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Preservation of the Posterior Ligaments for Preventing Postoperative Spinal Instability in Posterior Decompression of Lumbar Spinal Stenosis: Comparative Study between Port-Hole Decompression and Subtotal Laminectomy (요추부 척추관 협착증의 후방 감압술에서 후방 인대의 보존 여부와 술 후 척추 불안정성과의 연관성: 포트홀(Port-Hole) 감압술과 후궁 아전절제술 간 비교 연구)

  • Jung, Yu-Hun;Na, Hwa-Yeop;Choe, Saehun;Kim, Jin;Lee, Joon-Ha
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.71-77
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    • 2020
  • Purpose: To determine if sparing the interspinous and supraspinous ligaments during posterior decompression for lumbar spinal stenosis is significant in preventing postoperative spinal instability. Materials and Methods: A total of 83 patients who underwent posterior decompression for lumbar spinal stenosis between March 2014 and March 2017 with a minimum one-year follow-up period, were studied retrospectively. The subjects were divided into two groups according to the type of surgery. Fifty-six patients who underwent posterior decompression by the port-hole technique were grouped as A, while 27 patients who underwent posterior decompression by a subtotal laminectomy grouped as B. To evaluate the clinical results, the Oswestry disability index (ODI), visual analogue scale (VAS) for both back pain (VAS-B) and radiating pain (VAS-R), and the walking distance of neurogenic intermittent claudication (NIC) were checked pre- and postoperatively, while simple radiographs of the lateral and flexion-extension view in the standing position were taken preoperatively and then every six months after to measure anteroposterior slippage (slip percentage), the difference in anteroposterior slippage between flexion and extension (dynamic slip percentage), angular displacement, and the difference in angular displacement between flexion and extension (dynamic angular displacement) to evaluate the radiological results. Results: The ODI (from 28.1 to 12.8 in group A, from 27.3 to 12.3 in group B), VAS-B (from 7.0 to 2.6 in group A, from 7.7 to 3.2 in group B), VAS-R (from 8.5 to 2.8 in group A, from 8.7 to 2.9 in group B), and walking distance of NIC (from 118.4 m to 1,496.2 m in group A, from 127.6 m to 1,481.6 m in group B) were improved in both groups. On the other hand, while the other radiologic results showed no differences, the dynamic angular displacement between both groups showed a significant difference postoperatively (group A from 6.2° to 6.7°, group B from 6.5° to 8.4°, p-value=0.019). Conclusion: Removal of the posterior ligaments, including the interspinous and supraspinous ligaments, during posterior decompression of lumbar spinal stenosis can cause a postoperative increase in dynamic angular displacement, which can be prevented by the port-hole technique, which spares these posterior ligaments.

Periprosthetic Fracture around Tumor Prosthesis, Comparison of Results with or without Cortical Strut Onlay Allograft (종양인공관절 주위 골절의 피질골 지주 중첩 동종골 이식술 유무에 따른 결과 비교)

  • Kim, Yongsung;Cho, Wan Hyeong;Song, Won Seok;Lee, Kyupyung;Jeon, Dae-Geun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.42-50
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    • 2021
  • Purpose: Periprosthetic fractures of a tumor prosthesis are rare but have difficulties in achieving sound fixation because of the poor bone quality, which increases the risk of loosening or re-fracture, even after bone union. A cortical strut onlay allograft was adopted for peri-prosthetic fractures after hip arthroplasty into the periprosthetic fracture of a tumor prosthesis, assuming that it would assist in firm fixation, shorten the time to union, and increase the bone stock, thereby, lower the chance of loosening and re-fracture. Materials and Methods: This study reviewed 27 patients (30 cases) of periprosthetic fracture of tumor prosthesis. Sixteen cases (allograft group) had augmentation with an onlay allograft, while 14 cases (conventional group) had internal fixation or conservative treatment. The following were assessed; mode of periprosthetic fracture, difference in the time to union between a strut cortical onlay allograft and without it, and survival of prosthesis, complication, and functional outcome between the two groups. Results: According to the unified classification system (UCS), 21 cases were type B (70.0%; B1, 14; B2, 1; B3, 6) and 9 cases were type C. The five-, 10-year survival of the 30 reconstructions by Kaplan-Meier plot was 84.5%±4.18% and 42.2%±7.83%, respectively. The average time to bone union of the entire cohort was 5.1 months (range, 2.0-11.2 months). The allograft group (3.5 months) showed a shorter period for union than the conventional group (7.2 months) (p<0.0001). All four cases of major complications occurred in the conventional group. Two cases with loosening and anterior angulation were treated with a change of prosthesis, and another with infection underwent amputation. The remaining case with loosening had conservative management. At the final follow-up, the average Musculosketal Tumor Society score of the allograft group (26.1) was better than that of the conventional group (20.9). Conclusion: Bone union in periprosthetic fractures of a tumor prosthesis can be achieved, but the minimization of complications is important. An onlay allograft facilitates firm fixation and increases the bone stock with a shortened time to union. This simple method can minimize the risk of loosening, joint contracture, and re-fracture.

Clinical and Radiological Results of Treating Unstable Distal Radial Fractures with a Domestically Developed Volar Locking Plate That Has the Characteristic of Double-Tiered Subchondral Support (불안정성 원위 요골 골절의 치료에 있어 한국형 이중 연골하지지고정 전방 금속판의 임상적 및 방사선학적 결과)

  • Lee, Chul-Hyung;Jung, Deukhee;An, Chung-Han;Jeong, Uitak
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.495-502
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    • 2020
  • Purpose: The aim of this study was to assess the effectiveness of domestically developed volar locking plate which has the concept of double-tiered subchondral support (DSS) in maintaining the reduction after distal radial fracture surgery. Materials and Methods: From July 2017 to December 2018, 54 patients were assessed. Plain radiographs were obtained immediately after surgery and at the last follow-up, and the radiographic parameters were measured in those images: radial length, radial inclination, volar tilt, ulnar variance, and distal dorsal cortical distance. The patients were subdivided into their age, type of fracture, and the position of the plate to evaluate the influence of each factors on the reduction maintenance. Results: Distal dorsal cortical distance in radiographs after the surgery was 5.91 mm (standard deviation, ±1.95 mm) on average. Significant differences in the radial length (p=0.038) and ulnar variance (p=0.001) were observed between immediately after surgery and at the last follow-up. When the parameters were evaluated by dividing the patients into subgroups according to the three specific factors, the ulnar variance showed a significant increase at the last follow-up when the patients were included 65-years-old or older. AO/OTA type C3 fracture, and Soong classification grade 0 plate position (p=0.007, p=0.012, p=0.046, respectively). Conclusion: Using the domestically developed DSS-type volar locking plate, significant reduction after distal radial fracture surgery could be maintained successfully. On the other hand, further study will be needed to determine about the reduction loss of the lunate facet identified in special cases that deal with fractures in elderly patients, unstable AO/OTA type C3 distal radial fractures, and Soong classification grade 0 plate position.

Monitoring of Working Environment Exposed to Particulate Matter in Greenhouse for Cultivating Flower and Fruit (과수 및 화훼 시설하우스 내 작업자의 미세먼지 노출현황 모니터링)

  • Seo, Hyo-Jae;Kim, Hyo-Cher;Seo, Il-Hwan
    • Journal of Bio-Environment Control
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    • v.31 no.2
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    • pp.79-89
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    • 2022
  • With the wide use of greenhouses, the working hours have been increasing inside the greenhouse for workers. In the closed ventilated greenhouse, the internal environment has less affected to external weather during making a suitable temperature for crop growth. Greenhouse workers are exposed to organic dust including soil dust, pollen, pesticide residues, microorganisms during tillage process, soil grading, fertilizing, and harvesting operations. Therefore, the health status and working environment exposed to workers should be considered inside the greenhouse. It is necessary to secure basic data on particulate matter (PM) concentrations in order to set up dust reduction and health safety plans. To understand the PM concentration of working environment in greenhouse, the PM concnentrations were monitored in the cut-rose and Hallabong greenhouses in terms of PM size, working type, and working period. Compare to no-work (move) period, a significant increase in PM concentration was found during tillage operation in Hallabong greenhouse by 4.94 times on TSP (total suspended particle), 2.71 times on PM-10 (particle size of 10 ㎛ or larger), and 1.53 times on PM-2.5, respectively. During pruning operation in cut-rose greenhouse, TSP concentration was 7.4 times higher and PM-10 concentration was 3.2 times higher than during no-work period. As a result of analysis of PM contribution ratio by particle sizes, it was shown that PM-10 constitute the largest percentage. There was a significant difference in the PM concentration between work and no-work periods, and the concentration of PM during work was significant higher (p < 0.001). It was found that workers were generally exposed to a high level of dust concentration from 2.5 ㎛ to 35.15 ㎛ during tillage operation.

Analysis of the Characteristics of Container Ports in Busan Port Using Industrial Organization Approach (산업조직론을 활용한 부산항 컨테이너 하역산업의 특성 분석)

  • Ko, Byoung-Wook;Kil, Kwang-Soo;Lee, Da-Ye
    • Journal of Korea Port Economic Association
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    • v.37 no.3
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    • pp.117-128
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    • 2021
  • In order for the users (shipping firms and shippers) and suppliers (stevedoring firms) in the container terminal industry to win-win, it is necessary to have some appropriate diverse market conditions for the industry. This study analyses the basic conditions and demand and supply characteristics of the industry and investigates the market performance of Busan container ports. First, this article analyses the basic characteristics of demand and supply. As the demand characteristics, there are five ones such as 1) exogeneity of demand, 2) function as export/import transportation and hub for transshipment, 3) increase of users' bargaining power, 4) high substituting elasticity, 5) reduction of volume growth. As the supply characteristics, there are seven ones such as 1) inelasticity of supply, 2) homogeneity of stevedoring services, 3) over-supply, 4) adoption of cutting-edge stevedoring technology, 5) scale economy and impossibility of storage, 6) labor market rigidity, 7) enhancing port's role in SCM. In addition, this study conducts the so-called structure-conduct-performance analysis. For the structure analysis, 1) lacks of scale economy in stevedoring companies, 2) high entry barrier, 3) strengthening of shipping firms' bargaining power, 4) transitory permission scheme for tariff are analyzed. For the conduct analysis, 1) price discrimination between export/import and transshipment, 2) mid-term length of terminal use contract, 3) continuous investment in equipment, 4) low level of cooperation among terminal operating firms are derived. For the performance analysis, 1) inequality in profitability, 2) reduction of export/import cost, 3) delay in adopting cutting-edge technology, 4) idle equipment are analyzed. Following this logical flow, the hypothesis that the market structure influences the market conduct is tested based on the actual dataset. As a future agenda in the conclusion, this article recommends the so-called port industrial policy.

A Study on the Correlation between Marine Industry Cluster and Port Regeneration - Focused on the Busan North Port - (해양산업 클러스터와 항만도시재생의 상관성에 관한 연구 - 부산 북항을 중심으로 -)

  • Li, Yun-Zhang;Yang, Ming-Yin;Tian, Xue-Qin;Yu, Yong-Hao;Choi, Tae-Yeong
    • Journal of Korea Port Economic Association
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    • v.38 no.1
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    • pp.101-111
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    • 2022
  • As Asia's leading advanced country, Korea has an absolute advantage over foreign trade routes and maritime economies over inland countries. Following the change in social background, the original port area is for various reasons, and some ills are gradually revealing people's private interests. Due to this, it is the economic interest and future development space of the marine industry cluster in the port area that are directly affected and damaged. This study studied the relationship between marine industry clusters and port urban regeneration. It is intended to present the necessity and importance of activating the marine industry cluster through port urban regeneration while analyzing the regenerative design from the quantitative analysis angle. Therefore, first of all, the theoretical backgrounds were considered, and the cases of port cities that did well worldwide were analyzed according to the current status of the northern port of Busan, the research target site, through analysis. In addition, in order to increase the reliability of this study, the data of marine industry clusters and port city regeneration were reviewed using empirical analysis. Looking at the results of this study's case study and empirical analysis, it is a relationship that actually improved and interacted between the marine industry cluster and the port city regeneration. Through the study, it is expected that the Busan North Port Redevelopment Project will be promoted at the design, environmental, and economic level, and at the same time, it will be able to enhance its status as a marine city in Busan. The results show that, no matter which country or port city, the development of economy, society, culture and will inevitably promote the vigorous development of the marine industrial cluster, also, the port area development to a certain degree. will naturally the physical conditions of regional development obstacle through the port city of regeneration. This promotion will overcome.

A Study on Precision of 3D Spatial Model of a Highly Dense Urban Area based on Drone Images (드론영상 기반 고밀 도심지의 3차원 공간모형의 정밀도에 관한 연구)

  • Choi, Yeon Woo;Yoon, Hye Won;Choo, Mi Jin;Yoon, Dong Keun
    • Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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    • v.40 no.2
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    • pp.69-77
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    • 2022
  • The 3D spatial model is an analysis framework for solving urban problems and is used in various fields such as urban planning, environment, land and housing management, and disaster simulation. The utilization of drones that can capture 3D images in a short time at a low cost is increasing for the construction of 3D spatial model. In terms of building a virtual city and utilizing simulation modules, high location accuracy of aerial survey and precision of 3D spatial model function as important factors, so a method to increase the accuracy has been proposed. This study analyzed location accuracy of aerial survey and precision of 3D spatial model by each condition of aerial survey for urban areas where buildings are densely located. We selected Daerim 2-dong, Yeongdeungpo-gu, Seoul as a target area and applied shooting angle, shooting altitude, and overlap rate as conditions for the aerial survey. In this study, we calculated the location accuracy of aerial survey by analyzing the difference between an actual survey value of CPs and a predicted value of 3D spatial Model. Also, We calculated the precision of 3D spatial Model by analyzing the difference between the position of Point cloud and the 3D spatial Model (3D Mesh). As a result of this study, the location accuracy tended to be high at a relatively high rate of overlap, but the higher the rate of overlap, the lower the precision of 3D spatial model and the higher the shooting angle, the higher precision. Also, there was no significant relationship with precision. In terms of baseline-height ratio, the precision tended to be improved as the baseline-height ratio increased.

A Study on the Major Issues and Legislative Considerations of CCTV Installation in an Operating Room (수술실 CCTV 설치의 쟁점과 입법방향에 관한 소고(小考))

  • Kim, Sungeun;Choe, A Reum;Bae, Kyounghee
    • The Korean Society of Law and Medicine
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    • v.22 no.2
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    • pp.111-138
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    • 2021
  • 'Unlicensed medical practice by a non-medical practitioner' often represented by surrogate surgery or so-called 'ghost surgery,' causes irreparable damage to life or body, and therefore calls for very strict and effective controls. The 'bill on installment of CCTVs in an operating room' to prevent unlicensed surrogate surgery has been discussed for a long time, but due to numerous issues and heated confrontations, it has been pending in the National Assembly. Nevertheless, it is expected that the bill will be discussed again in earnest in the National Assembly because surrogate surgery and factory-type cosmetic surgery, which has been performed mainly in the field of cosmetic surgery, has also been occurring in the field of therapeutic surgery. In general, an operating room is considered as being locked or closed, as well as disallowing implicit complicity among insiders. Hence, if the insiders conspire to commit or cover up an illegal act, or if a surgeon performs rapid cosmetic surgery and then leaves the recipient (or medical institution) so as to perform more operations for profit - even if it is legitimate practice - it may result in serious consequences in terms of the recovery of a patient. In this case, installation of CCTVs can be of great help in identifying an illegal act and assessing any occurrence of negligence. On the other hand, while the fundamental purpose of therapeutic surgery is to restore a patient's life or body - that is, lifesaving - installation of CCTVs may base the relationship between a surgeon and a patient on distrust and surveillance, so it may increase the number of requests for CCTV footage or lead to more disputes, as well as placing a burden on the surgeon when best results are not achieved for a patient. As a result, the surgeon may choose non-invasive treatment contrary to conscience instead of risky but necessary surgery, or he/she may have significant difficulty in determining the timing of surgery, which may limit the provision of effective surgical medical care. Then, in terms of the relationship between a surgeon and patient, and in the long run, there could be significant disadvantages for the public and patients if CCTV footage is allowed. In this paper, we review domestic and overseas cases and issues regarding installation of CCTVs in an operating room, and present various viewpoints and suggestions to promote legislation with minimized legal problems and side effects, thereby contributing to protection of the lives and health of the public, patients, and recipients of surgery.

Analysis of Causality of the Increase in the Port Congestion due to the COVID-19 Pandemic and BDI(Baltic Dry Index) (COVID-19 팬데믹으로 인한 체선율 증가와 부정기선 운임지수의 인과성 분석)

  • Lee, Choong-Ho;Park, Keun-Sik
    • Journal of Korea Port Economic Association
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    • v.37 no.4
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    • pp.161-173
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    • 2021
  • The shipping industry plummeted and was depressed due to the global economic crisis caused by the bankruptcy of Lehman Brothers in the US in 2008. In 2020, the shipping market also suffered from a collapse in the unstable global economic situation due to the COVID-19 pandemic, but unexpectedly, it changed to an upward trend from the end of 2020, and in 2021, it exceeded the market of the boom period of 2008. According to the Clarksons report published in May 2021, the decrease in cargo volume due to the COVID-19 pandemic in 2020 has returned to the pre-corona level by the end of 2020, and the tramper bulk carrier capacity of 103~104% of the Panamax has been in the ports due to congestion. Earnings across the bulker segments have risen to ten-year highs in recent months. In this study, as factors affecting BDI, the capacity and congestion ratio of Cape and Panamax ships on the supply side, iron ore and coal seaborne tonnge on the demand side and Granger causality test, IRF(Impulse Response Function) and FEVD(Forecast Error Variance Decomposition) were performed using VAR model to analyze the impact on BDI by congestion caused by strengthen quarantine at the port due to the COVID-19 pandemic and the loading and discharging operation delay due to the infection of the stevedore, etc and to predict the shipping market after the pandemic. As a result of the Granger causality test of variables and BDI using time series data from January 2016 to July 2021, causality was found in the Fleet and Congestion variables, and as a result of the Impulse Response Function, Congestion variable was found to have significant at both upper and lower limit of the confidence interval. As a result of the Forecast Error Variance Decomposition, Congestion variable showed an explanatory power upto 25% for the change in BDI. If the congestion in ports decreases after With Corona, it is expected that there is down-risk in the shipping market. The COVID-19 pandemic occurred not from economic factors but from an ecological factor by the pandemic is different from the past economic crisis. It is necessary to analyze from a different point of view than the past economic crisis. This study has meaningful to analyze the causality and explanatory power of Congestion factor by pandemic.

Initial Analysis of the Underground Air Among Jeju Lava Forest(Sumgol) and its Healing Effect on the Human Body (제주 현무암 '숲' 지하 공기(숨골: Sumgol)의 분석과 인체에 미치는 치유 효과)

  • Sin, SBangsik;Kim, Hyek Nyeon;Lee, Deok Hee;Kim, Tae Seung;Kim, Yong Hwan;Kang, Chang Hee;Song, Kyu Jin;Lee, Hyung H.
    • Journal of Naturopathy
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    • v.11 no.1
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    • pp.18-30
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    • 2022
  • Background: It was to develop an air purification system (APS) using an underground air purification layer to verify the effect of basalt forest's underground air (sumgol) on a volcanic Jeju. Finally, it is necessary to analyze these purified air components and their usefulness to the human body in an air experience center. Purpose: It was to collect basalt forest air, analyze its composition, and explore its effect on the human body. Methods: We APS devices installed at four points in the Papaville area of Jeju. The air discharged from the APS was collected and analyzed the recycling components. An installed experience room filled with negative ions is about 5,000 ions/m3. After allowing the participants to stay for 60 to 120 minutes, we investigated the state of blood vessels. Results: In the analysis of the underground air, the O2 concentration was 21.18%, which was higher than the average oxygen concentration of 20.94% in the atmosphere. However, Formaldehyde was not detected, and the CO2 was 419 ppm, which was lower than that of indoor air. The PM2.5 concentration was less than 24 ㎍/m3 and detected anions over 5.000 /m3. The experiencer's vascular states improved, and the increase in pulse rate and stress relief were high. Conclusions: The valuable ingredients identified by analyzing the air were precious for natural healing. The experience results showed that it effectively improved the pulse rate, blood vessels, and stress. These conditions may be highly beneficial as a new area for expanding the basalt lava forest in the Jeju area into the natural healing and wellness industry.