• Journal of Korean Foot and Ankle Society
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• v.2 no.1
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• pp.42-47
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• 1998

The conventional surgical treatment for deformed foot has always consisted of massive soft tissue releases combined with varying methods of osteotomies and fusions to plantigrade functional foot. But, the resulting feet have often been foreshortened, stiff, and nothing more than a cosmetically acceptable but functionally poor foot. Now the techniques of distraction histogenesis has been given a new tool to apply to the complex foot deformity. We have recently experienced two cases of severe deformed feet and treated with Ilizarov technique. One patient had postcompartmental severe rigid equinocavovarus foot. And the other had traumatic severe rigid metatarsus abductus. The follow up periods were 14 and 28 months respectively. The feet were aesthetically pleasing. So, we believed that the Jlizarov technique is an excellent treating method for severe deformed foot.

• Investigative and Clinical Urology
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• v.59 no.6
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• pp.399-409
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• 2018

Purpose: To analyze data from an observational, prospective, cumulative registry study in 805 hypogonadal men stratified by mild or moderate-to-severe lower urinary tract symptoms (LUTS) according to International Prostate Symptom Score. Materials and Methods: A total of 412 men underwent testosterone therapy (TTh) with injectable testosterone undecanoate, 393 men served as untreated controls. Measures of urinary function, anthropometric and metabolic parameters were performed at least twice per year. Results: Data from 615 men with mild LUTS (253 treated, 362 untreated) and 190 with moderate-to-severe LUTS (159 treated, 31 untreated) were available. During a follow-up period of 8 years a significant improvement of LUTS was noted for all TTh-patients whereas the control-groups showed deterioration or fluctuation around initial values. Despite advancing age, TTh fully prevented worsening of symptoms. In parallel, a considerable improvement of anthropometric parameters, lipids and glycemic control, blood pressure, C-reactive protein, and quality of life was found. Moderate-to-severe LUTS was associated with worse cardiometabolic risk profile at baseline as well as worse cardiovascular outcomes during follow-up in comparison to mild LUTS. Effect size of TTh was more pronounced in men with moderate-to-severe than with mild LUTS. Conclusions: Correcting hypogonadism by TTh is highly effective and safe for improving LUTS in hypogonadal men. TTh may also improve cardiometabolic risk and major adverse cardiovascular events.

• The Korean Journal of Emergency Medical Services
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• v.22 no.3
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• pp.163-176
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• 2018

Purpose: The purpose of this study was to determine the effectiveness of hands-only CPR education according to the American Heart Association (2015) guideline for undergraduates with severe visual impairment, to provide basic data for expanding the subject of hands-only CPR education among the visually impaired. Methods: Twenty-one students attending four universities in C Province, aged 19 years or older, were enrolled in this study. These students had severe visual impairment and no other disabilities and have never received hands-only CPR education. This study data were collected from December 1, 2017 to January 11, 2018. The accuracy of the participants' technique was measured using Brayden Pro CPR manikin. The data were analyzed using SPSS version 24.0. Results: Hands-only CPR education was effective in increasing confidence and accuracy of chest compression among undergraduates with severe visual impairment. Conclusion: These findings suggest that individuals with severe visual impairment should be given more educational opportunities. Additionally, subsequent studies should develop equipment that helps increase accuracy by using video aids with commentary or other auditory components for the visually impaired.

• Nuclear Engineering and Technology
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• v.54 no.1
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• pp.138-151
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• 2022

Cladding ballooning and rupture are the important phenomena at the early stage of a severe accident. Most severe accident analysis codes determine the cladding rupture based on simple parameter models. In this paper, a FRTMB module was developed using the thermal-mechanical model to analyze the fuel mechanical behavior. The purpose is to judge the cladding rupture with the severe accident analysis code. The FRTMB module was integrated into the self-developed severe accident analysis code ISAA to simulate the PHEBUS FPT3 experiment. The predicted rupture time and temperature of the cladding were basically consistent with the measured values, which verified the correctness and effectiveness of the FRTMB module. The results showed that the rising of gas pressure in the fuel rod and high temperature led to cladding ballooning. Consequently, the cladding hoop strain exceeded the strain limit, and the cladding burst. The developed FRTMB module can be applied not only to rod-type fuel, but also to plate-type fuel and other types of reactor fuel rods. Moreover, the FRTMB module can improve the channel blockage model of ISAA code and make contributions to analyzing the effect of clad ballooning on transient and subsequent parts of core degradation.

• Journal of Chest Surgery
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• v.56 no.1
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• pp.56-58
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• 2023

Untreated severe tricuspid regurgitation (TR) is associated with poor outcomes. Functional TR occurs secondary to dilatation of the annulus and tethering of the leaflets. Ring annuloplasty alone can correct most cases, but is insufficient in cases of severe annular dilatation due to severe leaflet tethering. In such cases, a tricuspid edge-to-edge technique may be an option. However, stitching of the leaflet tips alone is likely to result in tearing of the leaflets. Approximation of the durable chordae tendineae is considered helpful for this problem. Herein, we present the case of a 39-year-old man who had undergone open-heart surgery for acute type A aortic dissection 13 months earlier. A right mini-thoracotomy approach with a beating-heart strategy was used, which did not require unnecessary pericardial adhesiolysis and dissection. This technique had the advantage of reducing the operation time and the risk of bleeding. To summarize, we present a case of tricuspid valve repair in a high-risk patient with severe leaflet tethering that was successfully managed using these methods.

• Nuclear Engineering and Technology
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• v.54 no.12
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• pp.4534-4550
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• 2022

Integrated severe accident codes should be capable of simulating not only specific physical phenomena but also entire plant behaviors, and in a sufficiently fast time. However, significant uncertainty may exist owing to the numerous parametric models and interactions among the various phenomena. The primary objectives of this study are to present best-practice uncertainty and sensitivity analysis results regarding the evolutions of severe accidents (SAs) and fission product source terms and to determine the effects of mitigation measures on them, as expected during a short-term station blackout (STSBO) of a reference pressurized water reactor (optimized power reactor (OPR)1000). Three reference scenarios related to the STSBO accident are considered: one base and two mitigation scenarios, and the impacts of dedicated severe accident mitigation (SAM) actions on the results of interest are analyzed (such as flammable gas generation). The uncertainties are quantified based on a random set of Monte Carlo samples per case scenario. The relative importance values of the uncertain input parameters to the results of interest are quantitatively evaluated through a relevant sensitivity/importance analysis.

• Korean Circulation Journal
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• v.53 no.11
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• pp.775-786
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• 2023

Background and Objectives: Tricuspid valve (TV) repair techniques other than annuloplasty remain challenging and frequently end in tricuspid valve replacement (TVR) in complicated cases. However, the results of TVR are suboptimal compared with TV repair. This study aimed to evaluate the clinical effectiveness of TV edge-to-edge repair (E2E) compared to TVR for severe tricuspid regurgitation (TR). Methods: We retrospectively reviewed 230 patients with severe TR who underwent E2E (n=139) or TVR (n=91) from 2001 to 2020. Clinical and echocardiographic results were analyzed using inverse probability of treatment weighting analysis and propensity score matching. Results: The two groups showed no significant differences in early mortality and morbidities. During the mean follow-up of 106.2±68.8 months, late severe TR and TV reoperation rates were not significantly different between groups. E2E group, however, showed better outcomes in overall survival (p=0.023), freedom from significant tricuspid stenosis (TS) (trans-tricuspid pressure gradient ≥5 mmHg, p=0.021), and freedom from TV-related events (p<0.001). Matched analysis showed consistent results. Conclusions: E2E for severe TR presented more favorable clinical outcomes than TVR. Our study supports that E2E might be a valuable option in severe TR surgery, avoiding TVR.

• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.316-323
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• 2023

Objective : Owing to advances in critical care treatment, the overall survival rate of preterm infants born at a gestational age (GA) <32 weeks has consistently improved. However, the incidence of severe intraventricular hemorrhage (IVH) has persisted, and there are few reports on in-hospital morbidity and mortality. Therefore, the aim of the present study was to investigate trends surrounding in-hospital morbidity and mortality of preterm infants with severe IVH over a 14-year period. Methods : This single-center retrospective study included 620 infants born at a GA <32 weeks, admitted between January 2007 and December 2020. After applying exclusion criteria, 596 patients were included in this study. Infants were grouped based on the most severe IVH grade documented on brain ultrasonography during their admission, with grades 3 and 4 defined as severe. We compared in-hospital mortality and clinical outcomes of preterm infants with severe IVH for two time periods : 2007-2013 (phase I) and 2014-2020 (phase II). Baseline characteristics of infants who died and survived during hospitalization were analyzed. Results : A total of 54 infants (9.0%) were diagnosed with severe IVH over a 14-year period; overall in-hospital mortality rate was 29.6%. Late in-hospital mortality rate (>7 days after birth) for infants with severe IVH significantly improved over time, decreasing from 39.1% in phase I to 14.3% in phase II (p=0.043). A history of hypotension treated with vasoactive medication within 1 week after birth (adjusted odds ratio, 7.39; p=0.025) was found to be an independent risk factor for mortality. When comparing major morbidities of surviving infants, those in phase II were significantly more likely to have undergone surgery for necrotizing enterocolitis (NEC) (29.2% vs. 0.0%; p=0.027). Additionally, rates of late-onset sepsis (45.8% vs. 14.3%; p=0.049) and central nervous system infection (25.0% vs. 0.0%; p=0.049) were significantly higher in phase II survivors than in phase I survivors. Conclusion : In-hospital mortality in preterm infants with severe IVH decreased over the last decade, whereas major neonatal morbidities increased, particularly surgical NEC and sepsis. This study suggests the importance of multidisciplinary specialized medical and surgical neonatal intensive care in preterm infants with severe IVH.

• The Korean Journal of Physiology
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• v.30 no.2
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• pp.231-236
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• 1996

In our previous study (Kim et al, 1991), GLUT 4 protein content correlated negatively with plasma glucose levels in skeletal muscles of STZ-induced diabetic rats. Thus, in this study, to confirm whether expression of GLUT 4 correlate negatively with degree of hyperglycemia, we measured levels of GLUT 4 mRNA in red and white gastrocnemius muscles in STZ-induced mild and severe diabetic rats. Rats were randomly assigned to control, mild, and severe diabetic groups, and the diabetes was induced by intraperitoneal administration of STZ. The experiment was carried out 10 days after STZ administration. Gastrocnemius red and white muscles were used fur the measurement of GLUT 4 expression. Plasma glucose levels of mild and severe diabetic rats were increased compared to control rats (control, mild, and severe diabetes; $6.4{\pm}0.32,\;9.4{\pm}0.68,\;and\;22.0{\pm}0.58$ mmol/L, respectively). Plasma insulin levels of mild and severe diabetic rats were decreased compared to control rats (control, mild, and severe diabetes; $198{\pm}37,\;l14{\pm}14,\;and\;90{\pm}15$ pmol/L, respectively). GLUT 4 mRNA levels of gastrocnemius red muscles in mild and severe diabetic rats were decreased compared to control rats ($64{\pm}1.2%\;and\;71{\pm}2.0%$ of control, respectively), but GLUT 4 mRNA levels in gastrocnemius white muscles were unaltered in diabetic rats. In summary, GLUT 4 mRNA levels were decreased in STZ-induced diabetic rats but did not correlated negatively with degree of hyperglycemia, and this result suggest that the regulatory mechanisms of decreased GLUT 4 mRNA levels are hypoinsulinemia and/or other metabolic factor but not hyperglycemia. And regulation of GLUT 4 expression in STZ-induced diabetes between red and white enriched skeletal muscles may be related to a fiber specific gene regulatory mechanism.

• Tribology and Lubricants
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• v.36 no.3
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• pp.117-123
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• 2020

In this study, the effect of the pre-mild wear mode test condition on the subsequent severe wear behavior of carbon steel has been investigated when the wear mode is varied according to the sliding speed change during sliding contact. Two sliding speeds of 0.3 m/s and 3 m/s for the mild wear mode test have been chosen and a sliding speed of 1 m/s for the severe wear mode test. A mild wear mode test at two different sliding speeds has been carried out during the severe wear mode test and total sliding distance of the mild wear mode test has been changed at this time. As a result, it could be found that the wear rate of carbon steel under the severe wear mode test after performing a pre-mild wear mode test is significantly reduced, compared with that before performing. However, its wear rate was slightly higher than that under the mild wear mode test. Oxides produced during the pre-mild wear mode test have been found to play a significant role in reducing the wear rate under the subsequent severe wear mode test. In particular, it was found that the effect of a pre-mild wear mode test performed at the sliding speed of 3 m/s has more rapid and the reduction in the wear rate was greater than thst at the sliding speed of 0.3 m/s.