Purpose: To investigate the clinical outcomes of distal hook augmentation using a pedicle screw in thoracolumbar fusion in elderly patients. Materials and Methods: This retrospective multicenter study recruited 20 patients aged 65 years or older, who underwent anterior support and long level posterior fusion in the thoracolumbar junction with a follow-up of one year. To assess the effect of distal hook augmentation, the patients were divided into two groups; the pedicle screw with hook group (PH group, n=10) and the pedicle screw alone group (PA group, n=10). Results: The average age was 72.4 years (65-83 years). The average fusion segment was 4.6 segments (3-6 segments). There were no significant differences in age, sex, causative diseases, bone mineral density of lumbar and proximal femur, number of patients with osteoporosis, and number of fused segments between the two groups (p≥0.05). At 1 year follow-up after surgery, parameters related with distal screw pullout were significantly worse in the PA group. No patients in the PH group had distal screw pullout. However, six patients (60%, 6/10) in the PA group had distal screw pullout. There were no significant differences in the progression of distal junctional kyphosis between the two groups. Conclusion: Distal hook augmentation is an effective procedure in protecting distal pedicle screws against the pullout when long level thoracolumbar fusion was performed in elderly patients aged 65 years or older.
Background: This study focuses on the establishment and operation of a stroke patient hotline program to help patients and their caregivers determine when acute neurological changes require emergency attention. Method: The stroke hotline was established at the Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, in June 2016. Patients diagnosed with stroke during admission or in outpatient clinics were registered and provided with stroke education. Consulting nurses managed hotline calls and made decisions about outpatient schedules or emergency room referrals, consulting physicians when necessary. The study analyzed consultation records from June 2016 to December 2020, assessing consultation volumes and types. Outcomes and hotline satisfaction were also evaluated. Results: Over this period, 6,851 patients were registered, with 1,173 patients (18%) undergoing 3,356 hotline consultations. The average monthly consultation volume increased from 29.2 cases in 2016 to 92.3 cases in 2020. Common consultation types included stroke symptoms (22.3%), blood pressure/glucose inquiries (12.8%), and surgery/procedure questions (12.6%). Unexpected outpatient visits decreased from 103 cases before the hotline to 81 cases after. Among the 2,244 consultations between January 2019 and December 2020, 9.6% were recommended hospital visits, with two cases requiring intra-arterial thrombectomy. Patient satisfaction ratings of 9-10 points increased from 64% in 2019 to 69% in 2020. Conclusion: The stroke hotline program effectively reduced unexpected outpatient visits and achieved high patient satisfaction. Expanding the program could enhance the management of stroke-related neurological symptoms and minimize unnecessary healthcare resource utilization.
With the development of medical technology and radiation treatment equipment, the frequency of high-precision radiation therapy such as intensity modulation radiation therapy has increased. Image-guided radiation therapy has become essential for radiation therapy in precise and complex treatment plans. In particular, with the introduction of imaging equipment for diagnosis in a linear accelerator, CBCT scanning became possible, which made it possible to calibrate and correct the patient's posture through 3D images. Although more precise reproduction of the patient's posture has become possible, the exposure dose delivered to the patient during the image acquisition process cannot be ignored. Radiation optimization is necessary in the field of radiation therapy, and efforts to reduce exposure are necessary. However, when acquiring 3D CBCT images by changing the imaging conditions to reduce exposure, there should be no image quality or artefacts that would make it impossible to align the patient's position. In this study, Rando phantom was used to scan and evaluate images for each shooting condition. The highest SNR was obtained at 100 kV 80 mA 25 ms F1 filter 180°. As the tube voltage and tube current increased, the noise decreased, and the bowtie filter showed the optimal effect at high tube current. Based on the actual scanned images, it was confirmed that patient alignment was possible under all imaging conditions, and that image-guided radiation therapy for patient alignment was possible under the condition of 70 kV 10 mA 20 ms F0 filter 180°, which showed the lowest SNR. In this study, image evaluation was conducted according to the imaging conditions, and low tube voltage, tube current, and small rotation angle scan are expected to be effective in reducing radiation exposure. Based on this, the patient's exposure dose should be kept as low as possible during CBCT imaging.
Geun-Hyeok Hong;Hye-ji Oh;Yerim Choi;Jun-Wan Kim;Beom-Myeong Choi;KwangHyeon Chang;Min-Ho Jang
Korean Journal of Ecology and Environment
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제56권2호
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pp.172-186
/
2023
Small ponds, which exhibit unstable succession pattern of plankton community, are less well studied than large lakes. Recently, the importance of small ponds for local biodiversity conservation has highlighted the necessity of understanding the dynamics of biological community. In the present study, we collected zooplankton from three small reservoirs with monthly basis and analyzed their seasonal dynamics. To understand the complicated zooplankton community dynamics of small reservoirs, we categorized zooplankton species into four groups (LALF Group, Low Abundance Low Frequency; LAHF Group, Low Abundance High Frequency; HALF Group, High Abundance Low Frequency; HAHF Group, High Abundance High Frequency) based on their occurrence pattern (abundance and frequency). We compared the seasonal pattern of each group, and estimated community diversity based on temporal beta diversity contribution of each group. The result revealed that there is a relationship between groups with the same abundance but different occurrence frequencies, and copepod nauplii are common important component for both abundance and frequency. On the other hand, species included with LALF Group throughout the study period are key in terms of monthly succession and diversity. LALF Group includes Anuraeopsis fissa, Hexarthra mira and Lecane luna. However, groups containing species that only occur at certain times of the year and dominate the waterbody, HALF Group, hindered to temporal diversity. The results of this study suggest that the species-specific occurrence pattern is one key trait of species determining its contribution to total annual biodiversity of given community.
Journal of the Korean Crystal Growth and Crystal Technology
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제33권2호
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pp.83-90
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2023
The β-Ga2O3 has the most thermodynamically stable phase, a wide band gap of 4.8~4.9 eV and a high dielectric breakdown voltage of 8MV/cm. Due to such excellent electrical characteristics, this material as a power device material has been attracted much attention. Furthermore, the β-Ga2O3 has easy liquid phase growth method unlike materials such as SiC and GaN. However, since the grown pure β-Ga2O3 single crystal requires the intentionally controlled doping due to a low conductivity to be applied to a power device, the research on doping in β-Ga2O3 single crystal is definitely important. In this study, various source powders of un-doped, Sn 0.05 mol%, Sn 0.1 mol%, Sn 1.5 mol%, Sn 2 mol%, Sn 3 mol%-doped Ga2O3 were prepared by adding different mole ratios of SnO2 powder to Ga2O3 powder, and β-Ga2O3 single crystals were grown by using an edge-defined Film-fed Growth (EFG) method. The crystal direction, crystal quality, optical, and electrical properties of the grown β-Ga2O3 single crystal were analyzed according to the Sn dopant content, and the property variation of β-Ga2O3 single crystal according to the Sn doping were extensively investigated.
Kim, Jun-Wan;Kim, Kyu-Jin;Choi, Beom-Myeong;Yoon, Ju-Duk;Park, Bae-Kyung;Kim, Jong-Hak;Jang, Min-Ho
Korean Journal of Ecology and Environment
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제55권1호
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pp.49-59
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2022
Total of 325 estuaries in Korea were surveyed to analyze the effect of presence of sluice gate on the estuary environment and fish community from 2016 to 2018. Fish community in closed and open estuaries showed differences generally, and the relative abundance (RA) of primary freshwater species in the closed and migratory species in the open estuaries were high. The result of classifying species by habitat characteristics in closed and open estuaries showed similar tendencies at the estuaries of south sea and west sea. The relative abundances of primary freshwater species in the closed estuaries at the estuaries of south sea and west sea were the highest, but estuarine and migratory species were high in both closed and open estuaries at the estuaries of east sea. Primary freshwater species showed higher abundances in the closed estuaries with reduced salinity due to blocking of seawater since they are not resistant to salt. However, primary freshwater species in open estuaries at east sea was higher than that of the closed estuaries, which is considered to be the result of reflecting the characteristics (tide, sand bar, etc.) of the east sea. Korea Estuary Fish Assessment Index (KEFAI) was showed to be higher at open estuaries than closed in all sea areas (T-test, P<0.001), the highest KEFAI was observed in closed estuaries at south sea, and open estuaries in east sea. Fish community of closed and open estuaries in each sea areas showed statistically significant differences (PERMANOVA, East, Pseudo-F=3.0198, P=0.002; South, Pseudo-F=22.00, P=0.001; West, Pseudo-F=14.067, P=0.001). Fish assemblage similarity by sea areas showed a significant differences on fish community in closed and open estuaries at east sea, south sea, and west sea (SIMPER, Group dissimilarity, 85.85%, 88.36%, and 88.05%). This study provided information on the characteristics and distribution of fish community according to the types of estuaries. The results of this study can be used as a reference for establishing appropriate management plans according to the sea areas and type in the management and restoration of estuaries for future.
KSCE Journal of Civil and Environmental Engineering Research
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제30권1B호
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pp.41-51
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2010
In this study, runoff simulation was carried out in the area of Bisan 7-dong, Seo-gu, Daegu as drainage basin and the effects of the installation of underground storage facilities were analyzed during heavy rainfall. SWMM model was used for the runoff and pipe network analysis on Typhoon Maemi, 2003. 2-D inundation analysis model based on diffusion wave was employed for inundation analysis and to verify computed inundation areas with observed inundation trace map. The simulation results agree with observed in terms of inundation area and depth. Also, the effects of flood damage mitigation were analyzed through the overflow discharge and 2-D inundation analysis, depending upon whether the underground storage facility is installed or not. When the underground storage facility ($W:120m{\times}L:180m{\times}H:1.7m$) is installed, volume of overflow could be reduced by 72% and flooding area could be reduced by 40.1%. When the underground storage facility ($W:120m{\times}L:180 m{\times}H:2.0m$) is installed, volume of overflow could be reduced by 84.8% and flooding area could be reduced by 50.6%. When the underground storage facility ($W:120m{\times}L:180m{\times}H:2.2m$) is installed, volume of overflow could be reduced by 94% and flooding area could be reduced by 91.2%. There is no overflow of manhole, when the height of storage facility is 2.5 m. It is expected that the study results presented through quantitative analysis on the effects of underground facilities can be used as base data for socially and economically effective installation of underground facilities to prevent flood damage.
KSCE Journal of Civil and Environmental Engineering Research
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제30권3A호
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pp.297-307
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2010
Recently, maintenance engineering and technology for civil and building structures have begun to draw big attention and actually the number of structures that need to be evaluate on structural safety due to deterioration and performance degradation of structures are rapidly increasing. When stiffness is decreased because of deterioration of structures and member cracks, dynamic characteristics of structures would be changed. And it is important that the damaged areas and extent of the damage are correctly evaluated by analyzing dynamic characteristics from the actual behavior of a structure. In general, typical measurement instruments used for structure monitoring are dynamic instruments. Existing dynamic instruments are not easy to obtain reliable data when the cable connecting measurement sensors and device is long, and have uneconomical for 1 to 1 connection process between each sensor and instrument. Therefore, a method without attaching sensors to measure vibration at a long range is required. The representative applicable non-contact methods to measure the vibration of structures are laser doppler effect, a method using GPS, and image processing technique. The method using laser doppler effect shows relatively high accuracy but uneconomical while the method using GPS requires expensive equipment, and has its signal's own error and limited speed of sampling rate. But the method using image signal is simple and economical, and is proper to get vibration of inaccessible structures and dynamic characteristics. Image signals of camera instead of sensors had been recently used by many researchers. But the existing method, which records a point of a target attached on a structure and then measures vibration using image processing technique, could have relatively the limited objects of measurement. Therefore, this study conducted shaking table test and field load test to verify the validity of the method that can measure multi-point displacement responses of structures using image processing technique.
Two-Cell mouse embryos were incubated in the anterior chamber of the rat eye, which has been known as the best place among other animals' for the mouse ovum maturation, in order to observe the capability of their early development. Within 120 hours after incubation, 71.0% of two-cell embryos have developed to the blastocysts in the male rat eye, while only 38.5% in the eye of the same mouse as donated two-cell embryos. Thus, the rat eye chamber provides more favourable environment to the embryos than the mouse itself. The results are consistent with those of the previous studies comparing the maturation of the mouse follicular oocytes in the mouse and the rat eye chamber. Although the aqueous humor which is filled in the anterior chamber of the eye is characterized by its specific properties, being of higher osmolarity, higher concentrations of ascorbic acid, pyruvate and lactate, but lower of proteins and lower temperature than those in blood or lymph serum, The embryos are able to under-take their cleavage as normal as in vivo or in vitro. Concerning with a number of studies in vitro on the development of the mouse embryos which are requiring a very limited condition, the fact that they are able to manage their further development under very different enviroment from our knowledges would provide us a moment to understand their behavior during the early development. The difference of the proportion of the developed blastocysts between in the mouse eye chamber and in the rat can possibly be resulted from the species specific difference in the physicochemical properties between their eye chambers. This assumption is based upon the findings by many investigators who chmpared the nature of the eye chamber of various animals. As a consequence, the rat eye chamber might consist of better properties for the embryonal growth than the mouse eye chamber. The mouse embryos cleaved with a delayed period. In normal development they complete almost the cleavage within 94 hours after fertilization. However, in the present studies, 81.1% of two-cell embryos developed to the blastocysts and the morula in 120 hours in the eye chamber, assumed to be about 154 hours after fertilization. Such delay in development would be caused mainly by the low temperature of the eye chamber. At present we can make two assumptions to explain the capability of the emtryonal development in the eye chambers. One is that the embryos would possess an ability to adapt themselves to the environment which provides unfavourable conditions. The other is that the embryos might remain for a certain duration in the eye chamber, which is filled with a new body fluid produced immediately after the loss of the aqueous humor and the fluid of which becomes similar to blood serum in component. The first assumption is highly reliable since the embryonal cells are mostly at the undifferentiated state and so they probably engage a simple metabolism during their early period. The second assumption is induced by the fact that the rabbit eye chamber produces a plasmoid humor which has mostly similar components to blood serum after loss of aqueous humor through cornea by puncturing. However, the plasmoid humor is substituted by the initial aqueous humor in eight hours. Even though this finding, production of the new fluid, could be applied to the rat eye, it is hardly reliabel that the plasmoid humor remains for such a long period as 120 hours. Consequently, the development of the embryos is more likely due to their adaptability to the new environment during their early developmental stages.
In the previous studies, the present author found that high proportion of the follicular oocytes from mouse and rabbit ovaries are able to resume their maturation division in the anterior chamber of the eye in which they have been incubated by auto- or homoplastic transplantation. Especially in the case of the homoplastic transplantation, it was known that no trouble has been detected in the process of resumption of the oval maturation in particular connection with the antigen-antibody reaction between donor and recipient. These findings provide a possibility that the follicular oocytes from various animals would be matured in the eye even after the xenoplastic transplantation. Under such an assumption, the present studies were performed to examine the behavior of the follicular oocytes in the eye chamber of the animals of different species. For the donor of the follicular oocytes, domestic rabbits, albino rats of Sprague-Dowley strain, and albino mice of A-strain bred in our laboratory were used. The oocytes obtained from the ovarian follicules were introduced to the anterior chamber of the eye of different species of animals, with an exception of rabbit in which only the female animals were used as a recipient. The procedures of collection of ova, introduction to the eye, harvest from the eye ball, fixation, and staining were the same as mentioned in the previous reports (Cho, 1967b; Cho and Kim, 1968). The conclusions obtained are summarized as below. 1. The rabbit follicular oocytes are able to mature in the eye chambers of both male mouse and rat, although the proportion of the maturation is lower than when they are incubated autoplastically in the eye. When the ova were incubated in the male mouse eye for 24 hours, 21 per cent of them showed chromosomes at metaphase I and II, whereas the rate was 32 per cent when they were incubated in the eye of the male rat. These are apparently low comparing to the rate of 52 per cent of autoplastic transplantation. 2. When rat follicular oocytes were transferred into the mouse eye chamber and recovered after 24 hours, 43 per cent of them produced the mataphase I and II chromosomes. This proportion was higher than the result of the homoplastic transplantation which yielded 23 per cent of the ova on maturation. 3. The most striking result was found in the experiment with mouse follicular oocytes. Seventy-six per cent of the oocytes resumed their maturation division within 24 hours after they were transferred into the male rat eye chamber, and this figure was significantly high compared to the result o 55 per cent obtained by the homoplastic transplantation. In the rat eye, the induction of the degenerative ova also was low (19%). On the other hand, the proportion of the oval maturation decreased to 45 per cent, while that of degeneration increased 33 per cent when they were incubated in the eye of the female rabbit. 4. It was apparent from the present experiments that the follicular oocytes can reveal their activation to maturation in the eye chamber which contains aqueous humor which is known to be composed of low protein content and of very little gamma-globulin which acts as an antibody(Oser, 1965), and that it shows higher osmolarity than blood serum(Levene, 1958). Taking these properities into consideration the humor may provide unfavourable environment to the cells and tissues incubated in. However, it could be noteworthy finding that only the follicular oocytes in the eye of the different species can grow in healthy condition although the maturation rates are varied with the animal species. The fact that the rabbit follicular oocytes show the lower proportion in maturation may be due to the greater amount of the yolk granules in the egg cytoplasm than those in the mouse and rat oocytes. That the mouse oocytes incubated in the eye of the rat mouse and rat oocytes. That the mouse oocytes incubated in the eye of the rat resumed their maturation process in greater proportion would e explained by the fact that the rat eye chamber particularly provides the better environment to the mouse oocytes than the eye chamber of mouse does.
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