• Journal of Korean Society on Water Environment
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• v.35 no.4
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• pp.362-369
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• 2019

In this study, biodegradation efficiency improvement of mixed sludge for the anaerobic digestion process in wastewater treatment plant was investigated. In order to release the organic material contained in the sludge cell and promote the hydrolysis step, mixed sludge of 7% TS (Total Solids) was physically shear-treated at a shear strength of 1,000 ~ 4,000 rpm and a maximum of 120 mins. As a result of the comparison between mixed sludge before and after the treatment, the concentration of $SCOD_{Cr}$(Soluble Chemical Oxygen Demand-chromium method) was increased through the conversion of granular organic matter into dissolved organic matter as shear strength and treatment time increases. The solubilization efficiency increased rapidly after 30 min of solubilization application time, and they were 11.23 %, 20.10 %, 22.52 % and 25.43% at 120 min for each shear strength conditions, respectively. Additionally, the BMP(Biochemical Methane Potential) test was conducted with the optimized samples to determine the increase of methane production by the shear pre-treatment. Consequently, methane production of each samples were 0.275, 0.310, 0.323 and $0.335m^3/kg\;VS_{add}$, which indicates that methane production was increased to a maximum of 21.28% compared to the control without the solubilization process ($0.262m^3/kg\;VS_{add}$). As a result, the physical shear-treatment is a promising process for sewage sludge pre-treatment to reduce the organic waste and increase the energy production.

• Korean Journal of Radiology
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• v.19 no.6
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• pp.1053-1065
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• 2018

Objective: To evaluate the clinical impact of using registration software for ablative margin assessment on pre-radiofrequency ablation (RFA) magnetic resonance imaging (MRI) and post-RFA computed tomography (CT) compared with the conventional side-by-side MR-CT visual comparison. Materials and Methods: In this Institutional Review Board-approved prospective study, 68 patients with 88 hepatocellulcar carcinomas (HCCs) who had undergone pre-RFA MRI were enrolled. Informed consent was obtained from all patients. Pre-RFA MRI and post-RFA CT images were analyzed to evaluate the presence of a sufficient safety margin (${\geq}3mm$) in two separate sessions using either side-by-side visual comparison or non-rigid registration software. Patients with an insufficient ablative margin on either one or both methods underwent additional treatment depending on the technical feasibility and patient's condition. Then, ablative margins were re-assessed using both methods. Local tumor progression (LTP) rates were compared between the sufficient and insufficient margin groups in each method. Results: The two methods showed 14.8% (13/88) discordance in estimating sufficient ablative margins. On registration software-assisted inspection, patients with insufficient ablative margins showed a significantly higher 5-year LTP rate than those with sufficient ablative margins (66.7% vs. 27.0%, p = 0.004). However, classification by visual inspection alone did not reveal a significant difference in 5-year LTP between the two groups (28.6% vs. 30.5%, p = 0.79). Conclusion: Registration software provided better ablative margin assessment than did visual inspection in patients with HCCs who had undergone pre-RFA MRI and post-RFA CT for prediction of LTP after RFA and may provide more precise risk stratification of those who are treated with RFA.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.650-657
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• 2018

Background and Objectives The present study aimed to compare receptive and expressive language development in children who have undergone simultaneous bilateral cochlear implantation (SCI) and those who have undergone bimodal stimulation (unilateral CI+ hearing aid). Subjects and Method In a retrospective analysis of clinical data, 15 pediatric patients who have received SCI and nine patients who have received bimodal stimulation (BM group) were enrolled. CI was performed for all patients at 24 months of age. Category of Auditory Performance (CAP) scores, Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) scores, and developmental quotients (DQ) for expressive and receptive language were compared between the groups at 12 month of follow-up. The Percentage of Consonants Correct (PCC) of children evaluated at 4 years old was also compared. Results At 12 months of follow-up, significantly greater improvements in CAP scores (${\Delta}4.25{\pm}0.5$) were noted in the SCI group compared to the BM group (${\Delta}3.56{\pm}0.88$, p=0.041). Significantly greater improvements in IT-MAIS scores were also noted in the SCI group (${\Delta}36.17{\pm}4.09$) than in the BM group (${\Delta}30.17{\pm}2.91$, p=0.004). The DQ of receptive language was higher in the SCI group than in the BM group ($87.6{\pm}15.4%$ vs. $75.5{\pm}12.0%$, p=0.023) at 12 months of follow-up. Moreover, early SCI was associated with better receptive language skills. PCC index of children at 4 years old was higher in the SCI group than in the BM group ($88.5{\pm}13.2%$ vs. $62{\pm}15.8%$, p=0.014). Earlier SCI was associated with even greater improvements. Conclusion Bilateral SCI is associated with significant improvements in language development when compared with bimodal stimulation. Earlier SCI was associated with better outcomes.

• Journal of Trauma and Injury
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• v.31 no.3
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• pp.143-150
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• 2018

Purpose: We have implemented a multi-disciplinary Screening, Brief Intervention and Referral to Treatment (SBIRT) protocol to prevent individuals who sustained alcohol-related traumatic injuries. We therefore conducted this single-center, prospective, randomized, controlled trial (RCT) to assess its efficacy. Methods: All the enrolled patients (n=30) were randomized to either the SBIRT group or the control group. In the current RCT, the proportion of the patients who reduced the amount of alcohol consumption and those who received a specialized treatment served as primary outcome measures. Moreover, changes in a 3-item version of the Alcohol Use Disorders Identification Test Consumption (AUDIT-C), Severity of Dependence Scale (SDS) and Kessler Psychological Distress Scale (K-6) scores at 3 months from baseline served as secondary outcome measures. Results: At 3 months, the proportion of the patients who reduced the amount of alcohol consumption was significantly higher in the SBIRT group as compared with the control group (86.7% vs. 57.1%, p=0.02). Moreover, the proportion of the patients who received a specialized treatment was also significantly higher as compared with the control group (26.7% vs. 1.4%, p=0.01). Furthermore, there were significant differences in changes in the AUDIT, SDS and K-6 scores at 3 months from baseline between the two groups (p<0.05). Conclusions: In conclusion, our results indicate that the SBIRT is effective in reducing hazardous and harmful levels of drinking, the degree of alcohol dependence and that of psychological distress in at-risk drinkers.

• Clinical and Experimental Pediatrics
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• v.62 no.2
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• pp.55-61
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• 2019

Purpose: Myotonic dystrophy, also known as dystrophia myotonica (DM), is an autosomal dominant disorder with 2 genetically distinct forms. DM type 1 (DM1) is the more common form and is caused by abnormal expansion of cytosine/thymine/guanine (CTG) repeats in the DM protein kinase (DMPK ) gene. Our study aimed to determine whether the age of onset is correlated with CTG repeat length in a population of pediatric patients with DM1. Methods: We retrospectively identified 30 pediatric patients with DM1 that underwent DMPK testing, of which the clinical data of 17 was sufficient. The cohort was divided into 2 subgroups based on the clinical phenotype (congenital-onset vs. late-onset) and number of CTG repeats (<1,000 vs. ${\geq}1,000$). Results: We found no significant difference between the age of onset and CTG repeat length in our pediatric patient population. Based on clinical subgrouping, we found that the congenital-onset subgroup was statistically different with respect to several variables, including prematurity, rate of admission to neonatal intensive care unit, need for respiratory support at birth, hypotonia, dysphagia, ventilator dependence, and functional status on last visit, compared to the late-onset subgroup. Based on genetic subgrouping, we found a single variable (poor feeding in neonate) that was significantly different in the large CTG subgroup than that in the small CTG subgroup. Conclusion: Clinical variables exhibiting statistically significant differences between the subgroups should be focused on prognosis and designing tailored management approaches for the patients; our findings will contribute to achieve this important goal for treating patients with DM1.

• Clinical and Experimental Pediatrics
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• v.62 no.1
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• pp.30-35
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• 2019

Purpose: Obesity is risk factor for nonalcoholic fatty liver disease (NAFLD). However, nonobese patients are also increasingly susceptible to NAFLD. The aim of this study was to compare the clinical characteristics of obese and nonobese pediatric patients with NAFLD. Methods: We retrospectively studied 68 patients who were diagnosed with NAFLD between January 2010 and October 2016 at 10-18 years of age. Body mass index ${\geq}95th$ percentile for age and sex was defined as obesity. Abdominal ultrasonography and laboratory, anthropometrics measurements were evaluated. Results: Among the 68, 26 (38.2%) were nonobese patients. The ratio of male to female was 5.8:1, and the median age at diagnosis was 13 years (range, 10-17 years). Significant higher triglyceride (223.0 mg/dL vs. 145.9 mg/dL, P=0.047) and total cholesterol levels (211.6 mg/dL vs. 173.2 mg/dL, P=0.011) were shown in nonobese than obese patients. High-density lipoprotein cholesterol level <40 mg/dL (hazard ratio [HR], 6.5; 95% confidence interval [CI], 2.13-7.10; P=0.048), total cholesterol level >200 mg/dL (HR, 5.6; 95% CI, 1.23-15.31; P=0.038) and abdominal obesity (HR, 2.53; 95% CI, 1.22-4.68; P=0.013) were significant risk factors for NAFLD in nonobese patients. Conclusion: Nonobese patients present a substantial proportion of pediatric NAFLD cases. Significant abnormal lipid concentrations were found in nonobese and abdominal obesity was important risk factor for nonobese NAFLD.

• Journal of Veterinary Clinics
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• v.36 no.3
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• pp.150-154
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• 2019

The purpose of this study was to investigate the etiological distribution, therapeutic outcome, and survival time in canine epilepsy. The medical records of 57 epileptic dogs were reviewed for the evaluation of etiological distribution. Among them, 27 dogs (47%) and 30 dogs (52%) had idiopathic epilepsy (IdE) and structural epilepsy (StE), respectively. Twenty-nine dogs (IdE: 16 dogs, StE: 13 dogs) were evaluated for therapeutic outcome and survival time. The incidence of generalized epileptic seizure (IdE, 56% vs. StE, 44%; P = 0.043) and the median seizure frequency at the time of first presentation (IdE, 2.0/month vs. StE, 13.3/month; P < 0.01) were significantly different between the two groups. Although pre-treatment seizure frequency and duration were not different, the median duration of seizure in the IdE group (0.5 min) was significantly shorter than that in the StE group (3 min) after treatment (P < 0.01). In addition, the median frequency of seizure was relatively lower in the IdE group (0.25/month) compared to the StE group (2.00/month) following antiepileptic therapy (P = 0.053). The median survival time of the IdE group (1.5 years [95% CI, 1.0-2.3 years]) was significantly longer than that of the StE group (0.4 year [95% CI, 0.2-1.3 years]) (P < 0.01). The information on etiological data and intracranial lesions may be useful for predicting treatment response and prognosis in epileptic dogs.

• Asian-Australasian Journal of Animal Sciences
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• v.32 no.4
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• pp.527-532
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• 2019

Objective: Phosphorous (P) sources with greater bioavailability might increase animal production efficiency and decrease environmental pollution. The objective of current study was to determine animal performance, nutrient digestibility, blood metabolites and fecal P concentration in finishing lambs fed a diet with either di-calcium phosphate (DCP) or di-ammonium phosphate (DAP) as a P source. Methods: Twelve 4-month-old male lambs (initial body weight $24.87{\pm}3.4kg$) were randomly allocated to a diet with either DCP or DAP (~261 g/kg of total diet P) fed ad libitum for 93 days. Diets were iso-nitrogenous and iso-energetic and had same calcium (Ca) and P concentrations. Results: The DAP contained 19.7 g/kg of dry matter (DM) Ca, 185.4 g/kg DM P and 14,623 ppm fluorine, while DCP contained 230.3 g/kg DM Ca, 195.2 g/kg DM P and 1,039 ppm fluorine. The diet with DAP contained 60 ppm fluorine while the diet with DCP contained 13 ppm fluorine. Lambs fed the diet with DAP tended to have a greater daily DM intake compared to those fed diet with DCP (p = 0.09). Lambs fed DAP had greater plasma P concentration and alkaline phosphatase activity ($p{\leq}0.01$) compared with lambs fed DCP. Dry matter and organic matter digestibility of the diets were similar between two treatments at days 60 and 90, while they were greater in lambs fed DCP (p<0.05) at day 30 of the trial. Feeding DAP increased P digestibility (58.7% vs 50.2%; p<0.05) and decreased fecal P concentration in lambs compared with feeding DCP (3.1 vs 3.8 g/kg DM; p<0.05). Conclusion: Providing ~261 g/kg of total diet P as DAP in the diet of finishing lambs improved the bioavailability of P in the body and decreased excretion of P in feces without affecting lamb performance.

• Archives of Craniofacial Surgery
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• v.20 no.3
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• pp.176-180
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• 2019

Background: Parotidectomy is the treatment of choice in many parotid tumors. Due to the extensive nature of the procedure, unfavorable complications such as gustatory sweating, surgical site depression are common. Various techniques using fascia, muscle or AlloDerm have been developed but debate still remains regarding its availability and affordability. We applied a newly developed acellular dermal matrix (Insuregraf) to the parotidectomy field to act as a physical barrier and to provide adequate filling effect for prevention of functional and aesthetic complications. Methods: From March 2010 to March 2017, 30 patients with parotid tumors underwent superficial parotidectomy. Twenty patients underwent only superficial parotidectomy. Ten patients had Insuregraf applied to the surgical site after superficial parotidectomy. We evaluated the incidence of Frey's syndrome, surgical site depression, and patient satisfaction rate in both groups. Results: The incidence of Frey's syndrome was lower in the Insuregraf group (0 vs. 2). Surgical site depression was also lower in the Insuregraf group (2 vs. 20). Satisfaction score for facial contour in Insuregraf group was 9.2 out of 10, which was comparable to 6.2 out of 10 in the control group. Conclusion: Application of Insuregraf after superficial parotidectomy is an effective surgical procedure to prevent complications such as Frey's syndrome and surgical site depression. This technique is affordable and safe with no immune reactions. Above all this surgical method should be considered as an option for patients who are concerned about the contour of the face after surgery.

• Journal of Trauma and Injury
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• v.34 no.2
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• pp.105-111
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• 2021

Purpose: Open extremity fractures require prompt antibiotic medication and initial debridement surgery to reduce the infection rate and restore functional stabilization. We aimed to report the effects and positive outcomes of a trauma team approach on the management of open extremity fractures in polytrauma patients. Methods: This retrospective review included all polytrauma patients with open extremity fractures admitted between March 2009 and December 2019. Patients were divided into two groups according to whether they were treated before or after the implementation of the trauma team approach (March 2014). We analyzed the outcomes in each group with respect to the time interval until the doctor's arrival, total length of stay in the emergency department, the time interval until initial antibiotic treatment and operation, whether the initial operation was performed within 24 hours, and the rate of deep infections. Results: A total of 123 patients met the inclusion criteria. There were no statistically significant differences in demographic characteristics. The time interval until the doctor's arrival (64.12±49.2 minutes vs. 19.82±15.23 minutes; p=0.035) and initial antibiotic treatment (115.47±72.12 minutes vs. 48.78±30.12 minutes; p=0.023) significantly improved after implementing the trauma team approach. The union rate was not significantly different. However, the time interval until initial debridement, opportunity for initial debridement within 24 hours, and the rate of deep infections demonstrated better results. Conclusions: The reduced time interval until initial antibiotic treatment and debridement could be attributed to the positive effect of the trauma team approach on the management of open extremity fractures in polytrauma patients.