• Title/Summary/Keyword: Operation deficit

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Guideline in the Management of Antenatally Diagnosed Unilateral Hydronephrosis (산전 초음파로 발견된 수신증의 치료 방침)

  • Hahn Hye-Won;Jun Nu-Lee;Kim Kun-Seok;Moon Dae-Hyuk;Yoon Chong-Hyun;Park Young-Seo
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.60-66
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    • 2003
  • Purpose : Neonatal hydronephrosis has been detected with increasing frequency with the widespread use of prenatal ultrasonography, but the consensus about its postnatal management has not yet been reached, especially about surgical intervention. We attempted to determine the guideline of follow-up study and surgical intervention of hydronephrosis by analyzing clinical outcomes of neonates with hydronephrosis. Materials and Methods : Between 1994 and 2000, 128 hydronephrotic kidneys were postnatally confirmed. Cases associated with other urologic anomalies were excluded and 90 unilateral hydronephrotic kidneys with a minimum follow-up of 12 months were enrolled in this study. We classified the patients into 6 groups according to the anterior posterior pelvic diameter(APPD) at initial ultrasonography(USG) within 1 month after birth. Renal USG and $Tc^{99m}-mercaptoacetyl$ triglycerine(MAG3) scan were done according to a set protocol, and pyeloplasty was performed when indicated according to our protocol. Results : Most cases whose APPD were below 10 mm improved or resolved. Only few cases with APPD above 20 mm showed spontaneous improvement and most(88%) had undergone operation. Those with initial APPD within 10-19 mm showed variable outcomes. When the risk factors for irreversible renal functional deterioration were analyzed, the age at pyeloplasty and pre-operative functional deficit were significant. Conclusion : We concluded that in infants with initial APPD below 10 mm, consideration of surgery is not needed, and in those with initial APPD above 20 mm, early operation is recommended. Our set protocol based on initial USG is useful, but the cut-off value of relative renal function(RRF) for operation might be increased to 40% to improve post operative RRF.

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Autograft versus Allograft for Anterior Cruciate Ligament Reconstruction - The clinical analysis of patellar tendon autografts compared with allografts - (자가 슬개건과 동종 슬개건을 이용한 전방 십자 인대 재건술의 비교)

  • Chun, Churl-Hong;Kim, Young-Jin;Yang, Jae-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.13-18
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    • 2000
  • Purpose : The purpose of this study was to compare the efficacy of bone-patellar tendon-bone(B-PTB) allograft with autograft B-PTB reconstruction of anterior cruciate ligament(ACL) according to the subjective and objective criteria. Materials and Methods : 42 patients were treated for acute rupture or chronic insufficiency of the ACL between March 1993 and June 1996. There were 18 autografts and 24 allografts for ACL reconstruction. At 2 years of follow-up after operation, autograft and allograft groups were compared based on subjective, objective criteria and Telos stress arthrometer. Results : The modified Feagin Scoring System revealed 16 patients$(88.9\%)$ with a satisfactory result by autografts, but 21 patients$(87.5\%)$ with a satisfactory result by allografts after 2-years follow-lip. There was no statistically significant difference between the two groups. ACL reconstruction with B-PTB allograft did not produce a significant functional deficit. But patellofemoral pain and crepitus were more frequent in the autografts$(33.3\%)$ than allografts$(8.3\%)$ (p<0.05). Conclusion : The ACL deficient knees treated with allografts for ACL reconstruction tended to be better than those reconstructed with autografts fur the reduction of patellofemoral crepitus and pain. B-PTB allograft provides an acceptable alternative to autograft tissue for reconstruction of the ACL.

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A Comparative Study on the Perception of the Impediment Factors between Mothers and Nurses in Nursery (모유수유 저해요인에 대한 산모와 신생아실 간호사간의 인식정도 비교 연구)

  • Lee, Mi-Ja
    • Women's Health Nursing
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    • v.1 no.1
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    • pp.138-152
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    • 1995
  • The condition of nutrition during infancy will greatly affect infants' physical, emotional growth, especially breast feeding is important in their growth and development, and emotional stability, too. Despite such advantages of breast-feeding, its rate has continued to fall year after year in Korea : the 95% rate in 1960's has fallen to 25.4% in 1990. It is known that such a downfall of breast-feeding rate is associated with various factors. The purpose of the study is to examine mother's and nurses' in nursery perception of the impediment factors of breast-feeding : to compare those between of breast-feeding : to compare those between two groups : to provide fundamental data for developing strategies for increasing breast-feeding. The subjects were 45 new mothers from one hospital and the same number of nurses sampled from 3 university hospitals, in Seoul. The data were collected for 11 days from April 12 to April 23, 1994 and a questionnaire was developed based on the interview with 14 nurses and 10 mothers and the literature reviews. Liker's Five-Point Scale was used as measurement. The Data were analyzed using SPSS / PC and descriptive statistics, t-test, ANOVA. The results of study are as follows : 1) Most new mothers get the information about breast-feeding from their mothers, books or newspaper, and relatives in rank than professionals(nurses or doctors). 2) The impediment factors the breast-feeding are categorized as mothers, hospital system, medical personnels and social factors. The most frequently mentioned impediment factors from mothers are 'Difficulty by operational wounds'(3.13), 'Lack of will for breast-feeding'(3.47), 'Insufficient rest and sleep'(3.52) and 'Opposition from husband or his family members'(4.77)in rank. On the other hand those factors from nurses are 'Inadequate nipple condition'(2.37), 'Decreasing milk secretion given medicine after operation'(2.63), 'Mothers knowledge deficit by poorly prepared education'(2.79) and 'Mothers abhorance of breast-feeing'(3.87) in rank. 3) As for the hospital system, the highly perceived impediment factors by mothers are 'Seperation of baby from mother after birth'(2.78), 'Lack of space for breast-feeding in the hospital'(2.93), 'Lack of facility for informing the time for breast-feeding'(3.18) and 'Because of babys' preference artificial nipple by being accustomed to it in hospital(3.97), in rank. Meanwhile, those from nurses are "Seperation of baby from mother after birth",(1.92), "Inconsistency between hospital's nursing time and mother's breast secretion time" scretion time(2.97), "Lack of space for breast-feeding in the hospital"(3.39), and "Lack of facility for informing the time for breast-feeding"(3.74) 4) As for the medical personnels, the highestly perceived Impediment factor from mothers in "Lack of professional nurses for breast-feeding"(2.96), and the lowestly perceived one is "Doctors' reluctance"(4.75). Nurses perceived same as mothers, too. 5) As for the social factors, the highestly perceived impediment factor by mothers and nurses is "Inconvience of social activities"(2.83) and the lowestly ones are "The sense of self-sacrifice"(4.22) by mothers, and "The sense of old fashioned"(4.13) by nurses. 6) The difference of the perception of impediment factors between mothers and nurses is statistically significant only in mother factor.

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Is it necessary to distinguish semantic memory from episodic memory\ulcorner (의미기억과 일화기억의 구분은 필요한가)

  • 이정모;박희경
    • Korean Journal of Cognitive Science
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    • v.11 no.3_4
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    • pp.33-43
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    • 2000
  • The distinction between short-term store (STS) and long-term store (LTS) has been made in the perspective of information processing. Memory system theorists have argued that memory could be conceived as multiple memory systems beyond the concept of a single LTS. Popular memory system models are Schacter & Tulving (994)'s multiple memory systems and Squire (987)'s the taxonomy of long-term memory. Those m models agree that amnesic patients have intact STS but impaired LTS and have preserved implicit memory. However. there is a debate about the nature of the long-term memory impairment. One model considers amnesic deficit as a selective episodic memory impairment. whereas the other sees the deficits as both episodic and semantic memory impairment. At present, it remains unclear that episodic memory should be distinguished from semantic memory in terms of retrieval operation. The distinction between declarative memory and nondeclarative memory would be the alternative way to reflect explicit memory and implicit memory. The research focused on the function of frontal lobe might give clues to the debate about the nature of LTS.

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The Experiences of the Emergency Antidote Stock and Delivery Service by the Korean Poison Information Center (독극물정보센터 구축사업의 일환으로 시행한 전국단위 응급해독제 비축 및 배송경험)

  • Park, So Young;Oh, Bum Jin;Sohn, Chang Hwan;Jeong, Ru Bi;Lim, Kyoung Soo;Kim, Won;Ryoo, Seung Mok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.11 no.1
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    • pp.9-18
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    • 2013
  • Purpose: Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea. Methods: An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week. Results: From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8). Conclusion: Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.

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A Study on the Function Overlap and Irrational Hierarchy System of Logistics Complexes of Inland Base: Focusing on the Case of the Integrated Freight Terminal in the Yeongnam Area (내륙 거점 물류단지 기능중첩 및 연계체계 불합리성에 관한 연구: 영남권 복합물류 터미널을 사례로)

  • JUNG, Jin Uk;PARK, Woonho;JOH, Chang-Hyeon;PARK, Dongjoo
    • Journal of Korean Society of Transportation
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    • v.34 no.4
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    • pp.304-317
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    • 2016
  • The advancement in technology including transportation and information communication has accelerated the flow of supplies, and the importance of the national logistics policy has increased following the expansion of the regional range of logistics to a national range. The rapid growth of the domestic logistics market results in the deficit of logistics facilities, inefficient operation of logistics facilities, and a complicated distribution structure. It has precipitated a plan aimed at efficiency improvement by building base logistics facilities, but this market is now undergoing difficulties due to low performance. Many studies on the revitalization of base logistics facilities have been conducted, but a causal analysis focusing on the function overlap of private logistics businesses has been absent. Therefore, this study has analyzed the function overlap of logistics facilities and the irrationality of the system, which resulted from the lost function of Inland Freight bases in the Yeongnam region. By suggesting the cause of disuse of base logistics complexes from the function overlap in the ground transportation of domestic freight, the study can provide the policy implication for the national logistics infrastructure.

Studies on the Condition and the Future of Korean Forestry (우리나라 임업(林業)의 현황(現況)과 장래(將來)에 관(關)한 소고(小考) (일본(日本) 임업(林業)과의 비교(比較)))

  • Kim, Young Ho
    • Current Research on Agriculture and Life Sciences
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    • v.4
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    • pp.163-168
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    • 1986
  • This study was carried out to compare the conditions of Korean and Japanese forestry. Two countries were appeared same trend in forestry condition, so our forestry in future can be estimated with compared Japanese forestry, but the results obtained are as follows ; 1) The average forest area per capita of the world, Japan and Korea are 0.9, 0.23 and 0.16 ha, respectively, this means that Korean forest area is not sufficient. The growing stock of forest per capita is $22.5m^3$ in Japan and $3.9m^3$ in Korea, but timber consumptions per capita are $1m^3$ in Japan and $0.2m^3$ in Korea. Those mean that both countries have not a plentiful resource of forestry. 2) The forestry production activity becomes gradually stagnation. Both in Korea and Japan, the reforestation and stumpage felling area show gradually decreasing tendency, the artificial forest ratio of total forest area is, at present, 28% in Korea and 40% in Japan. 3) In forestry demand aspect, the ratio of imported timber is 79% in Korea and 62.4% in Japan. Because the price index of timber is lower than the general price index, the dullness of forestry-related industries is expected in future. 4) The forestry labour supply has gradually difficulty because of the reduction in farming labour. 5) The managements of national forests show deficit operation, at present, both in Korea and Japan. The results above mentioned are derived form the poor forest resources, therefore, it is considered that rather more and continuous investment is necessary, but also forestry should be invested in the territorial conservation aspect.

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Are "Unstable" Burst Fractures Really Unstable?

  • Woo, Jun Hyuk;Lee, Hyun Woo;Choi, Hong June;Kwon, Young Min
    • Journal of Korean Neurosurgical Society
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    • v.64 no.6
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    • pp.944-949
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    • 2021
  • Objective : The stability is an important factor to decide the treatment plan in thoracolumbar burst fracture patients. Patients with an unstable burst fracture generally need operative management. Decrease in vertebral body height, local kyphosis, involvement of posterior column, and/or canal compromise are considered important factors to determine the treatment plan. On the other hand, in thoracolumbar injury classification system (TLICS), surgery is recommended in patients with TLICS of more than 5 points. The purpose of this study was to apply the TLICS score in patients with thoracolumbar burst fractures and to distinguish the differences of treatment plan on burst fracture. Methods : All patients, diagnosed as a thoracolumbar burst fracture between January 2006 and February 2019 were included in this study. Unstable thoracolumbar burst fracture was defined as burst fracture with neurologic deficit, three-column injury, kyphosis over 30 degrees, decrease of anterior body height over 40 percent and canal comprise more than 50%. TLICS score was measured with morphology, neurological involvement and posterior ligamentous complex integrity. The existence of instability was compared with TLICS score. Results : Total 233 patients (131 men, 102 women) were included in this study. In Denis classification, 51 patients (21.9%) diagnosed as stable burst fracture while 182 patients (78.1%) had unstable burst fracture. According to TLICS, 72 patients (30.9%) scored less than 4, while 161 patients (69.1%) scored 4 or more. All the patients with stable burst fracture scored 2 in TLICS. Twenty-one patients (9.0) scored 2 in TLICS but diagnosed as unstable burst fracture. Thirteen patients had over 40% of vertebra body compression, four patients had more than 50% of canal compromise, three patients had both body compression over 40% and kyphosis over 30 degrees, one patients had both body compression and canal compromise. Fifteen patients presented kyphosis over 30 degrees, and three (20%) of them scored 2 in TLICS. Seventy-three patients presented vertebral body compression over 40% and 17 (23.3%) of them scored 2 in TLICS. Fifty-three patients presented spinal canal compromise more than 50%, and five (9.4%) of them scored 2 in TLICS. Conclusion : Although the instability of thoracolumbar burst fracture was regarded as a critical factor for operability, therapeutic strategies by TLICS do not exactly match with the concept of instability. According to the concept of TLICS, it should be reconsidered whether the unstable burst fracture truly unstable to do operation.

Comparison of Magnetic Resonance Imaging and Operation Waiting Times in Patients Having Traumatic Cervical Spinal Cord Injury; with or without Bony Lesions

  • Heo, Jeong;Min, Woo-Kie;Oh, Chang-Wug;Kim, Joon-Woo;Park, Kyeong-hyeon;Seo, Il;Park, Eung-Kyoo
    • Journal of Trauma and Injury
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    • v.32 no.2
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    • pp.80-85
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    • 2019
  • Purpose: To compare the time intervals to magnetic resonance imaging (MRI) and surgical treatment in patients having traumatic cervical spinal cord injury (SCI) with and without bony lesions. Methods: Retrospectively analyzed adult patients visited Kyungpook National University Hospital and underwent surgical treatment for cervical SCI within 24 hours. The patients who were suspected of having cervical SCI underwent plain radiography and computed tomography (CT) upon arrival. After the initial evaluation, we evaluated the MRI findings to determine surgical treatment. Waiting times for MRI and surgery were evaluated. Results: Thirty-four patients were included. Patients' mean age was 57 (range, 23-80) years. Patients with definite bony lesions were classified into group A, and 10 cases were identified (fracture-dislocation, seven; fracture alone, three). Patients without bony lesions were classified into group B, and 24 cases were identified (ossification of the posterior longitudinal ligament, 16; cervical spondylotic myelopathy, eight). Mean intervals between emergency room arrival and start of MRI were 93.60 (${\pm}60.08$) minutes in group A and 313.75 (${\pm}264.89$) minutes in group B, and the interval was significantly shorter in group A than in group B (p=0.01). The mean times to surgery were 248.4 (${\pm}76.03$) minutes in group A and 560.5 (${\pm}372.56$) minutes in group B, and the difference was statistically significant (p=0.001). The American Spinal Injury Association scale at the time of arrival showed that group A had a relatively severe neurologic deficit compared with group B (p=0.046). There was no statistical significance, but it seems to be good neurological recovery, if we start treatment sooner among patients treated within 24 hours (p=0.198). Conclusions: If fracture or dislocation is detected by CT, cervical SCI can be easily predicted resulting in MRI and surgical treatment being performed more rapidly. Additionally, fracture or dislocation tends to cause more severe neurological damage, so it is assumed that rapid diagnosis and treatment are possible.

Revenue Change by Peak Hour Fare Imposition for Senior Free Ride : Using Seoul Metropolitan Subway Smart Card Data (노인무임승차 첨두시 요금부과에 따른 수입금 변화 : 수도권 스마트카드자료를 이용하여)

  • Seongil Shin;Jinhak Lee;Hasik Lee
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.22 no.2
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    • pp.1-14
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    • 2023
  • This study derives quantitative data on how much the fiscal deficit of subway operation agencies can be reduced in the process of charging free rides for the elderly in metropolitan subways during peak periods. In smart card data, every trip of elderly is recorded except fares. Therefore, it is required to establish a methodology for estimating the fares of elderly passengers and distributing them to subway opertation agencies as income. This study builds a simultaneous dynamic traffic allocation model that reflects the assumption that elderly selects a minimum time route based on the departure time. The travel route of the elderly is estimated, and the distance-proportional fare charged to the elderly is calculated based on this, and the fare is distributed by reflecting the connected railway revenue allocation principle of the metropolitan subway operating agencies. As a result of conducting a case study for before and after COVID-19 in 2019 and 2020, it is analyzed that Seoul Metro's annual free loss of 360 billion won could be reduced 6~8% at the morning peak (07:00-08:59), and 13~16% at the morning and afternoon peak (18:00-19:59).