Development of a greenhouse gas - air pollution interactions and synergies model for Korea (GAINS-Korea).

This study aimed to create Greenhouse Gas - Air Pollution Interactions and Synergies (GAINS)-Korea, an integrated model for evaluating climate and air quality policies in Korea, modeled after the international GAINS model. GAINS-Korea incorporates specific Korean data and enhances granularity for enabling local government-level analysis. The model includes source-receptor matrices used to simulate pollutant dispersion in Korea, generated through CAMx air quality modeling. GAINS-Korea's performance was evaluated by examining different scenarios for South Korea. The business as usual scenario projected emissions from 2010 to 2030, while the air quality scenario included policies to reduce air pollutants in line with air quality and greenhouse gas control plans. The maximum feasible reduction scenario incorporated more aggressive reduction technologies along with air quality measures. The developed model enabled the assessment of emission reduction effects by both greenhouse gas and air pollutant emission reduction policies across 17 local governments in Korea, including changes in PM2.5 (particulate matter less than 2.5 µm) concentration and associated benefits, such as reduced premature deaths. The model also provides a range of visualization tools for comparative analysis among different scenarios, making it a valuable resource for policy planning and evaluation, and supporting decision-making processes.

Can endoscopic submucosal dissection technique be an alternative treatment option for a difficult giant (≥ 30 mm) pedunculated colorectal polyp?

BACKGROUND: Snare polypectomy of a giant pedunculated colorectal polyp is sometimes technically demanding, and, therefore, piecemeal resection is inevitable, despite the relative risk of invasive cancer and postpolypectomy bleeding. OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of endoscopic submucosal dissection in comparison with conventional snare polypectomy for giant pedunculated polyps DESIGN AND SETTINGS: We retrospectively reviewed the clinical outcomes and complications of endoscopic polypectomy for giant pedunculated polyps from October 2006 to November 2011. PATIENTS: All the patients who underwent endoscopic submucosal dissection (n = 23) or snare polypectomy (n = 20) for pedunculated polyps ≥ 3 cm were enrolled consecutively. In the case of a giant pedunculated polyp with 1) poor visualization of the stalk, 2) technical difficulties in snare positioning for en bloc resection, or 3) need for trimming of the head, we did not attempt piecemeal snare polypectomy, and we performed endoscopic submucosal dissection instead. (These were arbitrarily defined as "difficult" giant pedunculated polyps.) MAIN OUTCOME MEASURES: Data on the patient's demography, endoscopic and histopathologic findings, clinical outcomes, and complications were analyzed. RESULTS: Among the 43 giant pedunculated polyps, 23 polyps were defined as "difficult" polyps and were removed with endoscopic submucosal dissection. Subpedunculated (stalk <1 cm) type was more common in the "difficult" polyp group (p = 0.01). The overall incidence of cancer was 18.6% (8/43). En bloc resection rates were 100% (23/23) in the endoscopic submucosal dissection group and 90% (18/20) in the snare polypectomy group. The procedure times of snare polypectomy and endoscopic submucosal dissection group did not differ significantly (41.7 ± 13.7 minutes vs 44.9 ± 35.6 minutes, p = 0.70). Postpolypectomy bleeding was noted in 1 case (4.3%) in the endoscopic submucosal dissection group and in 3 cases (15%) in the snare polypectomy group. CONCLUSIONS: Endoscopic submucosal dissection, as well as the snare polypectomy for giant pedunculated polyps, appeared to be effective without major complications and can be an alternative option to achieve en bloc resection, particularly for difficult cases, such as giant subpedunculated polyps.

Endoscopic submucosal dissection for colorectal tumors--1,000 colorectal ESD cases: one specialized institute's experiences.

PURPOSE: Endoscopic submucosal dissection (ESD) is a very useful endoscopic technique, making it possible to perform en bloc resection regardless of lesion size. Since the introduction of ESD at our hospital, we have performed 1,000 colorectal ESDs during 56 months. The purpose of this study was to evaluate the clinical outcomes of our colorectal ESD experience and to access the efficacy and safety of colorectal ESD. METHODS: Between October 2006 and August 2011, we performed ESD on 1,000 consecutive colorectal tumors in 966 patients. We evaluated the clinical outcomes of all said cases. RESULTS: The mean resected tumor size was 24.1 ± 13.3 (3-145) mm. Our overall endoscopic en bloc resection rate was 97.5% (975/1,000), and our R0 resection rate was 91.2% (912/1,000) respectively. Our perforation rate was 5.3% (53/1,000). Of these 53 perforations, 50 cases were treated through conservative management with/without endoscopic clipping, whereas the remaining 3 patients received laparoscopic operation. Pathological examination showed adenocarcinoma in 37.2% of cases (372/1,000) and neuroendocrine tumors in 11.2% (112/1,000). We recommended additional radical surgery to 82 patients who had a risk of lymph node metastasis. Follow-up colonoscopies were performed on 722 patients. During the median follow-up period of 13 (1-62) months, there were three recurrences (0.4%). CONCLUSIONS: ESD is technically difficult, with a substantial risk of perforation. However, ESD enabled en bloc resection and pathologically complete resection of large colorectal epithelial tumors and submucosal tumors. As experience with the technique increases, ESD may gradually replace piecemeal endoscopic mucosal resection and radical colon resection in the treatment of colorectal tumors.

Endoscopic treatment of large colorectal tumors: comparison of endoscopic mucosal resection, endoscopic mucosal resection-precutting, and endoscopic submucosal dissection.

BACKGROUND: Endoscopic mucosal resection (EMR) is a useful therapeutic technique for colorectal tumors. However, for tumors larger than 20 mm, the chance of piecemeal resection is high. Recently introduced endoscopic submucosal dissection (ESD) enables en bloc resection regardless of the tumor size. This study aimed to compare the effectiveness and outcomes of EMR, EMR-precutting (EMR-P), and ESD in the treatment of colorectal tumors 20 mm in size or larger. METHODS: This study reviewed 523 nonpedunculated colorectal tumors (499 patients) 20 mm or larger that received endoscopic treatment (EMR in 140 cases, EMR-P in 69 cases, and ESD in 314 cases) from January 2004 to November 2009. RESULTS: The mean sizes of the tumors were 21.7 ± 3.5 mm (EMR), 23.5 ± 5.6 mm (EMR-P), and 28.9 ± 12.7 mm (ESD). The ratios of adenocarcinomas were 15.7% (EMR), 29% (EMR-P), and 37.9% (ESD). The en bloc resection rates were 42.9% (EMR), 65.2% (EMR-P), and 92.7% (ESD), and the complete resection rates were 32.9% (EMR), 59.4% (EMR-P), and 87.6% (ESD). Perforation occurred in 2.9% of the EMR-P cases and 8% of the ESD cases. The recurrence rates were 25.9% (EMR; median follow-up period, 26 months), 3.2% (EMR-P; median follow-up period, 16 months), and 0.8% (ESD; median follow-up period, 17 months). CONCLUSION: For the treatment of large, nonpedunculated colorectal tumors, ESD is more effective than either EMR or EMR-P. Although ESD is technically demanding, it has clinical significance by overcoming the limitations of both EMR and EMR-P.

Clinical risk factors for perforation during endoscopic submucosal dissection (ESD) for large-sized, nonpedunculated colorectal tumors.

BACKGROUND: The possible risk of colonic perforation during endoscopic submucosal dissection (ESD) for colorectal tumors is a barrier to wide application. This retrospective study was performed to evaluate the risk and the predictive factors for perforation during ESD procedure. METHODS: Between October 2006 and November 2010, a total of 499 consecutive patients (mean age 60.0 ± 11.3 years) who underwent ESD for large-sized (≥ 20 mm), nonpedunculated colorectal tumor were analyzed. First, incidence rate and clinical course of perforation were evaluated. Second, patient-related variables (age, sex, history of aspirin or antiplatelet agents, and comorbidity), endoscopic variables (tumor size, location, and type), procedure-related variables (experience of procedures, procedure time, and materials of submucosal injection), and pathologic diagnosis were analyzed. RESULTS: The mean size of the lesions was 28.9 mm. The overall en bloc resection rate was 95.0%. Perforation occurred in 37 out of 499 patients (7.4%). Thirty-four patients could be successfully treated conservatively. The type (laterally spreading tumor) and the location (right-sided colon) of the tumors, less experience of the procedure (<100 cases) in each endoscopist, and submucosal injection without hyaluronic acid were associated with higher frequency of perforation (all P < 0.05). On multivariate analysis, laterally spreading type of tumor [odds ratio (OR) 4.10, 95% confidence interval (CI) 1.17-14.34] and submucosal injection with hyaluronic acid (OR 0.31, 95% CI 0.13-0.72) were independent predictive factors. CONCLUSIONS: Perforation rate was 7.4%, and most cases could be successfully managed nonsurgically. In case of laterally spreading type of tumor, more caution is needed during submucosal dissection and long-lasting submucosal cushion is important for preventing perforation.

PM2.5 Forecast in Korea using the Long Short-Term Memory (LSTM) Model.

The National Institute of Environmental Research, under the Ministry of Environment of Korea, provides two-day forecasts, through AirKorea, of the concentration of particulate matter with diameters of ≤ 2.5 µm (PM2.5) in terms of four grades (low, moderate, high, and very high) over 19 districts nationwide. Particulate grades are subjectively designated by human forecasters based on forecast results from the Community Multiscale Air Quality (CMAQ) and artificial intelligence (AI) models in conjunction with weather patterns. This study evaluates forecasts from the long short-term memory (LSTM) algorithm relative to those from CMAQ-solely and AirKorea using observations from 2019. The skills of the one-day PM2.5 forecasts over the 19 districts were 39-70% for CMAQ, 72-79% for LSTM, and 73-80% for AirKorea; the AI forecasts showed comparable skills to the human forecasters at AirKorea. The one-day forecast skill levels of high and very high PM2.5 pollution grades are 31-98%, 31-74%, and 39-81% for the CMAQ-solely, the LSTM, and the AirKorea forecasts, respectively. Despite good skills for forecasting the high and very high events, CMAQ-solely forecasts also generate substantially higher false alarm rates (up to 86%) than the LSTM and AirKorea forecasts (up to 58%). Hence, applying only the LSTM model to the CMAQ forecasts can yield reasonable forecast skill levels comparable to the operational AirKorea forecasts that elaborately combine the CMAQ model, AI models, and human forecasters. The present results suggest that applications of appropriate AI models can greatly enhance PM2.5 forecast skills for Korea in a more objective way. Supplementary Information: The online version contains supplementary material available at 10.1007/s13143-022-00293-2.

Statistical Seasonal Forecasting of Winter and Spring PM2.5 Concentrations Over the Korean Peninsula.

Concentrations of fine particulate matter smaller than 2.5 µm in diameter (PM2.5) over the Korean Peninsula experience year-to-year variations due to interannual variation in climate conditions. This study develops a multiple linear regression model based on slowly varying boundary conditions to predict winter and spring PM2.5 concentrations at 1-3-month lead times. Nation-wide observations of Korea, which began in 2015, is extended back to 2005 using the local Seoul government's observations, constructing a long-term dataset covering the 2005-2019 period. Using the forward selection stepwise regression approach, we identify sea surface temperature (SST), soil moisture, and 2-m air temperature as predictors for the model, while rejecting sea ice concentration and snow depth due to weak correlations with seasonal PM2.5 concentrations. For the wintertime (December-January-February, DJF), the model based on SSTs over the equatorial Atlantic and soil moisture over the eastern Europe along with the linear PM2.5 concentration trend generates a 3-month forecasts that shows a 0.69 correlation with observations. For the springtime (March-April-May, MAM), the accuracy of the model using SSTs over North Pacific and 2-m air temperature over East Asia increases to 0.75. Additionally, we find a linear relationship between the seasonal mean PM2.5 concentration and an extreme metric, i.e., seasonal number of high PM2.5 concentration days. Supplementary Information: The online version contains supplementary material available at 10.1007/s13143-022-00275-4.

A novel statistical-dynamical method for a seasonal forecast of particular matter in South Korea.

Societal concerns about air quality in East Asia are still growing despite country-level efforts to reduce air pollution emissions. In coping with this growing concern, the government and the public demand a longer­lead forecast of air quality to ensure sufficient response time until society prepares for countermeasures such as a temporary reduction of specific emission sources. Here we propose a novel method that produces skillful seasonal forecasting of wintertime (December to February) PM10 concentration over South Korea. The method is based on the idea that climate condition and air quality have co-variability in the seasonal time scales and that the state-of-art seasonal prediction model will benefit air quality forecasting. More specifically, a linear regression model is constructed to link observed winter PM10 concentration and climate variables where the predicted climate variables were furnished from NCEP CFSv2 forecast initialized during autumn. In this case, climate variables were selected as predictors of the model because they are not only physically related to air quality but also 'predictable' in CFS hindcast. Through analysis of retrospective forecasts of 20 winters for the period 2001-2020, we found this model shows statistically significant skill for the seasonal forecast of wintertime PM10 concentration.

Clinical outcomes of stapled transanal rectal resection (STARR) for obstructed defecation syndrome (ODS): a single institution experience in South Korea.

PURPOSE: The purpose of this study was to assess both the short- and long-term functional outcomes of stapled transanal rectal resection (STARR) in ODS patients. PATIENTS AND METHODS: We performed a retrospective review of data that were collected from January 2005 to October 2008. Between January 2005 to June 2006, 58 patients who underwent STARR were enrolled in this study. Follow-up was scheduled for 3 months and 1 year after surgery with the Cleveland Clinic Florida (CCF) constipation score and satisfaction grade. To evaluate the long-term functional outcome, we interviewed the patients by telephone using questionnaires for the CCF score and satisfaction grade on October 2008. RESULTS: The median follow-up period was 34 months (range, 27-46 months). The mean age and sex ratio were 54 years (range, 19-85 years) and 8:50 (M/F). The mean CCF constipation scores were 17.6 before the surgery, 9.5 at 3 months, 9.6 at 12 months, and 10.3 at the time of the latest interview. The satisfaction grade, which was rated as excellent and good by 63.4% of the patients at the time of the latest interview, was worse than that at 3 months (37.8%). Among the cases of the excellent group (19 cases) at postoperative 3 months, 13 cases (68.4%) were classified as excellent or good at the time of the latest interview. CONCLUSION: The STARR is a safe and effective surgical procedure for restoring the anatomy and function in ODS patients. Strict selection of patients is needed in enhancing and maintaining the patients' satisfaction after the procedure.

A novel CMAQ-CNN hybrid model to forecast hourly surface-ozone concentrations 14 days in advance.

Issues regarding air quality and related health concerns have prompted this study, which develops an accurate and computationally fast, efficient hybrid modeling system that combines numerical modeling and machine learning for forecasting concentrations of surface ozone. Currently available numerical modeling systems for air quality predictions (e.g., CMAQ) can forecast 24 to 48 h in advance. In this study, we develop a modeling system based on a convolutional neural network (CNN) model that is not only fast but covers a temporal period of two weeks with a resolution as small as a single hour for 255 stations. The CNN model uses meteorology from the Weather Research and Forecasting model (processed by the Meteorology-Chemistry Interface Processor), forecasted air quality from the Community Multi-scale Air Quality Model (CMAQ), and previous 24-h concentrations of various measurable air quality parameters as inputs and predicts the following 14-day hourly surface ozone concentrations. The model achieves an average accuracy of 0.91 in terms of the index of agreement for the first day and 0.78 for the fourteenth day, while the average index of agreement for one day ahead prediction from the CMAQ is 0.77. Through this study, we intend to amalgamate the best features of numerical modeling (i.e., fine spatial resolution) and a deep neural network (i.e., computation speed and accuracy) to achieve more accurate spatio-temporal predictions of hourly ozone concentrations. Although the primary purpose of this study is the prediction of hourly ozone concentrations, the system can be extended to various other pollutants.

Oscillopsia associated with pseudoaccommodation in pseudophakia.

Oscillopsia associated with near fixation after multifocal intraocular lens (IOL) implantation has not been fully recognized. A 46-year-old woman presented with shaking of vision in both eyes during near fixation after uneventful implantation of a single-piece multifocal posterior chamber IOL in both eyes. There was no sign of zonular weakness in either eye before or during cataract surgery, and the postoperative course was uneventful. Visual acuity was 20/25 in both eyes without correction. There was no IOL oscillation with distant fixation; however, when she changed her focus from a distant to a near object, the IOLs started to oscillate in both eyes, which was assumed to be the cause of her oscillopsia. On cycloplegia, there was no IOL oscillation either with distant or near fixation. A rare cause of oscillopsia associated with pseudoaccommodation after IOL implantation should be recognized.

Comparative assessment of net CO2 exchange across an urbanization gradient in Korea based on eddy covariance measurements.

BACKGROUND: It is important to quantify changes in CO2 sources and sinks with land use and land cover change. In the last several decades, carbon sources and sinks in East Asia have been altered by intensive land cover changes due to rapid economic growth and related urbanization. To understand impact of urbanization on carbon cycle in the monsoon Asia, we analyze net CO2 exchanges for various land cover types across an urbanization gradient in Korea covering high-rise high-density residential, suburban, cropland, and subtropical forest areas. RESULTS: Our analysis demonstrates that the urban residential and suburban areas are constant CO2 sources throughout the year (2.75 and 1.02 kg C m-2 year-1 at the urban and suburban sites), and the net CO2 emission indicate impacts of urban vegetation that responds to the seasonal progression of the monsoon. However, the total random uncertainties of measurement are much larger in the urban and suburban areas than at the nonurban sites, which can make it challenging to obtain accurate urban flux measurements. The cropland and forest sites are strong carbon sinks because of a double-cropping system and favorable climate conditions during the study period, respectively (- 0.73 and - 0.60 kg C m-2 year-1 at the cropland and forest sites, respectively). The urban area of high population density (15,000 persons km-2) shows a relatively weak CO2 emission rate per capita (0.7 t CO2 year-1 person-1), especially in winter because of a district heating system and smaller traffic volume. The suburban area shows larger net CO2 emissions per capita (4.9 t CO2 year-1 person-1) because of a high traffic volume, despite a smaller building fraction and population density (770 persons km-2). CONCLUSIONS: We show that in situ flux observation is challenging because of its larger random uncertainty and this larger uncertainty should be carefully considered in urban studies. Our findings indicate the important role of urban vegetation in the carbon balance and its interaction with the monsoon activity in East Asia. Urban planning in the monsoon Asia must consider interaction on change in the monsoon activity and urban structure and function for sustainable city in a changing climate.

Different epithelial cleavage planes produced by various epikeratomes in epithelial laser in situ keratomileusis.

PURPOSE: To determine the anatomic cleavage planes produced by various epikeratomes in epithelial laser in situ keratomileusis (epi-LASIK). SETTING: Department of Ophthalmology, IIsan Paik Hospital, Goyang, Korea. METHODS: Sixteen eyes (8 patients) were included in this study. Three epikeratomes, the Moria Epi-K, Centurion SES, and Amadeus II, were used to collect 4 epithelial flaps from 2 patients in the epi-LASIK procedure. Four epithelial flaps from 2 patients were also obtained by laser-assisted subepithelial keratectomy (LASEK). Immunohistochemical staining using monoclonal antibodies against integrin beta1, integrin beta4, laminin 5, and collagen type VII was performed. RESULTS: Immunohistochemical staining showed expression of integrin beta1 and integrin beta4 in all epithelial flaps. In epi-LASIK, the expression of laminin 5 and collagen type VII had a linear or dotted pattern that differed based on the epikeratome used. In the epithelial flaps obtained using LASEK, the expression of laminin 5 and collagen type VII had a dotted pattern. CONCLUSIONS: Each epikeratome yielded reproducible but different cleavage planes of corneal epithelium. The results suggest that further study is needed to elucidate the wound-healing process after epi-LASIK because different cleavage planes produced by different epikeratomes may influence the process.

Clinical Characteristics and Incidence of Perianal Diseases in Patients With Ulcerative Colitis.

PURPOSE: While perianal disease (PAD) is a characteristic of patients with Crohn disease, it has been overlooked in patients with ulcerative colitis (UC). Thus, our study aimed to analyze the incidence and the clinical features of PAD in patients with UC. METHODS: We reviewed the data on 944 patients with an initial diagnosis of UC from October 2003 to October 2015. PAD was categorized as hemorrhoids, anal fissures, abscesses, and fistulae after anoscopic examination by experienced proctologists. Data on patients' demographics, incidence and types of PAD, medications, surgical therapies, and clinical course were analyzed. RESULTS: The median follow-up period was 58 months (range, 12-142 months). Of the 944 UC patients, the cumulative incidence rates of PAD were 8.1% and 16.0% at 5 and 10 years, respectively. The incidence rates of bleeding hemorrhoids, anal fissures, abscesses, and fistulae at 10 years were 6.7%, 5.3%, 2.6%, and 3.4%, respectively. The cumulative incidence rates of perianal sepsis (abscess or fistula) were 2.2% and 4.5% at 5 and 10 years, respectively. In the multivariate analyses, male sex (risk ratio [RR], 4.6; 95% confidence interval [CI], 1.7-12.5) and extensive disease (RR, 4.2; 95% CI, 1.6-10.9) were significantly associated with the development of perianal sepsis. CONCLUSION: Although the clinical course of PAD in patients with UC is not serious, in clinical practice, PAD is not rare in such patients. Therefore, careful examination and appropriate management for PAD is needed if the quality of life for patients with UC is to be improved.

Comparison of partially-absorbable lightweight mesh with heavyweight mesh for inguinal hernia repair: multicenter randomized study.

PURPOSE: Prosthetic mesh is widely used for inguinal hernia repair; however, pain and stiffness can develop. This study was a prospective, multicenter, single-blind, randomized trial to assess postoperative pain and quality of life according to mesh type after inguinal hernia repair. METHODS: Forty-seven patients who underwent Lichtenstein repair for unilateral inguinal hernia with prosthetic mesh were enrolled and randomly allocated to the partially-absorbable lightweight mesh (LW group, n = 24) or heavyweight mesh group (HW group, n = 23). Data were collected using a visual analogue scale (VAS), Carolinas Comfort Scale (CCS), and Activities Assessment Scale (AAS) at screening and postoperative day 1, 7, 90, and 120; foreign body sensation, sense of stiffness, and sense of pull during activity were also evaluated. RESULTS: There were no significant differences in patients' demographics and clinical characteristics between groups. The VAS at day 90 was significantly lower in the LW group (0.46 ± 0.78 vs. 0.96 ± 0.82, P = 0.027). The CCS and AAS were significantly lower in the LW group at day 1 (51.33 ± 20.29 vs. 64.65 ± 22.64, P = 0.047 and 39.83 ± 9.88 vs. 46.43 ± 7.82, P = 0.015, respectively). Foreign body sensation was significantly lower in the LW group at day 120 (4.2% vs. 30.4 %, P = 0.023), as was sense of stiffness (P = 0.023). The sense of pull during activity was lower in the LW group at day 90 and 120 (P = 0.012 and P = 0.022, respectively). There was no recurrence or serious complication during follow-up. CONCLUSION: Partially-absorbable lightweight prosthetic mesh can be used for inguinal hernia repair safely and improve functional outcomes and quality of life after surgery.

Basement membrane and collagen deposition after laser subepithelial keratomileusis and photorefractive keratectomy in the leghorn chick eye.

OBJECTIVE: To evaluate corneal scar formation and new collagen deposition after laser subepithelial keratomileusis (LASEK) compared with photorefractive keratectomy (PRK) in the leghorn chick corneal model. METHODS: Leghorn chick corneas treated with LASEK surgery (using 20% ethanol for 30 seconds) or PRK were evaluated by indirect confocal immunofluorescence and transmission electron microscopy at 1, 2, 7, 14, and 28 days after surgery. New collagen deposition was determined by dichlorotriazinylaminofluorescein staining 2 and 4 weeks after surgery. RESULTS: Laminin was detected around the basal layers during the immediate postoperative period and 4 weeks after LASEK surgery, and from day 2 onwards after PRK. Collagen III deposition in the cornea was about 3 times greater with PRK than with LASEK. The thickness of new collagen deposition at 4 weeks was 34 microm +/- 2.5 microm in the PRK group, which was significantly greater than that of the LASEK group (11 microm +/- 1 microm; P<.001). CONCLUSIONS: Reduced subepithelial stromal tissue deposition was observed in LASEK-treated eyes compared with PRK-treated eyes. Postoperative preservation of the epithelial basement membrane and survival of epithelial cells in LASEK and possibly in epithelial laser in situ keratomileusis may contribute to this phenomenon. CLINICAL RELEVANCE: An advantage of LASEK over PRK is the reduction of postoperative haze.

Artisan phakic intraocular lens implantation after retinal detachment surgery.

PURPOSE: To report three cases of Artisan phakic intraocular lens (PIOL) implantation to correct myopic refractive error after previous retinal detachment surgery treated with scleral encircling. METHODS: Artisan PIOLs were implanted in a 29-year-old man with -21.0 -2.0 x 180 manifest refraction and best spectacle-corrected visual acuity (BSCVA) of 20/40 (case 1), a 28-year-old woman with BSCVA of 20/20 and -8.5 -1.0 x 180 manifest refraction (case 2), and a 44-year-old man with BSCVA of 20/32 and -11.75 -1.75 x 10 manifest refraction (case 3). RESULTS: In case 1, 24 months after implantation of the Artisan PIOL, uncorrected visual acuity (UCVA) was 20/40. In case 2, 24 months after surgery, UCVA was 20/32. In case 3, 3 months after surgery, UCVA was 20/32. There was no formation of new breaks, progressive vitreoretinal traction, or complications. CONCLUSIONS: The Artisan PIOL may provide an alternative method to correct high myopia after retinal detachment surgery.

Persistent Bleeding Following a Stapled Hemorrhoidopexy.

A stapled hemorrhoidopexy (SH) is widely used for treatment of patients with grades III and IV hemorrhoids. The SH is easy to perform, is associated with less pain and allows early return to normal activities. However, complications, whether severe or not, have been reported. Here, we present the case of a female patient with persistent bleeding after a SH. The bleeding was caused by the formation of granulation tissue at the stapler line, diagnosed with sigmoidoscopy, and successfully treated via transanal excision (TAE) under spinal anesthesia. The biopsy showed inflammatory granulation tissue. After the TAE, her symptom was completely gone.

Evaluating the predictability of PM10 grades in Seoul, Korea using a neural network model based on synoptic patterns.

As of November 2014, the Korean Ministry of Environment (KME) has been forecasting the concentration of particulate matter with diameters ≤ 10 µm (PM10) classified into four grades: low (PM10 ≤ 30 µg m-3), moderate (30 < PM10 ≤ 80 µg m-3), high (80 < PM10 ≤ 150 µg m-3), and very high (PM10 > 150 µg m-3). The KME operational center generates PM10 forecasts using statistical and chemistry-transport models, but the overall performance and the hit rate for the four PM10 grades has not previously been evaluated. To provide a statistical reference for the current air quality forecasting system, we have developed a neural network model based on the synoptic patterns of several meteorological fields such as geopotential height, air temperature, relative humidity, and wind. Hindcast of the four PM10 grades in Seoul, Korea was performed for the cold seasons (October-March) of 2001-2014 when the high and very high PM10 grades are frequently observed. Because synoptic patterns of the meteorological fields are distinctive for each PM10 grade, these fields were adopted and quantified as predictors in the form of cosine similarities to train the neural network model. Using these predictors in conjunction with the PM10 concentration in Seoul from the day before prediction as an additional predictor, an overall hit rate of 69% was achieved; the hit rates for the low, moderate, high, and very high PM10 grades were 33%, 83%, 45%, and 33%, respectively. Our findings also suggest that the synoptic patterns of meteorological variables are reliable predictors for the identification of the favorable conditions for each PM10 grade, as well as for the transboundary transport of PM10 from China. This evaluation of PM10 predictability can be reliably used as a statistical reference and further, complement to the current air quality forecasting system.

Accuracy of facial soft tissue thickness measurements in personal computer-based multiplanar reconstructed computed tomographic images.

The purpose of this study was to determine the precision and accuracy of facial soft tissue measurement using personal computer (PC)-based multiplanar reconstructed (MPR) computed tomography (CT) images and to evaluate the effect of the various CT scanning protocols on the facial soft tissue thickness measurement. Thirteen different CT imaging protocols were used to image a cadaver head. MPR reformations and three-dimensional (3D) reconstructions viewed on a laptop PC were used to make measurements at six specific sites on each set of images. These measurements were compared to physical measurements at the same sites. Increasing the slice thickness resulted in decreased image quality. Within the same slice thickness, increasing the pitch ratio in the spiral mode, resulted in decreasing image quality. The image quality of conventional CT scanning was relatively poorer than that of the spiral CT scanning. However, the mean deviation from the physical measurement was within 0.43 mm in every instance. This mean deviation was quite small and clinically acceptable for measuring the soft tissue thickness of the facial area. PC-based MPR CT images of the face using routine scanning CT protocols can be used to accurately measure soft tissue thickness in the facial region. However, for more fine and accurate data collection, scanning protocols with slice thicknesses less than 5mm, and a spiral/helical mode pitch less than 2:1 are recommended.