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Endoscopic Spine Surgery

  • Choi, Gun;Pophale, Chetan S;Patel, Bhupesh;Uniyal, Priyank
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.485-497
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    • 2017
  • Surgical treatment of the degenerative disc disease has evolved from traditional open spine surgery to minimally invasive spine surgery including endoscopic spine surgery. Constant improvement in the imaging modality especially with introduction of the magnetic resonance imaging, it is possible to identify culprit degenerated disc segment and again with the discography it is possible to diagnose the pain generator and pathological degenerated disc very precisely and its treatment with minimally invasive approach. With improvements in the optics, high resolution camera, light source, high speed burr, irrigation pump etc, minimally invasive spine surgeries can be performed with various endoscopic techniques for lumbar, cervical and thoracic regions. Advantages of endoscopic spine surgeries are less tissue dissection and muscle trauma, reduced blood loss, less damage to the epidural blood supply and consequent epidural fibrosis and scarring, reduced hospital stay, early functional recovery and improvement in the quality of life & better cosmesis. With precise indication, proper diagnosis and good training, the endoscopic spine surgery can give equally good result as open spine surgery. Initially, endoscopic technique was restricted to the lumbar region but now it also can be used for cervical and thoracic disc herniations. Previously endoscopy was used for disc herniations which were contained without migration but now days it is used for highly up and down migrated disc herniations as well. Use of endoscopic technique in lumbar region was restricted to disc herniations but gradually it is also used for spinal canal stenosis and endoscopic assisted fusion surgeries. Endoscopic spine surgery can play important role in the treatment of adolescent disc herniations especially for the persons who engage in the competitive sports and the athletes where less tissue trauma, cosmesis and early functional recovery is desirable. From simple chemonucleolysis to current day endoscopic procedures the history of minimally invasive spine surgery is interesting. Appropriate indications, clear imaging prior to surgery and preplanning are keys to successful outcome. In this article basic procedures of percutaneous endoscopic lumbar discectomy through transforaminal and interlaminar routes, percutaneous endoscopic cervical discectomy, percutaneous endoscopic posterior cervical foraminotomy and percutaneous endoscopic thoracic discectomy are discussed.

An Analysis of Paper and Pencil Test Items of Life Science I in High School (고등학교 생명 과학 I의 지필평가 문항 분석)

  • Lee, Donghoon;Jeong, Eunyoung
    • Journal of Science Education
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    • v.38 no.3
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    • pp.670-690
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    • 2014
  • The purpose of this study was to analyze paper and pencil test items of life science I in high school to diagnose problems of the test items developed by teachers, and to provide some implication for better assessment. 690 selection-type items and 162 supply-type items in life science I were collected from 10 general high schools. In the analysis of test items, the ratio of the selection-type item and the supply-type item was 81:19 in the number of items based on item type, while the ratio was 74.4:25.6 in the distribution of marks, indicating that the distribution of marks compared to the number of items was higher in the supply-type items. In the analysis by the Bloom's revised taxonomy of educational objectives, the items of 'conceptual knowledge' in the knowledge and those of 'understanding' in the cognition process were shown most in both the selection-type item and the supply-type item. In the analysis by the science assessment frameworks of NAEA, the items of 'knowledge' were shown 9 times more than those of 'inquiry'. When compared to the level of difficulty presented in the two-way specification table and the percentage of correct answers in the selection-type item, the concurrence was 41.5%. When compared to the ratio of number of items based on the item type of the supply-type items, the short-answer items were 34.0%, the descriptive items were 61.1%, and the drawing items were 4.9%. The drawing items were mainly developed in the unit of 'Cells and Continuity of Life'. When the descriptive items were classified by the acceptance of response, all the items were 'response restricted' type, and the items of 'restricted in content range' type among them were highest. When the items were classified by presentation of data, the items of 'presentation of data' type were highest(65.4%), and when classified by type of question, the items of 'knowledge description' type were highest(80.4%). In conclusion, it is needed to develop items belonging to 'inquiry' area more in the school, and to increase the ratio of the descriptive items, presenting various types of items.

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Effect of external-phosphorus supply on the phosphorus status of soybean nodules and the P-uptake system of isolated bacteroids (인산공급이 대두근류의 인산형태와 bacteroid의 인산흡수에 미치는 영향)

  • Sa, Tong-Min;Israel, Daniel W.
    • Applied Biological Chemistry
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    • v.34 no.2
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    • pp.117-124
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    • 1991
  • Soybean plants inoculated with Bradyrhizobium japonicum MN 110 were supplied with nutrient solutions containing 1.0, 0.25 and 0.5.nM-P to characterize the effect of externaI-P supply on the phosphorus status of nodules and on the P-uptake system of isolated bacteroids from nodules. After 48 days of growth, whole plant dry mass in the 0.25 and 0.05 mM-P treatments decreased significantly. The Pi concentrations in nodules were 4.1, 2.5 and 2.0 mM for 1.0, 0.25 and 0.05 mM-P treatments, respectively. The external-P supply did not significantly affect the distribution of phosphorus among inorganic phosphate(Pi), soluble organic-phosphorus(SOP) and insoluble organic-phosphorus(TOP) fractions in nodules. The Pi concentrations in young leaves of 0.25 and 0.05 mM-P plants were 33% and 20% , respectively, of those in young leaves of 1.0 mM-P plants and Pi concentrations in old leaves were only 16% and 7%, respectively, of those in old leaves of 1.0 mM-P plants. Phosphorus deficiency decreased the percentage of total leaf phosphorus in the Pi fraction and increased the percentage of total leaf phosphorus in the IOP fraction. The bacteroid number ranged from 0.87 to $1.30{\times}10^{11}$ Per GFW nodule regardless of external-P supply to the host Plants and Plant age, The P-uptake rates were the same (15-16 pmoles /min./$10^8$ bacteroids) for the bacteroids isolated from nodules of 1.0 mM-P and 0.05 mM-P plants. These results indicate that Pi concentrations in nodules of phosphorus-deficient plants are sufficient for proliferation of bacteroids and that the P-uptake system of bacteroids is in a repressed state even when host plant growth is severely restricted by phosphorus-deficiency stress.

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The Study of the Changeable Table Design with Units that made of Wasted Wood (소경단목재(小輕短木材) 접목을 활용한 유니트 가변형 테이블디자인 연구개발)

  • Kim, Myeong-Tae;Seo, Seok-Min
    • Journal of the Korea Furniture Society
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    • v.23 no.1
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    • pp.26-37
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    • 2012
  • This is the study about the New Formation Developement, the Changeable Table Design with Units that made of Wasted Wood to use restricted material rationally and to improve the space efficiency in the Table Design. We made some changeable table design with units that made of laminated wood wasted. And we found out the following formative characteristic and physical merits through this study. First, the space efficiency can be improve technically through the unit combination and organic transfomation of the specific form and a new method by laminated wood make the personal originality and the structral stability be built up. Second, there are some merits, moveable convenience and variable layout by the combination or transformation or personal fondness so that economical efficiency and variable of design can be improved. Third, we can remove original faults inside wood like a knot or not-uniform of wood organ when we laminate wood so that we use proper units that have original beauty of wood and can represent mild mood of furniture wholly. Fourth, much more strengthen tensile strength by the reciprocal action among the units that be made of laminated wood reduces wood's metamorphosis like bending or twisting so that the uniformity of wood can be gain and furniture's metamorphosis can be reduced. According to changes of nature environment, the difficulty of supply and demand for wood may be happen. According to changes of life style these days, supply and demand for environment friendly material, processing technique and developement of design to improve the efficiency of using space must be very important factor in morden furniture design. So we propose changeable furniture design by using new environment friendly meterial and processing method from this study.

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A Study on Residents Needs Survey and Analysis for Rural Village Development Planning - With Villages on Surrounding Area of Daecheong Dam - (개발제한구역의 농촌마을 개발 전략 수립을 위한 주민수요조사 분석 - 대청호변 마을을 중심으로 -)

  • Kim, Dae-Sik;Kwon, Yong-Dae;Kim, Jae-Hong
    • Korean Journal of Agricultural Science
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    • v.37 no.3
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    • pp.523-534
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    • 2010
  • This paper aims to develop a revitalized strategy for Daecheongdong district located on surrounding area of Daecheong dam, which general development projects are restricted by the acts of Green-belt area and Water supply protection zone. The study area consists of 13 villages in Donggu, Daejeon city. This study performed not only survey of amenity and human resources in the whole study area, but also development of new strategy integrating $1^{st}$, $2^{nd}$, and $3^{rd}$ industries for agriculture with potential. In the sample survey to 11% of village people, the new strategy was accepted positively with 88% of Understanding and 65% of Agreement in answer. The composition plans of farming association and total brand in the study area were agreed by 30% of residents with strong opinion. Representative groups of people living in Donggu, outside of the study area, have also positive opinion of 86% for Purchasing of agricultural products, 89% of Experience tourism, and 61% of Corporation for the study area, which the answering rate was 11% among 326 people. Finally, this study also investigated the corresponding Acts on performing of the new projects extracted in this study.

The effect of electronic commerce on the economy - logistics industry perspective - (전자상거래가 경제에 미치는 효과 - 물류 정보화를 중심으로 -)

  • 김범환
    • Proceedings of the Technology Innovation Conference
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    • 1999.12a
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    • pp.281-295
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    • 1999
  • This paper analyses the effects of the increase of logistics outsourcing on the economy which are largely classified into three parts. The firm level and industry level are two among them which will be summarized below. The another is consumers level. On the fm level, the logistics outsourcing of a manufacturing firm not only helps to increase the efficiency of itself and but also confront the competitive environments by weakening the entry barriers, i.e., the emergence of contestable market. The reasons why the efficiency of the firm enhances are also largely divided into two parts. One is due to the reduction of inventory cost by replacing it by the information cost resulting from internet use. The other is owing to reducing the life cycle of production process by the emergence of virtual enterprises which are located in one point in De process of supply chain management. The weakening of entry barriers is directly affected by the drastic increase of internet users in twofold reasons: one is based on the restricted competitive characteristics due to the long-term transaction relationship between logistics providers and the companies who offer logistics services and the other, due to the weakening of the restriction of space and time. The effect of industry level is due to the transition of traditional to virtual vertical integration system The firms corresponding to a connection point in the process of supply chain management would try to realize both the scale of economy and the scope of economy for strengthening the competitiveness. We indicated above the emergence of contestable market however, it is a short-term phenomenon and result in the oligopoly market due to the entry barriers in the long-run sense.

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Nutritional Intervention Through Ketogenic Diet in GLUT1 Deficiency Syndrome

  • Young-Sun Kim;Woojeong Kim;Ji-Hoon Na;Young-Mock Lee
    • Clinical Nutrition Research
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    • v.12 no.3
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    • pp.169-176
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    • 2023
  • Glucose transporter type 1 (GLUT1) deficiency syndrome (DS) is a metabolic brain disorder caused by a deficiency resulting from SLC2A1 gene mutation and is characterized by abnormal brain metabolism and associated metabolic encephalopathy. Reduced glucose supply to the brain leads to brain damage, resulting in delayed neurodevelopment in infancy and symptoms such as eye abnormalities, microcephaly, ataxia, and rigidity. Treatment options for GLUT1 DS include ketogenic diet (KD), pharmacotherapy, and rehabilitation therapy. Of these, KD is an essential and the most important treatment method as it promotes brain neurodevelopment by generating ketone bodies to produce energy. This case is a focused study on intensive KD nutritional intervention for an infant diagnosed with GLUT1 DS at Gangnam Severance Hospital from May 2022 to January 2023. During the initial hospitalization, nutritional intervention was performed to address poor intake via the use of concentrated formula and an attempt was made to introduce complementary feeding. After the second hospitalization and diagnosis of GLUT1 DS, positive effects on the infant's growth and development, nutritional status, and seizure control were achieved with minimal side effects by implementing KD nutritional intervention and adjusting the type and dosage of anticonvulsant medications. In conclusion, for patients with GLUT1 DS, it is important to implement a KD with an appropriate ratio of ketogenic to nonketogenic components to supply adequate energy. Furthermore, individualized and intensive nutritional management is necessary to improve growth, development, and nutritional status.

The Experimental Study on the Application of the Insulated Glass PV Module in the Curtain Wall (단열 복층유리 PV의 커튼 월 적용 가능성에 관한 실험적 연구)

  • Oh, Min-Seok;Kim, Hway-Suh
    • Journal of the Korean Solar Energy Society
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    • v.26 no.3
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    • pp.63-69
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    • 2006
  • In order to positively cope with the international environmental regulations like UNFCCC (UN Framework Convention on Climate Change) and to overcome energy crisis Korea, who depends on import for more than 97% of required energy, needs to continuously proceed to development, spread and expansion of alternativeenergy and then, to cultivate the capacity to keep the balance of demand and supply of energy by itself. In this aspect, the technology of BIPV (Building Integrated Photovoltaic) is the field that the world is most interested in. However, at present, this technology is centered on increasing the efficiency of the module itself so it has lots of problems to be applied to buildings. Application of the integrated PV system in building external curtain wall can obtain much more generation of electric power than in roof-types whose area for installation is restricted, so it is excellent in terms of its possibility of application. Therefore, this paper intends to advance its practical use by proposing how to get integrated PV system which can be applied to building external curtain wall, and how to apply it.

Taper Reduction in Micro Electrochemical Milling Using Disk-type Electrode (디스크 전극을 이용한 미세 전해 밀링 가공에서의 테이퍼 형상 방지)

  • Kim Bo Hyun;Lee Young Soo;Choi Deok Ki;Chu Chong Nam
    • Journal of the Korean Society for Precision Engineering
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    • v.22 no.4
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    • pp.167-172
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    • 2005
  • In this paper. micro electrochemical machining (ECM) for micro structure fabrications is presented. By applying ultra short pulses. the chemical reaction can be restricted only to the region very close to the electrode. Micro ECM is applied to machining micro structures through electrochemical milling process becasuse it doesn't suffer from tool wear. Using this method. 3D micro structures were machined on stainless steel. It was found that micro machining is possible with good surface quality in the low concentration electrolyte,0.1 M H₂SO₄. In ECM, as the machining depth increases, better flushing of electrolyte is required for sufficient ion supply. Layer-by-layer milling is advantageous in flushing. However, layer-by-layer milling causes taper of structures. To reduce the taper, application of a disk-type electrode was introduced. By electrochemical milling, various 3D micro structures including a hemisphere with 60 ㎛ diameter were fabricated.

Analysis of a New Current-Fed DC-DC Converter with the Double Outputs (이중출력을 갖는 새로운 전류환류형 DC-DC 컨버터의 해석)

  • Hong, S.M.;Kim, C.S.;Kim, H.J.
    • Proceedings of the KIEE Conference
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    • 1997.07f
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    • pp.2033-2036
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    • 1997
  • In this paper, we proposed a novel current-fed DC-DC converter with multi-output. It has two winding reactor in series with the input source of the converter. By using the 2nd winding recycling the energy stored in the reactor to the input, the double-outputs DC-DC converter can be created, which makes it a good choice for a multi-output power supply with more outputs and has savings in cost and space. The steady state and dynamic characteristics of the converter are analyzed in detail by using the state space averaging method. It is found that the maximum value of $V_{o2}$ exists in the 2nd output and also during the MOSFET off period, the energy stored in the magnetizing inductance is reset through auxiliary winding $N_3$, so the duty cycle is restricted to 50%. Theoretical and experimental results were taken from the converter rated at switching frequency 50kHz. input voltage 50V. output voltage 5V. 12V and output power 65W. As a result, both results were well consistent. Therefore, it is varified the validity of the proposed converter in this paper.

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