• Therapeutic Science for Rehabilitation
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• v.12 no.4
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• pp.67-80
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• 2023

Objective : This study aimed to investigate the current status of physical therapy in children and adolescents. Methods : Sixty questionnaires from physical therapists treating children and adolescents with disabilities were analyzed. The questionnaire consisted of questions on physical therapy, participants, satisfaction, and the assessment of pediatric and adolescent physical therapy. Descriptive statistics and frequencies were used to investigate the current status, participants, and satisfaction. Differences between physical therapy participation difficulty, importance-ability of major aspects of pediatric and adolescent physical therapy, and therapy goal frequency were analyzed using paired T-test. Results : 11 to 15 cases (66.7%) and one-on-one treatment (95.0%) were performed independently (95.0%). The main ages of the subjects were preschool and school, the diagnoses were brain lesions and developmental delay, and treatment was conducted for up to 20 years or older. Satisfaction with pediatric and adolescent physical therapy was high (70.0%), as was the intensity of work (71.7%). Neurodevelopmental therapy, gait training, and goal-directed rehabilitation were the main treatments, and Gross Motor Function Measures of 88 and 66, respectively, were used. Respondents said that current fee system is inadequate (66.1%) and appropriate fee system is needed. Conclusion : This study extensively investigated the content of and factors related to pediatric and adolescent physical therapy. Based on the current situation, efforts to improve the expertise and continuity of pediatric and adolescent physical therapists and apply the latest treatment techniques are required.

• Journal of Korean Neurosurgical Society
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• v.66 no.6
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• pp.726-734
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• 2023

Objective : Chronic subdural hematoma (CSDH) patients using antithrombotic agents (AT) at high risk for cardiovascular disease are increasing. The authors aimed to analyze the factors influencing outcome by targeting patients using AT and to establish a desirable treatment strategy. Methods : A retrospective analysis was performed on data from 462 patients who underwent burr hole trephination (BHT) surgery for CSDH at five hospitals from March 2010 to June 2021. Outcomes included incidence of postoperative acute bleeding, recurrence rate, and morbidity or mortality rate. Patients were divided into the following four groups based on their history of AT use : no AT. Only antiplatelet agents (AP), only anticoagulants (AC), both of AP and AC. In addition, a concurrent literature review was conducted alongside our cohort study. Results : Of 462 patients, 119 (119/462, 25.76%) were using AT. AP prescription did not significantly delay surgery (p=0.318), but AC prescription led to a significant increase in the time interval from admission to operation (p=0.048). After BHT, AP or AC intake significantly increased the period required for an in-dwelling drain (p=0.026 and p=0.037). The use of AC was significantly related to acute bleeding (p=0.044), while the use of AP was not (p=0.808). Use of AP or AC had no significant effect on CSDH recurrence (p=0.517 and p=1.000) or reoperation (p=0.924 and p=1.000). Morbidity was not statistically correlated with use of either AP or AC (p=0.795 and p=0.557, respectively), and there was no significant correlation with mortality for use of these medications (p=0.470 and p=1.000). Conclusion : Elderly CSDH patients may benefit from maintenance of AT therapy during BHT due to reduced thromboembolic risk. However, the use of AC necessitates individualized due to potential postoperative bleeding. Careful post-operative monitoring could mitigate prognosis and recurrence impacts.

• Archives of Craniofacial Surgery
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• v.25 no.2
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• pp.62-70
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• 2024

Background: The management of cleft lip and palate aims at improving the patient's aesthetic and functional outcomes. Delaying primary repair can disrupt the patient's functional status. Long-term follow-up is essential to evaluate the need for secondary repair or revision surgery. This article presents the epidemiology of cleft lip and palate, including comprehensive patient characteristics, the extent of delay, and secondary repair at our institutional center, the Bandung Cleft Lip and Palate Center, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia. Methods: This retrospective study aimed to determine the epidemiology and recurrence rates of cleft lip and palate at the Bandung Cleft Lip and Palate Center, Indonesia, from January 2007 to December 2021. The inclusion criteria were patients diagnosed with cleft lip and/or palate. Procedures such as labioplasty, palatoplasty, secondary lip and nasal repair, and alveolar bone grafting were performed, and data on recurrence were available. Results: In total, there were 3,618 patients with cleft lip and palate, with an age range of 12 months to 67 years. The mean age was 4.33 years, and the median age was 1.35 years. Males predominated over females in all cleft types (60.4%), and the cleft lip was on the left side in 1,677 patients (46.4%). Most cases were unilateral (2,531; 70.0%) and complete (2,349; 64.9%), and involved a diagnosis of cleft lip and palate (1,981; 54.8%). Conclusion: Delayed primary labioplasty can affect daily functioning. Primary repair for patients with cleft lip and palate may be postponed due to limited awareness, socioeconomic factors, inadequate facilities, and varying adherence to treatment guidelines. Despite variations in the timing of primary cleft lip repair (not adhering to the recommended protocol), only 10% of these patients undergo reoperation. Healthcare providers should prioritize the importance of the ideal timing for primary repair in order to optimize physiological function without compromising the aesthetic results.

• Journal of Korean Society of Disaster and Security
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• v.17 no.2
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• pp.1-11
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• 2024

Most reservoirs in South Korea are earthen dams, mainly because they are cost-effective and easy to construct. However, earthen dams are highly vulnerable to seepage and overtopping, making them prone to sudden failure during excessive flooding. Such sudden failures can lead to a rapid increase in flood discharge, causing significant damage to downstream rivers and inhabited areas. This study investigates the effect of riprap placement on the slopes of earthen dams in delaying dam failure. Delaying the failure time is crucial as it allows more time for evacuation, significantly reducing potential casualties, which is essential from a disaster response perspective. Hydraulic experiments were conducted in a straight channel, using two different sizes of riprap for protection. Unlike previous studies, these experiments were performed under unsteady flow conditions to reflect the impact of rising water levels inside the dam. The target dam for the study was a cofferdam installed in a diversion tunnel. Experimental results indicated that the presence of riprap protection effectively prevented slope failure under the tested conditions. Without riprap protection, increasing the size of the riprap delayed the failure time. This delay can reduce peak discharge, mitigating damage downstream of the dam. Furthermore, these findings can serve as critical reference material for establishing emergency action plans (EAP) for reservoir failure.

• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.37-41
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• 2003

Purpose : Although air enema reduction has been known as a good method of diagnosis and treatment of intussusception, it could develop colon perforation. However, there have been few studies about this complication. So we analyzed the risk factors of colon perforation during air enema reduction in patients with intussusception. Methods : We reviewed the charts of 12 colon perforation patients during air enema reduction of intussusception, who were admitted to Gil Medical Center from Jan. 1990 to Dec. 2001. Their age, sex, major symptoms, length of time till hospital visit, types of intussusception, operative findings and pathologic reports were reviewed. Results : Among 657 cases, 596 patients(90.7%) were successfully treated, but 12 patients(1.83%) failed in air enema reduction and had colon perforation. In patients with colon perforation the male to female ratio was 11 : 1, and average age was 5.3 months. The most common symptom at the time of hospital visit was vomiting(91.7%). Cyclic irritability(75.0%), bloody stool(75.0%) and abdominal mass(41.7%) were also noted. The average length of time between symptom onset and hospital visit was 44.7 hours. Types of intussusception were predominantly ileocolic, ileocecal, and ileoileocolic. The site of perforation was most commonly found at the proximal part of intussusception including ascending colon(50%) and transverse colon(50%). Most cases were uncomplicated, and had a single perforation. Pathologic reports showed hemorrhagic necrosis and mesenteric laceration at the site of colon perforation. Complications of colon perforation were tension pneumoperitonium(58.3%), requiring immediate decompression. Conclusion : The chance of colon perforation during air enema reduction increases in cases with small bowel obstruction on simple abdominal x-ray of a patient younger than 6 months, delay in time till hospital visit and higher air pressure during reduction. Therefore more careful investigation is needed in these cases.

• Journal of The Korean Society of Grassland and Forage Science
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• v.36 no.1
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• pp.1-6
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• 2016

The growth of Italian ryegrass (IRG) after wintering was very low in 2015 when IRG was broadcasted under growing rice in fall of 2014. To determine growth inhibitory factors of IRG, we examined the growth conditions of IRG in Nonsan region and meteorological conditions in Daejeon nearby Nonsan. Minimum temperature and maximum instantaneous wind speed on Feb. $8^{th}$ and $9^{th}$ of 2015 after wintering of IRG were $8.8^{\circ}C$, 10.7 m/s and $12.4^{\circ}C$, 9.6m/s, respectively. Air temperature was suddenly dropped due to strong wind with snow showers, which had unfavorable effect on root growth of IRG exposed at the soil surface. The minimum temperature and maximum instantaneous wind speed on Feb. $12^{th}$, $13^{th}$, and $14^{th}$ of 2015 were $4.1^{\circ}C$, 11.6 m/s, $-5.6^{\circ}C$, 10.3 m/s, and $-4.7^{\circ}C$, 7.5 m/s, respectively. The growth circumstance of IRG was not good because soil was dried due to drought continued from January. The minimum temperature and maximum instantaneous wind speed on Feb. $26^{th}$, $27^{th}$, and $28^{th}$ of 2015 were $1.8^{\circ}C$, 13.7 m/s, $-3.5^{\circ}C$, 10.6 m/s, and $4.1^{\circ}C$, 6.8 m/s, respectively. The number of wilting of IRG was more than 59% until Mar. $3^{rd}$ of 2015. IRG faced irreparable environment (low minimum temperatures and extreme instantaneous wind speeds) for 9 days from Mar. $4^{th}$ to Mar. $12^{th}$ of 2015. The main reason for the decrease of IRG productivity was collection delay of rice straw after rice harvest because there was continuous rain between Oct. and Nov. of 2014. For this reason, weakly grown IRG under rice straw was withered after wintering. IRG was withered by frost heaving, drought, and instantaneous wind speed in the spring. Furthermore, the root of IRG was damaged while growing in excess moisture in the surface of paddy soil during the winter season due to rain.

• Journal of Korea Port Economic Association
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• v.37 no.4
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• pp.161-173
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• 2021

The shipping industry plummeted and was depressed due to the global economic crisis caused by the bankruptcy of Lehman Brothers in the US in 2008. In 2020, the shipping market also suffered from a collapse in the unstable global economic situation due to the COVID-19 pandemic, but unexpectedly, it changed to an upward trend from the end of 2020, and in 2021, it exceeded the market of the boom period of 2008. According to the Clarksons report published in May 2021, the decrease in cargo volume due to the COVID-19 pandemic in 2020 has returned to the pre-corona level by the end of 2020, and the tramper bulk carrier capacity of 103~104% of the Panamax has been in the ports due to congestion. Earnings across the bulker segments have risen to ten-year highs in recent months. In this study, as factors affecting BDI, the capacity and congestion ratio of Cape and Panamax ships on the supply side, iron ore and coal seaborne tonnge on the demand side and Granger causality test, IRF(Impulse Response Function) and FEVD(Forecast Error Variance Decomposition) were performed using VAR model to analyze the impact on BDI by congestion caused by strengthen quarantine at the port due to the COVID-19 pandemic and the loading and discharging operation delay due to the infection of the stevedore, etc and to predict the shipping market after the pandemic. As a result of the Granger causality test of variables and BDI using time series data from January 2016 to July 2021, causality was found in the Fleet and Congestion variables, and as a result of the Impulse Response Function, Congestion variable was found to have significant at both upper and lower limit of the confidence interval. As a result of the Forecast Error Variance Decomposition, Congestion variable showed an explanatory power upto 25% for the change in BDI. If the congestion in ports decreases after With Corona, it is expected that there is down-risk in the shipping market. The COVID-19 pandemic occurred not from economic factors but from an ecological factor by the pandemic is different from the past economic crisis. It is necessary to analyze from a different point of view than the past economic crisis. This study has meaningful to analyze the causality and explanatory power of Congestion factor by pandemic.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.347-353
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• 2008

Background: Esophageal perforation is an emergency that. requires early diagnosis and effective treatment. A delay in diagnosis and treatment. significantly increases morbidity and mortality. Material and Method: Thirty-seven patients with esophageal perforation were surgically treated at our institutions between January 1990 and December 2006. We retrospectively reviewed the results of surgical treatment for esophageal perforation to understand the risk factors affecting survival inpatients. Result: Patients ranged in age from 21 to 87 years, with an average age of $52.7{\pm}16.98$ years. Thirty-one of the patients were men and six were women. There were 23 patients (62%) with spontaneous perforations, 10 patients (27%) with a traumatic perforation, and 4 patients (11%) with an iatrogenic perforation. The site of esophageal perforation was the cervical esophagus in 5 patients, the thoracic esophagus in 31 patients, and the abdominal esophagus in one patient. Twenty-nine patients underwent primary closure of the perforation and five patients had T-tube drainage. Exclusion-diversion procedures were performed in two patients and an esophagectomy was performed in one patient. There were six cases of mortality (16.22%) and 25 cases of postoperative complications in 15 patients (40.5%). Patients that were treated later than 24 hours after detection of the perforation showed a statistically significant high morbidity and mortality rate (p<0.05). Conclusion: The most important risk factor of esophageal perforation was the time interval between detection of the perforation and the initiation of treatment. A prompt diagnosis and effective treatment are necessary to decrease morbidity and mortality.

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.245-261
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• 1997

Slipped capital femoral epiphysis(SCFE) is a disorder in which there is a gradual or acute disruption through the capital physeal plate. The physiolysis is through a widened zone of hypertrophy, which is weakened due to altered chondrocytic maturation and endochondral ossification. The cause or causes of SCFE remain uncertain. The association of obesity and adolescent age with growth rate are predisposing factors. The possibility that most patients with subclinical hormonal abnormality were proved. The goal of treatment of slipped capital femoral epiphysis is to restore the function of the hip and delay the development of degenerative osteoarthrosis by prevention of additional displacement of the epiphysis. We report 10 patients(12hips) with SCFE who were treated by surgical means and followed along for more than one year, at Yeungnam University Hospital, from 1989 to 1996. There were six boys and four girls. The average age at operation was 11.8 years. Seven cases occurred in the left hip, one case in the right and 2 cases had bilateral involvement, five cases had a history of minor trauma on affected hip. Among hormonally studied six patients, panhypopituitarism patient was one case; decreased testosterone, two; decreased growth hormone, two; and decreased thyroid hormone, one. According to clinical stage, two cases were the acute type; five cases, acute on chronic type; and three cases, chronic type. On the radiological grades of slipping, mild slippage were nine hips; moderate, one; and severe, two. The eleven hips were treated by pin fixation in situ, and one, by cuneiform osteotomy. On the average follow-up of 2.6 years, ten hips were excellent or good functional results, two hips were failure.

• Journal of Korean Academy of Nursing
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• v.21 no.2
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• pp.129-149
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• 1991

Circadian rhythm is entrained in the 24-hour time interval by periodic factors in the environment, known as zeitgeber. But most rotating work schedules are outside the range of the entrainment of the pacemaker timing the human circadian sleep - wake cycle. It has been postulated that physiological and emotional disturbances occur in most human functions when the circadian rhythm is disturbed. So application of circadian principles to the design of shift schedules can aid in maintaining the temporal integrity of the circadian system and thereby minimize for the shift worker any detrimental consequences of circadian disruption. This study was a quasi-experimental study to test the effect of shift intervals for the clinical nurse on the circadian rhythm. Twenty nurses newly employed in general units of two hospitals were selected as an experimental group and twelve college nursing students as a control group. Both groups were selected according to an established criteria using a purposive sampling technique. Ten subjects were assigned to a weekly shift group and another ten to a biweekly shift group engaged in a semi -continuous shift schedule(sunday off) with a backward direction, that is, morning -evening - night shift. The control group worked a morning shift for 42 days. Oral temperature rhythm, waking tim, sleep - wake cycle, fatigue, and mental performance were measured during the experimental period. The data collection period was from April 30, 1990 to June 10, 1990. MANOVA, paired t-test, ANOVA, and Student Newman Keuls method were used for statistical analysis. The results are summarized as follows. 1. Phase delay in the acrophase of temperature rhythm was shown according to the backward rotating shift. A complete adaptation to work on the night shift was achieved between the sixth and ninth day of the night shift. 2. There was no difference in either waking time or sleep- wake cycle according to the duration of the working day for every shift group. Significant difference was found in the waking time and the sleep -wake cycle for subjects on the morning, evening, and night shift in both of the shift groups(weekly shift group : λ＝0.121, p＜0.01, λ＝0.112, p＜0.01, biweekly shift group : λ＝0.116, p＜0.01, λ＝0.084, p＜0.01). 3. There was no difference in fatigue between the first working day and the last working day for the control group and for the biweekly shift group. In the weekly shift group, physical fatigue was significantly different for the first day and the sixth day of the night shift(t＝-2.28, p＜0.05). Physical fatigue and total fatigue on the first day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F＝5.79, p＜0.01, F＝4.56, p＜0.05). There was a significant difference between the shift groups and the control group(p＜0.05), Physical fatigue, neurosensory fatigue and total fatigue on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F＝12.65, p＜0.01, F＝7.77, p＜0.01, F＝9.68, p＜0.01). There was a significant difference between the shift groups and the control group(p＜0.05). 4. No difference in mental performance was seen between the first day and the last day of work in each case. An arithmatic test on the first day of the night shift revealed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F＝3.79, p＜0.05). There was a significant difference between the shift groups and the control group(p＜0.05) . The digital symbol substitution test and the arithmetic test on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F＝3.68, p＜0.05, F＝5.55, p＜0.01), and both showed a significant difference between the shift groups and the control group(p＜0.05). Accordingly, this study showed that during night duty, the waking time, sleep- wake cycle, and fatigue increased and mental performance decreased compared with morning and evening duty. It was also found that the weekly shift group had a higher fatigue score on the sixth day of night duty as compared to the -first day, but the waking time, sleep- wake cycle, and mental performance revealed no difference for the duration of the night duty or between shift groups, and complete adaptation of temperature rhythm was achieved between the sixth and ninth day of night duty. It is possible to conclude from these results that for intermediate circadian type in a healthy young woman, a biweekly shift system is more compatible with the circadian timing system than weekly shift system.