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Congestive myelopathy due to spinal dural arteriovenous fistula mimicking CNS demyelinating disease
Nakhoon Kim,Hongil Kim,Hyunkee Kim,Jinseok Park 대한뇌혈관외과학회 2022 Journal of Cerebrovascular and Endovascular Neuros Vol.24 No.4
Spinal dural arteriovenous fistula (SDAVF) is known for its ambiguous and various clinical presentations. Among these presentations, congestive myelopathy is one of the most common, yet it is challenging to correctly diagnose SDAVF at initial presentation. Several diseases present as myelopathy, including demyelinating diseases. Herein, we present two cases of congestive myelopathy due to SDAVF presenting to the emergency room (ER) with progressive quadriparesis. Even though the patients had a proper magnetic resonance imaging (MRI) examination from the initial presentation, there was a delay in making a final diagnosis. Both patients’ clinical presentation and MRI mimicked central nervous system (CNS) demyelinating disease initially, and a more thorough examination revealed SDAVF. Such a delay in diagnosis can result in more neurological deterioration and may result in more sequelae. Hence, SDAVF should always be considered as a differential diagnosis when examining patients with myelopathy.
Lower Cranial Nerve Palsy due to Prevertebral Tuberculosis Infection
Nakhoon Kim,Hyunkee Kim,Il Mo Kang,Young Seo Kim 대한신경초음파학회 2021 대한신경초음파학회지 (JNN) Vol.13 No.2
Prevertebral tuberculosis is a rare infectious disease that often affects immunocompromised patients in developing countries. We present the case of a patient who complained of headache, dysarthria, and dysphagia. Neurological examination revealed multiple cranial nerve palsies, including the hypoglossal, glossopharyngeal, and vagus nerves. Brain magnetic resonance imaging demonstrated an infiltrative lesion in the prevertebral space, and the biopsy revealed chronic inflammation. On suspicion of immune-mediated inflammation, the patient was treated with intravenous dexamethasone and oral prednisolone, with minimal response. Eleven months after the initial diagnosis, the patient’s neurological symptoms were aggravated, and we detected newly developed pulmonary tuberculosis. After the treatment of pulmonary tuberculosis, his neurological symptoms improved, and the imaging study demonstrated improvements. Although we lacked positive laboratory or biopsy results for tuberculosis, we suspect that the lesions were distant tuberculosis infections. Tuberculosis should be considered in patients with unknown infiltrative mass-like lesions in the prevertebral spaces.
AR 전신 상호작용을 위한 이종 센서 간 좌표계 보정 기법
김항기 ( Hangkee Kim ),김대환 ( Daehwan Kim ),이동춘 ( Dongchun Lee ),이기석 ( Kisuk Lee ),백낙훈 ( Nakhoon Baek ) 한국정보처리학회 2023 정보처리학회논문지. 소프트웨어 및 데이터 공학 Vol.12 No.7
꾸준히 증가하는 노인성 질환 환자 대상으로 몰입형 디지털 콘텐츠를 이용한 쉽고 정확한 전신 재활 상호작용 기술이 필요하며, 본 연구에서는 이를 위해 홀로렌즈와 키넥트를 사용한 전신 상호작용 기술을 소개한다. 이를 위해 메쉬 특징점 기반 변환, AR 마커 기반 변환, 신체 인식 기반변환 방법의 3가지 좌표 변환 방식을 제안한다. 메쉬 특징점 기반 변환은 공간 메쉬에 3개의 특징점을 지정하고 변환 행렬을 이용하여 좌표계를 일치시킨다. 이 방법은 수작업이 필요하여 사용성이 떨어지지만 정확도가 8.5mm로 상대적으로 높다. AR 마커 기반 방식은 홀로렌즈s와 키넥트가동시에 인식하는 AR, QR마커를 사용하여 평균오차 11.2mm로 준수한 정확도를 달성했다. 신체 인식 기반 변환 방법은 두 기기가 동시에 인식하는 머리 혹은 HMD위치와 양 손 혹은 컨트롤러 위치를 이용하여 좌표계를 일치시킨다. 이 방법은 정확도가 떨어지지만 부가적인 도구나 수작업이 필요 없으므로 사용성이 좋다. 또한 후처리 기술로 RANSAC을 적용함으로써 오차를 10% 이상 줄였다. 이러한 3가지 방식은 콘텐츠가 필요한 사용편의성과 정확도에 따라서 선택적으로 적용할 수 있다. 본 연구에서는 이 기술을 이용해서 ‘썬더펀치’와 재활 치료 콘텐츠에 적용하여 검증하였다. A simple and accurate whole body rehabilitation interaction technology using immersive digital content is needed for elderly patients with steadily increasing age-related diseases. In this study, we introduce whole-body interaction technology using HoloLens and Kinect for this purpose. To achieve this, we propose three coordinate transformation methods: mesh feature point-based transformation, AR marker-based transformation, and body recognition-based transformation. The mesh feature point-based transformation aligns the coordinate system by designating three feature points on the spatial mesh and using a transform matrix. This method requires manual work and has lower usability, but has relatively high accuracy of 8.5mm. The AR marker-based method uses AR and QR markers recognized by HoloLens and Kinect simultaneously to achieve a compliant accuracy of 11.2mm. The body recognition-based transformation aligns the coordinate system by using the position of the head or HMD recognized by both devices and the position of both hands or controllers. This method has lower accuracy, but does not require additional tools or manual work, making it more user-friendly. Additionally, we reduced the error by more than 10% using RANSAC as a post-processing technique. These three methods can be selectively applied depending on the usability and accuracy required for the content. In this study, we validated this technology by applying it to the “Thunder Punch” and rehabilitation therapy content.