• Journal of Chest Surgery
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• v.53 no.1
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• pp.16-21
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• 2020

Background: Patients undergoing cardiac surgery require postoperative chest drainage. However, the drain is difficult to keep in place in children with congenital heart disease. Since 2015, at Kyungpook National University Hospital, the chest tube is removed on postoperative day 1 in patients who have undergone simple congenital cardiac surgery (i.e., closure of an atrial or ventricular septal defect). In this study, we evaluated the relationship between the duration of drain placement and the likelihood of pericardial effusion after congenital cardiac surgery. Methods: The medical records of patients who underwent closure of an atrial or ventricular septal defect at our hospital between January 2014 and December 2016 were reviewed. In total, 162 patients who received follow-up echocardiography and had information available on postoperative pericardial effusion after the repair procedure were enrolled. Results: Echocardiography was performed at a median of 5 days (range, 4 to 6 days) postoperatively before discharge from the hospital. Pericardial effusion occurred in 21 patients (13.0%), of whom only 3 (1.9%) had moderate or greater pericardial effusion, regardless of the drain duration. All patients improved during outpatient follow-up without invasive management. No patient had severe complications because of pericardial effusion. The duration of drain placement did not affect the incidence of postoperative pericardial effusion (p=0.069). Operative survival was 100%. Conclusion: Based on our study, we recommend removing the drain as soon as its role is complete, generally on postoperative day 1, because early removal does not increase the incidence of pericardial effusion in patients undergoing simple congenital cardiac surgery.

• Korean Journal of Ecology and Environment
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• v.46 no.1
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• pp.10-17
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• 2013

History of Instream Flow Incremental Methodology (IFIM) Following the large reservoir and water development era of the mid-twentieth century in North America, resource agencies became concerned over the loss of many miles of riverine fish and wildlife resources in the arid western United States. Consequently, several western states began issuing rules for protecting existing stream resources from future depletions caused by accelerated water development. Many assessment methods appeared during the 1960's and early 1970's. These techniques were based on hydrologic analysis of the water supply and hydraulic considerations of critical stream channel segments, coupled with empirical observations of habitat quality and an understanding of riverine fish ecology. Following enactment of the National Environmental Policy Act (NEPA) of 1970, attention was shifted from minimum flows to the evaluation of alternative designs and operations of federally funded water projects. Methods capable of quantifying the effect of incremental changes in stream flow to evaluate a series of possible alternative development schemes were needed. This need led to the development of habitat versus discharge functions developed from life stage-specific relations for selected species, that is, fish passage, spawning, and rearing habitat versus flow for trout or salmon. During the late 1970's and early 1980's, an era of small hydropower development began. Hundreds of proposed hydropower sites in the Pacific Northwest and New England regions of the United States came under intensive examination by state and federal fishery management interests. During this transition period from evaluating large federal reservoirs to evaluating license applications for small hydropower, the Instream Flow Incremental Methodology (IFIM) was developed under the guidance of the U.S. Fish and Wildlife Service (USFWS).

• The Korean Journal of Pain
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• v.8 no.2
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• pp.279-285
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• 1995

Extradural block is a form of treatment described as early as the beginning of the present centuries. It has since had positive criticism from a number of authors in different countries. Epidural injections of steroids with or without local anesthetic have become an occasional method of conservative treatment in sciatica & lumbago, especially in acute case. We assess the results of continuous epidural block with steroids and local anesthetics in sciatica & lumbago. From July 1994 to June 1995, we treated 46 case of lumbago and sciatica using continuous epidural block with steroids and local anesthetics. After placement of 17-Gauge Tuohy needle in the epidural space by the technique of loss of resistance, 0.25% bupivacaine 5 cc and triamcinolone 40 mg was administered and then epidural catheter was placed and connected to multiday infusor(Paragon) using 1% lidocaine with continuous infusion rate of 1 ml/hour. Usually, the catheter was removed after 1~2 weeks and then treated with the physical therapy. At the time of patient's discharge, 69.5% of all cases showed excellent or good results. Of particular note, 26 of the 46 cases were followed up by telephone. At present, in using Of particular note, 26 of the 46 cases were followed up by telephone. At present, in using continuous epidural block procedure, a relief in symptoms showed in 65.5% of these 26 cases. Continuous epidural block provides shortening of the recovery time from pain, avoidance of long period bed rest and early physical therapy and exercise. Therefore, continuous epidural block is simple and safe in the treatment of lumbago and sciatica, especially in acute phase.

• Journal of Gastric Cancer
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• v.17 no.4
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• pp.354-362
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• 2017

Purpose: Laparoscopic gastrectomy is accepted as a standard treatment for patients with early gastric cancer in Korea, Japan, and China. However, duodenal stump leakage remains a fatal complication after gastrectomy. We conducted a prospective phase II study to evaluate the safety of the new technique of laparoscopic reinforcement suture (LARS) on the duodenal stump. Materials and Methods: The estimated number of patients required for this study was 100 for a period of 18 months. Inclusion criteria were histologically proven gastric adenocarcinoma treated with laparoscopic distal or total gastrectomy and Billroth II or Roux-en-Y reconstruction. The primary endpoint was the incidence of duodenal stump leakage within the first 30 postoperative days. The secondary endpoints were early postoperative outcomes until discharge. Results: One hundred patients were enrolled between February 2016 and March 2017. The study groups consisted of 65 male and 35 female patients with a mean age (years) of 62.3. Of these, 63 (63%) patients had comorbidities. The mean number of retrieved lymph nodes was 38. The mean operation time was 145 minutes including 7.8 minutes of mean LARS time. There was no occurrence of duodenal stump leakage. Thirteen complications occurred, with one case of reoperation for splenic artery rupture and one case of mortality. Conclusions: Based on the results of this prospective phase II study, LARS can be safely performed in a short operation period without development of duodenal stump leakage. A future randomized prospective controlled trial is required to confirm the surgical benefit of LARS compared to non-LARS.

• Journal of Korean Society of Water and Wastewater
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• v.34 no.1
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• pp.35-43
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• 2020

Turbidity has various effects on the water quality and ecosystem of a river. High turbidity during floods increases the operation cost of a drinking water supply system. Thus, the management of turbidity is essential for providing safe water to the public. There have been various efforts to estimate turbidity in river systems for proper management and early warning of high turbidity in the water supply process. Advanced data analysis technology using machine learning has been increasingly used in water quality management processes. Artificial neural networks(ANNs) is one of the first algorithms applied, where the overfitting of a model to observed data and vanishing gradient in the backpropagation process limit the wide application of ANNs in practice. In recent years, deep learning, which overcomes the limitations of ANNs, has been applied in water quality management. LSTM(Long-Short Term Memory) is one of novel deep learning algorithms that is widely used in the analysis of time series data. In this study, LSTM is used for the prediction of high turbidity(>30 NTU) in a river from the relationship of turbidity to discharge, which enables early warning of high turbidity in a drinking water supply system. The model showed 0.98, 0.99, 0.98 and 0.99 for precision, recall, F1-score and accuracy respectively, for the prediction of high turbidity in a river with 2 hour frequency data. The sensitivity of the model to the observation intervals of data is also compared with time periods of 2 hour, 8 hour, 1 day and 2 days. The model shows higher precision with shorter observation intervals, which underscores the importance of collecting high frequency data for better management of water resources in the future.

• Neurospine
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• v.15 no.4
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• pp.348-352
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• 2018

Objective: Postoperative dynamic cryo-compression (DC) therapy has been proposed as a method of reducing pain and the inflammatory response in the early postoperative period after orthopedic joint reconstruction surgery. Our aim was to analyze the analgesic efficacy of DC therapy after adult lumbar spinal surgery. Methods: DC was applied for 30 minutes every 6 hours after surgery. Pain was measured by a visual analogue scale (VAS) in the preoperative period, immediately after surgery, and every 6 hours postoperatively for the first 72 hours of the hospital stay. Patients' pain medication requirements were monitored using the patient-controlled analgesia system and patient charts. Twenty patients who received DC therapy were compared to 20 historical controls who were matched for demographic and surgical variables. Results: In the postanesthesia care unit, the mean VAS back pain score was $5.87{\pm}0.9$ in the DC group and $6.95{\pm}1.0$ (p=0.001) in the control group. The corresponding mean VAS scores for the DC vs. control groups were $3.8{\pm}1.1$ vs. $5.4{\pm}0.7$ (p < 0.001) at 6 hours postoperatively, and $2.7{\pm}0.7$ vs. $6.25{\pm}0.9$ (p<0.001) at discharge, respectively. The cumulative mean analgesic consumption of paracetamol, tenoxicam, and tramadol in the DC group vs. control group was $3,733.3{\pm}562.7mg$ vs. $4,633.3{\pm}693.5mg$ (p<0.005), $53.3{\pm}19.5mg$ vs. $85.3{\pm}33.4mg$ (p<0.005), and $63.3{\pm}83.4mg$ vs. $393.3{\pm}79.9mg$ (p<0.0001), respectively. Conclusion: The results of this study demonstrated a positive association between the use of DC therapy and accelerated improvement in patients during early rehabilitation after adult spine surgery compared to patients who were treated with painkillers only.

• The Journal of Internal Korean Medicine
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• v.41 no.6
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• pp.1289-1299
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• 2020

Background: Hemorrhoid surgery is a frequently performed surgery in Korea, second only to cataract surgery. However, it has serious complications, including bleeding, infection, anal stenosis, and urinary retention, so active conservative therapies are in need at an early stage. Case summary: Thirteen patients with anal disease complained of main symptoms of pain, bleeding, and prolapse, with additional complaints of itching and mucus discharge. An herbal medicine mixture of Eulja-tang and Hwangryeonhaedok-tang was administered twice daily, and dry cupping therapy, acupuncture, and hot pack placements were administered on pelvic and sacral regions once weekly for four weeks. The symptoms were evaluated before and each week after the treatments. The treatments had statistically significant therapeutic effects. Conclusion: Korean medicine treatment-effectively alleviating the symptoms of anal disease, such as pain, bleeding, and prolapse-may represent an alternative therapy for conservative treatments in the early stages of anal disease.

• Clinics in Shoulder and Elbow
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• v.25 no.1
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• pp.36-41
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• 2022

Background: Distal biceps rupture is a relatively uncommon injury that can significantly affect quality of life. Early complications following biceps tendon repair are not well described in the literature. This study utilizes a national surgical database to determine the incidence of and predictors for short-term complications following distal biceps tendon repair. Methods: The American College of Surgeons' National Surgical Quality Improvement Program database was used to identify patients undergoing distal biceps repair between January 1, 2011, and December 31, 2017. Patient demographic variables of sex, age, body mass index, American Society of Anesthesiologists class, functional status, and several comorbidities were collected for each patient, along with 30-day postoperative complications. Binary logistic regression was used to calculate risk ratios for these complications using patient predictor variables. Results: Early postoperative surgical complications (0.5%)-which were mostly infections (0.4%)-and medical complications (0.3%) were rare. A readmission risk factor was diabetes (risk ratio [RR], 4.238; 95% confidence interval [CI], 1.180-15.218). Non-home discharge risk factors were smoking (RR, 3.006; 95% CI, 1.123-8.044) and ≥60 years of age (RR, 4.150; 95% CI, 1.611-10.686). Maleness was protective for medical complications (RR, 0.024; 95% CI, 0.005-0.126). Surgical complication risk factors were obese class II (RR, 4.120; 95% CI, 1.123-15.120), chronic obstructive pulmonary disease (COPD; RR, 21.981; 95% CI, 3.719-129.924), and inpatient surgery (RR, 8.606; 95% CI, 2.266-32.689). Conclusions: Complication rates after distal biceps repair are low. Various patient demographics, medical comorbidities, and surgical factors were all predictive of short-term complications.

• Clinical and Experimental Pediatrics
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• v.50 no.1
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• pp.7-13
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• 2007

Hearing loss in newborns is the most frequently occurring birth defect. If hearing impaired children are not identified and managed early, it is difficult for many of them to acquire the fundamental language, social and cognitive skills that provide the foundation for later schooling and success in society. All newborns, both high and low risk, should be screened for hearing loss in the birth hospital prior discharge (Universal Newborn Heaing Screening, UNHS). Objective physiologic measures must be used to detect newborns and very young infants with hearing loss. Recent technological developments have produced screening methods and both evoked otoacoustic emission (EOAE) and auditory brainstem response (ABR) have been successfully implemented for UNHS. Audiologic evaluation should be carried out before 3 months of age and infants with confirmed hearing loss should receive intervention before 6 months of age. All infants who pass newborn hearing screening but who have risk indicators for other auditory disorders and/or speech and language delay receive ongoing audiologic surveillance and monitoring for communication development. Infants with sensorineural hearing loss are managed with hearing aids and receive auditory and speech-language rehabilitation therapies. Cochlear implants can be an outstanding option for certain children aged 12 months and older with severe to profound hearing loss who show limited benefit from conventional amplifications.

• Nuclear Engineering and Technology
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• v.41 no.2
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• pp.199-214
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• 2009

High burn-up transformation process in low temperature nuclear fuel oxides material was observed in the early sixties in LWR $UO_2$ fuels, but not studied in depth. Increasing progressively the fuel discharge burn-up in PWR power plants, this material transformation was again observed in 1985 and identified as an important process to be accounted for in the fuel simulations due to its expected consequence on fuel heat transfer and therefore on the fission gas release. Fission gas release was one of the major concerns in PWR fuels, mainly during transient or accidents events. The behaviour of such a material in case of rod failure was also an important aspect to analyse. Therefore several national and international programs were launched during the last 25 years to understand the mechanisms leading to the high burn-up structure formation and to evaluate the physical properties of the final material. A large observations database has been acquired, using the more sophisticated techniques available in hot cells. This large database is discussed in this paper, providing basis to build an engineering-model, which is based on phenomenological description data and information accumulated. In addition this paper has the ambition to construct the best logical model to understand restructuring.