technique. Methods: A 41-year-old man with right great toe open fracture with soft tissue necrosis was referred from the orthopedic surgery department. On physical examination, there was the skin necrosis circumferentially and the fratured bone was severely fragmented. The metatarsophalangeal (MTP) joint of the big toe was intact. After the wound debridement, we harvested the innervated anterolateral thigh flap and transposed to the defected area. After five months, we finally retouched the flap by the dorsal defatting and distal debulking. Results: He had an uneventful postoperative course without infection, dehiscence and flap necrosis. He has remained asymptomatic for eight months without any recurrence such as the osteomyelitis. Finally, he kept the normal gait and posture with weight bearing on the reconstructed great toe and foot. Conclusion: The anterolateral thigh flap is described for the reconstruction of the great toe. It involves two stage procedure with the minimal donor site morbidity and provides a good cosmetic result.

• Journal of radiological science and technology
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• v.45 no.4
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• pp.355-363
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• 2022

This study was to investigate the prevalence rate of musculoskeletal disorders in relation to general characteristic factors, living environment factors, and work environment factors for sonographer's. For the response questions, the guidelines for musculoskeletal burden work were used. For statistical analysis, SPSS 26.0 version was used. For the common body parts of the sonographer's who responded, the prevalence was investigated by dividing the group into a group with high pain or discomfort and a group with low pain or discomfort according to the degree to which they experienced symptoms during the past 12 months. Multiple logistic regression analysis was used to determine the variance inflation factor(VIF), odds ratio (OR) and corresponding 95% confidence interval (CI). A p-value of <0.05 was considered statistically significant. As a result, housework hours, examination history, regular physical activity, number of patient examinations per day, and sitting posture were investigated as variables for rate musculoskeletal disorders. The sonographer's occupational group was found to have a high prevalence rate of musculoskeletal disorders like various other occupational groups. Based on the results of this study, it is judged that musculoskeletal disorders can be reduced by recognizing musculoskeletal disorders and improving work environment factors.

• Journal of Yeungnam Medical Science
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• v.40 no.3
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• pp.289-292
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• 2023

We describe the case of a 79-year-old man who presented with progressive aggravation of severe axial neck pain and fever 3 days after transurethral resection of the prostate (TURP), despite maintaining neutral neck posture during surgery. Laboratory examination revealed markedly elevated C-reactive protein levels and erythrocyte sedimentation rates. Computed tomography revealed crown-like calcifications surrounding the odontoid process. We diagnosed crowned dens syndrome (CDS) as the cause of acute-onset neck pain after TURP. The patient was treated with nonsteroidal anti-inflammatory drugs for 5 days, and his symptoms resolved completely. CDS is a rare disease characterized by calcific deposits around the odontoid process with acute onset of severe neck pain and restricted motion. Evidence of inflammation on serological testing and fever are typical of CDS. However, the prevalence and pathophysiology of CDS remain unclear. We hypothesized that systemic inflammation after prostate surgery may have induced a local inflammatory response involving calcification around the odontoid process.

• Journal of the Korean Society of Radiology
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• v.17 no.7
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• pp.1099-1108
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• 2023

The mortise view radiography procedure is an ankle joint examination and observes the presence of trauma, sprain, or dislocation suspected in the ankle joint. The auxiliary equipment used during the mortise view radiography procedure can generate artifacts in the radiograph images and is not diverse enough to be custom-made for each patient; not cost-efficient. The purpose of this study is to create a custom assistive device to support mortise view radiography procedure. This study utilized 3D printing technology to create the mortise view radiography procedure assistive device (ShinHan Device; SHD). The lengths of the tibiotalar joint (TTJ), talar calcaneal joint (TCJ), and medial joint (MJ) were measured and evaluated by five researchers using both SHD and the prototype Hologic tool. The mean ranges were found to be 39.42-39.47 mm for TTJ, 31.41-31.57 mm for TCJ, and 21.21-21.23 mm for MJ while using SHD device. On the other hand, the measurements showed mean ranges of 39.73-39.79 mm for TTJ, 31.46-31.50 mm for TCJ, and 21.31-21.35 mm for MJ while using the Hologic tool. Based on this study results, the error ranges at all positions decreased by 24% for TTJ, 17% for TCJ, and 36% for MJ when using SHD device compared to the Hologic tool. Moreover, when SHD was used, it allowed for a highly reproducible examination posture (ICC = 0.99), and it enabled the acquisition of radiograph images without artifacts, which were present in the Hologic tool.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.1
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• pp.97-103
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• 2009

The status and the property of a tongue are the important indicators to diagnose one's health like physiological and clinicopathological changes of inner organs. However, the tongue diagnosis is affected by examination circumstances like a light source, patient's posture, and doctor's condition. To develop an automatic tongue diagnosis system for an objective and standardized diagnosis, classifying tongue coating is inevitable but difficult since the features like color and texture of the tongue coatings and substance have little difference, especially in the neighborhood on the tongue surface. The proposed method has two procedures; the first is to acquire the color table to classify tongue coatings and substance by automatically separating coating regions marked by oriental medical doctors, decomposing the color components of the region into hue, saturation and brightness and obtaining the 2nd order discriminant with statistical data of hue and saturation corresponding to each kind of tongue coatings, and the other is to apply the tongue region in an input image to the color table, resulting in separating the regions of tongue coatings and classifying them automatically. As a result, kinds of tongue coatings and substance were segmented from a face image corresponding to regions marked by oriental medical doctors and the color table for classification took hue and saturation values as inputs and produced the classification of the values into white coating, yellow coating and substance in a digital tongue diagnosis system. The coating regions classified by the proposed method were almost the same to the marked regions. The exactness of classification was 83%, which is the degree of correspondence between what Oriental medical doctors diagnosed and what the proposed method classified. Since the classified regions provide effective information, the proposed method can be used to make an objective and standardized diagnosis and applied to an ubiquitous healthcare system. Therefore, the method will be able to be widely used in Oriental medicine.

• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.277-281
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• 2018

Objective : Craniovertebral junctional anomalies constitute a technical challenge. Surgical opening of atlantoaxial joint region is a complex procedure especially in patients with nuchal deformity like basilar invagination. This region has actually very complicated anatomical and functional characteristics, including multiple joints providing extension, flexion, and wide rotation. In fact, it is also a bottleneck region where bones, neural structures, and blood vessels are located. Stabilization surgery regarding this region should consider the fact that the area exposes excessive and life-long stress due to complex movements and human posture. Therefore, all options should be considered for surgical stabilization, and they could be interchanged during the surgery, if required. Methods : A 53-year-old male patient applied to outpatients' clinic with complaints of head and neck pain persisting for a long time. Physical examination was normal except increased deep tendon reflexes. The patient was on long-term corticosteroid due to an allergic disease. Magnetic resonance imaging and computed tomography findings indicated basilar invagination and atlantoaxial dislocation.The patient underwent C0-C3-C4 (lateral mass) and additional C0-C2 (translaminar) stabilization surgery. Results : In routine practice, the sites where rods are bound to occipital plates were placed as paramedian. Instead, we inserted lateral mass screw to the sites where occipital screws were inserted on the occipital plate, thereby creating a site where extra rod could be bound.When C2 translaminar screw is inserted, screw caps remain on the median plane, which makes them difficult to bind to contralateral system. These bind directly to occipital plate without any connection from this region to the contralateral system.Advantages of this technique include easy insertion of C2 translaminar screws, presence of increased screw sizes, and exclusion of pullout forces onto the screw from neck movements. Another advantage of the technique is the median placement of the rod; i.e., thick part of the occipital bone is in alignment with axial loading. Conclusion : We believe that this technique, which could be easily performed as adjuvant to classical stabilization surgery with no need for special screw and rod, may improve distraction force in patients with low bone density.

• The Journal of Internal Korean Medicine
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• v.33 no.1
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• pp.1-13
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• 2012

Background : In oriental medicine, the status of the tongue is an important indicator to diagnose the condition of one's health, such as physiological and the clinicopathological changes of internal organs. A tongue diagnosis is not only convenient but also non-invasive, and therefore widely used in Oriental medicine. However, the tongue diagnosis is greatly affected by examination circumstances, patient's posture, and doctor's diagnosis criteria. Objectives : This study was designed to assure the necessity for standardization of tongue diagnosis based on diagnostic criteria of tongue coating thickness (TCT). Methods : Thirty tongue photographs were acquired and analyzed by digital tongue diagnosis system (DTDS) which measured the percentage of TCT on the tongue surface. Fifteen oriental medical doctors evaluated TCT in 30 photographs. Afterward, the 15 assessors were trained for diagnostic criteria of TCT and evaluated the photographs again. The intraclass correlation coefficient (ICC) was used to obtain the agreement rate among the 15 assessors and the agreement rate between assessors' TCT scores and DTDS values. Results : The agreement rate among the 15 assessors after training was higher than before training. The agreement rate between assessors' TCT scores and DTDS values after training was also higher than before training. Furthermore, the difference of the agreement rate between before and after training was significant (p<0.05). Conclusions : The standardization of diagnostic criteria of TCT increased the agreement rate among the assessors and the agreement rate between assessors' TCT scores and DTDS values. Therefore, the standardization of diagnostic criteria is expected to contribute to the objectification and quantification of the tongue diagnosis system.

• Clinical and Experimental Pediatrics
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• v.59 no.1
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• pp.30-34
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• 2016

Purpose: Although Bednar's aphthae are common and regress spontaneously, these lesions may lead to feeding intolerance and are often misdiagnosed, rendering examinations useless. This study sheds new light on the clinical features of Bednar's aphthae. Methods: Sixteen neonates and infants were newly diagnosed with Bednar's aphthae via routine health check-ups in an outpatient clinic. Medical records were retrospectively reviewed, and the following parameters were analyzed; sex, gestational age, birth weight, mode of delivery, and perinatal problems. A physical examination was carried out during the next outpatient visit to examine the healing process and check for the existence of scars or complications. Results: Initial presentation included changes in feeding habits (n=10), longer feeding time, reduced intake, and increased irritability. In 6 patients, Bednar's aphthae were discovered incidentally, without prior symptoms. Feeding posture and method of feeding are important causes of Bednar's aphthae. Eleven patients were fed in a horizontal position, whereas 5 patients were fed in a semiseated position. Fifteen patients were bottle-fed, whereas 1 patient was exclusively breastfed. After correcting the feeding position, the ulcerative lesions disappeared within 1 month of diagnosis. During the follow-up period, lesions did not recur in any of the patients. Conclusion: This study suggests that Bednar's aphthae are caused by mechanical pressure. A diagnosis of Bednar's aphthae should be considered when lesions are found on the palate of infants and when symptoms seem to be feeding related. Proper education of parents can both treat Bednar's aphthae and easily prevent its recurrence.