• Title/Summary/Keyword: Bilateral

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Clinical Significance of Decompressive Craniectomy Surface Area and Side

  • Jo, KwangWook;Joo, Won Il;Yoo, Do Sung;Park, Hae-Kwan
    • Journal of Korean Neurosurgical Society
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    • v.64 no.2
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    • pp.261-270
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    • 2021
  • Objective : Decompressive craniectomy (DC) can partially remove the unyielding skull vault and make affordable space for the expansion of swelling brain contents. The objective of this study was to compare clinical outcome according to DC surface area (DC area) and side. Methods : A total of 324 patients underwent different surgical methods (unilateral DC, 212 cases and bilateral DC, 112 cases) were included in this retrospective analysis. Their mean age was 53.4±16.6 years (median, 54 years). Neurological outcome (Glasgow outcome scale), ventricular intracranial pressure (ICP), and midline shift change (preoperative minus postoperative) were compared according to surgical methods and total DC area, DC surface removal rate (DC%) and side. Results : DC surgery was effective for ICP decrease (32.3±16.7 mmHg vs. 19.2±13.4 mmHg, p<0.001) and midline shift change (12.5±7.6 mm vs. 7.8±6.9 mm, p<0.001). The bilateral DC group showed larger total DC area (125.1±27.8 ㎠ for unilateral vs. 198.2±43.0 ㎠ for bilateral, p<0.001). Clinical outcomes were nonsignificant according to surgical side (favorable outcome, p=0.173 and mortality, p=0.470), significantly better when total DC area was over 160 ㎠ and DC% was 46% (p=0.020 and p=0.037, respectively). Conclusion : DC surgery is effective in decrease the elevated ICP, decrease the midline shift and improve the clinical outcome in massive brain swelling patient. Total DC area and removal rate was larger in bilateral DC than unilateral DC but clinical outcome was not influenced by DC side. DC area more than 160 ㎠ and DC surface removal rate more than 46% were more important than DC side.

Bilateral Lipoma Arborescens of the Knee in an Adolescent Patient (청소년에서 양측 슬관절에 발생한 수지상 지방종)

  • Kim, Hee-June;Kim, Jeong-Woo;Lee, Hyun-Joo;Kyung, Hee-Soo
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.354-358
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    • 2020
  • Lipoma arborescens (LA) is a rare lesion that causes joint effusion and pain. LA usually presents as a unilateral knee lesion, and bilateral lesions are extremely rare. LA among adolescent patients is also extremely rare with the disorder having a much higher incidence among adults. This paper reports a 14-year-old boy who was treated for bilateral knee LA. X-rays revealed the characteristic features of LA in both knees, and arthroscopic synovectomy was performed to resect the lesions. Postoperative recovery progressed smoothly, and the patient was eventually relieved of pain and swelling. LA should be considered when adolescent patients present with bilateral pain and swelling, even though this condition is rare in this age group. Furthermore, surgical synovectomy for a complete resection is an appropriate treatment option.

Convergence analysis of cusp variation symmetry of the mandibular second premolars using 3-dimensional virtual models - Focusing on college students in Jeollabuk-do (3차원 가상모형을 이용한 하악 제2소구치 교두 변이 대칭성에 대한 융복합적 분석 - 전북지역 일부 대학생을 중심으로)

  • Nam, Shin-Eun
    • Journal of Digital Convergence
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    • v.20 no.2
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    • pp.317-323
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    • 2022
  • This study aimed to qualitative analyze the cusp variation pattern of the mandibular second premolars using a three-dimensional virtual models, and to analyze the left-right bilateral symmetry with a quantitative analysis of the tooth surface area according to the cusp variation. 127 virtual mandibular second premolars were prepared and individual absolute/relative cusp area, total crown area and groove form were analyzed using RapidForm2004(INUS technology INC, Seoul, Korea). Independent t-test, Kruskal-Wallis test and chi-square were performed. As a result, the groove form showed high bilateral symmetry between the left and right sides. Based on the left side of groove form, the bilateral symmetry was 100.0% for the U pattern, and 73.7% for the H patterned, and 78.9% for the Y pattern(p<.001). The finding could be as a meaningful reference for manufacturing CAD/CAM dental prostheses, and it is expected that further studies will be conducted on more samples including the mandibular second premolar immediately after eruption.

Retroperitoneal Suppurative Fistula Caused by Remnant Suture Material in a Poodle Dog

  • Kim, Keunyung;Lee, Chaeyeong;Kim, Minyeon;Choi, Hyeonjong;Hong, Jeongho;Kim, Hyoyeon;Park, Hyojin;Kim, Na-hyun;Lee, Dongbin;Lee, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.38 no.6
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    • pp.285-289
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    • 2021
  • An eight-year-old, 3.4 kg, spayed female poodle dog was referred to Gyeongsang National University Animal Medical Center with obstinate bilateral retroperitoneal subcutaneous abscess. The medical history revealed ovariohysterectomy (OHE), lipoma, and mammary gland tumor excision performed two years ago. The dog presented with left retroperitoneal subcutaneous abscess discharge five months back and was treated by abscess drainage and antibiotics in a local veterinary hospital, but a relapse was reported on discontinuing antibiotics. On physical examination, the dog was febrile (40℃) and both retroperitoneal masses showed typical inflammatory reaction and purulent discharge. On serum chemistry analysis, hyperproteinemia, hyperglobulinemia, and elevated levels of C-reactive protein were observed. Cytologic examination showed degenerative neutrophils and phagocytic macrophages. Radiological examination revealed encapsulated hypoechoic subcutaneous masses in bilateral abdominal flank and the left flank mass was connected with the caudal pole of left kidney through fistula. Based on the diagnostic examination, exploratory celiotomy was recommended and left nephrectomy, and resection of bilateral masses were performed. During procedure, fistula between caudal pole of left kidney and left subcutaneous abscess was detected and suture material was identified. Resected tissue was histologically examined and diagnosed as suppurative abscess caused by the suture material. This case report describes chronic suppurative foreign body reaction including caudal pole of left kidney and bilateral retroperitoneal subcutaneous masses induced by the suture material used in OHE two years ago and the necessity of computed tomography examination to identify character of mass and extent of surgical resection.

Restoration of the Broken Lumbopelvic-hip Neuromuscular Chain and Coordinated Synergistic Activation in Low Back Pain

  • Park, Haeun;Park, Chanhee;You, Joshua (Sung) Hyun
    • Physical Therapy Korea
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    • v.29 no.3
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    • pp.215-224
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    • 2022
  • Background: The presence of the lumbopelvic-hip neuromuscular chain is essential for dynamic spinal stabilization; its therapeutic effects on dynamic movements of the distal extremity segment and underpinning motor mechanism remain unknown and warrant further study on participants with low back pain (LBP). Objects: We aim to compare the effects of the broken chain exercise (BCE) and connected chain exercise (CCE) on electromyography (EMG) amplitude and onset time in participants with and without LBP. Methods: Randomized controlled clinical trial. A convenience sample of 40 nonathletic participants (mean age: 24.78 ± 1.70) with and without LBP participated in this study. All participants underwent CCE for 30 minutes, 30-minute daily. We measured EMG amplitude and onset times on bilateral erector spinae (ES), gluteus maximus (GM), hamstring (HAM), transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) during the prone hip extension (PHE) test before and after the BCE and CCE. We used multivariate analysis of variance (MANOVA) to analyze the amplitude and onset time difference between exercises (BCE and CCE) and Pearson's correlations to determine any synergistic relationship among the HAM, GM, bilateral TrA/IO, and ES muscles. The statistical analyses were used at p < 0.05. Results: MANOVA showed that CCE was more decreased on EMG amplitude in HAM and bilateral ES, while increased GM and contralateral TrA/IO than BCE (p < 0.05). MANOVA EMG onset time data analyses revealed that the main effect of the conditions was significant for all HAM, GM, and bilateral ES muscles, whereas the main effect for the group was significant only for GM and contralateral ES in healthy and LBP groups. Pearson's correlation coefficient was computed to assess the relationship between BCE and CCE on dependent variables. In most of the muscles, there was a strong, positive correlation between the two variables, and there was a significant relationship (p < 0.001). Conclusion: CCE produced more effective and coordinated core stabilization and motor control mechanism in the lumbopelvic-hip muscles in participants with and without LBP during PHE than BCE.

The Effect of Trade Agreements on Korea's Bilateral Trade Volume: Mitigating the Impact of Economic Uncertainty in Trading Countries

  • Heedae Park;Jiyoung An
    • Journal of Korea Trade
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    • v.27 no.5
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    • pp.153-166
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    • 2023
  • Purpose - This research empirically analyzes the influence of economic policy uncertainty and free trade agreements (FTAs) on bilateral trade volumes between Korea and its trading partners. The study investigates whether fluctuations in the Economic Policy Uncertainty Index (EPUI) for both Korea and its trading partners significantly impact trade volumes and whether the implementation of FTAs mitigates these effects. Design/methodology - The study employs dynamic panel data analysis using the system generalized method of moments (system GMM) estimation method to achieve its research objectives. It utilizes country-month-level panel data, including the EPUI, trade volume between Korea and its trading partner countries, and other pertinent variables. The use of system GMM allows for the control of potential endogeneity issues and the incorporation of country-specific and time-specific effects. Findings - The analysis yields significant results regarding the impact of economic policy uncertainty on Korea's exports and imports, particularly before the implementation of FTAs. An increase in the EPUI of trading partners leads to a notable increase in Korea's exports to them. Conversely, an increase in Korea's EPUI negatively affects its imports from trading partners. However, post-FTA implementation, the influence of each country's EPUI on trade volume is neutralized, with no significant difference observed. Originality/value - This research contributes to the existing literature by providing empirical evidence on the interaction effects between economic policy uncertainty and FTAs on bilateral trade volumes. The study's uniqueness lies in its examination of how FTAs mitigate the impact of economic uncertainty on trade relations between countries. The findings underscore the importance of trade agreements as mechanisms to address economic risks and promote international trade relations. In a world where global market uncertainties persist, these insights can aid policymakers in Korea and other countries in enhancing their trade cooperation strategies and navigating challenges posed by evolving economic landscapes.

DaVinci SP-based simultaneous bilateral partial nephrectomy from the midline transperitoneal approach: a case report

  • Young Hwii Ko;Jong Gyun Ha;Jae Yoon Jang;Yeung Uk Kim
    • Journal of Yeungnam Medical Science
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    • v.41 no.1
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    • pp.48-52
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    • 2024
  • While simultaneous bilateral partial nephrectomy with a conventional multiport robot has been consistently reported since the 2010s, the introduction of the DaVinci SP system (Intuitive Surgical, Sunnyvale, CA, USA) could provide a novel way to perform surgery on bilateral kidneys while innovatively reducing the number of incisions. In our first report worldwide, the patient with bilateral small renal mass (2.0 cm for the left and 1.5 cm for the right side) and preoperative normal renal function was placed in the lateral decubitus position on an inverted bed. After tilting the bed to be as horizontal as possible, a 4-cm incision was made in the lower part of the umbilicus for the floating trocar technique. The partial nephrectomy was performed reliably as with the conventional transperitoneal approach, and then the patient could be repositioned to the contralateral side for the same procedure, maintaining all trocars. Total operation time (skin to skin), total console time, and the left- and right-side warm ischemic times were 260, 164, 27, and 23 minutes, respectively, without applying the early declamping technique. The estimated blood loss was 200 mL. The serum creatinine right after the operation, on the first day, 3 days, and 90 days after surgery were 0.92, 0.77, 0.79, and 0.81 mg/dL, respectively. For 90 days after the procedure, no complications or radiologic recurrence were observed. Further clinical studies will reveal the advantages of using the DaVinci SP device for this procedure over traditional multiport surgery, maximizing the benefit of a single port-based approach.

Comparison of Trunk Muscles between 3 Different Squats in Normal Adults

  • Aran Choi;Jihye Jung;Seungwon Lee
    • Physical Therapy Rehabilitation Science
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    • v.13 no.1
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    • pp.78-85
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    • 2024
  • Objective: This Study aimed to examine the changes in muscle activity of trunk muscles by performing three squat exercises on normal adults. Design: cross-sectional study Methods: Thirty-two adult subjects participated in this study. General squat, overhead squat, and overhead squat combined with abdominal stabilization were randomly performed for 5 seconds, 3 times, to calculate the average muscle activation. Muscle activation was normalized using electrodes on the rectus abdominis, external oblique, internal oblique, and erector spinae muscles to measure maximum voluntary isometric contraction (MVIC) for 5 seconds, repeated 3 times each. Results: There was a significant difference in the mean and maximal muscle activity of the bilateral erector spinae (ES) when comparing the squat to the overhead squat (p<0.05). There was a significant difference (p<0.05) in the mean and maximal muscle activity of the bilateral external oblique (EO) when comparing the overhead squat to the overhead squat combined with the abdominal stabilization technique. When comparing the squat to the overhead squat with abdominal stabilization, there was a significant difference in the mean and maximum muscle activity of the bilateral RA, EO, and left Internal oblique (IO) (p<0.05), and there was a significant difference in the maximum muscle activity of the bilateral erector spinae (ES) (p<0.05). Post hoc tests showed significant differences between squatting methods for the RA, EO, IO, and ES (p<0.017). Conclusion: The results of this study showed that squats combined with abdominal stabilization were more effective at activating core muscles than squats or overhead squats alone.

Adversarial Attacks on Reinforce Learning Model and Countermeasures Using Image Filtering Method (강화학습 모델에 대한 적대적 공격과 이미지 필터링 기법을 이용한 대응 방안)

  • Seungyeol Lee;Jaecheol Ha
    • Journal of the Korea Institute of Information Security & Cryptology
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    • v.34 no.5
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    • pp.1047-1057
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    • 2024
  • Recently, deep neural network-based reinforcement learning models have been applied in various advanced industrial fields such as autonomous driving, smart factories, and home networks, but it has been shown to be vulnerable to malicious adversarial attack. In this paper, we applied deep reinforcement learning models, DQN and PPO, to the autonomous driving simulation environment HighwayEnv and conducted three adversarial attacks: FGSM(Fast Gradient Sign Method), BIM(Basic Iterative Method), PGD(Projected Gradient Descent) and CW(Carlini and Wagner). In order to respond to adversarial attack, we proposed a method for deep learning models based on reinforcement learning to operate normally by removing noise from adversarial images using a bilateral filter algorithm. Furthermore, we analyzed performance of adversarial attacks using two popular metrics such as average of episode duration and the average of the reward obtained by the agent. In our experiments on a model that removes noise of adversarial images using a bilateral filter, we confirmed that the performance is maintained as good as when no adversarial attack was performed.

Two Cases of Corneal Edema Due to Vaporized Amine (기화된 아민에 의한 각막부종 2예)

  • Hwang, Yousook;Cho, Yang Kyung
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1077-1081
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    • 2018
  • Purpose: We report two cases of corneal edema in patients who presented with bilateral blurry vision due to vaporized amines while working in a polyurethane processing plant. Case summary: A 28-year-old male presented with bilateral blurred vision. His work involved solidifying polyurethane liquid and he often found himself exposed to polyurethane heat and gas. Purpose: We report two cases of corneal edema in patients who presented with bilateral blurry vision due to vaporized amines while working in a polyurethane processing plant. Case summary: A 28-year-old male presented with bilateral blurred vision. His work involved solidifying polyurethane liquid and he often found himself exposed to polyurethane heat and gas. On examination, the patient's uncorrected visual acuity (UCVA) was 20/40 (right) and 30/50 (left). A slit lamp examination revealed subepithelial microbullae in both eyes. The central corneal thickness (CCT) was also increased in both eyes, measuring $698{\mu}m$ (right) and $672{\mu}m$ (left). After prescribing 0.5% moxifloxacin and, 1% fluorometholone eye drops for 3 days in both eyes, the UCVA recovered to 20/40 (right) and 20/20 (left). The CCT decreased to $644{\mu}m$ (right) and $651{\mu}m$ (left), and the microbullae improved significantly in the left eye. The second patient was a 34-year-old female who presented with bilateral decreased visual acuity while at work. She worked in a factory that produced car seat filling. Her UCVA was 20/25 (right) and 20/20 (left). The CCT by specular microscopy was $537{\mu}m$ (right) and $541{\mu}m$ (left). On slit lamp examination, both eyes demonstrated bilateral central subepithelial edema. The patient did not attend any follow-up outpatient appointments after the initial presentation. Conclusions: Exposure to vaporized amines such as polyurethane may causereversible corneal toxicityeven without direct contact. Further consideration should be given to ocular safety and protection from amine compounds in the industrial field.On examination, the patient's uncorrected visual acuity (UCVA) was 20/40 (right) and 30/50 (left). A slit lamp examination revealed subepithelial microbullae in both eyes. The central corneal thickness (CCT) was also increased in both eyes, measuring $698{\mu}m$ (right) and $672{\mu}m$ (left). After prescribing 0.5% moxifloxacin and, 1% fluorometholone eye drops for 3 days in both eyes, the UCVA recovered to 20/40 (right) and 20/20 (left). The CCT decreased to $644{\mu}m$ (right) and $651{\mu}m$ (left), and the microbullae improved significantly in the left eye. The second patient was a 34-year-old female who presented with bilateral decreased visual acuity while at work. She worked in a factory that produced car seat filling. Her UCVA was 20/25 (right) and 20/20 (left). The CCT by specular microscopy was $537{\mu}m$ (right) and $541{\mu}m$ (left). On slit lamp examination, both eyes demonstrated bilateral central subepithelial edema. The patient did not attend any follow-up outpatient appointments after the initial presentation. Conclusions: Exposure to vaporized amines such as polyurethane may causereversible corneal toxicityeven without direct contact. Further consideration should be given to ocular safety and protection from amine compounds in the industrial field.