• Journal of the Korean Society for Industrial and Applied Mathematics
• /
• 제25권4호
• /
• pp.327-336
• /
• 2021

In this paper, we will introduce the image processing methods for the remote pupillary light reflex measurement using the video taken by a general smartphone camera without a special device such as an infrared camera. We propose an algorithm for estimate the size of the pupil that changes with light using image data analysis without a learning process. In addition, we will introduce the results of visualizing the change in the pupil size by removing noise from the recorded data of the pupil size measured for each frame of the video. We expect that this study will contribute to the construction of an objective indicator for remote pupillary light reflex measurement in the situation where non-face-to-face communication has become common due to COVID-19 and the demand for remote diagnosis is increasing.

• Journal of Korean Neurosurgical Society
• /
• 제40권1호
• /
• pp.11-15
• /
• 2006

Objective : Acute cerebral infarction is often accompanied by transtentorial herniation which can be fatal. The aim of this study is to determine the timing of surgical intervention and prognostic factors in patients who present with acute cerebral infarction. Methods : We reviewed retrospectively 23 patients with acute cerebral infarction, who received decompressive craniectomy or conservative treatment from January 2002 to December 2004. We divided patients into two groups according to the treatment modalities [Group 1 : conservative treatment, Group 2 : decompressive craniectomy]. In all patients, the outcome was quantified with Glasgow Outcome Scale and Barthel Index. Results : Of the 23 patients, 11 underwent decompressive craniectomy. With decompressive craniectomy at the time of loss of pupillary light reflex, we were able to prevent death secondary to severe brain edema in all cases. Preoperative Glasgow Coma Scale and loss of pupillary light reflex were significant to the clinical outcome statistically. With conservative treatment, 9 of the 12 patients died secondary to transtentorial herniation. The clinical outcomes of remaining 3 patients were poor. Conclusion : This study confirms the value of life-saving procedure of decompressive craniectomy after acute cerebral infarction. We propose that the loss of pupillary light reflex should be considered one of the most important factors to determine the timing of the decompressive craniectomy.

• Journal of the Optical Society of Korea
• /
• 제17권3호
• /
• pp.249-254
• /
• 2013

In ophthalmology, a pupillometer, a device to measure the diameter of the pupil of the eye, can provide information on the function of the autonomic nervous system. The current pupillometers on the market are either too large to be a handheld instrument, or relatively expensive. In this study, a pupillometer based on a smartphone was designed. Both white and infrared LEDs and a 3M pixel camera of a smartphone were applied for the visual stimuli to an eye and for the acquisition of the eye images, respectively. Contrary to the existing method of pupil measurement that usually observe the variation of pupil diameter, the proposed algorithm in this study was applied to calculate the constriction ratio of the pupillary area in response to pupillary light reflex. The results showed that the constriction ratio of the pupillary area were all in the normal range (above 4.0) from the sixteen healthy participants. It is believed that the approach to pupil measurement used in this study is suitable for a mobile interface, and this system can be applied to clinical research, home-use healthcare, and distributed to some areas which suffer from problems like a lack of medical support.

• The Korean Journal of Physiology and Pharmacology
• /
• 제12권3호
• /
• pp.89-94
• /
• 2008

In order to reproduce chronic cerebral hypoperfusion as it occurs in human aging and Alzheimer's disease, we introduced permanent, bilateral occlusion of the common carotid arteries (BCCAO) in rats (Farkas et al, 2007). Here, we induced BCCAO in two different rat strains in order to determine whether there was a strain difference in the pathogenic response to BCCAO. Male Wistar and Sprague-Dawley (SD) rats (250-270 g) were subjected to BCCAO for three weeks. Kluver-Barrera and cresyl violet staining were used to evaluate white matter and gray matter damage, respectively. Wistar rats had a considerably higher mortality rate (four of 14 rats) as compared to SD rats (one of 15 rats) following BCCAO. Complete loss of pupillary light reflex occurred in all Wistar rats that survived, but loss of pupillary light reflex did not occur at all in SD rats. Moreover, BCCAO induced marked vacuolation in the optic tract of Wistar rats as compared to SD rats. In contrast, SD rats showed fewer CA1 hippocampal neurons than Wistar rats following BCCAO. These results suggest that the neuropathological process induced by BCCAO takes place in a region-specific pattern that varies according to the strain of rat involved.

• 대한수의학회지
• /
• 제58권4호
• /
• pp.219-221
• /
• 2018

A 2-year-old intact female Bengal cat was presented with a 6-month history of visual impairment. The cat manifested bilateral negative menace responses and dazzle reflexes and sluggish pupillary light reflexes. Bilateral fundus changes included generalized tapetal hyperreflectivity, advanced retinal vascular attenuation, and increased pallor of the optic disc. A diagnosis of bilateral retinal degeneration was made. The clinical findings suggest that the investigated Bengal cat was most likely to have an inherited retinal degeneration. Further studies of the Bengal cat breed are needed to determine the prevalence of inherited retinal degeneration in this breed in Korea.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제15권2호
• /
• pp.93-96
• /
• 2015

Although inferior alveolar nerve block is one of the most common procedures performed at dental clinics, complications or adverse effects can still occur. On rare occasions, ocular disturbances, such as diplopia, blurred vision, amaurosis, mydriasis, abnormal pupillary light reflex, retrobulbar pain, miosis, and enophthalmos, have also been reported after maxillary and mandibular anesthesia. Generally, these symptoms are temporary but they can be rather distressing to both patients and dental practitioners. Herein, we describe a case of diplopia caused by routine inferior alveolar nerve anesthesia, its related physiology, and management.

• Journal of Korean Neurosurgical Society
• /
• 제58권4호
• /
• pp.363-367
• /
• 2015

Objective : The purpose of this study was to evaluate the clinical utility and validity of using a pupillometer to assess patients with acute brain lesions. Methods : Pupillary examinations using an automated pupillometer ($NeurOptics^{(R)}NPi^{TM}$-100 Pupillometer) were performed every 4 hours and were simultaneously assessed using the Glasgow Coma Scale (GCS) and for intracranial pressure (ICP), from admission to discharge or expire in neuro-intensive care unit (NICU). Manual pupillary examinations were also recorded for comparison. By comparing these data, we evaluated the validity of using automated pupillometers to predict clinical outcomes. Results : The mean values of the Neurologic Pupillary index (NPi) were different in the groups examined manually. The GCS correlated well with NPi values, especially in severe brain injury patients (GCS below 9). However, the NPi values were weakly correlated with intracranial pressure (ICP) when the ICP was lower than 30 cm $H_2O$. The NPi value was not affected by age or intensity of illumination. In patients with a "poor" prognosis who had a Glasgow Outcome Scale (GOS) of 1 or 2, the mean initial NPi score was $0.88{\pm}1.68$, whereas the value was $3.89{\pm}0.97$ in patients with a "favorable" prognosis who had a GOS greater than 2 (p<0.001). For predicting clinical outcomes, the initial NPi value of 3.4 had the highest sensitivity and specificity. Conclusion : An automated pupillometer can serve as a simple and useful tool for the accurate measurement of pupillary reactivity in patients with acute brain lesions.

• Asian-Australasian Journal of Animal Sciences
• /
• 제30권9호
• /
• pp.1350-1357
• /
• 2017

Objective: The present study aimed to investigate whether the long-lasting, recurrent restricting of sows leads to the physiological and psychological reaction of discomfort. Methods: Sows (Large White) that had experienced restricting for about 0.5 or 3 years and agematched sows kept in a group housing system (loose sows) were compared. Pupillary light reflex parameters were measured at the weaning stage. Immediately after slaughter, blood samples were taken to measure serum cortisol levels, and the brain was dissected, gene expression in the hippo-campus, frontal cortex and hypothalamus was analyzed. Results: The serum cortisol levels were higher in the confined sows than in the loose sows. The full maturity, but not the young adolescent, confined sows had longer latency time in the onset of pupil constriction than their loose counterparts. Real-time polymerase chain reaction analyses revealed an increased expression of interleukin 6 mRNA in the hippocampus and decreased expression of brain derived neurotrophic factor mRNA in hippocampus and hypothalamus and to a lesser extent in the frontal cortex of the full maturity confined sows, compared with the full maturity loose sows. Conclusion: Taken together, these data indicated that recurrent restricting stress in full maturity sows leads to the physiological and psychological reaction of discomfort.

• 대한한의학회지
• /
• 제18권1호
• /
• pp.87-100
• /
• 1997

Clinical Observation was made on 29 cases of Hypertensive intracerebral hemorrhage patients in the ICU of In-Chon Oriental Medical Hosptital of Dongguk University from October in 1994 to June in 1996. The observation are ability in daily life(ADL) of patients by Location and Type of Hemorrhage, Amounts of Hematoma, Graeb's Score, Intraventricular Hemorrhage, States 4th Ventricle, Surrounding Edema around the Hematoma, Middle Line Shift, Age, Level of Consciousness. Pupillary Light Reflex and Treatment Modalities. Our conclusions on Prognostic Factors using Computerized Tomographic Findings and Ability in daily Life(ADL) Evaluation in patients with Hypertensive Intracerebral Hemorrhage Patients are as follows. A variety of prognostic factors that influence ADL5+6(%) were observed. 1. ADL5+6($\%$) of total cases was 34.9%. The prognosis were unfavorable when high Graeb score(P<0.05), dilated 4th ventricle(P<0.01), much surrounding edema around the hematoma (P<0.05), unilateral unreactive or both unreactive pupillary light reflex(P<0.05). 2. There was no difference of ADL5+6(%) in both hypertensive basal ganglionic and thalamic intracerebral hemorrhage. 3. The prognosis gets poorer as the volume of hematoma is more than 16cc. But there was no difference of ADL5+6(%) in each group. 4. The prognosis gets poorer in cases with IVH than without IVH. But there was no difference of ADL5+6(%) in each group. 5. The prognosis gets poorer as the middle line shift is more than 6mm. But there was no. difference of ADL5+6(%) in each group. 6. The prognosis gets poorer as the level of consciousness is more than drowsy. But there' was no difference of ADL5+6(%) in each group.

• 대한수의학회지
• /
• 제59권2호
• /
• pp.109-111
• /
• 2019

A 10-year-old intact female Jindo dog was presented with a 1-week history of conjunctival redness and ocular discharge in the left eye. There was an absence of menace response, dazzle reflex, and direct pupillary light reflex. Slit-lamp biomicroscopy revealed corneal edema, ciliary flush, and aqueous flare. Intraocular pressure was 68 mmHg. Based on the information available, a diagnosis of glaucoma and uveitis was made. Subsequent histopathologic examination showed the glaucoma was produced by the effects of goniodysgenesis, posterior synechia, and pigment dispersion in the trabecular meshwork. This is the first report of primary glaucoma caused by goniodysgenesis in Jindo dogs.