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Usefulness of Vibration Response Imaging (VRI) for Pneumonia Patients (폐렴환자에서 진동 공명 영상 검사(VRI)의 유용성)

  • Park, Eu-Gene;Park, Jung-Hee;Hong, Mi-Jin;Kim, Won-Dong;Lee, Kye-Young;Kim, Sun-Jong;Kim, Hee-Joung;Ha, Kyoung-Won;Chon, Gyu-Rak;Kim, Hyun-Ai;Yoo, Kwang-Ha
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.1
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    • pp.30-36
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    • 2011
  • Background: Pneumonia is commonly seen in outpatient clinics. it is widely known as the most common cause of death from infectious disease. Pneumonia has been diagnosed by its typical symptoms, chest X-ray and blood tests. However, both chest X-rays and blood tests have limitations in diagnosis. Thus primary care clinicians usually have been constrained due to a lack of adequate diagnostic tools. Vibration response imaging (VRI) is a newly emerging diagnostic modality, and its procedure is non-invasive, radiation-free, and easy to handle. This study was designed to evaluate the diagnostic usefulness of the VRI test among pneumonia patients and to consider its correlation with other conventional tests such as Chest X-ray, laboratory tests and clinical symptoms. Methods: VRI was performed in 46 patients diagnosed with pneumonia in Konkuk University Medical Center. VRI was assessed in a private and quiet room twice: before and after the treatment. Sensors for VRI were placed on a patient's back at regular intervals; they detected pulmonary vibration energy produced when respiration occurred and presented as specific images. Any modifications either in chest X-ray, C-reactive protein (CRP), white blood cell count (WBC) or body temperature were compared with changes in VRI image during a given time course. Results: VRI, chest X-ray and CRP scores were significantly improved after treatment. Correlation between VRI and other tests was not clearly indicated among all patients. But relatively severe pneumonia patients showed correlations between VRI and chest X-ray, as well as between VRI and CRP. Conclusion: This study demonstrates that VRI can be safely applied to patients with pneumonia.

An analysis of behavioral characteristics in drivers in roll-over accident (전복사고 운전자를 대상으로 자동차 안전장치에 대한 행동특성 분석)

  • Lee, Hyo-Ju;Kim, Ho-Jung;Lee, Kang-Hyun;Lee, Myung-Lyeol;Choi, Hyo-Jueng
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.11
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    • pp.7329-7334
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    • 2015
  • This is to analyze of driver behavioral and the accident characteristics in rollover. The study period was January 2011 to May 2014 and the subject of study was 102 person who were drivers visited the emergency room. Research tool includes a damage information of the vehicle, accident mechanism, damage to the patient clinical information with the injury data from the ROAD Traffic Authority. For data analysis, SPSS 18.0 was used for t-test, ANOVA and Chi-square test. Injury Severity Score average score according to the vehicle type is 6.00 points in the smaller vehicle, at high vehicle 11.78 points, from the other vehicle that showed 14.70 points. Significant differences between the three groups did not show (P=.267). Men did not use a seat belt significantly compared to women(P=.007). Vehicle type and weather, this was no correlation with whether or not use the seat belt(P=.755, P=.793). But showed a tendency to smaller size vehicles drivers do not use a seat belt, the weather could see a little more inclined to use a seat belt rather than a sunny day. Finally, in rollover accidents as in other types of accident it was confirmed that the seat belt has a great influence on the damage.

CdZnTe Detector for Computed Tomography based on Weighting Potential (가중 퍼텐셜에 기초한 CT용 CdZnTe 소자 설계)

  • Lim, Hyunjong;Park, Chansun;Kim, Jungsu;Kim, Jungmin;Choi, Jonghak;Kim, KiHyun
    • Journal of radiological science and technology
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    • v.39 no.1
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    • pp.35-42
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    • 2016
  • Room-temperature operating CdZnTe(CZT) material is an innovative radiation detector which could reduce the patient dose to one-tenth level of conventional CT (Computed Tomography) and mammography system. The pixel and pixel pitch in the imaging device determine the conversion efficiency of incident X-or gamma-ray and the cross-talk of signal, that is, image quality of detector system. The weighting potential is the virtual potential determined by the position and geometry of electrode. The weighting potential obtained by computer-based simulation in solving Poisson equation with proper boundaries condition. The pixel was optimized by considering the CIE (charge induced efficiency) and the signal cross-talk in CT detector system. The pixel pitch was 1-mm and the detector thickness was 2-mm in the simulation. The optimized pixel size and inter-pixel distance for maximizing the CIE and minimizing the signal cross-talk is about $750{\mu}m$ and $125{\mu}m$, respectively.

Comparative Evaluation of 18F-FDG Brain PET/CT AI Images Obtained Using Generative Adversarial Network (생성적 적대 신경망(Generative Adversarial Network)을 이용하여 획득한 18F-FDG Brain PET/CT 인공지능 영상의 비교평가)

  • Kim, Jong-Wan;Kim, Jung-Yul;Lim, Han-sang;Kim, Jae-sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.24 no.1
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    • pp.15-19
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    • 2020
  • Purpose Generative Adversarial Network(GAN) is one of deep learning technologies. This is a way to create a real fake image after learning the real image. In this study, after acquiring artificial intelligence images through GAN, We were compared and evaluated with real scan time images. We want to see if these technologies are potentially useful. Materials and Methods 30 patients who underwent 18F-FDG Brain PET/CT scanning at Severance Hospital, were acquired in 15-minute List mode and reconstructed into 1,2,3,4,5 and 15minute images, respectively. 25 out of 30 patients were used as learning images for learning of GAN and 5 patients used as verification images for confirming the learning model. The program was implemented using the Python and Tensorflow frameworks. After learning using the Pix2Pix model of GAN technology, this learning model generated artificial intelligence images. The artificial intelligence image generated in this way were evaluated as Mean Square Error(MSE), Peak Signal to Noise Ratio(PSNR), and Structural Similarity Index(SSIM) with real scan time image. Results The trained model was evaluated with the verification image. As a result, The 15-minute image created by the 5-minute image rather than 1-minute after the start of the scan showed a smaller MSE, and the PSNR and SSIM increased. Conclusion Through this study, it was confirmed that AI imaging technology is applicable. In the future, if these artificial intelligence imaging technologies are applied to nuclear medicine imaging, it will be possible to acquire images even with a short scan time, which can be expected to reduce artifacts caused by patient movement and increase the efficiency of the scanning room.

Principles of Intraoperative Neurophysiological Monitoring with Insertion and Removal of Electrodes (수술 중 신경계감시검사에서 검사에 따른 전극의 삽입 및 제거방법)

  • Lim, Sung Hyuk;Park, Soon Bu;Moon, Dae Young;Kim, Jong Sik;Choi, Young Doo;Park, Sang Ku
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.4
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    • pp.453-461
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    • 2019
  • Intraoperative neurophysiological monitoring (INM) examination identifies the damage caused to the nervous system during surgery. This method is applied in various surgeries to validate the procedure being performed, and proceed with confidence. The assessment is conducted in an operating room, using subdermal needle electrodes to optimize the examination. There are no textbooks or guides for the correct stimuli and recording areas for the surgical laboratory test. This article provides a detailed description of the correct stimuli and recording parts in motor evoked potential (MEP), somatosensory evoked potential (SSEP), brainstem auditory evoked potentials (BAEP) and visual evoked potentials (VEP). Free-running Electromyography (EMG) is an observation of the EMG that occurs in the muscle, wherein the functional state of most cranial nerves and spinal nerve roots is determined. In order to help understand the test, an image depicting the inserting subdermal needle electrodes into each of the muscles, is attached. Furthermore, considering both the patient and the examiner, a safe method is suggested for removal of electrodes after conclusion of the test.

Study on the Characteristics of Ordinary Symptoms in Overweight and Obesity Patients according to Sasang Constitution (사상체질에 따른 과체중 및 비만 환자의 소증(素證) 특성 비교)

  • Shin, Seung Won;Lee, Junhee
    • Journal of Korean Medicine for Obesity Research
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    • v.13 no.1
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    • pp.33-45
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    • 2013
  • Objectives: This study was aimed to find out the characteristics of ordinary symptoms between the control and patient groups, diagnosed as overweight or obesity, in Soyang, Taeeum, and Soeum Constitutions and among those 3 groups. Methods: As a prospective cross-sectional study based on medical records, 9213 patients, who visited Kyung Hee University Medical Center from May in 2007 to June in 2010, were included. To diagnose the constitution, Revised Questionnaire for the Sasang Constitution Classification II and examinations by oriental medical doctors who majored in Sasang Constitution Medicine were performed. Based on the World Health Organization criteria for Asian obesity assessment, body mass index (BMI) was classified into 3 groups; more than 25 as obesity, 23 to 25 as overweight, and less than 23 as normal. Ordinary symptoms questionnaire, which consists of 46 questions in 8 categories, were given to the subjects. One-way ANOVA test in continuous variables and chi-square test in categorical variables were carried out to analyze statistical significance. Results and Conclusions: 1) In general characteristics, we could find out the significant differences in age, sex, height, weight, BMI, waist circumference, blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, fasting blood sugar, and hemoglobin A1c among the 3 Constitutional groups. 2) Soyang Constitution of overweight and obesity has tendency to have higher appetite, like cool or cold water, defecate more, swear more, dislike heat, and have warmer or hotter extremities in the ordinary symptoms, compared with the control group. 3) Taeeum Constitution of overweight and obesity has tendency to have higher appetite, like cool or cold water, defecate more, swear more, dislike heat, and have warmer or hotter extremities in the ordinary symptoms, compared with the control group. 4) Soeum Constitution of overweight and obesity has tendency to have higher appetite and less fatigue in the ordinary symptoms, compared with the control group. 5) Soeum Constitution showed the slightest increase in appetite, preference about room temperature water, less number of feces, and feeling of chill and warmer extremities in ordinary symptoms, compared with Soyang and Taeeum Constitutions. Taeeum Constitution showed the distinct increase in appetite and sweating in ordinary symptoms, compared with Soyang and Soeum Constitutions.

Relationship between emergency department crowding and initial management, mortality of severe trauma patients (응급실 과밀화와 중증외상환자의 초기 처치 및 사망률과의 연관성)

  • Park, Chang Won;Ahn, Jae Yun;Seo, Kang Suk;Park, Jung Bae;Lee, Mi Jin;Kim, Jong Kun;Ryoo, Hyun Wook;Kim, Yun Jeong;Lee, Dong Eun;Moon, Sungbae;Choe, Jae Young
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.624-635
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    • 2018
  • Objective: This study examined whether emergency department (ED) crowding influences the timing of the initial assessment and treatment in severe trauma patients, as well as their mortality rates. Methods: This retrospective, observational study was conducted between January 2015 and October 2016, and included adult severe trauma patients who presented to the ED. The emergency department occupancy rate (EDOR) was used to measure ED crowding. The patients were divided into four groups using the EDOR quartile. The timeliness of the initial assessment and treatment in the four groups as well as the mortality rates were compared. Results: This study investigated 307 patients. The timing of the first computed tomography (CT) and laboratory test order, CT and laboratory test result acquisition, first transfusion, and patient transfer from the ED to the operating room were similar in the four groups. Multivariable logistic regression analysis did not show a significant difference in mortality between the groups. Conclusion: ED crowding was not associated with delays in the initial assessment and treatment of severe trauma patients, or in their mortality rates.

Efficacy of Endoscopic Electrocauterization for Recurrent Posterior Epistaxis (반복되는 후방 비출혈에서 내시경 지혈술의 효과)

  • Lee, Jung Joo;Lee, Eunkyu;Ryu, Gwanghui;Seo, Min Young;Hong, Sang Duk;Kim, Hyo Yeol;Dhong, Hun-Jong;Chung, Seung-Kyu
    • Journal of Rhinology
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    • v.25 no.2
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    • pp.75-79
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    • 2018
  • Background and Objectives: To investigate the common site of recurrent epistaxis after initial intervention such as packing and cauterization had failed and to evaluate the efficacy of surgical endoscopic electrocautery. Subjects and Method: Retrospective review of 47 patients with recurrent and uncontrolled idiopathic epistaxis between October 1995 and March 2016. All patients underwent endoscopic examination in the operating room after hospitalization. We performed electrocautery when a bleeding site was found. Results: The most common sites of bleeding were the inferior meatus (28%), sphenoethmoid recess (23%), superior septum around the olfactory cleft (13%), and the posterior end of the middle turbinate (15%). There was no serious complication during the one week after surgery. In 46 (98%) patients, refractory epistaxis was successfully controlled. One patient had recurrent epistaxis after electrocautery and underwent endoscopic sphenopalatine artery ligation. Conclusion: In patients with refractory idiopathic epistaxis after failure of first-line treatment, endoscopic examination through a surgical approach and electrocautery for suspected bleeding are effective.

Analysis on the Relationship between the Number of Clinics and the Use of Preventable Hospital Service: focusing on asthma patients (지역 내 의원 수와 예방 가능한 병원 서비스 이용 간의 관계분석: 천식 환자를 중심으로)

  • Lee, Hyun-Ji;Park, You-Hyun;Cho, Hyung-Kyung;Seol, Jin-Ju;Kwak, Jin-Mi;So, Ye-Kyeong;Park, Su-Jin;Lee, Kwang-Soo
    • Korea Journal of Hospital Management
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    • v.25 no.4
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    • pp.94-102
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    • 2020
  • Purposes: The purpose of this study was to analyze the trends of hospitalization and emergency room visits of asthma patients over the three years in 25 districts of Seoul. And analyzed the relationship between preventable hospital service uses and number of clinics for asthma patients. Methods: Data was collected from a customized database of the NHI(National Health Insurance) for 2016 to 2018. The number of clinics means Internal Medicine, Pediatrics, Ear-Nose-Throat, and Family Medicine clinics. The hospital service means the number of adults admission for asthma and the number of total asthma emergency visits. This study used kappa analysis to assess the agreements of indicators between years, and structural equation modeling analysis was applied to analyze the relationship. Findings: The kappa value of the number of adults admission for asthma was compared between 2016 and 2017(kappa score=0.68), and was lowered when compared between 2016 and 2018(kappa score=0.26). And the value of kappa in the number of total asthma emergency visits due to asthma between 2016 and 2017(kappa score=0.51) was lower than that of between 2016 and 2018(kappa score=0.60). And the results showed that the number of clinics significantly negatively related to the uses of hospital services in asthmatic patients(β=-0.5, p=0.005). Practical Implication: This research could provide policy implications for strengthening primary care services that can contribute to the reduction of preventable hospital services.

Smartphone Fundus Photography in an Infant with Abusive Head Trauma (학대뇌손상 영아에서 스마트폰으로 촬영한 안저소견)

  • Kim, Yong Hyun;Choi, Shin Young;Lee, Ji Sook;Yoon, Soo Han;Chung, Seung Ah
    • Journal of The Korean Ophthalmological Society
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    • v.58 no.11
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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.