Objective : The aim of this study was to evaluate the morphometric changes in neuroforamen in grade I isthmic spondylolisthesis by anterior lumbar interbody fusion [ALIF]. Methods : Fourteen patients with grade I isthmic spondylolisthesis who underwent single level ALIF with percutaneous pedicle screw fixation were enrolled. All patients underwent standing lateral radiography and magnetic resonance imaging [MRI] before surgery and at 1 week after surgery. For quantitative analysis, the foraminal height, width, epidural foraminal height, epidural foraminal width, and epidural foraminal area were evaluated at the mid-portion of 28 foramens using T2-weighted sagittal MRI. For qualitative analysis, degree of neural compression in mid-portion of 28 foramens was classified into 4 grades using T2-weighted sagittal MRI. Clinical outcomes were assessed using Visual Analogue Sale [VAS] scores for leg pain and Oswestry disability index before surgery and at 1 year after surgery. Results : The affected levels were L4-5 in 10 cases and L5-S1 in 4. The mean foraminal height was increased [p<0.001], and the mean foraminal width was decreased [p=0.014] significantly after surgery. The mean epidural foraminal height [p<0.001], epidural foraminal width [p<0.001], and epidural foraminal area [p<0.001] showed a significant increase after surgery. The mean grade for neural compression was decreased significantly after surgery [p<0.001]. VAS scores for leg pain [p=0.001] and Oswestry disability index [p=0.001] was decreased significantly at one year after surgery. Conclusion : Foraminal stenosis in grade I isthmic spondylolisthesis may effectively decompressed by ALIF with percutaneous pedicle screw fixation.
A forked tunnel, as a special complicated underground structure, is composed of big-arch tunnel, multi-arch tunnel, neighborhood tunnels and separate tunnels according to the different distances between two separate tunnels. Due to the complicated process of design and construction, surrounding jointed rock mass stability of the big-arch tunnel which belongs to the forked tunnel during excavation is a hot issue that needs special attentions. In this paper, an elasto-plastic damage constitutive model for jointed rock mass is proposed based on the coupling method considering elasto-plastic and damage theories, and the irreversible thermodynamics theory. Based on this elasto-plastic damage constitutive model, a three dimensional elasto-plastic damage finite element code (D-FEM) is implemented using Visual Fortran language, which can numerically simulate the whole excavation process of underground project and perform the structural stability of the surrounding rock mass. Comparing with a popular commercial computer code, three dimensional fast Lagrangian analysis of continua (FLAC3D), this D-FEM has advantages in terms of rapid computing process, element grouping function and providing more material models. After that, FLAC3D and D-FEM are simultaneously used to perform the structural stability analysis of the surrounding rock mass in the forked tunnel considering three different computing schemes. The final numerical results behave almost consistent using both FLAC3D and D-FEM. But from the point of numerically obtained damage softening areas, the numerical results obtained by D-FEM more closely approach the practical behaviors of in-situ surrounding rock mass.
There is a possibility of cavities occurring inside and behind the lining of an aged tunnel structure. In most cases, it is not easy to check the cavity because it exists in a place where visual inspection is impossible. Recently, attempts have been made to evaluate the condition of the tunnel lining and the backfill materials using non-destructive tests such as Ground Penetrating Radar, and various related model tests and numerical analysis studies have been conducted. In this study, the GPR signal characteristics for tunnel lining model testing were analyzed using gprMax software, which was compared with model test results. The numerical model applied to the model test reasonably simulated the electromagnetic wave signal according to the change of the material such as tunnel lining and internal cavity. Using the verified GPR model, B-scan data for the development of the GPR signal analysis technique were obtained, which can evaluate the thickness of the tunnel lining, the presence of the cavity, the effect of the waterproof membrane, and the frequency band.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.30
no.2
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pp.74-82
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2019
Objectives: The objective of this study was to investigate clinical and neuropsychological factors associated with treatment response and adverse events of atomoxetine in children with attention-deficit/hyperactivity disorder (ADHD) in Korea. Methods: Children with ADHD were recruited at the Department of Psychiatry of Asan Medical Center from April 2015 to April 2018. Diagnoses of ADHD and comorbid psychiatric disorders were confirmed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. The subjects were subsequently treated with atomoxetine for 12 weeks and illness severity was scored using the ADHD Rating Scale, Clinical Global Impression-Severity scale (CGI-S) and/or Improvement scale (CGI-I), at pre- and post-treatment. They also completed the Advanced Test of Attention (ATA), while their caregivers completed the Korean Personality Rating Scale for Children (KPRC) at pre- and post-treatment. Independent t-test, Fisher's exact test, ${\chi}^2$ test, mixed between-within analysis of variance and correlation analysis were used for statistical analysis. Results: Sixty-five children with ADHD (mean age: $7.9{\pm}1.4years$, 57 boys) were enrolled, of which, 33 (50.8%) were treatment responders. Scores on the social dysfunction subscale of the KPRC (p=0.021) and commission errors on the visual ATA (p=0.036) at baseline were higher in treatment non-responders than in responders; however, the statistical significances disappeared after adjusting for multiple comparisons. Mood changes were also observed in 13 subjects (20.0%), and three of them discontinued atomoxetine due to this. Additionally, atomoxetine-emergent mood change was observed more frequently in girls (p=0.006), while the intelligence quotient (p=0.040) was higher in those subjects with mood changes than in those without. Conclusion: The results of our study suggest that clinical and neuropsychological factors could be associated with treatment response or adverse events of atomoxetine in children with ADHD. Further long-term studies with larger samples are needed.
This study analyzes the technological structure of artificial intelligence (AI) and technological capabilities of AI companies based on patent information. 2589 AI patents registered in USPTO from 2007 to 2017 were collected and analyzed by the Latent Dirichlet Allocation (LDA) to derive 20 AI technology topics. Analysis of technology development trends by AI technology reveals that visual understanding, data analysis, motion control, and machine learning are growing, while language understanding and speech technology are sluggish. In addition, we also investigated leading companies in each sub-field of AI as well as core competencies of global IT companies. The findings of this study are expected to be fruitfully used for formulation and implementation of technology strategy of AI companies.
This systematic review focused on the efficacy of topical products in reducing temporomandibular joint disorder (TMD)-associated pain, in comparison to placebo or control interventions. The EMBASE, Web of Science, Cochrane Library, and MEDLINE via PubMed databases were searched for randomized controlled trials (RCTs) using topical interventions in adults diagnosed with TMD. The pain intensity was the primary outcome, and other clinical findings were the secondary outcomes. The risk of bias was evaluated according to the Cochrane's handbook. The search up to February 7, 2020 identified a total of 496 unduplicated references. Nine RCTs with 355 adult patients diagnosed with TMD were included. The meta-analysis did not show a significant reduction in baseline pain intensity in the nonsteroidal anti-inflammatory drug (NSAIDs) group, when compared to the placebo group (P = 0.288). One study demonstrated a statistically significant pain score decrease for Theraflex-TMJ compared to placebo after 10 d of treatment (P = 0.003) and follow-up, 5 d after the last application (P = 0.027). Ping On reduced pain at 4 weeks of application (P < 0.001) but not after 7 d of application (P = 0.136). In one study, cannabidiol (CBD) significantly improved the pain intensity compared to placebo (P < 0.001). However, no differences were found with capsaicin in the two studies (P = 0.465). Evidence was of low quality because the studies were considered as having an unclear or a high risk of bias and a small number of studies were analyzed. The evidence is not sufficient to support the use of topical NSAIDs and capsaicin, and limited evidence was found for Threraflex-TMJ, bee venom, Ping On, and CBD, with only one study reporting for each. Additional studies are recommended to validate these results.
Journal of the Korean Institute of Traditional Landscape Architecture
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v.29
no.4
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pp.198-206
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2011
Poems written on the tablets hanging in Kwanghanru(a pavilion in Namwon, Jeollabuk-do) reveal each author's view of landscape and their recognition of the pavilion and it surroundings. This study consists of the following four analysis frames of the characteristics, sensations, and temporal and spatial axes of the landscape elements grouping tablet poems into two categories of deunglusi of Joseon's literary men, and baegiljangsi and cheongtaksi of the 1930s. The result of the landscape element analysis shows that physical elements are shown more frequently than symbolic ones. Among the physical ones, natural elements are used more often than artificial ones. The landscape elements appearing in each individual poem of baegiljangsi and cheongtaksi are relatively more than those of deunglusi. When the landscape elements are analyzed by sensational aspect, most of them are visual in nature, and there also appear some that are aural or olfactory in nature. Analyzed from a temporal axis, expressions related to autumn and evening and night are used frequently. From the spatial axis, foreground elements are preferred to middleground or background ones.
Background: The options for stabilization appliance therapy for masticatory muscle pain include soft occlusal and hard stabilization appliances. A previous study suggested that hard stabilization appliance therapy was effective for patients with local myalgia who developed long facets on their occlusal appliances. The objective of this study was to identify patients in whom a soft occlusal appliance should be used to treat masticatory muscle pain by analyzing the type of muscle pain present and patient factors that influenced the effectiveness of this treatment. Methods: The study included 42 patients diagnosed with local myalgia or myofascial pain according to the Diagnostic Criteria for Temporomandibular Disorders Diagnostic Decision Tree. The analysis of patient factors included variables believed to be associated with temporomandibular disorders. First, a temporary screening appliance was used for 2 weeks to assess each patient for bruxism during sleep. Soft appliance therapy was then started. For each patient, the effectiveness of the appliance was evaluated according to the intensity of tenderness during muscle palpation and the treatment satisfaction score at one month after starting treatment. Results: Data from 37 of the 42 patients were available for analysis. Twenty-five patients reported satisfaction with the appliance. In logistic regression analysis, the odds ratio for reduction of facet length was 1.998. Nineteen patients showed at least a 30% improvement in the visual analog scale score. The odds ratio for local myalgia was 18.148. Conclusion: Soft appliance therapy may be used in patients with local myalgia. Moreover, patients who develop short facets on the appliance surface are likely to be satisfied with soft appliance therapy. Soft appliance therapy may be appropriate for patients with local myalgia who develop short facets on their occlusal appliance.
Journal of The Korea Institute of Healthcare Architecture
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v.28
no.2
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pp.31-38
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2022
Purpose: This study presents the results of the analysis on space utilization of kidney dialysis units in regional public hospitals, which plays a key role in local public medical services. The result aims to achieve safety from infection, allow comfort for the dialysis environment, and stability for medical support. The purpose of this study is to present fundamental data for architectural plans for the kidney dialysis unit, as well as to alleviate potential infectious diseases such as COVID-19. Methods: For research purposes, the investigation and analysis of space utilization were based on architectural floor plans, research papers and literature, related legal systems, and public statistics. Of the main 35 regional public hospitals, in regards to data accessibility, 15 facilities were selected to conduct the survey and analysis for the objective. Results: The space composition by area research results of kidney dialysis units in public hospitals are as follows: Firstly, most targets do not have required rooms in the access and support area, except for the hemodialysis beds in the treatment section. Secondly, the access area requires necessary room and space design that took into consideration of convenience and accessibility for patients. Thirdly, in regards to infection prevention and control, proper circulation and room plan is essential for storage and disposal of contaminated products and linen after use. For the treatment area, the arrangement plan needs to establish a visual connection between the isolation room, the nursing station, and the bed area. Additionally, consideration of circulation in the preparation, treatment, observation, examination, and all other rooms in the facility is required. Lastly, for the support area, the room is designed to consider adequate working and meeting spaces for the medical staff, consultation space for patients or guardians, separate storage and disposal of clean and contaminated items, and the storage of various equipment for dialysis. Implications: In preparation for the increase in chronic kidney failure patients and the spread of infectious diseases, such as COVID-19, the researched data demonstrates the basic guidelines for space composition of kidney dialysis units and the significant role of regional public hospitals.
The Journal of Churna Manual Medicine for Spine and Nerves
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v.16
no.2
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pp.97-105
/
2021
Objectives This study is aimed to evaluate cost-effectiveness of treatment of Korean Medicine for whiplash associated disorders (WAD) and to suggest the direction of future research. Methods We searched papers in Pubmed database to use some keywords indicating whiplash injury syndrome, treatment of Korean Medicine and cost-effectiveness. After searching, appropriate papers were selected depending on the exclusion criteria. The selected papers were analyzed in the sections of author, publication year, intervention and control groups, outcome measurement, the list including in the cost, cost-effectiveness, cost-utility and study design. Results Four studies about effect of Korean medicine and 3 studies about economic evaluation were finally included. Acupuncture was effective for balance disorder and neck pain. Economic evaluation studies used analytical decision model or cost-consequence analysis. Cost-effectiveness analysis using visual analog scale and cost-utility analysis using quality adjusted life years were performed. Initiating timing of proper management affected the consequence of treatments. Direct and indirect medical costs including supportive devices, and non-medical costs such as litigation were considered. Conclusions We conclude that studies haven't been conducted so far to evaluate the cost-effectiveness of Korean Medicine in whiplash injury syndrome. Thus, future studies are needed in this section.
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