• Clinics in Shoulder and Elbow
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• v.26 no.2
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• pp.162-168
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• 2023

Background: Reverse shoulder arthroplasty (RSA) has evolved continuously over recent years, with expanded indications and better outcomes. YouTube is one of the most popular sources globally for health-related information available to patients. Evaluating the reliability of YouTube videos concerning RSA is important to ensure proper patient education. Methods: YouTube was queried for the term "reverse shoulder replacement." The first 50 videos were evaluated using three different scores: Journal of the American Medical Association (JAMA) benchmark criteria, the global quality score (GQS), and the reverse shoulder arthroplasty-specific score (RSAS). Multivariate linear regression analyses were conducted to determine the presence of a relationship between video characteristics and quality scores. Results: The average number of views was 64,645.78±264,160.9 per video, and the average number of likes was 414 per video. Mean JAMA, GQS, and RSAS scores were 2.32±0.64, 2.31±0.82, and 5.53±2.43, respectively. Academic centers uploaded the highest number of videos, and surgical techniques/approach videos was the most common video content. Videos with lecture content predicted higher JAMA scores whereas videos uploaded by industry predicted lower RSAS scores. Conclusions: Despite its massive popularity, YouTube videos provide a low quality of information on RSA. Introducing a new editorial review process or developing a new platform for patients' medical education may be necessary. Level of evidence: Not applicable.

• Journal of the Korean Recycled Construction Resources Institute
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• v.11 no.4
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• pp.341-348
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• 2023

In this study, in order to minimize the increase in the amount of various industrial by-products due to the rapid growth of the industry and the intensification of the depletion of natural aggregate resources, the material test using recycled aggregate and steelmaking slag and the proper mixing ratio of recycled concrete were to be derived. In this study, first, the conformity of the quality standards of the materials used in the field was confirmed, and the workability and molding results were shown when used alone or mixed. Therefore, the feasibility of application as aggregate for concrete was evaluated through a total of 4-type mixtures of cement types, admixtures, coarse aggregates, and fine aggregates. As a result of the experiment, it was confirmed that the slump of unhardened concrete, the amount of air, chloride and compressive strength of hardened concrete according to the replacement rate were different from the measured values of general concrete quality characteristics. According to this, it was confirmed that the quality characteristics of the standard design criteria were satisfied.

• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.136-139
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• 2024

Rhabdomyolysis is a syndrome that causes various complications due to the release of substances from muscle cells, often associated with preceding infectious diseases. We report the case of a 7-year-old Korean boy with recent severe acute respiratory syndrome coronavirus 2 infection, presenting with fever, chills, and generalized body aches, diagnosed as rhabdomyolysis. Additionally, we conducted a systematic review with the aim of delineating the disease spectrum, treatment, and outcomes. We identified seven reports that met the inclusion criteria. Among the cases, 5 had fever, with creatine kinase levels ranging from 3,717 and 274,664 IU/L. Two individuals received treatment in intensive care unit, 2 underwent renal replacement therapy, and 1 case has deceased. For children with coronavirus disease 2019 infection and muscle pain, a thorough examination of urine color and an assessment of muscle enzymes through blood tests can help diagnose and treat rhabdomyolysis, a condition that might otherwise be overlooked.

• Clinics in Shoulder and Elbow
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• v.27 no.1
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• pp.18-25
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• 2024

Background: The Discovery Elbow System (DES) utilizes a polyethylene bearing within the ulnar component. An exchange bearing requires preoperative freezing and implantation within 2 minutes of freezer removal to allow insertion. We report our outcomes and experience using this technique. Methods: This was an analysis of a two-surgeon consecutive series of DES bearing exchange. Inclusion criteria included patients in which exchange was attempted with a minimum 1-year follow-up. Clinical and radiographic review was performed 1, 2, 3, 5, 8 and 10 years postoperative. Outcome measures included range of movement, Oxford Elbow Score (OES), Mayo Elbow Performance Score (MEPS), complications and requirement for revision surgery. Results: Eleven DESs in 10 patients were included. Indications were bearing wear encountered during humeral component revision (n=5); bearing failure (n=4); and infection treated with debridement, antibiotics and implant retention (DAIR; n=2). Bearing exchange was conducted on the first attempt in 10 cases. One case required a second attempt. One patient developed infection postoperatively managed with two-stage revision. Mean follow-up of the bearing exchange DES was 3 years. No further surgery was required, with no infection recurrence in DAIR cases. Mean elbow flexion-extension and pronosupination arcs were 107°(±22°) and 140° (±26°). Mean OES was 36/48 (±12) and MEPS was 83/100 (±19). Conclusions: Our results support the use of DES bearing exchange in cases of bearing wear with well-fixed stems or acute infection. This series provides surgeons managing DES arthroplasty with management principles, successful and reproducible surgical techniques and expected clinical outcomes in performing DES polyethylene bearing exchange. Level of evidence: IV.

• Health Policy and Management
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• v.34 no.1
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• pp.78-86
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• 2024

Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.305-312
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• 2014

Purpose : The purpose of this study is to analyze the mechanical and leaf speed accuracy of the dynamic multileaf collimator (DMLC) and determine the appropriate period of quality assurance (QA). Materials and Methods : The quality assurance of the DMLC equipped with Millennium 120 leaves has been performed total 92 times from January 2012 to June 2014. The the accuracy of leaf position and isocenter coincidence for MLC were checked using the graph paper and Gafchromic EBT film, respectively. The stability of leaf speed was verified using a test file requiring the leaves to reach maximum leaf speed during the gantry rotation. At the end of every leaf speed QA, dynamic dynalog files created by MLC controller were analyzed using dynalog file viewer software. This file concludes the information about the planned versus actual position for all leaves and provides error RMS (root-mean square) for individual leaf deviations and error histogram for all leaf deviations. In this study, the data obtained from the leaf speed QA were used to screen the performance degradation of leaf speed and determine the need for motor replacement. Results : The leaf position accuracy and isocenteric coincidence of MLC was observed within a tolerance range recommanded from TG-142 reports. Total number of motor replacement were 56 motors over whole QA period. For all motors replaced from QA, gradually increased patterns of error RMS values were much more than suddenly increased patterns of error RMS values. Average error RMS values of gradually and suddenly increased patterns were 0.298 cm and 0.273 cm, respectively. However, The average error RMS values were within 0.35 cm recommended by the vendor, motors were replaced according to the criteria of no counts with misplacement > 1 cm. On average, motor replacement for gradually increased patterns of error RMS values 22 days. 28 motors were replaced regardless of the leaf speed QA. Conclusion : This study performed the periodic MLC QA for analyzing the mechanical and leaf speed accuracy of the dynamic multileaf collimator (DMLC). The leaf position accuracy and isocenteric coincidence showed whthin of MLC evaluation is observed within the tolerance value recommanded by TG-142 report. Based on the result obtained from leaf speed QA, we have concluded that QA protocol of leaf speed for DMLC was performed at least bimonthly in order to screen the performance of leaf speed. The periodic QA protocol can help to ensure for delivering accurate IMRT treatment to patients maintaining the performance of leaf speed.

• Journal of Wetlands Research
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• v.24 no.3
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• pp.204-212
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• 2022

The LID technique began to be applied in Korea after 2009, and LID facilities are installed and operated for rainwater management in business districts such as the Ministry of Environment, the Ministry of Land, Infrastructure and Transport, and LH Corporation, public institutions, commercial land, housing, parks, and schools. However, looking at domestic cases, the application cases and operation periods are insufficient compared to those outside the country, so appropriate design standards and measures for operation and maintenance are insufficient. In particular, LID facilities constructed using LID techniques need to maintain the environment inside LID facilities because hydrological and environmental effects are expressed by material circulation and energy flow. The LID facility is designed with the treatment capacity planned for the water circulation target, and the proper maintenance, vegetation, and soil conditions are periodically identified, and the efficiency is maintained as much as possible. In other words, the soil created in LID is a very important design element because LID facilities are expected to have effects such as water pollution reduction, flood reduction, water resource acquisition, and temperature reduction while increasing water storage and penetration capacity through water circulation construction. In order to maintain and manage the functions of LID facilities accurately, the current state of the facilities and the cycle of replacement and maintenance should be accurately known through various quantitative data such as soil contamination, snow removal effects, and vegetation criteria. This study was conducted to investigate the current status of LID facilities installed in Korea from 2009 to 2020, and analyze soil changes through the continuity and current status of LID facilities applied over the past 10 years after collecting soil samples from the soil layer. Through analysis of Saturn, organic matter, hardness, water contents, pH, electrical conductivity, and salt, some vegetation-type LID facilities more than 5 to 7 years after construction showed results corresponding to the lower grade of landscape design. Facilities below the lower level can be recognized as a point of time when maintenance is necessary in a state that may cause problems in soil permeability and vegetation growth. Accordingly, it was found that LID facilities should be managed through soil replacement and replacement.

• Journal of the Korea Concrete Institute
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• v.25 no.3
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• pp.339-345
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• 2013

This study is to derive from the required performances and the optimum mix proportion of the roof concrete placed in the in-ground LNG storage tank with a capacity of 200000 $m^3$, and propose the actual data for site concrete work. The concrete placing work without sliding and segregation in the fresh concrete condition is very important because the slope of domed roof is varied in the large range by its curvature. Also the control of hydration heat and the strength development at test ages are classified with massive section about 1.4 m thick and considered to the pre-stressing work and removal of air support after concrete placing work. Considering above condition, slump range is selected $100{\pm}25$ mm under the slope $20^{\circ}$ and $150{\pm}25$ mm over the slope $20^{\circ}$ s until 60 minutes of elapsed time. Also, the roof concrete is satisfied with compressive strength range including design strength at 91 days (30 MPa), pre-stressing work at 7 days (10 MPa), air support removal work at 21 days (14 MPa). Replacement ratio of limestone powder is determined by confined water ratio test and main design factors include water-cement ratio (W/C), sand-aggregate ratio and dosage of admixture. As test results, the optimum mix proportion of the roof concrete used low heat cement is as followings. 1) Replacement ratio of limestone powder 25% by confined water ratio test 2) Water-cement ratio 57.8% 3) Sand-aggregate ratio 42.0%. Also, test results for the adiabatic temperature rising test is satisfied with its criteria and shown the lower value compared to preceding storage tank (TK-13, 14). These required performances and the optimum mix proportion is to apply the actual construction work.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.1
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• pp.19-26
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• 2008

Purpose: In general, We discharged radioactive wastewater and sewages less than $8.1{\times}10^{-13}$ Ci/ml in a exclusive water-purifier tank. Our hospital operating three exclusive water-purifier tank for radioactive wastewater and sewages of 60 tons capacity respectively. In order to meet the criteria it need a enough decay more than 125 days per each exclusive tank. However, recently we fell into the serious situation that decay period was decreased remarkably, owing to the wastewater amount increased rapidly by enlarge the therapy ward. For that reason, in this article, I'd like to say the way that reducing of radioactive wastewater and sewages rationally. Materials and Methods: From January, 2006 to October, four hundred and two cases were analyzed. They were all hospitalized during 3 days and 2 nights. We calculated the average amount of water used (include toilet water used, shower water used, washstand water used, $\cdots$), each exclusive water-purifier tank's decay period, as well as try to search the increased factors about water-purifier tank inflow flux by re-analysis of the procedure of radioisotope therapy step by step. Results: We could increase each exclusive water-purifier tank's decay period from 84 days to 130 days through the improvement about following cause: (1) Improvement of conventional toilet stool for excessive water waste $\rightarrow$ Replacement of water saving style toilet stool (2) Prevention of unnecessary shower and wash (3) Stop the diuretics taking during hospitalization (4) Analysis of relationship between water intakes and residual dose of body (5) Education about outside toilet utilization before the administration (6) Changed each water-purifier tank's maximum level from85% to 90% Conclusion: The originality of our efforts are not only software but hardware performance improvements. Incidentally the side of software's are change of therapy procedures and protocols, the side of hardware's are replacement of water saving style toilet stool and change of each water-purifier tank's maximum level. Thus even if a long lapse of time, problem such as return to the former conditions may not happen. Besides, We expect that our trials become a new reasonable model in similar situation.

• Journal of the Korean Geosynthetics Society
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• v.18 no.4
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• pp.115-127
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• 2019

The low-flow grouting injection technique, the target construction method for this study, is a method of pouring mortar into the ground by non-emission replacement principle, which can be expected to increase the density of the ground, and, in some cases, be used as a base file using the strength of the high injection solids, along with low noise, low pollution, and high durability. To verify that the dynamic characteristics of the ground are improved by the low-flow injection technique, the test work was conducted on the site and physical tests were performed, and the quality of the improvement formed in the ground was verified through the indoor test on the core and core recovery rate was analyzed. The density logs test layer calculated the volume density of the ground layer by using the Compton scattering of gamma-rays, and the sonic logs was tested on the ground around the drill hole using a detector consisting of sonar and receiver devices inside the drill hole. As a result of the measurement of the change in physical properties (density and sonic logs) before and after grouting, both properties were basically increased after infusion of grout agent. However, the variation in density increase was greater than the increase in speed after grouting, and the ground density measurement method was thought to be effective in measuring the fill effect of the filler. Strength and core recovery rates were measured from specimens taken after the age of 28 days, and the results of the test results of the diffusion and strength test of the improved products were verified to satisfy the design criteria, thereby satisfying the seismic performance reinforcement.