• Title/Summary/Keyword: Direct Treatment

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Arthroscopic Iliopsoas Tenotomy of Iliopsoas Impingement after Total Hip Arthroplasty (고관절 전치환술 후 발생한 장요건 충돌의 관절경하 장요건 절단술)

  • Huh, Soon Ho;Choi, Byeong Yeol;Han, Sang Roc;Chung, Woo Chull
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.125-133
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    • 2021
  • Purpose: The clinical outcomes were investigated to determine if arthroscopic management is a useful method for 19 hips with iliopsoas tendon impingement (IPI) after total hip arthroplasty (THA). Materials and Methods: Eighteen patients (19 hips), who complained of groin pain and flexion pain that persisted after THA from September 2013 to December 2019, were the subjects of this investigation. The mean time to manifestation after THA was four months (range, 1-9 months) in patients of an average age of 60 years (range, 50-69 years). Thirteen out of 18 patients underwent THA using the direct anterior approach and five by the lateral approach. IPI was diagnosed by the medical history, physical examination, blood test, radiographic examination using X-ray and computed tomography, and topical injection therapy. All patients underwent arthroscopic treatment and a dynamic arthroscopic physical examination after exposure to the iliopsoas tendon revealed impingement. Tenotomy was then performed on the muscle portion through the total tendon portion. Symptoms and pain levels of preoperative, postoperative and follow-up period were investigated and compared. Results: The Western Ontario and McMaster Universities Osteoarthritis Index score decreased from an average of 58.4 (range, 40-88) before surgery to an average of 35.0 (range, 15-76) after surgery. Similarly, the visual analogue scale decreased from an average of 4.0 (range, 2-6) before surgery to an average of 1.4 (range, 0-4) after surgery. Sixteen patients (88.9%) showed pain relief and improvement in the straight leg raise test, and two patients showed postoperative muscle weakness and sustained pain. In the follow-up period, muscle weakness improved. One patient underwent arthroscopic iliopsoas tenotomy at the lesser trochanteric level but the symptoms persisted. The clinical symptoms were improved after one more tenotomy at the joint level. Conclusion: Arthroscopic iliopsoas tenotomy performed in patients with IPI after THA showed good clinical results.

Study on Causes and Countermeasures for the Mass Death of Fish in Reservoirs in Andong-si (안동시 저수지에서의 대량 어류 폐사에 대한 원인과 대책에 관한 연구)

  • Su Ho Bae;Sun Jin Hwang;Youn Jung Kim;Cheol Ho Jeong;Seong Yun Kim;Keon Sang Ryoo
    • Korean Journal of Environmental Agriculture
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    • v.42 no.1
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    • pp.52-62
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    • 2023
  • This study focused on determining the specific causes and prevention methods of mass fish deaths occurred in five reservoirs (Gagugi, Neupgokgi, Danggokgi, Sagokji, and Hangokji) in Andong-si. For this purpose, a survey of agricultural land and livestock in the upper part of the reservoirs and analysis of water quality in the reservoir irrespective of whether it rains or not were conducted. We attempted to examine the changes in dissolved oxygen (DO) in the surface and bottom layers of reservoirs and changes in DO depending on the amount of livestock compost and time. Based on the above investigations, treatment plans were established to efficiently control the inflow of contaminated water into reservoirs. The rainfall and farmland areas in the upper part of the reservoir were investigated using Google and aviation data provided by the Ministry of Land, Infrastructure, and Transport. The current status of livestock farms distributed around the reservoirs was also examined because compost from these farms can flow into the reservoir when it rains. Various water quality parameters, such as phosphate phosphorus (PO4-P) and ammonium nitrogen (NH3-N), were analyzed and compared for each reservoir during the rainy season. Changes in the DO concentration and electrical conductivity (EC) were also observed at the inlet of the reservoir during raining using an automated instrument. In addition, DO was measured until the concentration reached 0 ppm in 10 min by adding livestock compost at various concentrations (0.05%, 0.1%, 0.3%, and 0.5% by wt.), where the concentration of the livestock compost represents the relative weight of rainwater. The DO concentration in the surface layer of reservoirs was 3.7 to 5.3 ppm, which is sufficient for fish survival. However, the fish could not survive at the bottom layer with DO concentration of 0.0-2.1 ppm. When the livestock compost was 0.3%, DO required 10-19 h to reach 0 ppm. Considering these results, it was confirmed that the DO in the bottom layer of the reservoir could easily change to an anaerobic state within 24 h when the livestock compost in the rainwater exceeds 0.3%. The results show that the direct cause of fish mortality is the inflow of excessive livestock compost into reservoirs during the first rainfall in spring. All the surveyed reservoirs had relatively good topographical features for the inflow of compost generated from livestock farms. This keeps the bottom layer of the reservoir free of oxygen. Therefore, to prevent fish death due to insufficient DO in the reservoir, measures should be undertaken to limit the amount of livestock compost flowing into the reservoir within 0.3%, which has been experimentally determined. As a basic countermeasure, minerals such as limestone, dolomite, and magnesia containing calcium and magnesium should be added to the compost of livestock farms around the reservoir. These minerals have excellent pollutant removal capabilities when sprayed onto the compost. In addition, measures should be taken to prevent fish death according to the characteristics of each reservoir.

Influence of Artificial Rainfall on Wheat Grain Quality During Ripening by Using the Speed-breeding System (세대단축시스템을 이용한 국내 밀 품종의 등숙기 강우에 의한 품질변이 평가)

  • Hyeonjin Park;Jin-Kyung Cha;So-Myeong Lee;Youngho Kwon;Jisu Choi;Ki-Won Oh;Jong-Hee Lee
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.68 no.3
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    • pp.188-196
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    • 2023
  • Wheat (Triticum aestivum L.) is an important crop in Korea, with a per capita consumption of 31.6 kg in 2019. In the southern region, wheat is grown after paddy rice, and it is harvested during the rainy season in mid-June. This timing, in combination with high humidity and untimely rainfall, activates the enzyme alpha-amylase, which breaks down starch in the wheat grains. As a result, sprouted grains have lower quality and value for flour. However, seeds that absorb water before sprouting are expected to maintain better quality. The aim of the study was to identify the critical period during wheat maturation when rainfall has the greatest impact on grain quality, to prevent price declines due to quality deterioration. Two wheat cultivars, Jokyoung and Hwanggeumal, were grown in a speed breeding room, and artificial rainfall was applied at different times after heading (30, 35, 40, 45, 50, and 55 days). The proportion of vitreous grains decreased from 40 to 55 days after heading (DAH). Both cultivars had chalky grain sections from 35 DAH, with Hwanggeumal having a higher proportion of vitreous grains. Starch degradation was observed using FE-SEM (Field Emission Scanning Electron Microscope) at 40 DAH for Jokyoung and 50 DAH for Hwanggeumal. Color measurements indicated increased L and E values from 40 DAH, with rain treatment at 55 DAH leading to a significant increase in L values for both cultivars. Ash content increased at 45 DAH, whereas SDSS decreased at 35 DAH. Overall, grain quality from 40 DAH until harvest was found to be affected to the greatest extent by direct exposure of the spikes to moisture. Red wheat showed better quality than white wheat. These findings have implications for the cultivation of high-quality wheat and can guide future research efforts in this area.

Consideration on Shielding Effect Based on Apron Wearing During Low-dose I-131 Administration (저용량 I-131 투여시 Apron 착용여부에 따른 차폐효과에 대한 고찰)

  • Kim, Ilsu;Kim, Hosin;Ryu, Hyeonggi;Kang, Yeongjik;Park, Suyoung;Kim, Seungchan;Lee, Guiwon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.1
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    • pp.32-36
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    • 2016
  • Purpose In nuclear medicine examination, $^{131}I$ is widely used in nuclear medicine examination such as diagnosis, treatment, and others of thyroid cancer and other diseases. $^{131}I$ conducts examination and treatment through emission of ${\gamma}$ ray and ${\beta}^-$ ray. Since $^{131}I$ (364 keV) contains more energy compared to $^{99m}Tc$ (140 keV) although it displays high integrated rate and enables quick discharge through kidney, the objective of this study lies in comparing the difference in exposure dose of $^{131}I$ before and after wearing apron when handling $^{131}I$ with focus on 3 elements of external exposure protection that are distance, time, and shield in order to reduce the exposure to technicians in comparison with $^{99m}Tc$ during the handling and administration process. When wearing apron (in general, Pb 0.5 mm), $^{99m}Tc$ presents shield of over 90% but shielding effect of $^{131}I$ is relatively low as it is of high energy and there may be even more exposure due to influence of scattered ray (secondary) and bremsstrahlung in case of high dose. However, there is no special report or guideline for low dose (74 MBq) high energy thus quantitative analysis on exposure dose of technicians will be conducted based on apron wearing during the handling of $^{131}I$. Materials and Methods With patients who visited Department of Nuclear Medicine of our hospital for low dose $^{131}I$ administration for thyroid cancer and diagnosis for 7 months from Jun 2014 to Dec 2014 as its subject, total 6 pieces of TLD was attached to interior and exterior of apron placed on thyroid, chest, and testicle from preparation to administration. Then, radiation exposure dose from $^{131}I$ examination to administration was measured. Total procedure time was set as within 5 min per person including 3 min of explanation, 1 min of distribution, and 1 min of administration. In regards to TLD location selection, chest at which exposure dose is generally measured and thyroid and testicle with high sensitivity were selected. For preparation, 74 MBq of $^{131}I$ shall be distributed with the use of $2m{\ell}$ syringe and then it shall be distributed after making it into dose of $2m{\ell}$ though dilution with normal saline. When distributing $^{131}I$ and administering it to the patient, $100m{\ell}$ of water shall be put into a cup, distributed $^{131}I$ shall be diluted, and then oral administration to patients shall be conducted with the distance of 1m from the patient. The process of withdrawing $2m{\ell}$ syringe and cup used for oral administration was conducted while wearing apron and TLD. Apron and TLD were stored at storage room without influence of radiation exposure and the exposure dose was measured with request to Seoul Radiology Services. Results With the result of monthly accumulated exposure dose of TLD worn inside and outside of apron placed on thyroid, chest, and testicle during low dose $^{131}I$ examination during the research period divided by number of people, statistics processing was conducted with Wilcoxon Signed Rank Test using SPSS Version. 12.0K. As a result, it was revealed that there was no significant difference since all of thyroid (p = 0.345), chest (p = 0.686), and testicle (p = 0.715) were presented to be p > 0.05. Also, when converting the change in total exposure dose during research period into percentage, it was revealed to be -23.5%, -8.3%, and 19.0% for thyroid, chest, and testicle respectively. Conclusion As a result of conducting Wilcoxon Signed Rank Test, it was revealed that there is no statistically significant difference (p > 0.05). Also, in case of calculating shielding rate with accumulate exposure dose during 7 months, it was revealed that there is irregular change in exposure dose for inside and outside of apron. Although the degree of change seems to be high when it is expressed in percentage, it cannot be considered a big change since the unit of accumulated exposure dose is in decimal points. Therefore, regardless of wearing apron during high energy low dose $^{131}I$ administration, placing certain distance and terminating the administration as soon as possible would be of great assistance in reducing the exposure dose. Although this study restricted $^{131}I$ administration time to be within 5 min per person and distance for oral administration to be 1m, there was a shortcoming to acquire accurate result as there was insufficient number of N for statistics and it could be processed only through non-parametric method. Also, exposure dose per person during lose dose $^{131}I$ administration was measured with accumulated exposure dose using TLD rather than through direct-reading exposure dose thus more accurate result could be acquired when measurement is conducted using electronic dosimeter and pocket dosimeter.

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Investigation of Study Items for the Patterns of Care Study in the Radiotherapy of Laryngeal Cancer: Preliminary Results (후두암의 방사선치료 Patterns of Care Study를 위한 프로그램 항목 개발: 예비 결과)

  • Chung Woong-Ki;Kim I1-Han;Ahn Sung-Ja;Nam Taek-Keun;Oh Yoon-Kyeong;Song Ju-Young;Nah Byung-Sik;Chung Gyung-Ai;Kwon Hyoung-Cheol;Kim Jung-Soo;Kim Soo-Kon;Kang Jeong-Ku
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.299-305
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    • 2003
  • Purpose: In order to develop the national guide-lines for the standardization of radiotherapy we are planning to establish a web-based, on-line data-base system for laryngeal cancer. As a first step this study was performed to accumulate the basic clinical information of laryngeal cancer and to determine the items needed for the data-base system. Materials and Methods: We analyzed the clinical data on patients who were treated under the diagnosis of laryngeal cancer from January 1998 through December 1999 In the South-west area of Korea. Eligiblity criteria of the patients are as follows: 18 years or older, currently diagnosed with primary epithelial carcinoma of larynx, and no history of previous treatments for another cancers and the other laryngeal diseases. The items were developed and filled out by radiation oncologlst who are members of forean Southwest Radiation Oncology Group. SPSS vl0.0 software was used for statistical analysis. Results: Data of forty-five patients were collected. Age distribution of patients ranged from 28 to 88 years(median, 61). Laryngeal cancer occurred predominantly In males (10 : 1 sex ratio). Twenty-eight patients (62$\%$) had primary cancers in the glottis and 17 (38$\%$) in the supraglottis. Most of them were diagnosed pathologically as squamous cell carcinoma (44/45, 98$\%$). Twenty-four of 28 glottic cancer patients (86$\%$) had AJCC (American Joint Committee on Cancer) stage I/II, but 50$\%$ (8/16) had In supraglottic cancer patients (p=0.02). Most patients(89$\%$) had the symptom of hoarseness. indirect laryngoscopy was done in all patients and direct laryngoscopy was peformed in 43 (98$\%$) patients. Twenty-one of 28 (75$\%$) glottic cancer cases and 6 of 17 (35$\%$) supraglottic cancer cases were treated with radiation alone, respectively. The combined treatment of surgery and radiation was used in 5 (18$\%$) glottic and 8 (47$\%$) supraglottic patients. Chemotherapy and radiation was used in 2 (7$\%$) glottic and 3 (18$\%$) supraglottic patients. There was no statistically significant difference in the use of combined modality treatments between glottic and supraglottic cancers (p=0.20). In all patients, 6 MV X-ray was used with conventional fractionation. The iraction size was 2 Gy In 80$\%$ of glottic cancer patients compared with 1.8 Gy in 59$\%$ of the patients with supraglottic cancers. The mean total dose delivered to primary lesions were 65.98 ey and 70.15 Gy in glottic and supraglottic patients treated, respectively, with radiation alone. Based on the collected data, 12 modules with 90 items were developed or the study of the patterns of care In laryngeal cancer. Conclusion: The study Items for laryngeal cancer were developed. In the near future, a web system will be established based on the Items Investigated, and then a nation-wide analysis on laryngeal cancer will be processed for the standardization and optimization of radlotherapy.

Consumer Awareness and Evaluation of Retailers' Social Responsibility: An Exploratory Approach into Ethical Purchase Behavior from a U.S Perspective (소비자인지도화령수상사회책임(消费者认知度和零售商社会责任): 종미국시각출발적도덕구매행위적탐색성연구(从美国视角出发的道德购买行为的探索性研究))

  • Lee, Min-Young;Jackson, Vanessa P.
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.1
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    • pp.49-58
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    • 2010
  • Corporate social responsibility has become a very important issue for researchers (Greenfield, 2004; Maignan & Ralston, 2002; McWilliams et al., 2006; Pearce & Doh 2005), and many consider it necessary for businesses to define their role in society and apply social and ethical standards to their businesses (Lichtenstein et al., 2004). As a result, a significant number of retailers have adopted CSR as a strategic tool to promote their businesses. To this end, this study sought to discover U.S. consumers' attitudes and behavior in ethical purchasing and consumption based on their subjective perception and evaluation of a retailer. The objectives of this study include: 1) determine the participants awareness of retailers corporate social responsibility; 2) assess how participants evaluate retailers corporate social responsibility; 3) examine whether participants evaluation process of retailers CSR influence their attitude toward the retailer; and 4) assess if participants attitude toward the retailers CSR influence their purchase behavior. This study does not focus on actual retailers' CSR performance because a consumer's decision making process is based on an individual assessment not an actual fact. This study examines US college students' awareness and evaluations of retailers' corporate social responsibility (CSR). Fifty six college students at a major Southeastern university participated in the study. The age of the participants ranged from 18 to 26 years old. Content analysis was conducted with open coding and focused coding. Over 100 single-spaced pages of written responses were collected and analyzed. Two steps of coding (i.e., open coding and focused coding) were conducted (Esterberg, 2002). Coding results and analytic memos were used to understand participants' awareness of CSR and their ethical purchasing behavior supported through the selection and inclusion of direct quotes that were extracted from the written responses. Names used here are pseudonyms to protect confidentiality of participants. Participants were asked to write about retailers, their aware-ness of CSR issues, and to evaluate a retailer's CSR performance. A majority (n = 28) of respondents indicated their awareness of CSR but have not felt the need to act on this issue. Few (n=8) indicated that they are aware of this issue but not greatly concerned. Findings suggest that when college students evaluate retailers' CSR performance, they use three dimensions of CSR: employee support, community support, and environmental support. Employee treatment and support were found as an important criterion in evaluation of retailers' CSR. Respondents indicated that their good experience with a retailer as an employee made them have a positive perception and attitude toward the retailer. Regarding employee support four themes emerged: employee rewards and incentives based on performance, working environment, employee education and training program, and employee and family discounts. Well organized rewards and incentives were mentioned as an important attribute. The factors related to the working environment included: how well retailers follow the rules related to working hours, lunch time and breaks was also one of the most mentioned attributes. Regarding community support, three themes emerged: contributing a percentage of sales to the local community, financial contribution to charity organizations, and events for community support. Regarding environments, two themes emerged: recycling and selling organic or green products. It was mentioned in the responses that retailers are trying to do what they can to be environmentally friendly. One respondent mentioned that the company is creating stores that have an environmentally friendly design. Information about what the company does to help the environment can easily be found on the company’s website as well. Respondents have also noticed that the stores are starting to offer products that are organic and environmentally friendly. A retailer was also mentioned by a respondent in this category in reference to how the company uses eco-friendly cups and how they are helping to rebuild homes in New Orleans. The respondents noticed that a retailer offers reusable bags for their consumers to purchase. One respondent stated that a retailer uses its products to help the environment, through offering organic cotton. After thorough analysis of responses, we found that a participant's evaluation of a retailers' CSR influenced their attitudes towards retailers. However, there was a significant gap between attitudes and purchasing behavior. Although the participants had positive attitudes toward retailers CSR, the lack of funds and time influenced their purchase behavior. Overall, half (n=28) of the respondents mentioned that CSR performance affects their purchasing decisions making when shopping. Findings from this study provide support for retailers to consider their corporate social responsibility when developing their image with the consumer. This study implied that consumers evaluate retailers based on employee, community and environmental support. The evaluation, attitude and purchase behavior of consumers seem to be intertwined. That is, evaluation is based on the knowledge the consumer has of the retailers CSR. That knowledge may influence their attitude toward the retailer and thus influence their purchase behavior. Participants also indicated that having CSR makes them think highly of the retailer, but it does not influence their purchase behavior. Price and convenience seem to surpass the importance of CSR among the participants. Implications, recommendations for future research, and limitations of the study are also discussed.

Early and Mid-term Results of Operation for Infective Endocarditis on Mitral Valve (감염성 승모판 심내막염의 중단기 수술 성적)

  • Ahn, Byong-Hee;Chun, Joon-Kyung;Yu, Ung;Ryu, Sang-Wan;Choi, Yong-Sun;Kim, Byong-Pyo;Hong, Sung-Bum;Bum, Min-Sun;Na, Kook-Ju;Park, Jong-Chun;Kim, Sang-Hyung
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.27-34
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    • 2004
  • Background: Infective endocarditis shows higher operative morbidity and mortality rates than other cardiac diseases. The vast majority of studies on infective endocarditis have been made on aortic endocarditis, with little attention having been paid to infective endocarditis on the mitral valve. This study attempts to investigate the clinical aspects and operative results of infective endocarditis on the mitral valve. Meterial and Method: The subjects of this study consist of 23 patients who underwent operations for infective endocariditis on the mitral valve from June 1995 to May 2003. Among them, 2 patients suffered from prosthetic valvular endocarditis and the other 21 from native valvular endocarditis. The subjects were evenly distributed age-wise with an average age of 44.8$\pm$15.7 (11∼66) years. Emergency operations were performed on seventeen patients (73.9%) due to large vegetation or instable hemodynamic status. In preoperative examinations, twelve patients exhibited congestive heart failure, four patients renal failure, two patients spleen and renal infarction, and two patients temporary neurological defects, while one patient had a brain abscess. Based on the NYHA functional classification, seven patients were determined to be at Grade II, 9 patients at Grade III, and 6 patients at Grade IV. Vegetations were detected in 20 patients while mitral regurgitation was dominant in 19 patients with 4 patients showing up as mitral stenosis dominant on the preoperative echocardiogram. Blood cultures for causative organisms were performed on all patients, and positive results were obtained from ten patients, with five cases of Streptococcus viridance, two cases of methicillin-sensitive Staphylococcus aureus, and one case each of Corynebacteriurn, Haemophillis, and Gernella. Operations were decided according to the AA/AHA guidelines (1988). The mean follow-up period was 27.6 $\pm$23.3 (1 ∼ 97) months. Result: Mitral valve replacements were performed on 43 patients, with mechanical valves being used on 9 patients and tissue valves on the other 4. Several kinds of mitral valve repair or mitral valvuloplasty were carried out on the remaining 10 patients. Associated procedures included six aortic valve replacements, two tricuspid annuloplasty, one modified Maze operation, and one direct closure of a ventricular septal defect. Postoperative complications included two cases of bleeding and one case each of mediastinitis, low cardiac output syndrome, and pneumonia. There were no cases of early deaths, or death within 30 days following the operation. No patient died in the hospital or experienced valve related complications. One patient, however, underwent mitral valvuloplasty 3 months after the operation. Another patient died from intra-cranial hemorrhage in the 31st month after the operation. Therefore, the valve-related death rate was 4.3%, and the valve-related complication rate 8.6% on mid-term follow-up. 1, 3-, and 5-year valve- related event free rates were 90.8%, 79.5%, and 79.5%, respectively, while 1, follow-up. 1, 3-, and 5-year valve- related event free rates were 90.8%, 79.5%, and 79.5%, respectively, while 1, 3-, and 5-year survival rates were 100%, 88.8%, and 88.8%, respectively. Conclusion: The findings suggest that a complete removal of infected tissues is essential in the operative treatment of infectious endocarditis of the mitral valve. It is also suggested that when infected tissues are completely removed, neither type of material nor method of operation has a significant effect on the operation result. The postoperative results also suggest the need for a close follow-up observation of the patients suspected of having brain damage, which is caused by preoperative blood contamination or emboli from vegetation, for a possible cerebral vascular injury such as mycotic aneurysm.