• Title/Summary/Keyword: risk-reduction

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Middle meningeal artery embolization for chronic subdural hematoma in elderly patients at high risk of surgical treatment

  • Jin Hoo Seok;Jong Hyun Kim;Taek Hyun Kwon;Joonho Byun;Won Ki Yoon
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.1
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    • pp.28-35
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    • 2023
  • Objective: The purpose of this study was to evaluate the effectiveness of middle meningeal artery embolization (MMAE) in elderly high-risk patients with symptomatic chronic subdural hematoma (CSDH) in terms of reduction in hematoma volume and recurrence rate. Methods: We retrospectively reviewed data prospectively collected from nine patients who underwent 13 MMAE for CSDH between June 2017 and May 2022. The volume of the subdural hematoma was measured using a computer-aided volumetric analysis program. Hematoma volume changes during the follow-up period were analyzed and clinical outcomes were evaluated. Results: The mean follow-up period was 160 days (range, 46-311 days). All procedures were technically successful and there were no procedure-related complications. Of the 13 MMAE, 84% (11 out of 13 hemispheres) showed mean 88% of reduction on follow-up volumetric study with eight cases of complete resolution. There was one refractory case with MMAE which had been performed multiple burr-hole trephinations, for which treatment was completed by craniotomy and meticulous resection of multiple pseudomembranes. There was no recurrent case during the follow-up period, except for refractory case. Conclusions: MMAE for CSDH in selected high-risk elderly patients and relapsed patients might be effective. Despite the small cohort, our findings showed a high rate of complete resolution with no complications. Further prospective randomized trials are warranted to evaluate its usefulness as a primary treatment option for CSDH.

INTRAORAL OPEN REDUCTION OF MANDIBULAR SUBCONDYLAR FRACTURES USING KIRSCHNER WIRE (Kirschner wire를 사용한 과두하 골절의 구강내 접근법)

  • Kim, Seong-Il;Kim, Seung-Ryong;Baik, Jin-Ah;Ko, Seung-O;Shin, Hyo-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.270-276
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    • 2001
  • The treatment of mandibular subcondylar fractures is a matter of controversy. The majority of mandibular subcondylar fracture are treated by closed reduction, but the displaced or dislocated mandibular subcondylar fractures may be treated by open reduction. The characteristics of open reduction are the anatomical reduction, the functional restoration, the rapid function, the maintenance of vertical ramus dimension, the better appearance and the less resultant TMJ problem etc. When an open reduction is considered, the wire, miniplate, lag screw and Kirschner wire are available with internal fixation. Of these, Kirschner wire is a simple method relatively and correct positioning of the wire achieves rigid fixation. But many open reduction methods for mandibular subcondylar fractures require extraoral approach. The extraoral approach has some problems, the facial scar and the risk of facial nerve injury. On the other hand, the intraoral approach eliminates the potency of the facial scar and the facial nerve injury, but is difficult to access the operation site. Since the intraoral approach was first described by Silverman (1925), the intraoral approach to the mandibular condyle has been developed with modifications. The purpose of this article is to describe the intraoral technique with the Kirschner wire on mandibular subcondylar fractures. Conclusion : The intraoral reduction with Kirschner wire on mandubular subcondylar fractures avoids the facial scar and facial nerve injury and is simple method to the extraoral approach. And it has minimal morbidity and better esthetics.

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Measurement of Disaster Damage Reduction Effect of the Farm-customized Early Warning Service for Weather Risk Management in Korea (농장맞춤형 기상재해 조기경보서비스의 재해피해 경감효과 측정)

  • Sangtaek Seo;Yun Hee Jeong;Soo Jin Kim;Kyo-Moon Shim
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.25 no.3
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    • pp.197-207
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    • 2023
  • This study was conducted with the purpose of measuring the disaster damage reduction effect according to the provision of the early warning service ahead of the nationwide expansion. The damage reduction effect was measured using insurance data for 19 insured crops in areas that early warning services were provided during the period from 2017 to 2020. As a result of the measurement, it was analyzed that the early warning service had the effect of preventing or reducing disaster damage to farms. In particular, it was found that the disaster reduction effect was greater when disaster prevention facilities were equipped. The implications obtained from the results are as follows. First, by presenting subjectively experienced disaster reduction cases as numerical effects using insurance data with public confidence and objectivity, it can be used as basic data such as expansion of service area, discount of insurance premium with service adoption, and promotional materials for service subscription for early warning service. Second, in expanding and distributing early warning services, giving priority to areas or crops equipped with disaster prevention facilities can help increase the efficiency and effectiveness of the project.

Effect of Iterative-metal Artifact Reduction (iMAR) at Tomotherapy: a Phantom Study (토모테라피에서 반복적 금속 인공물 감소 알고리즘의 유용성 평가: 팬톰 실험)

  • Daegun, Kim;Jaehong, Jung;Sungchul, Kim
    • Journal of the Korean Society of Radiology
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    • v.16 no.6
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    • pp.709-718
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    • 2022
  • We evaluated the effect of high-density aluminum, titanium, and steel metal inserts on computed tomography (CT) numbers and radiation treatment plans for Tomotherapy. CT images were obtained using a cylindrical TomoPhantom comprising cylindrical rods of various densities and metal inserts. Three CT image sets were evaluated for image quality as the mean CT number and standard deviation. Dose evaluation also performed. The reference values did not significantly differ between the CT image sets with the corrected metal inserts. The higher-density material exhibited the largest difference in the mean CT number and standard deviation. The conformity index at Iterative-Metal Artifact Reduction (iMAR) was approximately 20% better than that of non-iMAR. No significant target or organ at risk dose difference was observed between non-iMAR and iMAR. Therefore, iMAR is helpful for target or organ at risk delineation and for reducing uncertainty for three-dimensional conformal radiation therapy in Tomotherapy.

Disinfectant effectiveness of chlorhexidine gel compared to sodium hypochlorite: a systematic review with meta-analysis

  • Theodoro Weissheimer;Karem Paula Pinto;Emmanuel Joao Nogueira Leal da Silva;Lina Naomi Hashizume;Ricardo Abreu da Rosa;Marcus Vinicius Reis So
    • Restorative Dentistry and Endodontics
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    • v.48 no.4
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    • pp.37.1-37.17
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    • 2023
  • This study aimed to compare the disinfectant ability of chlorhexidine (CHX) gel and sodium hypochlorite (NaOCl). Systematic searches were conducted from inception until December 8th, 2022 (MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, Embase, and Grey Literature databases). Only randomized clinical trials were included. The revised Cochrane risk of bias tools for randomized trials were used to assess the quality of studies. Meta-analyses were performed. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool. Six studies were included. Five had a low risk of bias and 1 had some concerns. Three studies assessed bacterial reduction. Two were included in the meta-analysis for bacterial reduction (mean difference, 75.03 [confidence interval, CI, -271.15, 421.22], p = 0.67; I2 = 74%); and 3 in the meta-analysis for cultivable bacteria after chemomechanical preparation (odds ratio, 1.03 [CI, 0.20, 5.31], P = 0.98; I2 = 49%). Five studies assessed endotoxin reduction. Three were included in a meta-analysis (mean difference, 20.59 [CI, -36.41, 77.59], p = 0.48; I2 = 74%). There seems to be no difference in the disinfectant ability of CHX gel and NaOCl, but further research is necessary.

A Study on Developing a Model for Cancer Damage Cost Due to Risk from Benzene in Ulsan Metropolitan City (울산 지역에서 대기중 벤젠으로 인한 암 사망 손실비용 추정 모형에 관한 연구)

  • Lee, Yong-Jin;Kim, Ye-Shin;Shin, Dong-Chun;Shin, Young-Chul
    • Environmental and Resource Economics Review
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    • v.13 no.1
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    • pp.49-82
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    • 2004
  • The study aimed to evaluate cancer damage cost due to risk from benzene inhalation. We performed health risk assessment based on US EPA guideline to estimate annual population risk in Ulsan metropolitan city. Also, we estimated a willingness-to-pay amount for reducing a cancer mortality rate to evaluate a value of statistical life. We combined the annual population risk and the value of statistical life to calculate the cancer damage cost. In the health risk assessment, we applied the benzene unit risk ($2.2{\times}10^{-6}{\sim}7.8{\times}10^{-6}$) in the US EPA'S Integrated Risk Information System to assess the annual population risk. Average concentration of benzene in ambient air is $7.88{\mu}g/m^3$(min: 1.16~max: $23.32{\mu}g/m^3$). We targeted an exposure population of 516,641 persons who aged over 30 years old. Using a Monte-Carlo simulation for uncertainty analysis, we evaluated that the population risk of benzene during ten years in Ulsan city is 2.90 persons (5 percentile: 0.32~95 percentile: 9.11persons). And the monthly average WTP for 5/1,000 cancer mortality reduction during ten years is 14,852 Won(95% C.I: 13,135~16,794 Won) and the implied VSL is 36 million Won(95% C.I: 30~40 million Won). Cancer damage cost due to risk from benzene inhalation during 10 years in Ulsan city is about 104 million Won(5 percentile: 13~95 percentile: 328 million Won). Health benefit cost to reduce a cancer mortality risk of benzene is about 50 million Won is Ulsan metropolitann city. But, it is very important that this cost is not for all health damage cost of cancer mortality in some area. We just recommended a model for evaluating a cancer risk reduction, so we must re-evaluate an integrated application of total VOCs damage cost including benzene.

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A Study on Countermeasures for Risk Factors Through Risk Analysis of Earthwork (흙막이공의 리스크 분석을 통한 리스크 요인별 대응 방안에 관한 연구)

  • Jeon, Byung Ju;Isah, Muritala Adebayo;Kim, Hyun Bee;Lee, Yang Gyu;Kim, Byung Soo
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.42 no.5
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    • pp.681-688
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    • 2022
  • According to a recent study, most construction companies in Korea do not manage risk effectively, and it is judged that the risk management system needs to be improved. In addition, most risk-related studies deal with risks from a macroscopic perspective, and there are few studies dealing with process risks at the project construction stage. Therefore, this study tried to suggest a risk response plan through analysis and classification of risk factors that may occur in retaining work among process risks. To this end, a workshop was held for risk experts to identify and analyze risks that may occur during the construction of retaining work for apartments. As a result of the study, it was expected that savings of KRW 4.97 billion would be possible in the 95 % confidence interval, and the maximum possible cost was reduced from KRW 15 billion to about KRW 10 billion. Based on the risk reduction ratio, it was found that risks that can be reduced without any special input cost, risks with large effects in response to risks, and risks with insignificant effects were found. Therefore, using the types and risk factors presented in this study as guides, it is expected that it will be helpful in successfully operating the project if an appropriate response strategy is prepared and systematically responded to the site conditions.

Eating Habits, Trend of disordered Eating, Weight Reduction Practice and Body Size Evaluation of College Students in Seoul (서울지역 일부 대학생의 식습관, 섭식장애 발생경향, 체중조절행태 및 비만도)

  • Sohng, Kyeong-Yae;Park, Chai-Soon
    • Women's Health Nursing
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    • v.9 no.4
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    • pp.457-466
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    • 2003
  • Purpose: To provide the epidemiological information for developing preventive programs encourage appropriate eating and weight control behaviors. Method: 349 college students in Seoul were administered self-report question- naires to examine eating habits, trend of disordered eating, weight reduction practice and body size evaluation from September to October 2002. Data were analyzed by SAS program for frequency, t-test, ANOVA with Scheff test. Result: The mean eating score was moderate and it differed by subjects' characteristics. The mean score of EAT-26 was relatively lowered, and 3.4% of the subjects score showed disordered eating behavior. It differed significantly by subjects' general characteristics. 30.4% of total sample were currently trying to lose weight and had interested in trying to lose weight. EAT-26 was significantly different by weight reduction practices and interest. Perceived body size differed by the score of eating habit and EAT-26. Conclusion: It can be suggested weight preoccupation have a relation to eating habits, weight control practice and disordered eating. Further study is recommended educational interventions targeting at-risk subjects.

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Effect of Portulaca oleracea Extract in Removing Nicotine Component of Tobacco (쇠비름 추출물이 담배의 Nicotine 성분 제거에 미치는 영향)

  • 배지현
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.28 no.3
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    • pp.607-612
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    • 1999
  • Cigarette smoking is the potential risk factor for lung cancer and chronic pulmonary disease, as well as inflammatory bowel disease and reproductive malfunction. Nicotine and tar have been im plicated as a major factor in the pathogenesis of the diseases. Nicotine increases heart rate and blood pressure due to stimulation sympathetic neurotransmission and tar also accounts for the severe damage of peridontal diseases and osteoporosis in postmenopausal women. Portulaca oleracea, which contains significant amount of K+, noradrenaline and dopamine as well as various nutrients, has been used for many medicinal purposes and one of which is the detoxification of insect or snake toxins. The purpose of this study was to investigate the action of Portulaca oleracea extracts on the reduction of harmful materials of tabacco. The reduction percentages were measured in the presence and absence of each solvent extract of Portulaca oleracea using reversed C18 column of HPLC. Nicotine reduction effects were obtained from aqueous, methanol and chloroform extracts of Portulaca oleracea as 89%, 55% and 51%, respectively. The results suggest that the polar extracts of Portulaca oleracea affects the reduction of nicotine which is responsible for many diseases.

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A Systematic Review of Breast Care for Postpartum Mothers (산욕기 산모의 유방간호에 대한 체계적 문헌고찰)

  • Song, Ji-Ah;Hur, Myung Haeng
    • Women's Health Nursing
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    • v.25 no.3
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    • pp.258-272
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    • 2019
  • Purpose: The purpose of this study was to identify nursing interventions for the postpartum breast care of mothers and determine the effectiveness of interventions for breast pain and engorgement by systematic review. Methods: Eight national and international databases were reviewed to retrieve and collect randomized controlled trial and controlled clinical trial literature published up to March 2015. Two reviewers independently selected the studies and performed data abstraction and validation. The risk of bias was assessed using Cochrane criteria. A meta-analysis of the studies was performed to analyze the data. Results: The meta-analysis showed that breast massage, along with routine breast care, resulted in a 3.52-point reduction in pain on a 10-point visual analogue scale. Meta-analysis of therapy with cold cabbage leaves and routine breast care showed a pain reduction of 0.54 points. Meta-analysis of cold cabbage leaf application in the experimental group versus cold compress therapy in the comparison group showed a pain reduction of 0.44 points. Meta-analysis of cold cabbage leaf application and routine breast care showed an engorgement reduction of 0.67 points. Conclusion: The results of the analysis of 12 articles showed that hot and cold compresses, breast massage, and cabbage application were effective for postpartum breast pain and engorgement.