We introduce a convenient method of urethrography before catheterization for patients with pelvic trauma that can be used in a resuscitation area. A 10-mL syringe without a needle was used. X-ray contrast medium (Iohexol, 300 mg I/mL) was administered through the urethral orifice using a 10-mL syringe without needle and a simple pelvic anteroposterior film was taken (70 kilovolt [peak], 50 mAs). A 36-year-old soldier with a saddle injury from a gun barrel was taken to a trauma center. He had a pelvic fracture and complained of hematuria. Bedside urethrography above described was performed. The anterior urethra showed nonspecific findings, but dye leaked from the posterior urethra. Bedside Foley catheter insertion was attempted, but the catheter could not be advanced past the membranous urethra. Thereafter, suprapubic catheterization was performed. On the day of the injury, iliac artery embolization was carried out. The dislocated sacroiliac joint was also treated using open reduction and internal fixation. On hospital day 7, guidewire Foley insertion was performed. This bedside urethrography technique is simple and useful for pelvic fractures in which urethral injury is suspected.
Purpose: Prior studies regarding ethical management on worker's performance have primarily focused on specific industries or regions, potentially limiting the generalizability. This gap in knowledge underscores the need for a comprehensive investigation that considers a diverse range of industries and thoroughly examines the multifaceted aspects of ethical management. Research design, data and methodology: The academic search platform used for this study was 'Google Scholar', 'Scopus', and 'Web of Science' indexes various scholarly articles, including peer-reviewed journals and books. By utilizing specific search terms such as "corporate ethical management" and "employee performance," a vast pool of relevant studies was identified. Results: The findings indicated four effects: first, a positive correlation between ethical management practices and heightened employee motivation and engagement; second, an augmentation in organizational commitment and job satisfaction among employees; third, a reduction in turnover rates, indicating enhanced employee retention; and fourth, an elevation in overall productivity and performance outcomes. Conclusions: In sum, this study offers actionable insights, advocating for adopting and reinforcing ethical management strategies as a potent means to foster a high-performance work culture. These encompass fostering a robust ethical framework, cultivating a culture of transparency and open communication, and providing avenues for employees to voice ethical concerns without fear of retribution.
Objectives The purpose of this study is to report the effects of Korean medicine treatment on tibia, fibula, and patellar fractures with sequelae of poliomyelitis. Methods A 64-year-old male patient was treated with acupuncture, herbal medicine, cupping, moxibustion, and exercise treatment for 59 days after open reduction and internal fixation and tension band wiring surgery. The effects were evaluated using a visual analog scale (VAS), manual muscle testing (MMT), range of motion (ROM), Western Ontario and McMaster Universities (WOMAC), and EuroQol-5 dimension (EQ-5D) index. Results After treatment, VAS decreased from 7 to 2. MMT, ROM, WOMAC, EQ-5D and walking ability were improved. Conclusions This case study suggests that Korean medicine treatment could be effective for tibia, fibula, patellar fractures in patients with sequelae of poliomyelitis.
Floating offshore wind turbines (FOWTs) have been developed to overcome large water depths and leverage the abundant wind resource in deep seas. However, wind-wave misalignment can occur depending on the weather conditions, and most megawatt (MW)-class turbines are horizontal-axis wind turbines subjected to yaw errors. Therefore, the power performance and dynamic response of super-large FOWTs exposed simultaneously to these external conditions must be analyzed. In this study, several scenarios combining wind-wave misalignment and yaw error were considered. The IEA 15 MW reference FOWT (v1.1.2) and OpenFAST (v3.4.1) were used to perform numerical simulations. The results show that the power performance was affected more significantly by the yaw error; therefore, the generator power reduction and variability increased significantly. However, the dynamic response was affected more significantly by the wind-wave misalignment increased; thus, the change in the platform 6-DOF and tower loads (top and base) increased significantly. These results can be facilitate improvements to the power performance and structural integrity of FOWTs during the design process.
This is clinicostatistical study of mandibular fractures. This study was based on a series of 677 patients with mandibular fracture during the period of 1982 to 1987. This results obtained were as follows : 1. In respect of incidence, there were high frequency in May and September, and in large city(63%). 2. The age frequency was the highest in the 20s-year old group (38.7%), and the ratio of male to female was 4.64 : 1. 3. The most common etiologic factor was blow(31.5%), but in children that was traffic accident followed by fall down. 4. The most common site of bone fractures was symphysis, followed by angle, condyle. In comparison of right and left sides, left side was more frequently involved(364 cases) than right side(257 cases). 5. The patients arrived in hospital immediately within 24 hours after accident were 62.9% of all, and 42.4% was arrived via private medical and dental clinic. 6. In respect of treatment, open reduction was 55.5% of all, closed reduction was 37.2%. In children, closed reduction was done in 50.6%.
Choi, Jae Il;Lee, Seong Pyo;Ji, So Young;Yang, Wan Suk
Archives of Craniofacial Surgery
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v.11
no.1
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pp.28-32
/
2010
Purpose: In accordance with the increasing number of accidents caused by various reasons and recently developed fine diagnostic skills, the incidence of orbital blow-out fracture cases is increasing. As it causes complications, such as diplopia and enophthalmos, surgical reduction is commonly required. This article reports a retrospective series of 5 blow-out fracture cases that had unusual nerve injuries after reduction operations. We represents the clinical experiences about treatment process and follow-up. Methods: From January 2000 to August 2009, we treated total 705 blow-out fracture patients. Among them, there were 5 patients (0.71%) who suffered from postoperative neurologic complications. In all patients, the surgery was performed with open reduction with insertion of $Medpor^{(R)}$. Clinical symptoms and signs were a little different from each other. Results: In case 1, the diagnosis was oculomotor nerve palsy. The diagnosis of the case 2 was superior orbital fissure syndrome, case 3 was abducens nerve palsy, and case 4 was idiopathic supraorbital nerve injury. The last case 5 was diagnosed as optic neuropathy. Most of the causes were extended fracture, especially accompanied with medial and inferomedial orbital blow-out fracture. Extensive dissection and eyeball swelling, and over-retraction by assistants were also one of the causes. Immediately, we performed reexploration procedure to remove hematomas, decompress and check the incarceration. After that, we checked VEP (visual evoked potential), visual field test, electromyogram. With ophthalmologic test and followup CT, we can rule out the orbital apex syndrome. We gave $Salon^{(R)}$ (methylprednisolone, Hanlim pharmaceuticals) 500 mg twice a day for 3 days and let them bed rest. After that, we were tapering the high dose steroid with $Methylon^{(R)}$ (methylprednisolon 4 mg, Kunwha pharmaceuticals) 20 mg three times a day. Usually, it takes 1.2 months to recover from the nerve injury. Conclusion: According to the extent of nerve injury after the surgery of orbital blow-out fracture, the clinical symptoms were different. The most important point is to decide quickly whether the optic nerve injury occurred or not. Therefore, it is necess is to diagnose the nerve injury immediately, perform reexploration for decompression and use corticosteroid adequately. In other words, the early diagnosis and treatment is most important.
Purpose: The bony mallet finger injury is generally managed by conservative treatments, but operative treatments are needed especially when the fractures involve above 30% of articular surface or distal phalanx is accompanied by subluxation in the volar side. This is the reason they often result in chronic instability, articular subluxation and unsatisfactory cosmetic. In this report, We describe new method using the hook plate as an operative treatment of Mallet finger deformity. Methods: Among 13 patients with Mallet finger deformity who came from February 2006 to February 2008, six patient were included in surgical indication. Under local anesthesia, H or Y type incision was made at the DIP joint area. After the DIP joint extension, the hook plate was put on the fracture line, and one self tapping screw was used for fixation. 2 hole plate which was one of the holes in 1.5 mm diameter was cut in almost half and bended through approximately $100^{\circ}$. Results: In all six cases which applied the hook plate, complications such as loss of reduction or nail deformity were not seen. In only one patient, hook pate was removed due to inflammatory reaction after surgery. At 2 weeks after operation, active motion of DIP joint was performed. The result was satisfactory not only cosmetically but also functionally. At 6 weeks after operation, the range of motion of DIP joint was average $64^{\circ}$. Conclusion: The purpose of the operative treatment for mallet finger deformity using the hook plate is to provide anatomical reduction with rigid fixation and to prevent contracture at the DIP joint. While other operations take 6 weeks, the operation using the hook plate begins an active motion at 2 weeks after operation. Complication rate was low and the method is rather simple. Thus, the operation using the hook plate is recommended as a good alternative method of the mallet finger deformity treatment.
This study generated regression models through a direct harvesting method to estimate carbon storage and uptake by Pinus densiflora and Pinus koraiensis, the major evergreen tree species in urban landscape, and established essential information to quantify carbon reduction by urban trees. Open-grown landscape tree individuals for each species were sampled reflecting various diameter sizes at a given interval. The study measured biomass for each part including the roots of sample trees to compute the total carbon storage per tree. Annual carbon uptake per tree was quantified by analyzing radial growth rates of stem samples at breast height. The study then derived a regression model easily applicable in estimating carbon storage and uptake per tree for the two species by using diameter at breast height (DBH) as an independent variable. All the regression models showed high fitness with $r^2$ values of higher than 0.98. While carbon storage and uptake by young trees tended to be greater for P. densiflora than for P. koraiensis in the same diameter sizes, those by mature trees with DBH sizes of larger than 20 cm showed results to the contrary due to a difference in growth rates. A tree of P. densiflora and P. koraiensis with DBH of 25 cm stored 115.6 kg and 130.0 kg of carbon, respectively, and annually sequestered 9.4 kg and 14.6 kg. The study has broken new grounds to overcome limitations of the past studies which quantified carbon reduction of the study species by substituting, due to a difficulty in direct cutting and root digging of landscape trees, coefficients from forest trees such as biomass expansion factors, ratios of below ground/above ground biomass, and diameter growth rates.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.8
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pp.23-28
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2019
The structural integrity of a surface metal coating was evaluated through numerical results to improve the efficiency and reduce the damage caused by cavitation in ships and marine plants. The goal was to ensure structural strength and performance, even if the thickness of the wing is reduced to reduce the weight of the material and surface coating. Analytical methods were used for four models: a non-coating model, one with the same thickness after coating, one with a thickness reduction of 3% after coating, and one with thickness reduction of 5% after coating. With a thickness reduction of 5% after coating, the stress was increased to 12%, and the safety factor was 0.99%, so the structural integrity was insufficient. However, a better material or a thicker coating could allow a sufficient safety factor to be secured. The structural integrity was improved by the coating, and even when the weight was reduced up to 5%, the structural integrity could be sufficiently secured due to the coating effect.
Objective : In an aging society, the number of patients with symptomatic degenerative spondylolisthesis (DS) is increasing and there is an emerging need for fusion surgery. However, few studies have compared transforaminal lumbar interbody fusion (TLIF) and lateral lumbar interbody fusion (LLIF) for the treatment of patients with DS. The purpose of this study was to investigate the clinical and radiological outcomes between TLIF and LLIF in DS. Methods : We enrolled patients with symptomatic DS at L4-5 who underwent TLIF with open pedicle screw fixation (TLIF group, n=41) or minimally invasive LLIF with percutaneous pedicle screw fixation (LLIF group, n=39) and were followed-up for more than one year. Clinical (visual analog scale and Oswestry disability index) and radiological outcomes (spondylolisthesis rate, segmental sagittal angle [SSA], mean disc height [MDH], intervertebral foramen height [FH], cage subsidence, and fusion rate) were assessed. And we assessed the changes in radiological parameters between the postoperative and the last follow-up periods. Results : Preoperative radiological parameters were not significantly different between the two groups. LLIF was significantly superior to TLIF in immediate postoperative radiological results, including reduction of spondylolisthesis rate (3.8% and 7.2%), increase in MDH (13.9 mm and 10.3 mm) and FH (21.9 mm and 19.4 mm), and correction of SSA ($18.9^{\circ}$ and $15.6^{\circ}$) (p<0.01), and the changes were more stable from the postoperative period to the last follow-up (p<0.01). Cage subsidence was observed significantly less in LLIF (n=6) than TLIF (n=21). Fusion rate was not different between the two groups. The clinical outcomes did not differ significantly at any time point between the two groups. Complications were not statistically significant. However, TLIF showed chronic mechanical problems with screw loosening in four patients and LLIF showed temporary symptoms associated with the surgical approach, such as psoas and ileus muscle symptoms in three and two cases, respectively. Conclusion : LLIF was more effective than TLIF for spondylolisthesis reduction, likely due to the higher profile cage and ligamentotactic effect. In addition, LLIF showed mechanical stability of the reduction level by using a cage with a larger footprint. Therefore, LLIF should be considered a surgical option before TLIF for patients with unstable DS.
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