Objective : The objective of this study is to evaluate and compare the clinical results between classical open surgery and percutaneous endoscopic lumbar discectomy[PELD] in cases of extraforaminal lumbar disc herniation. Methods : We obtained the clinical data from 47 patients with extraforaminal lumbar disc herniations who underwent the open paramedian muscle-splitting approach or percutaneous endoscopic lumbar discectomy[PELD] between January 2001 and February 2004. This study consisted of patients with soft disc extraforaminal herniations. The patients were assessed with the visual analogue scale[VAS] and MacNab's criteria before surgery, just before discharge, and postoperative 1 year. Results : There were 25 cases in the open surgery group and 22 cases in the PELD group. The average operating time was $78{\pm}36.71\;min$ in the PELD group and $110{\pm}29.68\;min$ in the open surgery group. The mean hospital stay was $2.73{\pm}2.62$ days in the PELD group and $7.68{\pm}2.59$ days in the open surgery group. VAS decreased from $8.34{\pm}0.66$ to $1.29{\pm}2.27$ in the PELD group and from $8.40{\pm}1.40$ to $1.70{\pm}1.72$ in the open surgery group at the one-year follow-up. The success rate of PELD was 86.4%, compared with 80.0% for open surgery. However, there were no statistically significant difference between two groups for success rate and VAS. Conclusion : Although the success rates were similar in both groups, PELD is less invasive, faster, and safe procedure than open surgery for extraforaminal disc herniation in selected patients.
Kim, Bongyoung;Myung, Rangmi;Kim, Jieun;Lee, Myoung-jae;Pai, Hyunjoo
Journal of Korean Medical Science
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v.33
no.49
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pp.310.1-310.11
/
2018
Background: Acute pyelonephritis (APN) is one of the most common community-acquired bacterial infections. Recent increases of antimicrobial resistance in urinary pathogens might have changed the other epidemiologic characteristics of APN. The objective of this study was to describe the current epidemiology of APN in Korea, using the entire population. Methods: From the claims database of the Health Insurance Review and Assessment Service in Korea, the patients with International Classification of Diseases, 10th Revision codes N10 (acute tubulo-interstitial nephritis) or N12 (tubulo-interstitial nephritis, neither acute nor chronic) as the primary discharge diagnosis during 2010-2014 were analyzed, with two or more claims during a 14-day period considered as a single episode. Results: The annual incidence rate of APN per 10,000 persons was 39.1 and was on the increase year to year (35.6 in 2010; 36.7 in 2011; 38.9 in 2012; 40.1 in 2013; 43.8 in 2014, P = 0.004). The increasing trend was observed in both inpatients (P = 0.014) and outpatients (P = 0.004); in both men (P = 0.042) and women (P = 0.003); and those aged under 55 years (P = 0.014) and 55 years or higher (P = 0.003). Eleven times more women were diagnosed and treated with APN than men (men vs. women, 6.5 vs. 71.3), and one of every 4.1 patients was hospitalized (inpatients vs. outpatients, 9.6 vs. 29.4). The recurrence rate was 15.8%, and the median duration from a sporadic episode (i.e., no episode in the preceding 12 months) to the first recurrence was 44 days. The recurrence probability increased with the number of previous recurrences. The average medical cost per inpatient episode was USD 1,144, which was 12.9 times higher than that per outpatient episode (USD 89). Conclusion: The epidemiology of APN in Korea has been changing with an increasing incidence rate.
Background: Readmissions related to lack of quality care harm both patients and health insurance finances. If the factors affecting readmission are identified, the readmission can be managed by controlling those factors. This paper aims to identify factors that affect readmissions of convalescent rehabilitation patients. Methods: Health Insurance Review and Assessment Service claims data were used to identify readmissions of convalescent patients who were admitted in hospitals and long-term care hospitals nationwide in 2018. Based on prior research, the socio-demographics, clinical, medical institution, and staffing levels characteristics were included in the research model as independent variables. Readmissions for convalescent rehabilitation treatment within 30 days after discharge were analyzed using logistic regression and generalization estimation equation. Results: The average readmission rate of the study subjects was 24.4%, and the risk of readmission decreases as age, length of stay, and the number of patients per physical therapist increase. In the patient group, the risk of readmission is lower in the spinal cord injury group and the musculoskeletal system group than in the brain injury group. The risk of readmission increases as the severity of patients and the number of patients per rehabilitation medicine specialist increases. Besides, the readmission risk is higher in men than women and long-term care hospitals than hospitals. Conclusion: "Reducing the readmission rate" is consistent with the ultimate goal of the convalescent rehabilitation system. Thus, it is necessary to prepare a mechanism for policy management of readmission.
In this study, we developed the nanoparticle multi-generator by 3D printer fusion deposition modeling (FDM) method that can reliably generate and deliver nanoparticles at a constant concentration for inhalation risk assessment. A white ABS filament was used as the test material, and SMPS was used for concentration analysis such as particle size and particle distribution. In the case of particle size, the particle size was divided by 100 nm or less and 100 to 1,000 nm, and the number of particles concentration, mass concentration, median diameter of particles, geometric average particle diameter, etc were measured. The occurrence conditions were the extruder temperature, the extruding speed of the nozzle, and the air flow rate, and experiments were conducted according to the change of conditions including the manufacturer's standard conditions. In addition, the utility of inhalation risk assessment was reviewed through a stability maintenance experiment for 6 h. As a result of the experiment, the size of the nanoparticles increased as the discharger temperature increased, as the discharge speed of the nozzle increased, and as the air flow rate decreased. Also, a constant pattern was shown according to the conditions. Even when particles were generated for a long time (6 h), the concentration was kept constant without significant deviation. The distribution of the particles was approximately 80 % for particles of 60 nm to 260 nm, 1.7 % for 1 ㎛ or larger, 0.908 mg/㎥ for the mass concentration, 111 nm for MMAD and 2.10 for GSD. Most of the ABS particles were circular with a size of less than 10 nm, and these circular particles were aggregated to form a cluster of grape with a size of several tens to several hundred nm.
Study Design: Retrospective case series. Purpose: Cauda equina syndrome (CES) is associated with etiologies such as lumbar disc herniation (LDH) and lumbar canal stenosis (LCS). CES has a prevalence of 2% among patients with LDH and exhibits variable outcomes, even with early surgery. Few studies have explored the factors influencing the prognosis in terms of bladder function. Therefore, we aimed to assess the factors contributing to bladder recovery and propose a simplified bladder recovery classification. Overview of Literature: Few reports have described the prognostic clinical factors for bladder recovery following CES. Moreover, limited data are available regarding a meaningful bladder recovery status classification useful in clinical settings. Methods: A single-center retrospective study was conducted (April 2012 to April 2015). Patients with CES secondary to LDH or LCS were included. The retrieved data were evaluated for variables such as demographics, symptom duration, neurological symptoms, bladder symptoms, and surgery duration. The variable bladder function outcome during discharge and at follow-up was recorded. All subjects were followed up for at least 2 years. A simplified bladder recovery classification was proposed. Statistical analyses were performed to study the correlation between patient variables and bladder function outcome. Results: Overall, 39 patients were included in the study. Majority of the subjects were males (79.8%) with an average age of 44.4 years. CES secondary to LDH was most commonly seen (89.7%). Perianal sensation (PAS) showed a significant correlation with neurological recovery. In the absence of PAS, bladder function did not recover. Voluntary anal contraction (VAC) was affected in all study subjects. Conclusions: Intactness of PAS was the only significant prognostic variable. Decreased or absent VAC was the most sensitive diagnostic marker of CES. We also proposed a simplified bladder recovery classification for recovery prognosis.
In this study, the baseflow indices in Nakdong river watershed and the whole country's river were calculated by using SWAT model and PART method. The annual averaged baseflow in the Nakdong river watershed was estimated at 40% - 44% of the total discharge rate, and it is found to be higher than 90% during the winter months of December and January. An analysis of the baseflow index from 317 gauge stations across the country revealed that the contribution of baseflow to the nation's stream flow rate stood at an annual average of 40%, ranging from less than 20% to over 80% by region. Also, the impact of the decreasing baseflow due to land use changes in 1975 and 2000 was analyzed in Keumhogang river watershed under the same weather conditions. The results revealed that the number of days under the standard instream flow increased by 19-24 days as a result of the increase in the urbanization rate.
Proceedings of the Korea Water Resources Association Conference
/
2015.05a
/
pp.243-243
/
2015
Low-flow simulation and forecasting is one of the emerging issues in hydrology due to the increasing demand of water in dry periods. Even though low-flow simulation and forecasting remains a difficult issue for hydrologists better simulation and earlier prediction of low flows are crucial for efficient water management. The UN has never stated that South Korea is in a water shortage. However, a recent study by MOLIT indicates that Korea will probably lack water by 4.3 billion m3 in 2020 due to several factors, including land cover and climate change impacts. The two main situations that generate low-flow events are an extended dry period (summer low-flow) and an extended period of low temperature (winter low-flow). This situation demands the hydrologists to concentrate more on low-flow hydrology. Korea's annual average precipitation is about 127.6 billion m3 where runoff into rivers and losses accounts 57% and 43% respectively and from 57% runoff discharge to the ocean is accounts 31% and total water use is about 26%. So, saving 6% of the runoff will solve the water shortage problem mentioned above. The main objective of this study is to present the hydrological modelling approach for low-flow simulation and forecasting using a model that have a capacity to represent the real hydrological behavior of the catchment and to address the water management of summer as well as winter low-flow. Two lumped hydrological models (GR4J and CAT) will be applied to calibrate and simulate the streamflow. The models will be applied to Seolmacheon catchment using daily streamflow data at Jeonjeokbigyo station, and the Nash-Sutcliffe efficiencies will be calculated to check the model performance. The expected result will be summarized in a different ways so as to provide decision makers with the probabilistic forecasts and the associated risks of low flows. Finally, the results will be presented and the capacity of the models to provide useful information for efficient water management practice will be discussed.
Kim, Ho-Sub;Park, Yun-Hee;Kim, Yong-Sam;Kim, Sang-Yong
Journal of Korean Society on Water Environment
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v.35
no.1
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pp.43-54
/
2019
The objective of this study was to assess the effect of policies on water quality management based on the changes in pollutants and water quality in Special Water Preservation Area (SWPA) of Lake Paldang watershed from 1990 to 2016. The population, total sewage and flow rate of wastewater in SWPA continuously increased from 1990 to 2016, while the location of new facilities for industrial and livestock facilities has been restricted. However, unlike the buffer zone in which industrial and livestock facilities were continuously reduced after implementing of TMDL, it was found that the effect of land-use regulations on industrial and livestock facilities in SWPA were mitigated by the increase in the size of large facilities. Since 1999 when the emission standard of public sewage treatment plants (STP) was changed, the water quality of Lake Paldang has increased despite the increase of pollutant source. Since emission standard of STP changed in 2012 (BOD 5 mg/L, TP 0.2 mg/L), BOD concentration in Lake Paldang has also improved to the level of water quality in the early 1990s where as TP concentration has remained at its lowest since 1990. BOD and TP average discharge concentration of 43 STP (${\geq}500m^3/day$) in 2016 have been maintained $1.7{\pm}0.7mg/L$ and $0.06{\pm}0.02mg/L$ respectively. While the discharged load of STP in SWPA was decreased by the concentration management, the contribution rate to the total discharged load of non-point pollutants increased to 70 % in 2015, and the contribution rate to the point discharged load of individual treatment facilities increased to 80 %.
It is very important to treat infected livestock carcasses safely and quickly. In this study, the degradation characteristics and odor generation characteristics of carcasses were investigated during the treatment of swine carcasses using the anaerobic burial composting method. While the carcasses were decomposed, the temperature remained high, at $40{\sim}55^{\circ}C$ on average, and most of the carcasses were decomposed rapidly. The major odor-contributing substances in the buried composting method are sulfuric odor substances such as $H_2S$, $CH_3SH$, dimethyl sulfide (DMS) and dimethyl disulfide (DMDS), and the odor contribution of these substances is 93~99%. Among them, $CH_3SH$, which accounts for about 56~89% of odor contribution, was the most representative indicator substance. Despite the anaerobic digestion process, the methane concentration in the digestion process was as low as 0.5~0.8% at the burial point of the carcass. The odor and methane produced during the decomposition of the carcasses decreased considerably during the discharge to the surface layer through the buried layer consisting of compost. These results suggest that anaerobic high temperature burial composting is one of the most useful methods to treat carcasses of infected livestock.
Lee, Dae Eop;Jung, Sung Ho;Yeon, Min Ho;Lee, Gi Ha
Korean Journal of Agricultural Science
/
v.48
no.3
/
pp.433-446
/
2021
In this study, the future flood inundation changes under a climate change were simulated in the Tonle Sap basin in Cambodia, one of the countries with high vulnerability to climate change. For the flood inundation simulation using the rainfall-runoff-inundation (RRI) model, globally available geological data (digital elevation model [DEM]; hydrological data and maps based on Shuttle elevation derivatives [HydroSHED]; land cover: Global land cover facility-moderate resolution imaging spectroradiometer [GLCF-MODIS]), rainfall data (Asian precipitation-highly-resolved observational data integration towards evaluation [APHRODITE]), climate change scenario (HadGEM3-RA), and observational water level (Kratie, Koh Khel, Neak Luong st.) were constructed. The future runoff from the Kratie station, the upper boundary condition of the RRI model, was constructed to be predicted using the long short-term memory (LSTM) model. Based on the results predicted by the LSTM model, a total of 4 cases were selected (representative concentration pathway [RCP] 4.5: 2035, 2075; RCP 8.5: 2051, 2072) with the largest annual average runoff by period and scenario. The results of the analysis of the future flood inundation in the Tonle Sap basin were compared with the results of previous studies. Unlike in the past, when the change in the depth of inundation changed to a range of about 1 to 10 meters during the 1997 - 2005 period, it occurred in a range of about 5 to 9 meters during the future period. The results show that in the future RCP 4.5 and 8.5 scenarios, the variability of discharge is reduced compared to the past and that climate change could change the runoff patterns of the Tonle Sap basin.
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