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Endoscopic Third Ventriculostomy for Adult Aqueduct Stenosis : Double Fenestration - A Case Report and Technical Note - (성인 수도관 폐쇄증에 대한 내시경적 제3뇌실 누공술 : 이중개창술 - 증례보고 및 수술수기 -)

  • Shim, Yong-Jin;Ha, Ho-Gyun;Jung, Ho;Kim, Yong-Seog;Park, Moon-Sun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1019-1023
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    • 2000
  • Objective : Endoscopic third ventriculostomy is gaining popularity as a minimally invasive surgical option for certain types of hydrocephalus as an alternative to shunting. The authors have tried to fenestrate down to the subdural space passing through the prepontine cistern to lessen or avoid the chance of redoing due to healing. Materials and Method : A 48-year-old male patient with several years of intractable headache was presented. Magnetic Resonance Image(MRI) of the brain revealed marked ventricular dilatation with stenotic cerebral aqueduct. A 2.3mm flexible steerable endoscope($Neuroview^{(R)}$) was introduced via precoronal route and accessed to the third ventricular floor. Using 3-French Fogarty balloon catheter, thin third ventricular floor and the arachnoid membrane of the prepontine cistern were fenestrated, so called "double fenestration". To confirm the fenestration, subdural compa-rtment of the left abducens nerve was identified during the procedure. Forceful pulsating flow through the orifice convinced the patency of the opening. Results : The patient was discharged on the third postoperative day without any postoperative complications. The postoperative follow-up MRI of the brain, at second and sixth months, clearly demonstrated the flow void through the third ventricular floor. Conclusions : Endoscopic third ventriculostomy was successfully performed on an adult hydrocephalus patient with aqueduct stenosis. The third ventricular floor and arachnoid membrane of the prepontine cistern were fenestrated to achieve double fenestration to minimize the chance for failure. The details of this procedure and results are described.

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Case analysis of medical dispute about plastic surgery (성형수술과 관련된 의료분쟁 사례 분석)

  • Choi, Min;Sun, Hook
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.262-268
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    • 2009
  • Purpose: Recently medical dispute about plastic surgery is increasing rapidly as result of growing surgery itself due to high interest in appearance and advertisement of plastic surgery. So we want to find a way to prevent similar medical accident by making better solution of plastic surgery through case analysis of medical dispute. Method: 161 cases about plastic surgery asked for aid at Korea Consumer Agency and 41 cases judged at the court was surveyed and gender, location and kind of hospital, goal and kind of operation, making operation agreement or not, kind of damage, result of process, result of lawsuit was studied from 2004.1.1. to 2006.12.31. Result: Medical doctor have to explain about symptoms of disease, method of treatment, possibility of complication, prognosis to patients before therapy so they can make decision if they take operation by doctor or not. On this survey, among the patients who underwent re - operation or had complication, 88.1%(96 from 109 cases) of them didn't get enough explanation about possibility of complication before surgery They brought lawsuit insisting they would not undergo operation if they got enough explanation about possibility of complication and result of operation before surgery. Conclusion: It is advisable that doctor must observe the duty of explanation before surgery and respect the right to decide of patient, make operation agreement and put down concrete progress note and store the pre and post operative photo to avoid medical accident. It is also needed to have guideline of therapy, Code of ethics, organization which deals with medical dispute, reconsideration of law to control that.

Note on the Development of Ballast Water Shifting System for Solar Tracking of the Floating Photovoltaic Plant (밸러스트 수 이동으로 태양을 추적하는 부유식 태양광 발전시스템 개발)

  • Oh, Jungkeun;Kim, Jun-Ho;Kim, Seung-Sup;Kim, Hyochul;Lew, Jae-Moon
    • Journal of the Society of Naval Architects of Korea
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    • v.53 no.4
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    • pp.290-299
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    • 2016
  • The most powerful energy resource in nature is solar energy which becomes directly converted to electric power in worldwide. Most of the photovoltaic power plants are commonly installed on sunny side of the ground. Thus the installation of photovoltaic power plant could produce an unexpected adverse effect by sacrificing the productivity from green field or forest. To avoid these adverse effect floating photovoltaic plant has been devised and installed on inland reservoir. The photovoltaic plant could utilize ignored water surface without sacrificing the productivity of the ground. Additionally the photovoltaic efficiency has been reenforced by the cooling effect induced by the circulating air flow from water surface. The floating photovoltaic plant could be furnished solar tracking ability by tilting the system operated with the aid of the ballast system. This report is provided to introduce the design of the floating structure with solar panel which furnished solar tracking ability with the aid of ballast system.

An Analysis of the Urban Fringe Management Initiative's Operational Process in UK Using the Actor Network Theory - A Case Study of Thames Chase Community Forest Initiative - (행위자연계망이론을 통한 영국 도시교외지역 관리시책의 운영과정 특성 분석 -테임즈 체이스 마을 숲 조성 시책을 사례로-)

  • Kim, Yong-Bum;Park, Jae-Hong;Chun, Sung-Hwan
    • Journal of Korean Society of Rural Planning
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    • v.13 no.1 s.34
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    • pp.97-109
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    • 2007
  • The purpose of this research was to investigate and analyse how Community Forest Initiatives as urban fringe management initiatives made alliances with a variety of interest groups, enrol them in the urban fringe management processes using the Actor Network Theory. The Thames Chase Community Forest Initiative was selected and its area of operation included a $97 km^2$ area of green-belt area in East London. It was a instrument far improving and protecting the unique characteristics of the countryside landscape from urban developments as well as evaluating the impact of forestry inclusion in land use planning in the urban fringe. It was operated through a tiered structure comprising the Thames Chase Joint Committee and the management team. They employed a variety of devices to speak with one voice to bring about an effective operation process and to secure the enrolment of a variety of interest groups in its operational processes. Of note, the initiative's actor network impacted on improvement to and management of the countryside landscape despite not owning any land itself. As a result, when urban fringe management initiatives will be launched in South Korea to achieve a more effective and efficient urban fringe management, local councillors and representatives from public and non-government bodies should be more responsive to local communities' views and needs and work more vigorously on their behalf through lobbying, seeking media support, and so on. Moreover, better understanding and communication between local authorities' officers and management initiatives' teams are essential to avoid duplication of work practice.

A Note on Estimating and Managing Groundwater Reserves (지하수 부존량 평가와 관리에 대한 소고)

  • Lee, Byung Sun;Park, Jong Hwan;Myoung, Wooho;Son, Joohyeong;Lee, Sanghaw;Shim, Gyuseong;Song, Sung-Ho
    • Journal of Soil and Groundwater Environment
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    • v.23 no.6
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    • pp.28-36
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    • 2018
  • This study was conducted to estimate groundwater reserves within a designated depth. Three methods were applied to one representative county in southern Gyeongsang province, South Korea, to estimate the groundwater reserves in the aquifers. Estimated amounts of groundwater reserves in the region ranged from $20.2{\times}10^9m^3$ to $68.7{\times}10^9m^3$ (average $37.9{\times}10^9m^3$). Groundwater recharge obtained with a recharge ratio of 16.6% was $1.1{\times}10^9m^3/year$. Exploitable groundwater with an assumption of decadal-cycle minimal rainfall of 977.0 mm/year was approximated as 72% ($0.8{\times}10^9m^3/year$) of the total replenished water by recharge. The volume of recharge and exploitable water accounted for only 1.1% and 0.8% of groundwater reserves, respectively, which indicates substantial capacity of the reservoir to supply groundwater in an event of unexpected droughts. Nonetheless, each groundwater well should strictly comply with its allocated pumping rate to avoid alluvial groundwater depletion.

Percutaneous Screw Fixation in a Displaced Pubic Fracture: Technical Note (전위성 치골 골절의 경피적 고정술: 술기보고)

  • Kong, Gyu Min;Kim, Seung Chul
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.361-365
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    • 2021
  • Pelvic fractures are high-energy injuries, often accompanied by damage to the adjacent tissues and organs. For patients with pelvic trauma, active treatment is required early in the injury, because mortality can increase if appropriate treatment is not provided. In most cases, however, minimally invasive surgery is considered because extensive surgery cannot be performed due to the patient's condition. Percutaneous fixation of the pubis has been introduced because it can be applied easily to achieve the stability of the anterior part of the pelvis. Although many studies introduced percutaneous fixation of pubic bone fractures, most describe screw fixation for nondisplaced fractures. When treating displaced fractures with percutaneous screw fixation, it is difficult for the guide pin or drill bit to avoid the joint surface. Using a bent guide pin could allow easy insertion of the cannulated screw while avoiding the articular surface.

A Study on the FIDIC Conditions of Contract for Design, Build and Operate Projects (FIDIC의 DBO 프로젝트용 표준계약조건에 관한 연구)

  • Choi, Myung-Kook
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.46
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    • pp.29-60
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    • 2010
  • The incentive and reasons to publish FIDIC Conditions of Contract for Design, Build and Operate Projects(DBO Form) are manifold. It is partly a response to the increasing need for sophisticated project delivery methods in both the public and private sectors and the already widespread use of the FIDIC Yellow Book with operation and maintenance obligations and partly a response to the challenge to decrease maintenance cost to a minimum by means of a new procurement route. As a result, FIDIC has developed a new model form to meet this market place requirement. On the other hand, FIDIC did not simply adapt the Yellow Book but has developed a new form from it, whilst preserving the style of the already known FIDIC Forms and maintaining the wording where it was not necessary to change it for the purposes of a DBO Form. Moreover DBO Form fills up supposed gaps in other FIDIC Forms and ameliorates the claim management and dispute management framework. FIDIC DBO approach may be shortly summarized as follows. First, DBO Form provides for single project responsibility. Second, DBO Form has the clear objective of ensuring the use of a most reliable and efficient technology at the lowest life-cycle cost. Third, DBO Form is intended to operate as an effective quality increase in the design and construction of projects. Fourth, DBO Form is intended to provide significant benefits with regard to system integration and reduction of risks. Fifth, DBO Form accelerates and enhances completion schedule compliance. Sixth, DBO takes care of all three supporting pillars of sustainability(including economical, environmental and social elements). DBO Form is obviously a good starting point for negotiations and the preparation of calls for tenders, thus saving the parties time and money. However, existing cultural and legal differences, particular local conditions and the particular needs of some branches of the industry may require the form to be adapted according to the particular needs of a project. And Civil law practitioners are strongly recommended to verify carefully the underlying legal concepts and background of each clause of the General Conditions in order to avoid unnecessary and sometimes unnatural changes and amendments being made. Note that when preparing the Particular Conditions ensure that terminology is consistent and that existing inherent concepts should not be ignored.

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The Effect of Resource Depletion on Deciding on Product Assortments Size (소비자의 자원고갈이 제품구색간 의사결정에 미치는 효과)

  • Cho, Yeon-Jin;Park, Cheong-Kyu;Lim, Hyun-Woo
    • Journal of Distribution Science
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    • v.14 no.3
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    • pp.85-91
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    • 2016
  • Purpose - Prior research has suggested that consumers typically prefer to have a larger number of options. However, preference of assortment size may depend on how depleted resources in consumers' mind are. Reduced capacity for self-regulation by resource depletion makes people rely on more intuitive and less effortful decision processing. When they are mentally depleted, people are likely to focus on the choice difficulty from large assortment, which leads to preference for the small assortment when they make a decision. It could be an important question potentially how being in a depleted mode through effortful self-regulation will influence on the evaluation of assortment size. To answer this questioner, we hypothesized that being engaged in self-regulation, as compared with not being engaged in self-regulation, will influence on the evaluation of product assortment size such as attractiveness, difficulty of choice, and anticipated regret. Research design, data, and methodology - In this study, we first manipulated self-regulatory resource availability using a self-regulation task (i.e., instructing participants to solve Sudoku puzzle vs. to solve diagram cube by filling any diagrams that they prefer into cube instead of number) and asked to indicate the difficulty of the tasks available to them ("How much difficulty did you feel when you complete the task?") Next, participants were asked to imagine that they were planning to buy a laptop at one of the two stores (small assortment: 6 options vs. large assortment: 30 options), both offering good quality of products. After reading the product descriptions, participants were instructed to consider all the information and choose a store that they would like to shop. Finally we measured the choice difficulty, evaluation of product assortments, and anticipated regret on a 7-point scale. We conducted two-way ANOVA in testing the main hypothesis that depleted consumers will show poorer subsequent self-control than non-depleted consumers when they make a decision in large assortment. Results - Compared with non-depleted participants, depleted participants showed the bigger difference from the degree of choice difficulty and product attractiveness between large and small assortments, but the result revealed only a significant interaction effect of resource depletion and assortment size on choice difficulty. Also depleted participants showed the smaller difference from the degree of anticipated regret between large and small assortments than non-depleted participants. Conclusion - Depleted individuals by a prior task are relatively effortless and intuitive form of choosing products so that they try to avoid making effortful trade-offs among choice difficulty such as large assortment, compare with non-depleted individuals. However, for anticipated regret, non-depleted individuals in small assortment anticipate more regret by excluding or at least restricting the possibility of buying attractive items or another kind of potential items than depleted individuals, regardless less choice difficulty in small option. To sum up, it is important to note that individuals are influenced by self-regulatory resources and their self-regulatory conditions contribute to the overall positive or negative impact of product assortment on choice.

Improving A Stealth Game Level Design Tool (스텔스 게임 레벨 디자인 툴의 개선)

  • Na, Hyeon-Suk;Jeong, Sanghyeok;Jeong, Juhong
    • Journal of Korea Game Society
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    • v.15 no.4
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    • pp.29-38
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    • 2015
  • In the stealth game design, level designers are to develop many interesting game environments with a variety of difficulties. J. Tremblay and his co-authors developed a Unity-based level design tool to help and automate this process. Given a map, if the designer inputs several game factors such as guard paths and velocities, their vision, and the player's initial and goal positions, then the tool visualizes simulation results including (clustered) possible paths a player could take to avoid detection. Thus with the help of this tool, the designer can ensure in realtime if the current game factors result in the intended difficulties and players paths, and if necessary adjust the factors. In this note, we present our improvement on this tool in two aspects. First, we integrate a function that if the designer inputs some vertices in the map, then the tool systematically generates and suggests interesting guard paths containing these vertices of various difficulties, which enhances its convenience and usefulness as a tool. Second, we replace the collision-detection function and the RRT-based (player) path generation function, by our new collision-check function and a Delaunay roadmap-based path generation function, which remarkably improves the simulation process in time-efficiency.

A Suture Bridge Transosseous-Equivalent Technique for Bankart Lesions with Deficient Bony Stability - Technical Note - (골안정성 결손을 가진 Bankart 병변에 대한 경 골-유사 교량형 봉합술식 - 술기 보고 -)

  • Choi, Chang-Hyuk;Kim, Shin-Kun;Chang, Il-Woong;Chae, Sung-Bum
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.179-182
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    • 2009
  • Purpose: Point fixation at the margin of the glenoid is a limitation of conventional arthroscopic stabilization using suture anchors, and does not afford sufficient footprint healing, especially in glenoid bone deficiency. So, we introduce an arthroscopic suture bridge transosseous-equivalent technique for bony Bankart lesions to avoid the technical disadvantage of point contact with anchor fixation and to improve mechanical stability through cross compression of the labrum. Surgical approach: The technique was adapted from the transosseous-equivalent rotator cuff repair technique using suture bridges, which improved the pressurized contact area and mean pressure between the tendon and footprint. After preparation of the glenoid bed by removal, reshaping, or mobilization of the bony lesion, two anchors (3.0 mm Biofastak, $Arthrex^{(R)}$, Naples, FL) were inserted into the superior and inferior portion of the bony Bankart lesion. Using a suture hook, medial mattress sutures were applied around the capsulolabral portion of the IGHL complex to obtain sufficient depth of glenoid coverage. A 3.5 mm pushloc anchor ($Arthrex^{(R)}$, Naples, FL) hole was made in the articular edge of the anterior glenoid rim. distal, suture bridge was applied, and proximal was inserted to mobilize the labrum in the proximal direction. This avoided the technical disadvantage of point contact with anchor fixation and decreased the level of gap formation through cross-compression of the labrum.

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