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Trochlear Nerve Palsy Caused by Quadrigeminal Cistern Lipoma (사구수조지방종에 의한 도르래신경마비 1예)

  • Choi, Nam Hyeon;Kim, Won Jae;Kim, Myung-Mi
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1087-1090
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    • 2018
  • Purpose: To report a case of trochlear nerve palsy caused by quadrigeminal cistern lipoma located in the dorsal midbrain. Case summary: A 65-year-old male visited our clinic for intermittent vertical diplopia over 2-year period. Symptoms of diplopia had worsened over the past two weeks. He had no previous medical history except having had diabetes for 1 month. The best-corrected visual acuity was 20/25 in the right eye and 20/20 in the left eye. Pupillary examination was not remarkable. Extraocular examination showed 4 prism diopters (PD) left hypertropia at distant gaze and 4 PD exotropia at near gaze, with adduction elevation of the left eye. The Bielschowsky head tilt test revealed 6 PD left hypertropia on the left gaze and orthotropia on the right tilt. Fundus examination showed excyclotorsion of the right eye and incyclotorsion of the left eye. Brain magnetic resonance imaging revealed quadrigeminal cistern lipoma. Prism glasses were prescribed to alleviate diplopia, and we followed up the lesions without further treatment. Conclusions: Trochlear nerve palsy can be caused by quadrigeminal cistern lipoma; however, it is uncommon for this condition to be caused by a compressive lesion. Prompt neuroimaging can be helpful to rule out the causes of this condition in patients with atypical symptoms.

Toxic Optic Neuropathy Caused by Chlorfenapyr Poisoning (클로르페나피르 음독 후 발생한 독성 시신경병증 1예)

  • Park, Su Jin;Jung, Jae Uk;Kang, Yong Koo;Chun, Bo Young;Son, Byeong Jae
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1097-1102
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    • 2018
  • Purpose: To report a case of toxic optic neuropathy caused by chlorfenapyr ingestion accompanied by central nervous system involvement. Case summary: A 44-year-old female visited our clinic complaining of reduced visual acuity in both eyes for 7 days. She had ingested a mouthful of chlorfenapyr for a suicide attempt 2 weeks prior to the visit. Gastric lavage was performed immediately after ingestion at the other hospital. Her best-corrected visual acuity was finger count 30 cm in the right eye and hand motion in the left eye. Both pupils were dilated by 5.0 mm and the response to light was sluggish in both eyes. A relative afferent pupillary defect was detected in her left eye. Funduscopy revealed optic disc swelling in both eyes. Magnetic resonance imaging of the brain showed a symmetric hyper-intense signal in the white matter tract including the internal capsule, corpus callosum, middle cerebellar peduncle, and brainstem. The patient was diagnosed with toxic optic neuropathy induced by chlorfenapyr ingestion, and underwent high-dose intravenous corticosteroid pulse therapy. Three days later, the best-corrected visual acuity was no light perception in both eyes. Three months later, optic atrophy was observed in both eyes. Optical coherence tomography revealed a reduction in the thicknesses of the retinal nerve fiber layer and ganglion cell and inner plexiform layer in the macular area. Conclusions: Ingestion of even a small amount of chlorfenapyr can cause severe optic nerve damage through the latent period, despite prompt lavage and high-dose steroid treatment.

Factors and Their Correlation with Injury Severity of Elderly Pedestrian Traffic Accidents

  • Hyun, Tae gyu;Yeom, Seok-Ran;Park, Sung-Wook;Lee, Deasup;Kim, Hyung bin;Wang, Il Jae;Bae, Byung Gwan;Song, Min keun;Cho, Youngmo
    • Journal of Trauma and Injury
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    • v.32 no.3
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    • pp.143-149
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    • 2019
  • Purpose: No previous study has assessed elderly pedestrian traffic accidents based on a nationwide database. This study aimed to help primary physicians who examine patients in emergency departments to determine and make prompt and accurate treatment decisions. Methods: This study used data from the Emergency Department-based Injury Indepth Surveillance from 2013 to 2017, managed by the Korea Centers for Disease Control and Prevention. Pedestrians aged ${\geq}65years$ were included, and using multivariate logistic regression multiple factors were analyzed to determine their relationship with injury severity. Results: Of 227,695 subjects, 6,498 were included, of whom 2,065 (31.8%) were severely injured. There were more female than male patients in all severity groups. Most accidents occurred in the afternoon and on general roads. In the multivariate analysis, the odds ratio (OR) of injury severity for male pedestrians was 1.165 (95% confidence interval: 1.034-1.313, p=0.012). Older age of patients and the use of ambulances were associated with greater injury severity. The accident time affected the degree of injury severity; i.e., compared to dawn, injury severity increased in the morning (OR: 1.246, p=0.047) and decreased at night (OR: 0.678, p<0.001). A significant difference was noted in the correlation between the type of vehicle causing the accident and the accident severity; i.e., motorcycle accidents had lower severity than bicycle accidents (OR: 0.582, p=0.047). Conclusions: Injury severity was correlated with sex, age, transportation to the ED, TA onset time, and type of vehicle. The study results suggest that injury severity may be positively reflected in initial assessments and overall integrated treatments by physicians and in the related policies.

Impacts of Food-Service Franchise's SNS Marketing Activities on Customer Behavior Intention (외식 프랜차이즈 기업의 SNS 마케팅 활동이 소비자 행동의도에 미치는 영향)

  • Lee, Ju-Yeon;Lee, Min-Ji;Kwon, Da-Jeong;Jeong, Seung-Yeon;Hur, Soon-Beom
    • The Korean Journal of Franchise Management
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    • v.10 no.1
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    • pp.43-52
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    • 2019
  • Purpose - Many companies use the Internet to conduct their business to maintain and acquire their customers. SNS is used as a site where users can create profiles, build personal networks, and then share and exchange information with others. Not only do people use SNS for their self-promotion, but they also promote their services by creating SNS pages. SNS is recognized as a medium for implementing effective advertising strategies and is being used as an important means of promoting the company. Therefore, in this study, we investigate the effect of SNS marketing characteristics of restaurant franchise firms on utilitarian value and hedonic value and examine their effects on purchase intention. Research design, data, and methodology - The data were collected from 20s-60s respondents who have used SNS for restaurant visit using Google survey. A total of 159 responses were collected and used for final analysis. Smart PLS 3.0 was used for the hypothesis test. Results - As a result of an analysis, it was shown that the influence of the playfulness and affordability of information on the utilitarian value had a significant positive effect. Interaction and up-to-date did not have a positive effect on utilitarian value. Interaction, affordability, and up-to-date have no significant positive effects on hedonic value. The playfulness of information has a positive effect on the hedonic value. Both utilitarian value and hedonic value had positive effects on purchase intention. Conclusions - The findings of this study suggest that the SNS marketers of restaurant franchisors should focus on the playfulness, affordability, and up-to-date rather than the interactivity of SNS. In marketing through SNS, the act of presenting the basis of information and enhancing the provision of information through objective criteria makes it possible to experience the practical value of information. It is necessary to develop differentiated contents which cause customers interest and fun and to induce many customers' purchase intent by providing objective and realistic information. In order to increase the customers' repurchase intentions toward the food service business, customers should maximize the hedonic value and practical value felt through information. It should also focus on providing information that customers are receptive to, rather than providing prompt information.

Individual Ortho-rectification of Coast Guard Aerial Images for Oil Spill Monitoring (유출유 모니터링을 위한 해경 항공 영상의 개별정사보정)

  • Oh, Youngon;Bui, An Ngoc;Choi, Kyoungah;Lee, Impyeong
    • Korean Journal of Remote Sensing
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    • v.38 no.6_1
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    • pp.1479-1488
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    • 2022
  • Accidents in which oil spills occur intermittently in the ocean due to ship collisions and sinkings. In order to prepare prompt countermeasures when such an accident occurs, it is necessary to accurately identify the current status of spilled oil. To this end, the Coast Guard patrols the target area with a fixed-wing airplane or helicopter and checks it with the naked eye or video, but it was difficult to determine the area contaminated by the spilled oil and its exact location on the map. Accordingly, this study develops a technology for direct ortho-rectification by automatically geo-referencing aerial images collected by the Coast Guard without individual ground reference points to identify the current status of spilled oil. First, meta information required for georeferencing is extracted from a visualized screen of sensor information such as video by optical character recognition (OCR). Based on the extracted information, the external orientation parameters of the image are determined. Images are individually orthorectified using the determined the external orientation parameters. The accuracy of individual orthoimages generated through this method was evaluated to be about tens of meters up to 100 m. The accuracy level was reasonably acceptable considering the inherent errors of the position and attitude sensors, the inaccuracies in the internal orientation parameters such as camera focal length, without using no ground control points. It is judged to be an appropriate level for identifying the current status of spilled oil contaminated areas in the sea. In the future, if real-time transmission of images captured during flight becomes possible, individual orthoimages can be generated in real time through the proposed individual orthorectification technology. Based on this, it can be effectively used to quickly identify the current status of spilled oil contamination and establish countermeasures.

A Male Neonate with Prolonged Jaundice Secondary to 21-hydroxylase Deficiency (지속된 황달로 내원한 21-수산화효소 결핍증 남아 증례)

  • Min Woog Kwag;Yena Lee;Gu-Hwan Kim;Min Jae Kang
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.24 no.1
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    • pp.37-42
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    • 2024
  • Congenital adrenal hyperplasia (CAH) is a genetic disorder characterized by decreased cortisol secretion, with 21-hydroxylase deficiency being the most common type. It is uncommon for CAH to present primarily as cholestasis; therefore, when a patient presents with prolonged jaundice, it is difficult to suspect CAH immediately. In this report, we aim to share our experience with an exceptional case of 21-hydroxylase deficiency. A 28-day-old male visited the outpatient clinic due to prolonged jaundice and elevated 17α-hydroxyprogesterone (17-OHP) levels in the newborn screening test. Since he showed no other symptoms such as lethargy or vomiting, he underwent a routine blood test for jaundice and a retest of 17-OHP at the outpatient clinic. Two hours after the blood draw, he was found to have severe hyponatremia and hyperkalemia, so he was immediately admitted to the intensive care unit. After treatment with hydrocortisone, fludrocortisone, sodium chloride, and intravenous fluids, the cholestasis and electrolyte imbalances improved over time. He was diagnosed with 21-hydroxylase deficiency, salt-wasting type, which was confirmed by the ACTH stimulation test and genetic testing. It is important to make a prompt diagnosis of CAH to avoid missing critical timing. Therefore, CAH should not be overlooked, even if the patient does not exhibit typical symptoms.

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Agricultural Applicability of AI based Image Generation (AI 기반 이미지 생성 기술의 농업 적용 가능성)

  • Seungri Yoon;Yeyeong Lee;Eunkyu Jung;Tae In Ahn
    • Journal of Bio-Environment Control
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    • v.33 no.2
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    • pp.120-128
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    • 2024
  • Since ChatGPT was released in 2022, the generative artificial intelligence (AI) industry has seen massive growth and is expected to bring significant innovations to cognitive tasks. AI-based image generation, in particular, is leading major changes in the digital world. This study investigates the technical foundations of Midjourney, Stable Diffusion, and Firefly-three notable AI image generation tools-and compares their effectiveness by examining the images they produce. The results show that these AI tools can generate realistic images of tomatoes, strawberries, paprikas, and cucumbers, typical crops grown in greenhouse. Especially, Firefly stood out for its ability to produce very realistic images of greenhouse-grown crops. However, all tools struggled to fully capture the environmental context of greenhouses where these crops grow. The process of refining prompts and using reference images has proven effective in accurately generating images of strawberry fruits and their cultivation systems. In the case of generating cucumber images, the AI tools produced images very close to real ones, with no significant differences found in their evaluation scores. This study demonstrates how AI-based image generation technology can be applied in agriculture, suggesting a bright future for its use in this field.

Clinical Features of Henoch-Schönlein Purpura Gastroenteropathy without Purpura before Diagnosis (진단 전에 자반이 동반되지 않았던 Henoch-Schönlein 자반 위장병증의 임상적 고찰)

  • Oh, Jae Min;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.54-60
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    • 2004
  • Purpose: Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a small-vessel vasculitic disease that most often affects the skin. Abdominal symptoms precede the typical purpuric rash of HSP in 14~36%. It is a challenge to diagnose HSP in the absence of a rash, because there are no biologic tests that can identify HSP with certainty, so we tried to find out the characteristic features of HSP gastroenteropathy without purpura before diagnosis. Methods: This study included 82 children with HSP who had been admitted or visited outward of the Department of Pediatrics, Pusan National University Hospital from 1995 to 2000. The cases that the onset of purpura preceded or coincided that of abdominal pain were defined as purpura-positive group. The cases that the onset of abdominal pain preceded purpura more than 1 week and purpura was not presented till diagnosed as HSP gastroenteropathy were defined as purpura-negative group. We compared and analyzed the clinical features of the two groups by reviewing the medical records retrospectively. To ensure the diagnosis of HSP gastroenteropathy, we conducted upper GI series, abdominal ultrasonogram, abdominal CT, endoscopy and/or skin biopsy. Results: The number of cases of purpura-positive group and purpura-negative group were 72 and 10, respectively. There is no difference between two groups in the incidence of clinical symptoms and laboratory findings. Children with HSP gastroenteropathy had characteristic erosive or ulcerative lesions in the stomach or duodenum on esophagogastroduodenoscopy, or mural thickening of the small bowel on abdominal ultrasonogram, CT or upper GI series. Skin biopsy revealed leukocytoclastic vasculitis in 3 of them, although biopsy specimen was taken from any areas of normal- appearing skin. In purpura-negative group, 9 patients improved by steroid therapy. Conclusion: In purpura-negative group, there is no diagnostic feature on the laboratory findings and clinical features. Therefore, to diagnose HSP gastroenteropathy in patients with abdominal pain in the absence of the characteristic rash, careful observation of clinical features and laboratory data, and prompt application of available diagnostic tools such as gastrointestinal endoscopy, radiologic study and skin biopsy are recommended. Early use of corticosteroid may reduce the suffering in these patients.

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Efficacy and Cost Benefits of Rapid Antigen Detection Test for Group A Streptococci Obtained from Acute Pharyngitis in Children (소아 세균성 인두 편도염의 진단에 있어 신속 항원 검출 검사의 유용성과 비용 효과의 평가)

  • Youn, Suk;Chung, Hye-Jeon;Kim, Yun-Ho;Choi, Jin-Dong;Lee, Sang-Hoon;Min, Jung-Sik;Jung, Sang-Young;Jung, Sung-Ki;Ahn, Byung-Moon;Lee, Hee-Joo;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.124-134
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    • 2005
  • Purpose : It has been known that the diagnostic confirmation of group A streptococcal pharyngitis is accompanied with the results of throat culture and/or rapid antigen detection test(RADT). This study was designed to evaluate the usefulness and cost benefits of the RADT in patients with a sore throat compared the empirical antibiotic treated group without using RADT or throat culture with the antibiotic treated group according to the results of RADT test and/or throat culture. Methods : From April 2003 to August 2003, total 369 patients were enrolled this study. They were redistributed into two groups. In one group, the RADT test and throat culture were used and the patients received antibiotic treatment according to the results of test and in the other group, no diagnostic examinations were used and the patients were treated with antibiotics which were chosen empirically. The flow sheet with questionnaire was drawing up and obtained the clinical symptoms, signs and the name of antibiotics that were administered. Results : A total of 244 patients were treated after the throat culture and/or RADT, and 125 patients were treated empirically. The prevalence of bacteriologically confirmed group A streptococcal pharyngitis was 20.1%. The sensitivity and specificity of RADT were 89.8% and 86.1%, respectively. Positive predictive value and negative predictive value were 62.0% and 97.1%, respectively. The rate of antibiotic use was high in both groups. Because the physician used the antibiotics even if the result of RADT was negative. So about 37% of reduction of antibiotics use might be possible if we used antibiotics according to the results of RADT. There were no cost differences between the RADT applied group and the empirically treated antibiotic group if we could reduce the price of RADT to 63% of the current price. Conclusion : The RADT could be applied for the easy and rapid diagnosis and prompt treatment for group A streptococcal pharyngitis, and RADT could reduced the number of antibiotics used if the price of RADT was reduced to 63% of current price. For accurate evaluation of efficacy and cost effect, further controlled study is needed.

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Epidemiology and Clinical Characteristics of Clostridium difficile-associated Disease in Children: Comparison between Community- and Hospital-acquired Infections (소아에서 발생한 Clostridium difficile 관련 질환의 역학과 임상양상: 지역사회감염과 원내감염의 비교)

  • Cho, Hye-Jung;Ryoo, Eell;Sun, Yong-Han;Cho, Kang-Ho;Son, Dong-Woo;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.2
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    • pp.146-153
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    • 2010
  • Purpose: Recent studies have reported an increase in the incidence of community-acquired Clostridium difficile-associated disease (CA-CDAD) among children. There is an overall lack of information on CA-CDAD in the pediatric population. The aim of our study was to compare the epidemiologic and clinical features between CA-CDAD and hospital-acquired C. difficile-associated disease (HA-CDAD) in children. Methods: We retrospectively reviewed the medical records of all patients who were diagnosed with C. difficile-associated disease (CDAD) at Gil Hospital between April 2008 and March 2009. The diagnosis of CDAD was made when patients with gastrointestinal symptoms had positive results for C. difficile toxins A and B assay or stool culture. Results: Sixty-one (male, 32 and female, 29) patients were included. The mean age was 3.79${\pm}$4.54 years. Of the 61 patients, 22 (36.1%) were <1 year of age. Twenty-three patients (37.7%) had a history of antibiotic exposure in the previous 3 months. Forty-one patients (67.2%) were diagnosed with CA-CDAD. There were no significant differences in age, gender, symptoms, laboratory findings, recovery period, complications, and recurrence between the CA-CDAD and HA-CDAD groups. On the other hand, exposure to antibiotics was significantly more frequent among patients in the HA-CDAD group (p=0.005). Conclusion: This study suggests that the occurrence of CA-CDAD is increasing in the pediatric population, especially in younger children with no history of exposure to antibiotics and in outpatients. Awareness of the increasing incidence of CA-CDAD and prompt investigation of C. difficile in susceptible patients is needed to avoid misdiagnosis and for appropriate therapy.