• Archives of Hand and Microsurgery
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• v.23 no.4
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• pp.223-229
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• 2018

Purpose: A number of procedures were introduced to stabilize the 1st metacarpal bone after resection of the trapezium in the thumb carpometacarpal joint (CMCJ) arthroplasty. However, some surgical procedures may inevitably damage normal structures, such as harvesting tendons or drilling of a bone for tendon passage. Suture suspension arthroplasty is relatively less invasive and easier to perform than the previously described surgical methods. The purpose of this study was to report the therapeutic efficiency of the suture suspension arthroplasty. Methods: We retrospectively reviewed 12 patients who underwent suture suspension arthroplasty for the treatment of thumb CMCJ arthritis. Pain visual analogue scale (VAS), satisfaction about surgical outcomes, and the disabilities of the arm, shoulder and hand (DASH) scores were measured to evaluate the functional outcomes and the Trapezial Space Ratios were measured. Satisfaction was measured in the range of "very dissatisfied" (0) to "very satisfied" (10). Results: The mean follow-up period was 23 months. Pain VAS score improved significantly from 7.0 to 2.9 (p<0.05). And mean satisfaction scale was 6.9. However, there was no significant difference in DASH scores between before and after surgery (p=0.06). The mean trapezial space ratio was calculated to be 0.45 before surgery, 0.33 immediately after surgery, 0.23 at the last follow-up. Conclusion: Suture suspension arthroplasty is a satisfactory surgical procedure. And compared with other procedures, there is no significant difference in the reduction of the trapezial space. It may be useful in advanced thumb CMCJ arthritis.

• Journal of Environmental Policy
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• v.13 no.4
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• pp.3-49
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• 2014

Growing interest of stakeholders on corporate responsibilities for environment and tightening environmental regulations are highlighting the importance of environmental management more than ever. However, companies' awareness of the importance of environment is still falling behind, and related academic works have not shown consistent conclusions on the relationship between environmental performance and economic performance. One of the reasons is different ways of measuring these two performances. The evaluation scope of economic performance is relatively narrow and the performance can be measured by a unified unit such as price, while the scope of environmental performance is diverse and a wide range of units are used for measuring environmental performances instead of using a single unified unit. Therefore, the results of works can be different depending on the performance indicators selected. In order to resolve this problem, generalized and standardized performance indicators should be developed. In particular, the performance indicators should be able to cover the concepts of both environmental and economic performances because the recent idea of environmental management has expanded to encompass the concept of sustainability. Another reason is that most of the current researches tend to focus on the motive of environmental investments and environmental performance, and do not offer a guideline for an effective implementation strategy for environmental management. For example, a process improvement strategy or a market discrimination strategy can be deployed through comparing the environment competitiveness among the companies in the same or similar industries, so that a virtuous cyclical relationship between environmental and economic performances can be secured. A novel method for measuring eco-efficiency by utilizing Data Envelopment Analysis (DEA), which is able to combine multiple environmental and economic performances, is proposed in this report. Based on the eco-efficiencies, the environmental competitiveness is analyzed and the optimal combination of inputs and outputs are recommended for improving the eco-efficiencies of inefficient firms. Furthermore, the panel analysis is applied to the causal relationship between eco-efficiency and economic performance, and the pooled regression model is used to investigate the relationship between eco-efficiency and economic performance. The four-year eco-efficiencies between 2010 and 2013 of 23 companies are obtained from the DEA analysis; a comparison of efficiencies among 23 companies is carried out in terms of technical efficiency(TE), pure technical efficiency(PTE) and scale efficiency(SE), and then a set of recommendations for optimal combination of inputs and outputs are suggested for the inefficient companies. Furthermore, the experimental results with the panel analysis have demonstrated the causality from eco-efficiency to economic performance. The results of the pooled regression have shown that eco-efficiency positively affect financial perform ances(ROA and ROS) of the companies, as well as firm values(Tobin Q, stock price, and stock returns). This report proposes a novel approach for generating standardized performance indicators obtained from multiple environmental and economic performances, so that it is able to enhance the generality of relevant researches and provide a deep insight into the sustainability of environmental management. Furthermore, using efficiency indicators obtained from the DEA model, the cause of change in eco-efficiency can be investigated and an effective strategy for environmental management can be suggested. Finally, this report can be a motive for environmental management by providing empirical evidence that environmental investments can improve economic performance.

• Sleep Medicine and Psychophysiology
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• v.24 no.1
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• pp.24-31
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• 2017

Objectives: Periodic limb movement disorder (PLMD) has been debated with regard to its clinical significance and diagnostic criteria. The current diagnostic criterion for PLMD in adults has been changed from periodic limb movement index (PLMI) > 5/hour to PLMI > 15/hour by the International Classification of Sleep Disorders (ICSD). In this study, we aimed to investigate the changes in polysomnographic sleep variables according to PLMI and to determine the relevance of the diagnostic criterion for PLMD. Methods: Out of 4195 subjects who underwent standard polysomnography, we selected 666 subjects (370 males and 296 females, aged $47.1{\pm}14.8$) who were older than 17 years and were not diagnosed with primary insomnia, sleep apnea, narcolepsy, or REM sleep behavior disorder. Subjects were divided into three groups according to PLMI severity: group 1 ($PLMI{\leq}5$), group 2 (5 < $PLMI{\leq}15$), and group 3 (PLMI > 15). Demographic and polysomnographic sleep variables and Epworth sleepiness scale (ESS) were compared among the three groups. Results: There were significant differences among the three groups in age and gender. Sleep efficiency (SE) and stage 3 sleep percentage in group 1 were significantly higher than those in groups 2 and 3. The wake after sleep onset (WASO) score in group 1 was significantly lower than those in groups 2 and 3. However, there were no significant differences in SE, stage 3 sleep percentage, or WASO between groups 2 and 3. Sleep latency (SL) in group 1 was significantly lower than that in group 3, but there was no difference in SL between group 2 and group 3. ESS score in group 1 was significantly higher than that in group 3, but there was no difference between group 2 and group 3. Partial correlation analysis adjusted by age showed that PLMI was significantly related to SE and WASO. Conclusion: This study suggests that PLMI influences polysomnographic sleep variables. In addition, we found the individuals who did not have PLMD but had PLMI > 5 were not different in polysomnographic sleep variables from the individuals who had PLMD according to the current criterion. These results raise questions about the relevance of the current diagnostic criterion of PLMD.

• Journal of Korean Society of Water and Wastewater
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• v.29 no.2
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• pp.261-269
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• 2015

In this study, we applied a membrane distillation process to investigate a feasibility of treating a wastewater with high concentration of organic matters including nitrogen and phosphorus. The laboratory scale experiment was performed by using a hydrophobic PVDF membrane with the pore size of $0.22{\mu}m$ and porosity of 75%. The installation was direct contact type where the temperature difference between a feed and permeate side was controlled to have a range from 20 to $60^{\circ}C$. We observed a flux variation and a concentration changes of COD, $PO{_4}^{3-}$-P, $NH_4{^+}$-N and conductivity of feed side as well as permeate side with various temperature differences (20 to $60^{\circ}C$), cross flow velocities (0.09 to 0.27 m/s) through the module, and pH (6.6 to 12.0) of the feed that has the initial concentration of COD about 1,000 mg/L, total nitrogen 390 mg/L, total phosphorus 10 mg/L, conductivity of $7,000{\mu}s/cm$. The results showed that the average flux was ranged from 4 to $40L/m^2/hr$ which was almost similar with the flux of NaCl and deionized water used as a feed solution. The lowest flux was obtained at the operating condition with the temperature difference of $20^{\circ}C$ and cross flow velocity of 0.09 m/s while the highest one was measured with $60^{\circ}C$ and 0.27 m/s. Above 99% of COD and $PO{_4}^{3-}$-P in the feed could be rejected regardless of an operating condition. However, the removal rate of ammonium nitrogen was varied from 64 to 99% depending on the pH of feed solution.

• Journal of Korean Society of Environmental Engineers
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• v.34 no.2
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• pp.91-96
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• 2012

In this study we investigated the effects of operational parameters of a multi-layered soil filtration (filter depth, filtration velocity, and continuous/intermittent operation) on removal of pollutants in river water. As filter depth increased removal of all the pollutants (COD, TP, TN, and $NH_4$-N) was increased because the increase in filter depth increased in contact time between media and pollutants. The removal of TP and $NH_4$-N more increased with the increase in filter depth, comparing to the biological COD removal which was performed only in the top layer, since the removal mechanism of TP and $NH_4$-N was physicochemical process occurring throughout the whole layers. However, the reduction in filtration velocity resulted in decrease of removal all the pollutants removal due to shorter retention time. Biological COD removal was more influenced with the reduction in filtration velocity (longer retention time), than the removal of TP and $NH_4$-N. Because biological process was occurred only in the top layer which has relatively shorter retention time, comparing with physicochemical process occurred throughout whole media. Therefore, it is desirable that the operation parameters be controlled toward increasing retention time, in order to achieve efficient pollutants removal. The change in operation mode (continuos vs. intermittent operations) did not provide significant effects on the pollutant treatment efficiency by the multi-layered soil filtration system. Our findings suggest that for stable long-term operation it should be considered keeping conditions for biological activity and accelerating clogging.