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Objectives To examine the association between cigarette smoke exposure and depression among Korean adolescents using the seventh Korea Youth Risk Behavior Web-based Survey (KYRBWS). Design Cross-sectional study. Setting A nationally representative sample of middle and high school students across South Korea. Participants 75 643 eligible participants across the country. Primary outcome measures Current smoking, secondhand smoke exposure and depression. Methodology Data were analysed from a nationally representative survey of 75 643 participants (37 873 men and 37 770 women). Data were gathered on extensive information including current smoking, secondhand smoke exposure and depression in adolescence. Multiple logistic regression analysis was used to estimate the association between current smoking, secondhand smoke exposure and depression in Korean adolescents. Results Among those who had never smoked, secondhand smoke exposure was positively associated with depression in male and female adolescents in a dose–response relation (OR 1.27, OR 1.52 in males; OR 1.25, OR 1.72 in females). Similar associations were observed among currently smoking men and women in a dose–response manner (OR 1.29, OR 1.55 in males; OR 1.22, OR 1.41 in females). These significant trends were consistently observed even after adjustments. Conclusions We suggested that current smoking and secondhand smoke exposure were positively associated with depression in male and female adolescents. Efforts to encourage no smoking and no secondhand smoke exposure will be established for adolescents.

Osteochondromas are one of the most common benign bone tumors. They usually arise from the metaphyses of long bones. Involvement of the bicipital tuberosity is rare. To date, no reports have described avulsed rupture of the distal biceps tendon caused by an osteochondroma of the bicipital tuberosity. This article presents a case of avulsion of the distal biceps tendon secondary to sessile osteochondroma of the bicipital tuberosity in a 65-year-old right-handed sedentary worker who presented with insidious pain and limited motion in his left elbow for 2 months. Intraoperative findings showed a bony mass of 25×23×5 mm with osteocartilaginous nodules on the bicipital tuberosity. The distal biceps tendon with an avulsed bony fragment was displaced proximally, with a 20-mm gap between the tendon and the bicipital tuberosity. After complete excision of the mass, footprint preparation at the bicipital tuberosity was performed using a 4.0-mm burr and anatomic reattachment of the distal biceps tendon with a 5.0-mm suture anchor. The pathologic diagnosis of osteochondroma was confirmed microscopically. We suggest that osteochondroma of the bicipital tuberosity be considered as a cause of painful limitation of forearm rotation or avulsed rupture of the distal biceps tendon.

A radio frequency (RF) sputtering system is used to coat nano-thick TiO2 layer on the overlithiated layered metal oxide (OLO) electrode. The X-ray diffraction (XRD) and the field emission-scanning electron microscope (FE-SEM) images indicate amorphous TiO2 is coated on the top surface of the electrode with a thickness of approximately 20 nm for the 40 min sputtered sample. The sample sputtered for 40 minutes cycled at 90 mA g(-1) between 2 and 4.8 V versus Li+/Li has 15 mA h g(-1) more specific capacity at 100th cycle than that of the uncoated sample. In the voltage profiles, additional overpotential is unobservable upon sputtering TiO2 in comparison to that of the reference sample. Further analyses by the electrochemical impedance spectroscopy (EIS) and X-ray photoelectron spectroscopy (XPS) demonstrate the sputtered sample has less electrolyte decomposition products on the surface than that of the reference sample. Moreover, in the case of sputtering, reduced amount of transition metal and Li2O are deposited on the surface of the counter electrode, Li. In summary, the sputtered TiO2 acts as nano-sized artificial solid electrolyte interface (SEI) layer, which protects the surface of the electrode and improves kinetic properties, leading to improved performance.

Summary The economic feasibility of the exploitation of unconventional resources is highly dependent on the ability of the operator to maximize individual well productivity, making hydraulic fracture design and implementation the defining factor for a successful field development in most cases. Some unconventional reservoirs, as shallow coal bed methane and over-pressured oil and gas shale formations, commonly present the minimum principal stress in the vertical direction, resulting in the occurrence of horizontal hydraulic fractures. Models for the transient flow and pressure behavior of horizontal fractures emanating from vertical wells exist and clearly show distinct performance from those for vertical fractures. This suggests that the widely accepted unified fracture design (UFD) approach to maximize well productivity for vertical and horizontal wells with vertical hydraulic fractures cannot be used for horizontal fractures. Thereafter, the necessity for guidelines to model and design horizontal fractures becomes evident. This investigation begins by presenting a new set of equations for horizontal fracture design based on the UFD approach, which allows the direct calculation of fracture width, half-length and conductivity for a given proppant number. Later, a reservoir numerical simulator is used to model well productivity behavior for horizontal fractures in homogeneous formations, with or without vertical to horizontal permeability anisotropy and for different aspect ratios as a function of suitably-defined proppant number, dimensionless fracture conductivity, and fracture penetration index parameters. The findings of this work reveal a complex behavior for horizontal fractures that prohibits the extrapolation of previous generalizations between proppant number, penetration index and dimensionless fracture conductivity established for vertical fractures. For a number of scenarios, new relationships among these variables are provided to guide horizontal fracture design. Anisotropy and reservoir aspect ratio were also found to significantly impact fracture performance. Additionally, a set of multi-variable functions that permit the estimation of maximum achievable productivity index for the horizontal fracture has been fitted, based on commonly known reservoir parameters and the proppant number. This investigation provides a comprehensive framework to assist the design of optimal horizontal fracture geometry that maximizes productivity for a given mass of proppant.

Oil shales are lamellar, non-porous, impermeable hydrocarbon bearing rocks that contain organic matter called kerogen which, when heated at pyrolysis temperature of approximately 650-700 oF, thermo-chemically decomposes to liberate hydrocarbons. They are at the base of the resource triangle because cutting edge technology and higher fuel prices are required to economically produce them. Technologies for oil shale production include surface and in-situ retorting. This study focusses on in-situ oil shale production methodologies. The process of heating oil shale to the pyrolysis temperature can be achieved by direct or indirect heating. Direct heating geometries include the Shell in-situ conversion process (ICP) using downhole electric heaters in vertical holes and the ExxonMobil approach using longitudinal vertical fractures created from horizontal wells and propped with electrically conductive material such as calcined coke. Indirect heating approaches propose injection and circulation of steam or a non-condensable gas like CO2. These include the Chevron concept of creating horizontal fractures in vertical wells or the Texas A&M concept using multiple vertical transverse fractures penetrated by horizontal wells. The objective of this paper is to compare energy and recovery efficiency of various in-situ retorting technologies using different heating schemes and well configurations as mentioned above. Thermo-physical parameters like thermal conductivity, specific heat capacity, porosity, permeability needed for the numerical simulation have been obtained by extensive literature survey of various oil shale deposits in Green river formation of USA. A sensitivity analysis of direct heating pattern and spacing reproduces previous work. Then the validated model is used to evaluate the size and fracture spacing sufficient to heat the oil shale in the direct and indirect heating approaches and to compare pressurized hot fluid circulation to heating elements. The use of the same wells for both heating and hydrocarbon production offer an economic edge for indirect heating approaches.

Non-aqueous sol-gel routes involving the reaction of metal oxide precursors in organic solvents (e.g., benzyl alcohol) at moderate temperature and pressure, offer advantages such as high purity, high reproducibility and the ability to control the crystal growth without the need of using additional ligands. In this paper, a study carried out on a series of iron oxide/reduced graphene oxide composites is presented to elucidate a structure-properties relationship leading to an improved electrochemical performance of such composites. Moreover, it is demonstrated that the easy production of the composites in a variety of temperature and composition ranges, allows a fine control over the final particles size, density and distribution. The materials obtained are remarkable in terms of the particle's size homogeneity and dispersion onto the reduced graphene oxide surface. Moreover, the synthesis method used to obtain the graphene oxide clearly affects the performances of the final composites through the control of the restacking of the reduced graphene oxide sheets. It is shown that a homogeneous and less defective reduced graphene oxide enables good electrochemical performances even at high current densities (over 500 mAh/g delivered at current densities as high as 1600 mA/g). The electrochemical properties of improved samples reach the best compromise between specific capacity, rate capability and cycle stability reported so far.

Psychological status may be an important predictor of outcome and patient satisfaction after treatment for rotator cuff disease. Few prior studies have considered these factors. The objective of the study was to investigate the prevalence of psychological distress and its effect on self-assessed pain, disability, and health-related quality of life in patients scheduled for rotator cuff repair.We assessed 107 consecutive patients preoperatively using the Hospital Anxiety and Depression Scale (HADS); visual analog scale pain score; American Shoulder and Elbow Surgeons (ASES) scale; Korean Shoulder Scale (KSS); and World Health Organization Quality of Life Scale, Abbreviated Version (WHOQOL-BREF). Preoperative demographic, clinical, and radiologic parameters were also evaluated.Of the patients, 28 (26.2%) had depression and 25 (23.4%) had anxiety. The HADS depression score was positively correlated with the visual analog scale pain score (P = .048) and negatively correlated with the ASES, KSS, and WHOQOL-BREF scores (P = .005, P = .004, and P.0001, respectively). The HADS anxiety score was negatively correlated with the ASES, KSS, and WHOQOL-BREF scores (P = .034, P = .037, and P.0001, respectively). On multivariate analysis with a linear regression model, the HADS depression score was an independent predictor of ASES, KSS, and WHOQOL-BREF scores (P = .02, P = .005, and P = .001, respectively).Depression and anxiety had a negative impact on self-assessed outcome measurements in patients scheduled for rotator cuff repair. Depression was a strong predictor of functional disability and health-related quality of life. Our results suggest that preoperative psychological status may influence postoperative outcome after rotator cuff repair and thus is an essential part of preoperative assessment.

Carnitine palmitoyltransferase 1A (CPT1A) is an enzyme functioning in mitochondrial fatty acid oxidation (FAO) of the liver. Patients with CPT1A deficiency have impaired mitochondrial FAO and display hypoketotic hypoglycemia and hepatic encephalopathy as typical manifestations. In this report, we present a case of CPT1A deficiency presenting jaundice as the first manifestation. A 1.9 years old boy showed jaundice and elevated levels of free and total carnitine were observed. From direct sequencing analysis of CPT1A, two novel mutations, c.1163+1G>A and c.1393G>A (p.Gly465Arg), were identified. At the age of 2.2 years, hypoglycemia, tachycardia, and altered mental status developed just after cranioplasty for craniosynostosis. High glucose infusion rate was required for recovery of his vital signs and mentality. Diet rich in high carbohydrate, low fat and inclusion of medium chain triglyceride oil resulted in improvement in cholestatic hepatitis and since then the boy has shown normal growth velocity and developmental milestones to date.

Purpose This study was conducted to evaluate the results of internal fixation for stable femoral neck fractures occurring in patients over 65 years old. Materials and Methods Between 2008 and 2014, we evaluated 25 patients over 65 years old with Garden type 1 and 2 femoral neck fractures that were treated with internal fixation after a minimum follow up of 1 year. There were 5 males and 20 females and the average age was 72.3 years (range, 65-84 years) at the time of surgery. Fracture site union, horizontal shortening and complications were evaluated as radiographic parameters and change of walking ability (as measured using Koval walking ability score) was investigated as a clinical parameter. Results Union of fracture site was achieved in 24 out of the 25 cases (96.0%). The average length of horizontal shortening was 6.5 mm (range, 0.2-19.7 mm). At final follow up, 3 cases experienced complications: nonunion (n=1), avascular necrosis (n=1), and subtrochanteric fracture after minor trauma (n=1). Walking ability decreased an average of 1 step at the final follow up. Conclusion Internal fixation for stable femoral neck fractures occurring in patients over 65 years showed satisfactory union rates. However, care should be taken with this technique given the possibility of decreased walking ability resulting from horizontal shortening.

Esophageal candidiasis is commonly seen in immunocompromised patients; however, candida esophagitis induced stricture is a very rare complication. We report the first case of esophageal stricture secondary to candidiasis in a glycogen storage disease (GSD) 1b child. The patient was diagnosed with GSD type 1b by liver biopsy. No mutation was found in the G6PC gene, but SLC37A4 gene sequencing revealed a compound heterozygous mutation (p.R28H and p.W107X, which was a novel mutation). The patient's absolute neutrophil count was continuously under 1,000/µL when he was over 6 years of age. He was admitted frequently for recurrent fever and infection, and frequently received intravenous antibiotics, antifungal agents. He complained of persistent dysphagia beginning at age 7 years. Esophageal stricture and multiple whitish patches were observed by endoscopy and endoscopic biopsy revealed numerous fungal hyphae consistent with candida esophagitis. He received esophageal balloon dilatation four times, and his symptoms improved.

Purpose: The purpose of this study was to evaluate clinical and radiographic results of revision total hip arthroplasty with constrained liner in patients with abductor insufficiency. Materials and Methods: In this study, 30 patients treated with constrained liner during revision total hip arthroplasty due to abductor insufficiency were evaluated after minimum 2-year follow-up. There were 14 men and 16 women and the mean follow-up period was 4.6 years. Re-dislocation and aseptic loosening of the implant were defined as a failure of the constrained liner. Harris hip score and ambulatory function were evaluated as a clinical parameter and osteolysis, aseptic loosening of the implant and other complications were evaluated as a radiologic parameter. Results: During the follow-up period, there were 4 cases (13.3%) of constrained liner failure including two cases of re-dislocation and two cases of acetabular cup aseptic loosening. The average Harris hip score was improved from 38.3 points preoperatively to 73.4 points at last follow up. At the final follow-up, there were 20 cases (66.7%) of improvement in ambulatory function. There was 1 case of infection and 1 case of periprosthetic fracture. Conclusion: Use of a constrained liner during revision total hip arthroplasty showed satisfactory results for prevention of re-dislocation in patients with abductor insufficiency. However longer term studies on loosening of implants are needed.

The occurrence and the consistency of the popliteomeniscal fascicle between the popliteus tendon and the lateral meniscus have been the subject of debate. It is difficult to diagnose and treat popliteomeniscal fascicle tears. Furthermore, popliteomeniscal fascicle tears are difficult to identify with arthroscopy. This article describes the diagnostic factors for popliteomeniscal fascicle tears and the safe, effective operative techniques that can be used for their treatment. We suggest that popliteomeniscal fascicle tears are diagnosed when the following 3 conditions are confirmed: (1) existence of mechanical symptoms such as pain, locking, and giving way in the lateral compartment of the knee; (2) identification of hypermobility of the lateral meniscus through arthroscopic probing; and (3) occurrence of an osteochondral lesion in the posterior area of the lateral femoral condyle. In the case of popliteomeniscal fascicle tears, the tear area can be repaired with a suture hook and polydioxanone with an all-inside technique. If the joint space is narrowing because of soft-tissue tightness, it can be repaired with a zone-specific cannula through an inside-out technique.

Objective: The purpose of this study was to report the long-term follow-up results of chronic Monteggia fractures treated with angulation–translation osteotomy of ulna and closed reduction of the radial head. Design: Retrospective. Setting: Level 1 trauma center. Patients: We retrospectively reviewed 10 missed Monteggia fractures in children. The mean age of the patients was 7.5 years (range, 6–10 years), and there were 2 girls and 8 boys. The mean duration of time between initial injury and initial presentation was 1.7 years (range, 6 weeks to 5 years). Intervention: Closed reduction with ulna osteotomy or lengthening was performed in all 10 cases. Annular ligament reconstruction (ALR) was done in 2 cases. Final follow-up ranged from 3 to 20 years (mean 10 years). Main Outcome Measurement: We assessed preoperative and postoperative radiographs to evaluate the quality of the radial head reduction. Clinical results were assessed according to the functional elbow score devised by Kim et al. Results: Radial head reduction was achieved and maintained in 8 of 10 cases after primary or secondary surgery. The radial head was mildly subluxated in one case and dislocated in another case at final follow-up. ALR was performed in only 2 cases. Open reduction and ALR is not required in every case, and its need should depend on intraoperative stability of radial head. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Subcutaneous sacrococcygeal myxopapillary ependymoma is extremely rare tumor that has a tendency to develop in children and adolescents. There have been several case reports and sporadic reports in the literature. However, no case has been reported in an Asian patient, to the best of our knowledge. We describe a 25-year-old Asian female patient with a subcutaneous sacrococcygeal myxopapillary ependymoma that had been clinically diagnosed as a pilonidal cyst. The tumor was treated successfully by surgical excision and the patient is doing well without evidence of local recurrence or distant metastasis at 2 years after surgery. Keywords Myxopapillary ependymoma; Subcutaneous; Sacrococcygeal

BACKGROUND A pathognomonic finding of slipped capital femoral epiphysis (SCFE) is a combination of the decrease in the height of the slipped epiphysis and the position of external rotation and flexion of hip. We believe that decrease in the acetabulotrochanteric distance (ATD) on an anteroposterior (AP) radiograph represents this finding. MATERIAL AND METHODS In a retrospective study of 25 consecutive cases of unilateral SCFE, we defined ATD as the distance between a line connecting the superolateral margins of the acetabulae with a second line, parallel to the first line, which goes through the tip of the greater trochanter on each hip and acetabulotrochanteric angle (ATA) as the angle between a line connecting the superolateral margins of the acetabulae with a second line connecting the tip of greater trochanter on each side. The difference in ATD and ATA between both hips in each case was evaluated and their correlation was determined using the Pearson correlation coefficient. RESULTS Nineteen cases (76%) showed difference in ATD of > 2 mm and positive ATA divergence of >1 degree. The average difference in ATD was 6.6 mm (range, 0 to 25 mm); the average ATA divergence was 2.4 degree (range, 0 to 5.3 degree). CONCLUSIONS Our findings show that the difference in acetabulotrochanteric distance (ATD) between hips is an easy, reliable, and sensitive finding present on an AP radiograph of patients with unilateral SCFE. ATD should be taken into consideration while evaluating AP radiographs of a patient suspected to have SCFE, and further evaluation with lateral hip radiographs should be carried out to confirm the diagnosis. LEVEL OF EVIDENCE Level IV.

Quetiapine is an atypical antipsychotic and has also been used in the treatment of depression. Since anti-inflammatory effects of antidepressants are well established, we hypothesized that quetiapine may also exert anti-inflammatory effects. Thus this study was designed to examine the anti-inflammatory effect of quetiapine in murine collagen-induced arthritis. Mice were immunized with collagen type II for the induction of arthritis and treated with quetiapine (10mg/kg) daily for 2weeks. Mice were divided into 3 groups: control, CIA, and CIA+quetiapine treatment. Arthritic index and paw thickness were used to compare severity of arthritis. In additions, radiological and histological assessments were employed. Anti-type II collagen-specific antibody, interleukin-6 (IL-6), interleukin-17 (IL-17), and prostaglandin E(2) (PGE(2)) were evaluated at the end of the treatment period. Both arthritic index and paw thickness were markedly improved in CIA+quetiapine treatment group compared with those in CIA groups (arthritic index; P

A new pull-string technique uses polydioxanone to improve visualization and maintain adequate working space in arthroscopic procedures.

Decreased BMI has been reported that it may be associated with cognitive decline in the elderly. Weight loss is common in patients with PD. However, studies comparing cognitive changes according to BMI changes in PD have not been done yet. We performed this study to know a relationship between BMI changes and the rate of cognitive decline in PD. PD patients were recruited retrospectively. The patients (n=104) were divided into two groups according to BMI changes during initial 6 months of follow-up: decreased (n=52) vs. stable BMI groups (n=52). Cognitive functions were repeated until 36 months of follow-up using the Korean version of the Mini-Mental State Examination (K-MMSE) and the modified Mini-Mental State (3MS) test. We calculated the rate of cognitive decline (K-MMSE and 3MS score changes/month) and compared it between the two groups. The decreased BMI group showed lower level of cognitive function than that of stable BMI group, especially at the 36th month of follow-up (p

Despite the development of surgical techniques, postoperative pancreatic fistula is still one of the main causes of serious morbidity after pancreaticoduodenectomy. Nevertheless numerous studies have been done, studies on preventing pancreatic fistula are lacking. This study is focused on the effectiveness of negative pressure external drainage for pancreaticojejunostomy in pancreaticoduodenectomy patients.Seventy-six patients were scheduled for pancreaticoduodenectomy at Soonchunhyang University Hospital from January of 2003 to August of 2007. Negative suction drainage group (n = 41) and no negative suction drainage group (n = 35) were compared by patient characteristics, parameters related to operation, and complications.There were no statistical differences between both groups in patient demographics and parameters related to operation. The complication rates were significantly lower in negative suction drainage group in terms of postoperative bleeding (P = 0.012), choledochojejunostomy leak (P = 0.014), and pancreatic fistula (P = 0.018).This retrospective study showed that external stenting with negative pressure suction drainage of the pancreatic duct has significantly reduced the rate of pancreatic fistula in duct-to-mucosa pancreaticojejunostomy with improved surgical outcomes.

In this study, three types of inlet distortion simulating device - screen, blockage and delta wing type - were developed and preliminary testing was carried out with dummy engine in the Altitude Engine Test Facility(AETF) of Korea Aerospace Research Institute(KARI) in order to evaluate operational capability of simulating device. According to preliminary test result, the inlet distortion device could be used in simulating various inlet distortion cases. Based on preliminary distortion test results, inlet distortion test with real gar-turbine engine was performed using blockage and delta wing type inlet distortion devices. During the test, the deterioration of overall performance and stability was observed.

Abstract For sustainable development and to feed the world's energy demand continuous supply of fuel resources is of utmost important. Wells drilled in deep waters and permafrost regions contain challenging gas hydrate bearing formations. The oil industry has made certain advancements by drilling and casing gas hydrates bearing formation safely. However, when a well gets deeper gas hydrates start dissociation behind the casing due to heat transfer from the heated mud. The objective of this study is to analyze the heat transfer to these formations and drilling parameters effecting heat transfer. We developed a wellbore temperature simulator to model the temperature profile in deep formations and to determine the disturbance due to the circulation of the heated mud. We used the range of hydrate dissociation for the wellbore stability analysis to monitor the disturbance caused in gas hydrate bearing formations. The stability analysis shows that a well is in a great danger, if we are drilling deep formations through gas hydrates. On the basis of wellbore stability analyses we suggest to insulate the outer surface of casing for controlling the heat transfer and dissociation of gas hydrates. The suggested approach is found to be very useful for decreasing heat transfer and consequently reducing gas hydrates dissociation and for stabilizing the well in deep water and permafrost regions. Introduction Gas hydrates are the solid crystalline compounds with a well-defined structure that consists of a cage network of water molecules with hydrocarbon mainly methane trapped inside these cages. These hydrates form at certain temperature and pressure conditions. The temperature for gas hydrate formation is above the freezing point of water. These naturally occurring gas hydrates can exist in deep water at relatively shallow depths, below the sea floor or at terrestrial locations within and beneath deep permafrost (Sloan, 1998). Major portion of gas hydrates occur in oceans due to the methanogenesis in sub-ocean sediments. The parameters which affect the formation of gas hydrates in the subsea sediments are temperature, pressure, organic content, water salinity, sediments characteristics and presence of geological features. Worldwide increasing energy demand, raising energy prices and declining hydrocarbon reserves are increasing the exploitation of oil and gas. For this, a number of Exploration and Production companies are searching for hydrocarbons in terrestrial and harsh environments. These environments lie at low temperature and high pressure conditions which coexist in sediments, making gas and water to form a gas hydrate.

Most injuries resulting from break-dancing are minor, such as sprains and strains, but there is great potential for dance participants to sustain severe and life-threatening conditions, such as cervical cord injuries. Break-dancing carries many of the risks of conventional dance and gymnastics, but unlike those forms of activity, it is usually performed without trained supervision, as is supplied by coaches in other sports. It is necessary for clinicians to inquire more thoroughly into the nature of the activities that result in both unusual and common injuries in break-dancers and to educate break-dancers about the hazards of these activities. The pleasure of break-dancing carries with it the responsibility of proper and thorough preparation. It is essential that break-dancers wear protective devices and perform proper warm-up and cool-down exercises. Break-dancing has become a popular youth subculture. Its complex acrobatic moves, such as splits, handstands, spins, and tumbling, have important medical implications. We report 3 cases of scaphoid nonunion in a break-dancer, the first such report in the English literature to our knowledge. Accordingly, we believe that the clinician must inquire more thoroughly into the nature of patients' activities that result in both unusual and common injuries and educate those who are break-dancers about the hazards of this activity. Careful screening, instruction, and coaching of break-dancers will help prevent injuries.

This study is aim to be programmed the simulation which is available for real-time performance analysis so that is to be developed gas turbine engine’s condition monitoring system with analyzing difference between performance analysis results and measuring data from test cell. In addition, test cell created by this study have been developed to use following applications: to use for learning principals and mechanism of gas turbine engine in school, and to use performance test and its further research for variable operating conditions in associated institutes. The maximum thrust of the micro turbojet engine is 137 N (14 kgf) at 126,000 rpm of rotor rotational speed if the Jet A1 kerosene fuel is used. The air flow rate is measured by the inflow air speed of duct, and the fuel flow is measured by a volumetric fuel flowmeter. Temperatures and pressures are measured at the atmosphere, the compressor inlet and outlet and the turbine outlet. The thrust stand was designed and manufactured to measure accurately the thrust by the load cell. All measuring sensors are connected to a DAQ (Data Acquisition) device, and the logging data are used as function parameters of the program, LabVIEW. The LabVIEW is used to develop the engine condition monitoring program. The proposed program can perform both the reference engine model performance analysis at an input condition and the real-time performance analysis with real-time variables. By comparing two analysis results the engine condition can be monitored. Both engine performance analysis data and monitoring results are displayed by the GUI (Graphic User Interface) platform.Copyright © 2009 by ASME

Background Despite the ability of lateral closed-wedge osteotomy for cubitus varus deformity to restore carrying angle and preserve elbow motion, there have been reports of poor cosmetic appearance of the elbow because of lateral condylar prominence. Method We evaluated long-term results of remodeling of lateral condylar prominence after osteotomy in 11 patients (7 of the prepuberty group, 4 of the postpuberty group). The follow-up period ranged from 4.7 to 14.2 years (average, 10). Results The mean preoperative and postoperative lateral condylar prominence index (LCPI) of the affected elbow were –1.2% and 36%, respectively. At final follow-up, the mean LCPI of the corrected elbow was 11.1%. In the prepubertal group, the mean LCPI decreased from 41.2% after surgery to 5.2% at final follow-up, whereas it decreased from 26.8% to 21.3% in the postpubertal group. The difference in reduction between the mean postoperative LCPI and the mean LCPI at final follow-up in the prepubertal group (36%) was greater than in the postpubertal group (5.4%) ( P = .006). Conclusion Lateral closed-wedge osteotomy is a relatively simple and effective procedure for correction of cubitus varus deformity before puberty, allowing cosmetically pleasing remodeling of lateral condylar prominence. Level of evidence Level 4.

Many surgeons treat progressive femoral osteolysis in association with a well-fixed stem with bone grafting but in uncontained proximal defects the graft could get into the joint, raising a question regarding whether the osteolysis can be treated by simple debridement without bone grafting. We investigated whether the curetted proximal osteolysis around an unrevised femoral component progressed in size and whether this lesion would have a deleterious effect on fixation of the femoral component in patients with isolated acetabular revision. We prospectively followed 21 patients (24 hips) who underwent acetabular revision and curetting of femoral osteolysis. The minimum followup was 3 years (mean, 4.3 years; range, 3–7.4 years). By the latest followup, no hips had major progression of the osteolytic defect through the followup period and none had any new osteolytic lesions. All hips were judged stable and to have well-fixed acetabular cups and femoral stems. Provided a femoral component is bone ingrown with osseointegration sufficient to provide long-term stability, the osteolytic defect is in the proximal aspect of the femur, and the defect is uncontained, simple curettage may preserve femoral implant stability and may prevent progression of osteolysis to another Gruen zone for at least 3 to 7 years. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Previous studies have demonstrated that pioglitazone, a peroxisome proliferator-activated receptor gamma (PPARgamma) agonist, inhibits ischemia-induced injury in various tissues including neural tissue. Pioglitazone has also been shown to reduce matrix metalloproteinase (MMP) activity. Because MMP is known to play a major role in the pathophysiology of brain ischemia, the present study was undertaken to test whether pioglitazone attenuates ischemic neuronal damage through MMP inhibition. C57BL/6 mice were subjected to global brain ischemia for 20 min. Animals were killed 72 h after ischemia. Oral pioglitazone (40 mg/kg/day, as a suspension in 0.5% carboxymethylcellulose) was administered to mice twice daily for 3 days before ischemia and twice daily after ischemia until the animals were killed. We investigated gelatinase activity by zymography and laminin immunohistochemistry. Histological analysis was also performed to test the protective effect of pioglitazone on neuronal damage. Mice treated with pioglitazone had attenuated gelatinase activity. Gelatin gel and in situ zymography showed up-regulation of gelatinase activity after ischemia. Pioglitazone significantly inhibited ischemia-induced elevation of the active form of MMP-9. Pioglitazone also reduced up-regulation of in situ gelatinase activity and laminin breakdown induced by ischemia in the hippocampus. There was marked neuronal damage in the CA1 and CA2 areas after ischemia. Neuronal damage in mice was significantly decreased by pioglitazone treatment, compared with vehicle-treated mice. Pioglitazone also inhibited TdT-mediated dUTP nick end labeling staining in CA1 and CA2 areas. Pioglitazone, a PPARgamma agonist, reduces delayed neuronal damage induced by global ischemia through inhibition of MMP-9 activity.

Results obtained with ceramic bearings in total hip arthroplasty have been disappointing because of increased component loosening rates primarily caused by design issues and use of low-quality ceramic, resulting in fracture and debris generation. Although new-generation ceramics have produced a reduced incidence of fracture, concerns still persist about the fracture of ceramic liners. After investigating the underlying cause of fracture in contemporary ceramic-on-ceramic bearings, we sought to determine the incidence of ceramic liner fracture and to formulate technical guidelines for avoiding catastrophic failure. Between January 2000 and January 2005, we prospectively studied a consecutive series of 147 patients (179 hips) who had undergone primary cementless total hip arthroplasty with modern ceramic-on-ceramic articulation so that we could detect ceramic liner fracture. The mean length of the follow-up period was 3.1 years (range, 2–6.5 years). By the latest follow-up examination, delayed ceramic liner fracture had occurred in 3 hips (1.7%). One liner was chipped during insertion because of eccentric seating of the liner. Head fracture occurred in 2 hips (1.1%). Despite the improved wear characteristics of modern ceramic-on-ceramic articulations, a catastrophic failure with ceramic liner failure was still observed during short-term follow-up monitoring. This finding prompted us to define important technical aspects to be considered to minimize ceramic liner fractures.

We present a novel interactive system that uses electroencephalographic (EEG) signals obtained from the user as a primary input for navigation through an immersive real-time 3-D visualization of various regions of the human brain. This "NeuroFloat" system is delivered via a head-mounted display (HMD). Our primary goal in developing NeuroFloat was to create a system where the brain-computer interface (BCI) was intrinsically related to the virtual-reality (VR) environment that it interfaced with. Accordingly, at this early stage in the development of NeuroFloat, we chose to develop multiple VR environments that collectively represent a tour through the early stages of the user's own visual system.

We prospectively examined the association between coffee consumption and the risk of developing colorectal cancer in a large population-based cohort study (the JPHC Study) of Japanese men and women. Data were analyzed from a population-based cohort of 96,162 subjects (46,023 men and 50,139 women). A total of 1,163 incident colorectal cancers were identified during the follow-up period, including 763 cases of colon cancer and 400 of rectal cancer. We observed a significant inverse association between coffee consumption and the risk of developing invasive colon cancer among women. Compared with those who almost never consumed coffee, women who regularly consumed 3 or more cups of coffee per day had a RR of 0.44 (95% CI = 0.19-1.04; p for trend = 0.04) after adjustment for potential confounding factors. However, no significant association was found for rectal cancer in women. In men, no significant decrease was observed in any colorectal cancer site. Further, additional analyses on the association of green tea consumption with colorectal cancer risk found no significant association in men or women. These findings suggest that coffee consumption may lower the risk of colon cancer among Japanese women.

박 현 아·남 수 연·이 상 길·김 상 균·심 기 남·박 상 민·이 선 영·한 혜 승·신 용 문·김 경 미·이 경 재·이 태 용· 최 일 주·홍 성 숙·김 재 우·이 윤 재·김 수 영·김 열·이 원 철·정 일 권 | 인제대학교 의과대학 서울백병원 가정의학과, 경북대학교 의과대학 경북대학교병원 소화기내과, 연세대학교 의과대학 세브란스병원 내과, 서울대학교 의과대학 내과학교실 간연구소, 이화여자대학교 의학전문대학원 내과학교실, 서울대학교 의과대학 가정의학교실, 건국대학교 의학전문대학원 내과학교실, 건국대학교 의학전문대학원 병리학교실, 울산대학교 의과대학 서울아산병원 영상의학과, 성균관대학교 의과대학 병리학교실, 순천향대학교 의과 대학 순천향대학 서울병원 직업환경의학과, 충남대학교 의학전문대학원 예방의학교실, 국립암센터 위암센터, 순천향대학교 서울병원 영상의학과, 국립암센터 암검진사업과, 분당차병원 한방부인과, 한림대학교 의과대학 강동성심병원 가정의학과, 가톨릭대학교 의과 대학 예방의학교실, 순천향대학교 의과대학 순천향대학 천안병원 내과학교실

Purpose The aim of the present study was to investigate the clinical features and outcome of eosinophilic gastroenteritis (EGE) in children. Methods Our study enrolled 24 children who were diagnosed with EGE from 1993 to 2014 at the Department of Pediatrics, Seoul National University Children's Hospital. The patients' clinical manifestations, treatments, and outcomes were reviewed from the medical records. Results The mean age at diagnosis was 5.3 years. Most patients had gastrointestinal symptoms including diarrhea (54.2%) and abdominal pain (45.8%). Peripheral eosinophilia was present in 91.7% of the patients. Thirteen patients (54.2%) showed anemia, and 15 patients (62.5%) had hypoalbuminemia. EGE was classified as mucosal, subserosal, or muscular in 75.0%, 20.8%, and 4.2% of cases, respectively. Three patients showed gastroduodenal ulcers upon endoscopic analysis. A history of allergy was reported in 13 patients, including atopic dermatitis, allergic rhinitis, and asthma. Five patients (20.8%) improved with food restrictions. Among the 19 patients treated with steroids, 11 (57.9%) discontinued steroid treatment without subsequent relapse, 4 (21.1%) relapsed after ceasing steroid treatment, and 4 (21.1%) showed no response to steroids. Two patients who were resistant to steroids underwent therapeutic surgery. The presence of gastroduodenal ulcers was significantly associated with relapse and steroid resistance. Conclusion A high suspicion of EGE is warranted when children have nonspecific gastrointestinal symptoms and peripheral eosinophilia. Most patients improved with food restrictions or steroid treatment, although one-third of patients showed a relapse or steroid resistance.

Purpose The purpose of this study was to evaluate the clinical and radiological results of revision total hip arthroplasty using modular distal fixation stems for proximal femoral deficiency. Materials and Methods Forty-five patients (47 hips) were analyzed more than 24 months after revision total hip arthroplasty that used modular distal fixation stems and was performed between 2006 and 2012. There were proximal femoral defects in all cases. Preoperative femoral defect classification revealed Paprosky type II in 31 cases, type IIIA in 7, and type IIIB in 9. The mean duration of follow-up was 53.4 (25-100) months. We evaluated the Harris hip score (HHS), walking ability according to Koval as clinical parameters, stem stability, and stem position change as radiographic parameters. Kaplan-Meier survival analysis was performed. Results The average HHS improved form 39.5 points to 91.3 points and walking ability also improved in most cases; all patients had stable fixation of the femoral stem. Postoperative complications included 5 cases of infection and 2 cases of dislocation. The survival rate with the end point of re-revision surgery due to infection or dislocation was 86% after 8-year follow-up. Conclusion Cementless revision total hip arthroplasty using modular femoral stems is useful because the stems can be stably fixed on the diaphyseal portion of the femur, which has relatively good bone quality at mid-term follow-up.

Regardless of the efforts of several treatments after pelvic bone fracture, as many as 5% of all pelvic fractures result in malunion or nonunion of the pelvis. These complications can cause disabling symptoms, including pain, instability, and gait disturbance, which can decrease life quality of patients and increase socioeconomic problems. Therefore concerns regarding the treatment of malunion and nonunion after pelvic bone fracture are increasing. We report our experience and surgical management for pelvic malunion and nonunion.

Osteoporosis is a metabolic disease that is increasing in prevalence as people live longer. Because the orthopedic surgeon is frequently the first and often the only physician to manage patients with osteoporotic hip fractures, every effort should be made to prevent future fractures. A multidisciplinary approach is essential in treatment of osteoporotic fractures. Basic treatment includes calcium and vitamin D supplementation, fall prevention, hip protection, and balance and exercise programs. Currently available pharmacologic agents are divided into antiresorptive and anabolic groups. Antiresorptive agents such as bisphosphonates limit bone resorption through inhibition of osteoclastic activity. Anabolic agents such as parathyroid hormone promote bone formation.

We prospectively investigated the association between gastric cancer screening and subsequent risk of gastric cancer in a large-scale population-based prospective cohort study, with a 13-year follow-up in Japan. Data were analyzed from a population-based cohort of 42,150 (20,326 men and 21,824 women) subjects. Approximately 36% of subjects reported that they had undergone screening photofluorography during the preceding 12 months, and were regarded as the screened group. A total of 179 gastric cancer deaths and 636 incident gastric cancers were identified during the follow-up period. We observed a 2-fold decrease in gastric cancer mortality in screened versus unscreened subjects (RR = 0.52; 95% CI = 0.36-0.74). The extent of the reduction in mortality for gastric cancer was greater than in death from all causes excluding gastric cancer (RR = 0.71; 95% CI = 0.65-0.78). A significant decrease in the incidence of advanced gastric cancer was observed in screened subjects (RR = 0.75; 95% CI = 0.58-0.96), although the overall incidence rate did not differ significantly between the screened and unscreened subjects (RR = 1.06; 95% CI = 0.90-1.25). In age-stratified analyses, a significant reduction in gastric cancer mortality was seen in screened subjects aged 40-49 years at baseline, compared with a lesser reduction in screened subjects aged 50-59 (RR = 0.30, 95% CI = 0.13-0.72; and RR = 0.60, 95% CI = 0.40-0.88, respectively). These findings suggest that gastric cancer screening may be associated with a reduced risk of mortality from gastric cancer.

To elucidate the correlates of self-rated fatigue in Korean employees.The data for 10,176 (men, 7984; women, 2192; mean age, 34.2; SD: 8.8) employees recruited from a nation-wide sample were examined. A structured questionnaire was used to measure the participants' fatigue, sociodemographics (sex, age, education, and marital status), job-related characteristics (work duration, grade at work, work hours, shiftwork, employment type, and magnitude of workplace), and health-related habits (smoking, drinking, coffee intake, and exercise). Two types of measurement for fatigue were used to evaluate the magnitude of fatigue: self-rated question and a standardized measurement tool (Multidimensional Fatigue Scale: MFS).According to the self-rated fatigue, 32% of employees reported that they felt fatigue for the past two weeks, and 9.6% of males and 8.7% of females had experienced excessive fatigue (6 months or more). Hierarchical multiple regression analysis showed that fatigue measured by MFS was more common in women, younger, college or more graduated, single, and employees who do not regularly exercise. Fatigue was also associated with long work hours, and the size of the workplace (1000 employees).These results suggest that fatigue has been considered as a common complaint, and that it is affected by job-related factors like work hours and the workplace size as well as sociodemographics or health-related behaviors. Further research is needed to clarify the effects of fatigue on adverse health,outcomes, work performance, work disability, sick absence and medical utilization, and to examine the relationship of job characteristics (e.g.: work demand, decision latitude) to fatigue.

[corrected] To investigate the fatigue subjective symptoms and VDT related risk factors in bank workers.A total of 2178 workers (62.8% male, 37.2% female) were surveyed with a self-administered and structured questionnaire consisting of 30 fatigue symptoms and other VDT related factors regarding work characteristics, work postures, work environments, personal medical histories, etc. Fatigue subjective symptoms were divided into 3 groups of 10 questions each: a dull, drowsy and exhausted feeling (Group I), a mental decline of working motivation (Group II), or a feeling of incongruity in the body and dysfunction of autonomic nervous system (Group III). Each question was weighted as 0 for 'none', 1 for 'sometimes', and 2 for 'always'.Mean age was 35.8 +/- 7.2 years (38.9 +/- 6.0 in males, 30.6 +/- 5.8 in females), Mean work duration was 7.7 +/- 7.1 years (8.4+7.4 in males, 6.5 +/- 6.4 in females). Mean symptom score in males was 11.0 +/- 8.1 (4.9 +/- 3.1 in Group I, 3.0 +/- 3.1 in Group II, 3.1 +/- 2.8 in Group IIl) and in females was 17.5 +/- 9.5 (7.0 +/- 3.8 in Group I, 4.6 +/- 3.5 in Group II, 5.9 +/- 3.4 in Group III). Mean scores were higher in the order of Group IIIIII. Females had significanntly higher scores than males in all three groups (p0.001). Most common symptoms complained of as 'always' or sometimes' were 'feel strained in the eyes' (85.4%) among Group I, 'find difficulty in thinking' (54.2%) amongGroup II, and 'feel stiff in the shoulders' (72.3%) among Group III. In multiple regression analysis, female, non-straight spine at workstation, more VDT work hours, history off physical therapy, glare of screen, overtime work, youngage, and non-horizontal elbow position were significantly related with high score of symptoms.More supportive VDT work environment and education for correct work postures for VDT workers are recommended.

To estimate the magnitude of psychosocial distress and examine eligible factors associated with the development of psychosocial distress in Korean employees, using a nationwide sample.A total of 6977 workers were recruited from 245 companies. A structured questionnaire was used to assess sociodemographics, health-related behaviors, job characteristics, social support at work, personality traits (locus of control, type A behavior pattern), self-esteem, and psychosocial distress.The results showed that 23% of workers were categorized as high stress, 73% as moderate, and 5% as normal. Hierarchical multiple regression analysis showed that psychosocial distress was more common in younger workers, both male and female. Regular exercise was negatively associated with increase of psychosocial distress. In job characteristics, as expected, low decision latitude, high job insecurity, and low social support at work were related to high psychosocial distress. Personality traits such as locus of control and type A behavior pattern, and self-esteem were more powerful predictors of psychosocial distress than general characteristics, health-related behavior, and job characteristics. There were some gender differences. While men who are less educated and single (unmarried, divorced, and separated) experienced higher levels of psychosocial distress than those who are educated and married, women who feel high job demand experienced higher levels of psychosocial distress than those who feel low job demand.The proportion of the high stress group was higher than expected, and psychosocial factors like social support and personality characteristics (e.g. locus of control, type A behavior pattern and self-esteem) were more significant factors for psychosocial distress than other variables. This finding suggests that some psychosocial factors, especially inadequate social support, low self-esteem and lack of internal locus of control for the development of psychosocial distress, will also operate as an intervention strategy in the worksite stress reduction program. It is strongly required that worksite stress reduction programs should be established in at both occupational and level as well as in individual levels.