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The pupillary dilation reflex (PDR), the change in pupil size after a nociceptive stimulus, has been used to assess antinociception during anesthesia. The aim of this study was to compare the antinociceptive properties of sevoflurane and desflurane by measuring the PDR amplitude.Seventy patients between 20 and 55 years of age were randomly allocated to receive either sevoflurane or desflurane. The PDR amplitude after an electrical standardized noxious stimulation (SNT) was measured using an infrared pupillometer under 1.0 minimum alveolar concentration (MAC). The pupil diameter was measured from 5 seconds before to 5 minutes after the SNT. The mean arterial pressure (MAP), heart rate (HR), and bispectral index (BIS) were also measured immediately before and after SNT as well as 1 minute and 5 minutes after SNT. The primary outcome was the maximum percent increase from the prestimulation value of the pupil diameter, and the secondary outcomes were the maximum percent increase from the prestimulation value of the MAP, HR, and BIS after SNT.The maximum percent increase of the pupil diameter after SNT was not different between the 2 groups (median [first quartile to third quartile], 45.1 [29.3-80.3] vs 43.4 [27.0-103.1]; median difference, -0.3 [95% confidence interval, -16.0 to 16.5]; P = .986). Before SNT, the MAP was higher under 1.0 MAC of sevoflurane than desflurane; however, the maximum percent increase of MAP, HR, and BIS was not different between the 2 groups.The amount of change in the PDR amplitude, MAP, and HR after SNT was not different between sevoflurane and desflurane anesthesia. This result might suggest that sevoflurane and desflurane may not have different antinociceptive properties at equivalent MAC.

BACKGROUND: Nerve-sparing radical prostatectomy (NSRP) had to be performed because approximately 94% of patients are diagnosed with localized prostate cancer (PCa). Although NSRP is generally done to improve functional outcomes, erectile dysfunction (ED) is one of the most prevailing complications after radical prostatectomy (RP). Phosphodiesterase type 5 inhibitors (PDE5-Is) are the most well-known treatment agent for postoperative ED. This study aimed to assess the efficacy of PDE5-Is in patients with ED after NSRP. METHODS: In this systematic literature review, randomized controlled trials on the efficacy and safety of PDE5-Is in patients who underwent NSRP were searched in MEDLINE, EMBASE, and the Cochrane Controlled Trials Register using the OVID platform. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Cochrane Review Methods. The quality of the evidence of the outcome data was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS: A total of 14 trials involving 2,822 patients were included. Significant improvements in the International Index of Erectile Function—Erectile Function (IIEF) domain score [mean difference (MD) =4.93; 95% confidence interval (CI): 4.14–5.71; P

Aims The aim of this study was to compare patient-reported outcome measures (PROMs) and the Single Assessment Numerical Evaluation (SANE) score in patients treated with a volar locking plate for a distal radial fracture. Methods This study was a retrospective review of a prospective database of 155 patients who underwent internal fixation with a volar locking plate for a distal radial fracture between August 2014 and April 2017. Data which were collected included postoperative PROMs (Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) and Patient-Rated Wrist Evaluation (PRWE)), and SANE scores at one month (n = 153), two months (n = 155), three months (n = 144), six months (n = 128), and one year (n = 73) after operation. Patients with incomplete data were excluded from this study. Correlation and agreement between PROMs and SANE scores were evaluated. Subgroup analyses were carried out to identify correlations according to variables such as age, the length of follow-up, and subcategories of the PRWE score. Results The Pearson correlation coefficient (r) between PROMs and SANE scores was -0.76 (p < 0.001) for DASH and -0.72 (p < 0.001) for PRWE, respectively. Limits of agreement between PROMs and ‘100-SANE’ scores were met for at least 93% of the data points. In subgroup analysis, there were significant negative correlations between PROMs and SANE scores for all age groups and for follow-up of more than six months. The correlation coefficient between PRWE subcategories and SANE score was -0.67 (p < 0.001) for PRWE pain score and -0.69 (p < 0.001) for PRWE function score, respectively. Conclusion We found a significant correlation between postoperative SANE and PROMs in patients treated with a volar locking plate for a distal radial fracture. The SANE score is thus a reliable indicator of outcome for patients who undergo surgical treatment for a radial fracture. Cite this article: Bone Joint J 2020;102-B(6):744–748.

Previous studies show no difference in clinical outcomes between patients with healed and structurally failed rotator cuff repairs. The objective of this study was to assess ceiling effects when reporting surgical outcomes of arthroscopic rotator cuff repair using four of the currently most popular clinical shoulder outcome scoring systems. Ninety-two patients who underwent arthroscopic rotator cuff repair were examined. The simple shoulder test (SST), American Shoulder and Elbow Surgeons (ASES) score, University of California at Los Angeles (UCLA) shoulder rating scale, and Constant–Murley shoulder score were completed 2 years postoperatively. Demographic data of the subjects were analysed using descriptive statistics. The ceiling effects in the outcome data assessed for each scale were estimated based on two previously reported definitions. The number of patients with the maximum possible score was 31 (33.7%) with the SST, 26 (28.3%) with the ASES score, 28 (30.4%) with the UCLA scale, and 18 (19.6%) with the Constant–Murley score. The standardised distance of the outcome data assessed by the SST, ASES score, UCLA scale, and Constant–Murley scores were 0.92, 0.97, 0.96, and 1.18, respectively. The SST, ASES score, and UCLA scale evaluated at 2 years postoperatively have substantial ceiling effects showing that the proportion of patients with the maximum possible score is > 20%, and the standardised distance is

Satellites should have high reliability because they are required to operate autonomously, while performing a given mission. To realize this, it is necessary to use heritage parts or include redundancy. However, for nanosatellites, where it is difficult to include redundancy due to volume and weight limitations, fault management becomes crucial. In this study, a new method based on deep learning is proposed for detecting and identifying the faults in the reaction wheel, which is one of the satellite actuators. A deep learning model is applied to learn the fault and fault type using the residual between the measured attitude data and the estimated attitude date. In this study, it is assumed that three reaction wheels are installed, and fault detection is designed accordingly. The proposed model enables the satellite to detect faults autonomously, even when it is not communicating with the ground station, and is expected to be highly beneficial for the autonomous operation of the mega-constellation mission using nanosatellite that is to be activated in future.

Rationale: Laryngomalacia is defined as the collapse of supraglottic structures and can cause not only strider but also trigger difficulties with ventilation and endotracheal intubation during anesthesia management. High-flow nasal cannula (HFNC) has been used to manage patients at high risk of hypoxemia in the intensive care unit; however, limited literature information is available for the application of HFNC to infant patients with laryngomalacia during anesthesia practice. Patient concerns: A 2-month-old male infant was scheduled to undergo surgery for inguinal hernia and undescended testis with general anesthesia. Diagnosis: The patient had subcostal retraction while breathing and frequent oxygen desaturation events and was diagnosed laryngomalacia. Interventions: After the patient was supplied oxygen via HFNC and then given general anesthesia, the initial 2 attempts of endotracheal intubation with a rigid laryngoscope were unsuccessful because the vocal cords were obscured by the epiglottis. A third intubation attempt was performed and successful with a 3.0-sized, uncuffed endotracheal tube within 20 minutes of the initial attempt. Outcomes: No airway complications emerged and oxygen saturation remained at greater than 98% during general anesthesia. The patient was discharged 5 days after surgery without any adverse side effects. Lessons: Continuous oxygenation via HFNC is a good choice to prevent desaturation during difficult tracheal intubations in infant patients with laryngomalacia. This device is expected to be useful for intubation not only in patients with laryngomalacia, but also in infant patients with a predicted high risk of oxygen desaturation events during general anesthesia.

We fabricated a fiber-optic directional coupler based on evanescent field coupling between side-polished large mode area (LMA) double clad fibers (DCFs) for a high power fiber laser. The tapping ratio of the fabricated coupler was measured to be - 32 dB. The fundamental mode coupled in a core of the lower side-polished fiber (SPF) was transferred to the upper SPF without clad-mode coupling. Two SPFs were directly faced to increase an optical handling power up to 740 W. The tapping ratio of the coupler was constantly maintained at the applied laser output. The beam quality of the laser including the fabricated coupler was maintained to be 1.22, without mode distortion by the coupler.

This study aimed to compare the contact area, mean pressure, and peak pressure of the radiocapitellar joint (RCJ) in the upper limb after transradial amputation with those of the normal upper limb during elbow flexion and forearm rotation. Testing was performed using ten fresh-frozen upper limbs, and the transradial amputation was performed 5 cm proximal to the radial styloid process. The specimens were connected to a custom-designed apparatus for testing. A pressure sensor was inserted into the RCJ. The biomechanical indices of the RCJ were measured during elbow flexion and forearm rotation in all specimens. There was no significant difference in the contact area between the normal and transradial amputated upper limbs. However, in the upper limbs after transradial amputation, the mean pressure was higher than that in the normal upper limbs at all positions of elbow flexion and forearm rotation. The peak pressure was significantly higher in the upper limbs after transradial amputation than in the normal upper limbs, and was especially increased during pronation at 45° of elbow flexion. In conclusion, these results could cause cartilage erosion in the RCJ of transradial amputees. Thus, methods to reduce the pressure of the RCJ should be considered when a myoelectric prosthesis is developed.

When the equipment which is related to safety or important to power production is installed in nuclear power plant units (NPPs), verification of equipment Electromagnetic Susceptibility (EMS) must be performed. The low-frequency radiated magnetic field susceptibility (RS101) test is one of the EMS tests specified in U.S NRC (Nuclear Regulatory Commission) Regulatory Guide (RG) 1.180 revision 1. The RS101 test verifies the ability of equipment installed in close proximity to sources of large radiated magnetic fields to withstand them. However, RG 1.180 revision 1 allows for an exemption of the low-frequency radiated magnetic susceptibility (RS101) test if the safety–related equipment will not be installed in areas with strong sources of magnetic fields. There is no specific exemption criterion in RG 1.180 revision 1. EPRI TR-102323 revision 4 specifically provides a guide that the low-frequency radiated magnetic field susceptibility (RS101) test can be conservatively exempted for equipment installed at least 1 m away from the sources of large magnetic fields (>300 A/m). But there is no exemption criterion for equipment installed within 1 m of the sources of smaller magnetic fields (

This study aimed to evaluate the incidence rates of and risk factors for complex regional pain syndrome type 1 (CRPS-1) after surgery for distal radius fractures (DRFs). Using data from January 2007 to December 2014, we analysed the data from the Korean Health Insurance Review and Assessment (HIRA) service. After extracting the data of patients aged ≥18 years whose diagnostic and operation codes for DRFs were entered into the HIRA database, we analysed the incidence rates of and risk factors for CRPS-1. From 2007 to 2014, 172,194 DRFs were treated surgically. Within 1 year postoperatively, 1,103 CRPS-1 cases were diagnosed, with an incidence of 0.64%. On univariate and multivariate analyses, the risk factors that significantly correlated with the incidence of CRPS-1 included female sex, rheumatoid arthritis, open reduction, open fracture, and accompanying ulnar fracture, whereas old age, psychiatric disease, and external fixation were not statistically significant. The incidence of CRPS-1 after surgery for DRF was very low (0.64%) in South Korea. Careful monitoring is necessary for patients with complex fractures and rheumatoid arthritis who are at increased risk of developing CRPS-1.

The purpose of this study is to analyze the age-friendliness status of 16 Korean cities and provinces using age-friendly indicators selected from our previous studies. In total, 52 indicators were used to focus on measurable indicators of physical environment in Korea’s present circumstances. The data employed to verify the age-friendly index were collated from regional statistics and studies by major Korean institutions. In order to compare the age-friendly index level, which consists of four primary areas, 10 sub-areas, and the 52 indicators, the indices of the 10 sub-areas were expressed as a spidergram. Despite limitations in the ability to ascertain details of present conditions and causes in each city and province due to the large scale of the survey, this study contributes to understanding the situation in 16 Korean cities and provinces based on age-friendly indicators and to providing a basic framework for periodic comparison. A more accurate and meaningful study would be possible if an analysis in relation to the size and characteristics of small- or medium-sized cities was included. Furthermore, the indicators selected from this study can be applied to other countries after revisions are made to reflect the individual circumstance in each country.

Our purpose was to compare the contributions of these two systems to assess PIP joint extension in fresh cadaver models. Nine middle fingers of fresh cadavers were used. The PIP joint angle was measured while an extension load was applied on the extensor tendons. Specimens on which extension load was applied on the extrinsic extensors were classified as the extrinsic group, and those on which extension load was applied on the intrinsic extensors were classified as the intrinsic group. Linear regression analyses were performed to obtain regression equation and the extension load-PIP joint angle curve. The mean of slope of the curve was compared between the two groups using pairedt-test. The same experiments were done for the metacarpophalangeal (MP) joint in 0° and 60° flexion to evaluate the effect of MP joint flexion on PIP joint extension. The mean slope of the extension load-PIP joint angle curve of the extrinsic group was significantly greater than that of the intrinsic group. With the MP joint in 0° flexion, the mean slope of the extrinsic and intrinsic groups was -0.148 and -0.117, respectively (greater absolute value means greater slope,p=0.01). With the MP joint in 60° flexion, the mean slopes were -0.147 and -0.104, respectively (p=0.015). The contribution of the intrinsic extensor for PIP joint extension shows decreasing trends with MP joint flexion. The extrinsic extensors have greater contribution for PIP joint extension compared with the intrinsic extensors.

Malignant peripheral nerve sheath tumor (MPNST) is a very rare type of sarcoma, with an incidence of 0.001%. MPNST has a 5-year survival rate near 80%, so successful reconstruction techniques are important to ensure the patient’s quality of life. Sarcoma of the forearm is known for its poor prognosis, which leads to wider excision, making reconstruction even more challenging due to the unique anatomical structure and delicate function of the forearm. A 44-year-old male presented with a large mass that had two aspects, measuring 9×6 cm and 7×5 cm, on the dorsal aspect of the right forearm. The extensor compartment muscles (EDM, EDC, EIP, EPB, EPL, ECRB, ECRL, APL) and invaded radius were resected with the mass. Tendon transfer of the entire extensor compartment with skin defect coverage using a 24×8 cm anterolateral thigh (ALT) perforator free flap was performed. The patient was discharged after 18 days without wound complications, and has not complained of discomfort during supination, pronation, or wrist extension/flexion through 3 years of follow-up. To our knowledge, this is the first report of successful reconstruction of the entire forearm extensor compartment with ALT free flap coverage after resection of MPNST.

Distributed Control System (DCS) communication networks, which use Fast Ethernet with redundant networks for the transmission of information, have been installed in digitalized nuclear power plants. Normally, failover tests are performed to verify the reliability of redundant networks during design and manufacturing phases; however, systematic integrity tests of DCS networks cannot be fully performed during these phases because all relevant equipment is not installed completely during these two phases. In additions, practical verification tests are insufficient, and there is a need to test the actual failover function of DCS redundant networks in the target environment. The purpose of this study is to verify that the failover functions works correctly in certain abnormal conditions during installation and commissioning phase and identify the influence of network failover on the entire DCS. To quantify the effects of network failover in the DCS, the packets (Protocol Data Units) must be collected and resource usage of the system has to be monitored and analyzed. This study introduces the use of a new methodology for verification of DCS network failover during the installation and commissioning phases. This study is expected to provide insight into verification methodology and the failover effects from DCS redundant networks. It also provides test results of network performance from DCS network failover in digitalized domestic nuclear power plants (NPPs).

The objective of this study was to investigate the national trends in rotator cuff surgery in Korea and analyze hospital type-specific trends. We analyzed a nationwide database acquired from the Korean Health Insurance Review and Assessment Service (HIRA) from 2007 to 2015. International Classification of Diseases, 10th revision (ICD-10) codes, procedure codes, and arthroscopic device code were used to identify patients who underwent surgical treatment for rotator cuff disease. A total of 383,719 cases of rotator cuff surgeries were performed from 2007 to 2015. The mean annual percentage change in the age-adjusted rate of rotator cuff surgery per population of 100,000 persons rapidly increased from 2007 to 2012 (53.3%, P < 0.001), while that between 2012 to 2015 remained steady (2.3%, P = 0.34). The proportion of arthroscopic surgery among all rotator cuff surgeries steadily rose from 89.9% in 2007 to 96.8% in 2015 (P < 0.001). In terms of hospital types, the rate of rotator cuff surgery increased to the greatest degree in hospitals with 30–100 inpatient beds, and isolated acromioplasty procedure accounted for a larger proportion of the rotator cuff surgeries in small hospitals and clinics compared to large hospitals. Overall, our findings indicate that cases of rotator cuff surgery have increased rapidly recently in Korea, of which arthroscopic surgeries account for the greatest proportion. While rotator cuff surgery is a popular procedure that is commonly performed even in small hospitals, there was a difference in the component ratio of the procedure code in accordance with hospital type., Graphical Abstract

Objectives We performed preoperative ultrasonography (US) to detect the anatomic course of the superficial radial nerve (SRN) and dominant pathologic tendon of the first extensor compartment in de Quervain tenosynovitis. Methods We prospectively studied 27 patients (29 wrists) with de Quervain tenosynovitis who underwent surgical release of the first extensor compartment. Preoperatively, US was performed to evaluate the presence of the dominant pathologic tendon and the septum in the subcompartment, number of SRNs in the area of the surgical incision, and anatomic running course of the SRN. These variables were also checked intraoperatively. Cohen κ statistics were calculated to investigate agreement between US and surgical field findings. Results There were 7 men and 20 women (mean age, 47.8 years; range, 26-67 years). For the dominant pathologic tendon, there were 2 cases (6.9%) of an abductor pollicis longus, 11 cases (37.9%) of an extensor pollicis brevis, and 16 cases (55.2 %) of a nondominant tendon (κ = 0.94). For the subcompartment, there were 10 cases (34.5%) without a septum, 8 (27.6%) with an incomplete septum, and 11 (37.9%) with a complete septum (κ = 0.95). Most SRNs crossed over the first extensor compartment (κ = 0.78). Conclusions Preoperative US can be useful in detecting the anatomic running course of the SRN and dominant pathologic tendon before surgery for de Quervain tenosynovitis. Classifying the anatomic course of the SRN could be essential to planning surgery, and it could be helpful to prevent injury of the SRN during surgery.

In this paper, we propose a novel algorithm for automatic camera parameter adjustment, which is exploited for getting the correct image exposure required for iris recognition. We use two-step processing, where the first step adjusts the camera parameters on the basis of a single shot, and the second step applies precise iterative adjustment. In order to get the correct iris exposure, we use a weighted mask, which is constructed offline using a set of face images. In contrast to the existing algorithms, our method does not need to be calibrated for a particular camera sensor. We show that the proposed method significantly decreases false rejection rate caused by incorrect image exposure and reduces recognition time.

The Shielding Effectiveness (SE) of structures should be considered for radiated electromagnetic pulse effect analysis. General structures are composed of reinforced concrete and concrete is a mixture of aggregates (gravel, sand, water, iron, graphite, flay ash, etc.). It can be difficult to obtain a dielectric parameter for use during the modeling process for shielding performance analysis. In this paper, a simple approach is presented that can determine the dielectric properties of concrete using backward tracing. Two structures are considered for the comparison of measured and simulated results. It is possible to verify the dielectric properties of concrete using loss tangent variation.

BackgroundThe purpose of this study was to investigate residual rotation of patients with forearm amputation and the contribution of involved muscle to residual rotation.MethodsTesting was performed using five fresh-frozen cadaveric specimens prepared by isolating muscles involved in forearm rotation. Amputation was implemented at 25 cm (wrist disarticulation), 18 cm, or 10 cm from the tip of olecranon. Supination and pronation in the amputation stump were simulated with traction of involved muscle (supinator, biceps brachii, pronator teres, pronator quadratus) using an electric actuator. The degree of rotation was examined at 30°, 60°, 90°, and 120° in flexion of elbow.ResultsAverage rotation of 25 cm forearm stump was 148° (SD: 23.1). The rotation was decreased to 117.5° (SD: 26.6) at 18 cm forearm stump. It was further decreased to 63° (SD 31.5) at 10 cm forearm stump. Tendency of disorganized rotation was observed in close proximity of the amputation site to the elbow. Full residual pronation was achieved with traction of each pronator teres and pronator quadratus. Although traction of supinator could implement residual supination, the contribution of biceps brachii ranged from 4 to 88% according to the degree of flexion.ConclusionsClose proximity of the amputation site to the elbow decreased the residual rotation significantly compared to residual rotation of wrist disarticulation. The preservation of pronosupination was 80% at 18 cm forearm stump. Although the pronator teres and the pronator quadratus could make a full residual pronation separately, the supinator was essential to a residual supination.

Background It is known that there are large regional variations in treatment methods for the management of proximal humeral fractures. The objective of this study was to investigate the national surgical trends in elderly patients with proximal humeral fractures in South Korea. Methods We analyzed the Korean Health Insurance Review and Assessment Service database from 2008 to 2016. International Classification of Diseases, 10th revision codes and procedure codes were used to identify patients aged ≥65 years with proximal humeral fractures. Results A total of 69,120 proximal humeral fractures were identified from 2008 to 2016. The overall operative rate for proximal humeral fractures increased steadily from 24.6% in 2008 to 36.8% in 2016 (p

Background Rotator cuff tears can be asymptomatic in some cases; however, even when the tear size is small, clinical symptoms can be very severe. This suggests that symptoms of rotator cuff tears are related to factors other than the size. Although synovitis has been cited as one of the factors, there is no grading system for synovitis in rotator cuff tears. Moreover, there are few studies that evaluated the relationship between synovitis and clinical features in patients with rotator cuff tears. Methods Patients with medium-sized rotator cuff tears, who were scheduled for arthroscopic repair, were recruited for this study. The glenohumeral joint was divided into 4 quarters. Then, vascularity and hypertrophy of the joint were graded in each quarter using a modified scoring system. Clinical assessment was performed preoperatively and at 3 months and 6 months after surgery. Finally, correlation between the severity of synovitis and clinical features was analyzed. Results The intraobserver correlation coefficient was 0.815 to 0.918 and the interobserver correlation coefficient was 0.779 to 0.992 for the single measurement. Vascularity was significantly correlated with the range of motion, strength, and constant score within 6 months after surgery. Hypertrophy was correlated with the range of motion within 6 months after surgery. Conclusions Synovitis in the shoulder with rotator cuff tears can be graded by using our modified scoring system. The severity of synovitis was closely related to the clinical features after surgery. Therefore, when treating patients with rotator cuff tears, treatment of synovitis should also be considered.

A UAV(Unmanned Aerial Vehicle) flies along pre-programed navigation points(in-flight, take-off, or landing) automatically without pilot input. Even though UAVs fly differently from general piloted aircraft as the pilot controls the aircraft from a ground station through means of a data-link system. Occasionally, the data-link connection can be lost for any number of reasons, in which case, the FLCC(Flight control Computer) must automatically switch to autopilot to continue flying. Hence, the FLCC is a flight-critical component that must be throughly tested and validated. This paper discusses the development of a HILS(Hardware in the Loop Simulation) test environment designed to simulate real flight conditions to verify the FLCC satisfies flying quality requirements and maintains robustness despite any potential malfunctions or emergency situations.

Spectral beam combining technique is a simple and straightforward method to obtain high power laser beam. The beam combining system typically consists of three parts, fiber laser array, transform optical system and diffraction grating. Performance of the system (diffraction efficiency and laser induced damage threshold) is mainly determined by the diffraction grating. This paper describes a multilayer dielectric diffraction gating with high diffraction efficiency and low laser induced damage threshold, which can be potentially used to obtain a high power laser by combing laser beams. The diffraction grating is designed by coupled-wave analysis, and single-beam laser interference lithography is used to fabricate diffraction gratings. To verify the optical and thermal characteristics of the beam, we measure diffraction efficiency and the threshold for laser-induced damage. FEM simulation accurately represented temperature distribution in the grating during laser irradiation. This work provides integrated methods that include design of multilayer dielectric gratings, thermal analysis and device characterization using high power laser.

Dear Editor, Pasteurella canis is a small, gram-negative coccobacillus that is a part of the normal flora of healthy domestic animals, especially dogs [1]. Although P. canis is a well-known major pathogen of infections caused by dog bites, only few cases of human infections with P. canis have been reported [2-5]. We report a case of soft tissue infection caused by P. canis. A 54-yr-old woman without underlying diseases visited the emergency department with multiple lacerations caused by a dog bite incurred two days prior. She had received immediate treatment with wound dressing, antibiotics (amoxicillin/clavulanic acid), and tetanus immunoglobulin at another hospital on the day she was bitten. However, the wound was worsening. The initial vital signs were as follows: temperature, 37.7°C; pulse rate, 88/min; respiratory rate, 20/min; blood pressure 108/73 mmHg. The wounds were located on the right distal arm (3 cm in the anteromedial area, 3 cm in the anterolateral area, and 4 cm in the posterior area with muscle exposure). Abnormalities such as fracture were absent on plain radiographs. The initial blood counts were as follows: white blood cells (WBCs), 10.4×10/L (neutrophils, 80.5%); hemoglobin, 12.4 g/ dL; and platelets 173×10/L. No prominent abnormalities in blood chemistry were observed on routine tests except for mildly elevated acute phase reactants (C-reactive protein [CRP], 5.82 mg/dL; erythrocyte sedimentation rate [ESR], 52 mm/hr). The patient was admitted, and amoxicillin/clavulanic acid were administered immediately and maintained throughout the hospitalization period. Tetanus and rabies vaccines were also given to prevent potential infections. Microbiological examination of the wounds was performed. A specimen was collected for Gram staining and culture. Gram-negative coccobacilli were observed on a direct gram-stained smear from the wound specimens (Fig. 1A). Pus specimens were inoculated on 5% sheep blood agar, chocolate agar, and MacConkey agar. After 24 hr, the growth of smooth, grayish-white colonies was observed on the blood agar and chocolate agar but not on the MacConkey agar (Fig. 1B). The colonies were positive for catalase and oxidase reactions. All isolates were identified with MicroScan Walkaway (Beckman Coulter, Brea, CA, USA) and Vitek automated bacterial identification systems 2 (bioMerieux, Marcy-l’Etoile, France) and a VITEK MS matrix-assisted laser desorption ionization mass spectrometry (MALDI-TOF MS) system (bioMerieux). For further identification of bacterial species, 16S ribosomal RNA (rRNA) gene sequencing was carried out. The universal primers 8F (5 -TTGGAGAGTTTGATCCTGGCTC-3 ) and 801R (5 -GGCGTGGACTTCCAGGGTATCT-3 ) were used to amplify

To perform the complex tasks with telerobot system in cluttered environments such as disaster, underwater, space, the necessity of shared teleoperation is increased. However, designing an autonomy while keeping in mind the environmental uncertainty is challenging. This paper proposes shared teleoperation framework and virtual guidance generation for a human interactive shared teleoperation. The major concept of both shared teleoperation and virtual guidance generation is utilizing the cognitive ability of a human operator. In shared teleoperation case, the human intention information is provided to the autonomous system in the form of a path which is acquired by our proposed sketch method. Our novel proposed sketch method allows the operator to sketch the path on the visual feedback image of the remote environments and the information is then transmitted to the autonomous system. In virtual guidance generation, we employ human cognitive abilities to assist the computer to generate virtual guidance for teleoperation tasks. The resulting both systems are more efficient and less fatigued than direct teleoperation.

Background To date, there have been few reports on the nationwide population-based epidemiology of Dupuytren's disease (DD). We investigated the prevalence and incidence of DD in Korea using the large dataset provided by the Korean Health Insurance Review and Assessment Service. This study is the second nationwide epidemiological study of DD after the study in Taiwan. Methods Records of patients diagnosed with DD between 2007 and 2014 were extracted from the large dataset by diagnostic code searching (International Classification of Disease 10th revision code M72.0) and were included in the study. We calculated the prevalence and incidence of DD based on the total population of Korea provided by the Korean Statistical Information Service. Diseases associated with DD and the trends in surgery for DD were also analyzed. Results A total 16,630 patients were diagnosed with DD during the study period. The mean annual prevalence was 32.2 per 100,000 population (41.8 per 100,000 for men; 22.5 per 100,000 for women). The mean annual incidence was 1.09 per 100,000 population (1.80 per 100,000 for men; 0.38 per 100,000 for women). The common diseases associated with DD were hypertension (30.5%), diabetes mellitus (26.7%), hyperlipidemia (20.4%), ischemic heart disease (7.9%), and cerebrovascular disease (4.6%). The mean annual proportion of the patients who had surgery for DD was 5.24% of all DD patients. Conclusion The prevalence and incidence of DD in Korea were 100–1,000 times lower than those in western countries; however, it was slightly larger than that in Taiwan., Graphical Abstract

Background The present study aimed to investigate the incidence and seasonal variation of distal radius fractures (DRFs) in Korea. Methods We analyzed a nationwide database acquired from the Korean Health Insurance Review and Assessment Service from 2011 to 2015. We used International Classification of Diseases, 10th revision codes and procedure codes to identify patients of all ages with newly diagnosed DRFs. Results An average of about 130,000 DRFs occurred annually in Korea. The incidence of DRF, by age group, was highest in the 10 to 14-year-old age group for males and the highest in the 70s age group for females, with a rapid increase of incidence after 50 years. The peak incidence of DRF occurred during winter; however, the incidence greatly varied annually when compared with that of other seasons. The incidence of DRFs during the winter season was correlated with the average temperature. Conclusion The annual incidence of DRF was 130,000 in Korea. The incidence increased under an intense cold surge during winter. Active preventive measures are recommended especially in women exceeding 50 years considering the higher incidence in this age group., Graphical Abstract

We analyzed the damage effect on Glass Fibre Reinforced Plastics(GFRP) under air flow by irradiation of continuous wave near-IR laser. Damage process and temporal temperature distribution were demonstrated and material characteristics were observed with laser intensity, surface flow speed and angle. Surface temperature on GFRP rapidly increased with laser intensity, and the damaged pattern was different with flow characteristics. In case of no flow, penetration on GFRP by burning and flame generation after laser irradiation was appeared at once. GFRP was penetrated by the heat generated from resin ignition. In case of laser irradiation under flow, a flame generated after burning extinguished at once by flow and penetration pattern on GFRP were differently shown with flow angle. From the results, we presented the damage process and its mechanism.