• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.166-173
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• 2003

Purpose: We assessed the treatment result of the distal chevron osteotomy in the patients with moderate to severe hallux valgus. Materials and Methods: In a total of 28 cases of hallux valgus in 20 patients, underwent distal chevron osteotomy between July 1999 and February 2001, were enrolled in this study. 21 cases were moderate and 7 cases were severe. The preoperative average hallux valgus angle and 1st-2nd intermetatarsal angle of the two groups were $31.5^{\circ}$, $15.8^{\circ}$ in moderate cases and $44.1^{\circ}$, $17.3^{\circ}$ in severe cases, respectively. Radiologic evaluation was done preoperatively, postoperatively and on the final follow-up visit using weight-bearing radiographic imaging to determine the hallux valgus angle and 1st-2nd intermetatarsal angle. Results: Radiographic evaluation revealed hallux valgus angle and 1st-2nd intermetatarsal angle in moderate cases to be $13.0^{\circ}$, $11.3^{\circ}$ (postoperatively and in severe cases $15.6^{\circ}$, $10.9^{\circ}C$, postoperatively. On final follow up, the results were $14.5^{\circ}$, $11.6^{\circ}$ in moderate cases and $18.3^{\circ}$, $11.9^{\circ}$ in severe cases, respectively. Conclusion: Distal chevron osteotomy can be usefully applied to the treatment of moderate to severe hallux valgus.

• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.144-147
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• 2014

Despite the necessity of surgical aortic valve replacement, many patients with symptomatic severe aortic stenosis (AS) cannot undergo surgery because of their severe comorbidities. In these high-risk patients, percutaneous transcatheter aortic valve implantation (TAVI) can be safely accomplished. However, no study has shown that TAVI can be performed for patients with severe AS accompanied by acute decompensated heart failure. In this case report, 1 patient presented a case of severe pulmonary hypertension with decompensated heart failure after diagnosis with severe AS, and was successfully treated via emergency TAVI. Without any invasive treatment, acute decompensated heart failure with severe pulmonary hypertension is common in patients with severe AS, and it can increase mortality rates. In conclusion, TAVI can be considered one of the treatment options for severe as presented as acute decompensated heart failure patients with pulmonary hypertension.

• Journal of Trauma and Injury
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• v.32 no.1
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• pp.26-31
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• 2019

Purpose: Rhabdomyolysis (RB) is a syndrome characterized by the decomposition of striated muscles and leakage of their contents into the bloodstream. Acute kidney injury (AKI) is the most significant and serious complication of RB and is a major cause of mortality in patients with RB. Severe RB (creatine kinase [CK] ${\geq}5,000$) has been associated with AKI. However, early prediction is difficult because CK can reach peak levels 1-3 days after the trauma. Hence, the aim of our study was to identify predictors of severe RB using initial patient information and parameters. Methods: We retrospectively analyzed 1,023 blunt trauma patients admitted to a single tertiary hospital between August 2011 and March 2018. Patients with previously diagnosed chronic kidney disease were excluded from the study. RB and severe RB were defined as a CK level ${\geq}1,000U/L$ and ${\geq}5,000U/L$, respectively. The diagnosis of AKI was based on RIFLE criteria. Results: The overall incidence of RB and severe RB was 31.3% (n=320) and 6.2% (n=63), respectively. On multivariable analysis, male sex (odds ratio [OR] 3.78, 95% confidence interval [CI] 1.43 to 10.00), initial base excess (OR 0.85, 95% CI 0.80 to 0.90), initial CK (OR 2.07, 95% CI 1.67 to 2.57), and extremity abbreviated injury scale score (OR 1.78, 95% CI 1.39 to 2.29) were found to predict severe RB. The results of receiver operating characteristic analysis showed that the best cutoff value for the initial serum CK level predictive of severe RB was 1,494 U/L. Conclusions: Male patients with severe extremity injuries, low base excess, and initial CK level >1,500 U/L should receive vigorous fluid resuscitation.

• Journal of Korea Society of Industrial Information Systems
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• v.27 no.6
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• pp.95-103
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• 2022

Quick and accurate understanding of the situation in a severe accident is essential for conducting the appropriate accident management and response using the accident diagnosis information. This study employed deep learning technology to diagnose severe accidents through the major safety parameters transferred from a nuclear power plant (NPP) to AtomCARE. After selecting the major accident scenarios to consider, a learning database was established for particular scenarios affiliated with major scenarios by performing a large number of severe accident analyses using MAAP5 code. The severe accident diagnosis technology, which classifies detailed accident scenarios using the major safety parameters from NPPs, was developed by training it with the established database . Verification and validation were conducted by blind test and principal component analysis. The technology developed in this study is expected to be extended and applied to all severe accident scenarios and be utilized as a base technology for quick and accurate severe accident diagnosis.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.4
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• pp.394-402
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• 2023

Backgrounds/Aims: Acute pancreatitis is an emergency presentation, which can range from mild to life threatening. Intravenous fluids are the cornerstone of management. Although the WATERFALL trial described the optimal fluid rate in mild/moderate pancreatitis, this trial excluded patients with moderate-severe/severe pancreatitis. The aim of this study was to establish clinical practice regarding intravenous fluid administration in acute pancreatitis and assess its effect on mortality. Methods: Prospective multi-centre audit of patients with acute pancreatitis was conducted. Data were collected regarding intravenous fluid administration within 72 hours of admission. The primary outcome was 30-day mortality. Multivariable logistic regression was used to identify predictors of 30-day mortality. Results: Those with severe pancreatitis received more fluid; median 5.7 L versus 4 L in 72 hours (p = 0.003). Participants with severe pancreatitis who died within 30 days received a median of 2,750 mL in the first 24 hours, compared to 4,000 mL in those who survived. The following factors were significant predictors of 30-day mortality: age, Glasgow score, C-reactive protein, ischaemic heart disease, and pancreatitis aetiology. Overall, volume of intravenous fluid was not associated with mortality. However, the effect of intravenous fluid volume on mortality differed significantly depending on pancreatitis severity. In severe pancreatitis, increased volume of intravenous fluid was associated with significant reductions in mortality (odds ratio = 0.655; 0.459-0.936; p = 0.020). Conclusions: In severe pancreatitis, more aggressive fluid prescription was associated with decreased mortality; however, this was not the case in milder disease. Further prospective trials guiding fluid resuscitation in severe pancreatitis are needed, as the impact of fluid on this population appears to differ from that in those with milder disease.

• Animal Bioscience
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• v.37 no.1
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• pp.142-150
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• 2024

Objective: This study was conducted to assess effects of heat stress on growth performance, physiological parameters, and blood profiles of Hanwoo steers during early-fattening period in climate chambers. Methods: Four Hanwoo steers (body weight, 454.3±10.9 kg; age, 14±0.1 month) were allocated into four levels of temperature-humidity index (THI) in a 4×4 Latin square design for 21 days (pre-adaptation, 7 d; heat stress, 7 d; post-adaptation, 7 d) per period. Experimental treatments were assigned according to THI chart based on National Institute Animal Science (NIAS, 2022): Comfort (25.5℃ to 26.5℃, 60%; THI 73 to 75), Mild (28℃ to 29℃, 60%; THI 77 to 79), Moderate (29.5℃ to 30.5℃, 80%; THI 82 to 84), and Severe (31℃ to 32℃, 80%; THI 85 to 86) in separate climatic controlled chambers. Results: The dry matter intake (DMI) of the formula feed was lower in Severe compared to Mild and Comfort (p<0.05). The DMI of rice straw was the lowest in Severe and lower in Moderate than Comfort and Mild (p<0.05). Both average daily gain and feed conversion ratio of Severe and Moderate were lower than those of Mild and Comfort (p<0.05). Water intake was the highest in Severe and lower in Moderate compared with Comfort and Mild (p<0.05). Heart rate and rectal temperature increased as THI level increased (p<0.05). Glucose was the lowest in Severe and lower in Moderate compared to Comfort (p<0.05). On the contrary, non-esterified fatty acid was the highest in Severe and lower in Moderate compared with Comfort (p<0.05). Blood urea nitrogen of Moderate and Severe were higher than those of Comfort and Mild (p<0.05). Cortisol increased as THI increased (p<0.05). Conclusion: This study demonstrated the negative effects of heat stress on the performance and physiological responses of Hanwoo steers during the early-fattening period. In addition, it is judged that the THI chart for Hanwoo steers of National Institute of Animal Science (2022) was properly calculated.

• Journal of Cardiovascular Imaging
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• v.31 no.1
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• pp.26-38
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• 2023

BACKGROUND: Dobutamine and adenosine stress cardiac magnetic resonance (CMR) imaging is relatively contraindicated in patients with moderate to severe aortic valve stenosis (AS). We aimed to determine the safety of dobutamine and adenosine stress CMR in patients with moderate to severe AS. METHODS: In this retrospective study patients with AS who underwent either dobutamine or adenosine stress CMR for exclusion of obstructive coronary artery disease were enrolled. We recorded clinical data, CMR and echocardiography findings, and complications as well as minor symptoms. Patients with AS were compared to matched individuals without AS. RESULTS: A total of 187 patients with AS were identified and compared to age-, gender- and body mass index-matched 187 patients without AS. No severe complications were reported in the study nor the control group. The reported frequency of non-severe complications and minor symptoms were similar between the study and the control groups. Nineteen patients with AS experienced non-severe complications or minor symptoms during dobutamine stress CMR compared to eighteen patients without AS (p = 0.855). One patient with AS and two patients without AS undergoing adenosine stress CMR experienced minor symptoms (p = 0.562). Four examinations were aborted because of chest pain, paroxysmal atrial fibrillation and third-degree atrioventricular block. Inducible ischaemia, prior coronary artery bypass grafting, prior stroke and age were associated with a higher incidence of complications and minor symptoms. CONCLUSIONS: Moderate to severe AS was not associated with complications during CMR stress test. The incidence of non-severe complications and minor symptoms was greater with dobutamine.

• Clinical and Experimental Vaccine Research
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• v.13 no.1
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• pp.28-34
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• 2024

Purpose: Coronavirus disease 2019 (COVID-19) is a highly formidable disease. Globally, multiple vaccines have been developed to prevent and manage this disease. However, the periodic mutations of severe acute respiratory syndrome coronavirus 2 variants cast doubt on the effectiveness of commonly used vaccines in mitigating severe disease in the Indian population. This study aimed to assess the effectiveness of the BBV152 vaccine and ChAdOx1-S vaccine in preventing severe forms of the disease. Materials and Methods: This retrospective study, based on hospital records, was conducted on 204 vaccinated COVID-19 patients using a consecutive sampling approach. Data on their vaccination status, comorbidities, and high-resolution computed tomography lung reports' computed tomography severity scores were extracted from their medical records. Fisher's exact test and binomial logistic regression analysis were employed to assess the independent associations of various factors with the dependent variables. Results: Of the 204 records, 57.9% represented males, with a mean age of 61.5±9.8 years. Both vaccines demonstrated effective protection against severe illness (90.2%), with BBV152 offering slightly better protection compared to ChAdOx1-S. Male gender, partial vaccination, comorbid conditions, and the type of vaccine were identified as independent predictors of severe lung involvement. Conclusion: This study indicates that both vaccines were highly effective (90%) in preventing severe forms of the disease in fully vaccinated individuals. When comparing the two vaccines, BBV152 was slightly more effective than ChAdOx1-S in preventing severe COVID-19.

• Progress in Medical Physics
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• v.14 no.4
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• pp.268-278
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• 2003

Purpose：The aim of this study was to evaluate the striatal binding ratio, the anterior/posterior ratio and reproducibility using a template based registration method using the standard MR template as a replacement for each patients MR image. Materials and Methods：This study analyzed the 123I IPT SPECT images of 30 patients with IPD, who were subdivided into 17 patients (56.6$\pm$10.8 yr, M/F : 8/9.) with mild IPD, and 13 patients (56.4$\pm$11.1 yr, M/F : 8/5) with severe IPD. In addition, 11 normal controls (57.8$\pm$14.4 yr, M/F : 4/7) were also analyzed. The ROIs were positioned manually in the same slice showing the highest striatal activity using the traditional manual method, whereas those were positioned automatically in a mid striatal slice of the SPECT image coregistered to the standard T1 weighted MR template. Results : The specific binding ratio (SBR) obtained using the template based registration method strongly correlated with those using the manual method in all groups : normal controls (r=0.85, P<0.001), mild IPD (r=0.84, P<0.001) and severe IPD (r=0.7, P=0.01). The SBRs obtained using both methods were significantly different among the three groups (P=0.05) and the SBRs obtained by the template based registration method were higher than those by the manual method (P=0.05) in all three groups. The APRs obtained by the template based registration correlated with those using manual method in only mild IPD (r=0.72, P=0.0). The APRs obtained by the template based registration method were significantly different from the normal controls and those with mild or severe IPD (P<0.05), whereas those obtained using the manual method were not significantly different among the three groups (P＞0.1). The reproducibility (rmsCV) of the template based registration method was 7.2% (normal controls：5.2%, mild IPD：4.2%, severe IPD：10.8%), whereas the reproducibility of the manual method was 31% (normal controls：19.7%, mild IPD：21.7%, severe IPD：46.2%). Conclusion：These results show that the use of $^{123}$ I-IPT SPECT for assessing IPD is affected by the methods used to position the striatal ROI. The template based registration method using the standard MR template can be useful in diagnosing IPD and assessing the disease severity with a high reproducibility. Therefore, the template based registration method appears to be a good replacement for the manual method.

• Transactions of Materials Processing
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• v.7 no.5
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• pp.439-444
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• 1998

Recently many automotive parts have been made with stainless steels by deep drawing processes, But there are various problems occurred in deep drawing works of stainless steels compared with low carbon steels. For the severe deep drawing of complex cylindrical housing optimum process planning is required to eliminate intermediate annealing improve shape accuracy and maintain surface integrity without drawing defects such as tears wrinkles and scratches or galling. Therefore in this study a sample process planning of the severe of the severe deep drawing process is applied to a complex cylindrical housing needed for a 6 multi-stepped deep drawing of type STS 305 . A series of experiments are performed to investigate optimum process variables such as drawing rate radius and clearance. Through experiments the variations of the thickness strain distribution and hardness distribution in each drawing step are observed. Also the effects of other factors on formability such as drawing oil, blank holding force and die geometry are examined and discussed.