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Scapular Free Flap (유리 견갑 피판 이식술)

  • Chung, Duke-Whan;Han, Chung-Soo;Yim, Chang-Moo
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.24-34
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    • 1996
  • There are many kinds of free flaps for management of extensive soft tissue defect of extremities in orthopaedic field. Free vascularized scapular flap is one of the most useful and relatively easy to application. This flap has been utilize clinically from early eighties by many microsurgical pioneers. Authors performed 102 cases of this flap from 1984 to 1995. We have to consider about the surgical anatomy of the flap, technique of the donor harvesting procedures, vascular varieties and anatomical abnormalities and success rate and the weak points of the procedure. This flap nourished by cutaneous branches from circumflex scapular vessels emerges from the lateral aspect of the subscapular artery 2.5-5cm from its lateral origin passing through the triangular space(bounded by subscapularis, teres minor, teres major, long head of triceps). The terminal cutaneous branch runs posteriorly around the lateral border of the scapular and divided into two major branches, those transeverse horizontally and obliquely to the fascial plane of overlying skin of the scapular body. We can utilize these arteries for scapular and parascapular flap. The vascular pedicle ranged from 5 to 10 cm long depends on the dissection, usually two venae comitantes accompanied circumflex scapular artery and its major branches. The diameter of the circumflex scapular artery is more than 1mm in adult, rare vascular variation. Surgical techniques : The scapular flap can be dissected conveniently with prone or lateral decubitus position, prone position is more easier in my experience. There are two kinds of surgical approaches, most of the surgeon prefer elevation of the flap from its outer border towards its base which known easier and quicker, but I prefer elevation of the flap from its outer border because of the lowering the possibilities of damage to vasculature in the flap itself which runs just underneath the subcutaneous tissue of the flap and provide more quicker elevation of the flap with blunt finger dissection after secure pedicle dissection and confirmed the course from the base of the pedicle. There are minimal donor site morbidity with direct skin closure if the flap size is not so larger than 10cm width. This flap has versatility in the design of the flap shape and size, if we need more longer and larger one, we can use parascapular flap or both. Even more, the flap can be used with latissimus dorsi musculocutaneous flap and serratus anterior flap which have common vascular pedicle from subscapular artery, some instance can combined with osteocutaneous flap if we include the lateral border of the scapular bone or parts of the ribs with serratus anterior. The most important shortcoming of the scapular free flap is non sensating, there are no reasonable sensory nerves to the flap to anastomose with recipient site nerve. Results : Among our 102 cases, overall success rate was 89%, most of the causes of the failure was recipient site vascular problems such as damaged recipient arterial conditions, and there were two cases of vascular anomalies in our series. Patients ages from 3 years old to 62 years old. Six cases of combined flap with latissimus dorsi, 4 cases of osteocutaneous flap for bone reconstruction, 62 parascapular flap was performed - we prefer parascapular flap to scapular. Statistical analysis of the size of the flap has less meaningful because of the flap has great versatility in size. In the length of the pedicle depends on the recipient site condition, we can adjust the pedicle length. The longest vascular pedicle was 14 cm in length from the axillary artery to the enter point cutaneous tissue. In conclusion, scapular free flap is one of the most useful modalities to manage the large intractable soft tissue defect. It has almost constant vascular pedicle with rare anatomical variation, easy to dissect great versatility in size and shape, low donor morbidity, thin and hairless skin.

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Management Improvement of Big and Old Trees in the Byeol-seo Scenic Sites (별서 명승지역 내 노거수목의 관리개선방안)

  • Lee, Jong-Bum;Lee, Chang-Hun;Choi, Byoung-Jae;Lee, Jae-Keun
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.31 no.1
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    • pp.98-107
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    • 2013
  • Big and old trees in the scenic spots with the attributes of remote villas are vulnerable to man-made damages and very sensitive to the external environment such as soil conditions, so the corresponding management plans are required. Thus this study has been conducted to survey the big and old trees in the scenic remote villas and suggest the ideal management plans. The results can be summarized as follows. First, regarding the tree heath above the ground, transformation of tree, death of branches, and death of barks are closely related to tree vigor. Particularly, the areas receiving many visitors require prompt countermeasures against the dried and dead tress above the ground and the areas in which dried and dead tress occurred and also the safety measures for the visitors and facilities. Second, regarding the soil environment, visitor traffic is closely related to the tree vigor. In 15 remote villa gardens, 64% of trees are exposed to heavy traffic and the tree vigor has declined due to an increase of visitor. Thus, there is a need to give positive consideration the installation of the complementary facilities and the plantation of herbal plants in the congested areas to form the ground surface that can tolerate the heavy visitor traffic. Third, remote gardens are in general located adjacent to ponds and mountain streams and thus the trees in the waterfront areas require the prompt countermeasures against the decline of growth due to the excess-moisture in the soil. Further the blockage of the sewage system due to the heavy rains dampens the surrounding soil, which results in lethal damages to the trees. Thus, there is a need of the maintenance of the waterfront areas and sewage system before and after the rainy season. In addition, there is a need to establish medium-long term management polices through the recognition of the importance of the main trees of remote villa gardens in scenic spots and prepare the tree management manual depending on the attributes of the corresponding areas. I strongly suggest making manuals for the systematic management as well as the extensive PR activities and education for the preservation of tress on a long-term basis; and furthermore securing the budget and manpower for the research and development of a systematic management system.

Suppressive Mechanism of Soil-borne Disease Development and its Practical Application -Isolation and Identification of Species of Trichoderma Antagonistic to Soil diseases and its activities in the Rhizosphere- (토양병의 발병억제 기작과 그 실용성 -길항성 Trichoderma spp.의 분리, 동정 및 근권내 활동-)

  • Kim, S.I.;Shim, J.O.;Shin, H.S.;Choi, H.J.;Lee, M.W.
    • The Korean Journal of Mycology
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    • v.20 no.4
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    • pp.337-346
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    • 1992
  • Trichoderma spp. are an effective control agent for damping-off or other plant diseases. The interaction between. T. hamatum and Rhizoctonia solani on the rhizosphere or surface soil were examined to assess the possible roles of antibiosis or competition in the mechanisms of biological control agents as a basic research. In a proportional comparison, total bacteria, fungi, actinomycetes and Trichoderma spp were 65%, 8.8%, 25.9% and 0.28% respectively in their distribution in the soil. Among Trichoderma spp isolated, the 5 species of Trichoderma spp were indentified as T. koninggii, T. pseudokoninggii, T. aureoviridi, T. hamatum and T. viride respectively. In a mycoparasitic test, one isolate of T. hamatum strain Tr-5 showed an enzymatic ability to break fungal hyphae into piecies and infected on the R. solani hyphae showing a parasitism. Spore germination of the all isolates of Trichoderma spp showed a 1.7-7.3% of germination in natural soil conditions, but the percentage was high in sterile soil indicating all the natural soil were fungistatic on conidia of Trichoderma spp. In rhizosphere competent assay in pea plant, the antagonistic T. hamatum, T. viride, T. koninggii, T. pseudokoninggii showed a colonizing upper soil depth in rhizosphere around 1-3 cm in root zone, but the colonizing ability was much reduced along the deeper the soil depth. Propagule density was decreased in deeper the soil layer. Disease development rate treated alone with plant pathogens, Fusarium solani, Rhizoctonia solani, Cylindrocarpon destructans increased, but disease incidence rate reduced in treatment with combinations with antagonistic T. hamatum strain Tr-5.

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Analysis on Change in Korean Marriage Behaviors (한국인 혼인행태 변화분석)

  • 이삼식
    • Korea journal of population studies
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    • v.16 no.2
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    • pp.84-110
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    • 1993
  • This study aims at identifying the recent change in marriage behaviors in Korea. The data used here is the vital statistics compiled from the vital registration system of which registration form is put on one from together with the civil registration form. According to the results of this analysis, since 1970 the number of marriages has steadily increased from about 300, 000 in the former of 1970s to about 400, 000 in the latter of 1980s, appproximately coincided with the change in population size at the marriageable age span. The few exceptions that can be seen in the 1970s seem to result from the impact of social upheavals during 1950s; since the birth cohorts affected by the low fertility during the Korean war and the post-war baby-boom generations chracterized by the high fertility entered the marriage market in the 1970s. However, the marriage rate shows a little increase from around 7 in the former of 1970s to around 9 in the latter of 1980s, indicating that the marriage prevalence has been more or less inconsiderably changed during this period. It is also found that the proportion of remarriage to the total marriages has increased to around 10 per cent in 1989, while decreasing that of first marriage. This fact can be attributable to the higher prevalence of divorces and the collapsing of the Confucianism ethic which contributed to expediting the remarriage of widows. Although this proportion is insignificant compared with that of the of more developed countries, it is not difficult to say that the proportion of remarriages will continue to increase in future. The age first at first marriage(AFM) which directly affects the span exposed to the risks pregnancy has increased to the age about 28 for male and about 25 for female in recent years. However, big difference in AFM between urban and rural areas has narrowed, resultant from the increasing involuntary postponement of marriage of rural young population who have met difficulties in seeking their bride or bridegroom in rural areas characterized by the heavy out-migration of young, particularly female, population. The present study shows the reverse relationship between AFM and educational attainment; i.e, the higher the educational attainment the lower the AFM. The conditions which are taken into considerations were the class and the family in the past time but which are, educational attainment, job and personal characteristics. With regard to the age condition, in recent years the male prefers the female younger than himself on the average by 3 years and vice versa, which is reduced form 4-5 years in beginning of 1970s. The age difference bride and bridegroom tends to decrease with the educational attainment increase. This may be attributable to the fact that the persons with the higher educational attainment prefer the love marriage and hence are more likely to choose their counterparts in the about same age. The education condition is characterized by the bridegroom having the higher educational level than bride. It is also significant to note that the proportion of love marriage has increased, whereas that of traditional arranged marriage has decreased. This is true in the urban areas than the rural areas, indicating that rights as well as responsibilities for marriage have been handed over the young population from their parents. In conclusion, the change in the marriage behaviors in Korea are characterized by increasing tendency for the postponement of first marriage, higher prevalences of divorces and a result remarriages, increase of love marriages, narrowing age difference between bride and bridegroom, etc. which are the main results of rapid industrization, increase in educational and economic activity opportunities and change in the ideals of marriages during the past decades. These phenomena prevailing in Korean society would affect not only the family structure that will become less proliferiated but the population size and structure. The most important is that the changes in marriage behaviors of Koreans and their impact on the society with respect to norms, values, morals, of individual and family in the social aspect, change in population size and structure in the demograpic aspects, and economic development in the economic aspects should be integrated into the plannings towards to the future.

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Potentials of Synbiotics for Pediatric Nutrition and Baby Food Applications: A Review (소아 영양 및 유아식 응용을 위한 신바이오틱스의 잠재력: 총설)

  • Jung, Hoo Kil;Kim, Sun Jin;Seok, Min Jeong;Cha, Hyun Ah;Yoon, Seul Ki;Lee, Nah Hyun;Kang, Kyung Jin
    • Journal of Dairy Science and Biotechnology
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    • v.33 no.2
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    • pp.111-118
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    • 2015
  • Probiotic, prebiotic, and synbiotic substances as well as microorganisms were added to infant formula in an attempt to influence the intestinal microflora with an aim to stimulate the growth of lactic acid bacteria, especially bifidobacteria and lactobacilli. Over the last 10 years, new synbiotic infant formulas containing probiotics and prebiotics have been proposed in order to simulate the effect of breast-feeding on the intestinal microflora. Owing to their synergistic effect, the new synbiotics are expected to be more helpful than using probiotics and prebiotics individually. Maintenance of the viability of the probiotics during food processing and the passage through the gastrointestinal tract should be the most important consideration, since a sufficient number of bacteria ($10^8cfu/g$) should reach the intended location to have a positive effect on the host. Storage conditions and the processing technology used for the manufacture of products such as infant formula adversely affect the viability of the probiotics. When an appropriate and cost-effective microencapsulation methodology using the generally recognized as safe (GRAS) status and substances with high biological value are developed, the quality of infant formulas would improve. The effect of probiotics may be called a double-effect, where one is an immunomodulatory effect, induced by live probiotics that advantageously alter the gastrointestinal microflora, and the other comprises anti-inflammatory responses elicited by dead cells. At present, a new terminology is required to define the dead microorganisms or crude microbial fractions that positively affect health. The term "paraprobiotics" (or ghost probiotics) has been proposed to define dead microbial cells (not damaged or broken) or crude cell extracts (i.e., cell extracts with complex chemical composition) that are beneficial to humans and animals when a sufficient amount is orally or topically administered. The fecal microflora of bottle-fed infants is altered when the milk-based infant formula is supplemented with probiotics or prebiotics. Thus, by increasing the proportion of beneficial bacteria such as bifidobacteria and lactobacilli, prebiotics modify the fecal microbial composition and accordingly regulate the activity of the immune system. Therefore, considerable attention has been focused on the improvement of infant formula quality such that its beneficial effects are comparable to those of human milk, using prebiotics such as inulin and oligosaccharides and potential specific probiotics such as bifidobacteria, which selectively stimulate the proliferation of beneficial bacteria in the microflora and the indigenous intestinal metabolic activity of the microflora.

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Choledochal Cyst in Korea - A Survey by the Korean Association of Pediatric Surgeons - (담관낭종 -대한소아외과학회회원 대상 전국조사-)

  • Choi, Kum-Ja;Kim, D.Y.;Kim, S.Y.;Kim, S.C.;Kim, S.K.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, J.C.;Kim, H.Y.;Kim, H.J.;Park, K.W.;Park, W.H.;Park, J.Y.;Paek, H.K.;Seo, J.M.;Song, Y.T.;Oh, S.M.;Yoo, S.Y.;Lee, D.S.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Park, Y.S.;Lee, T.H.;Chung, S.Y.
    • Advances in pediatric surgery
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    • v.9 no.1
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    • pp.45-51
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    • 2003
  • A nationwide survey on choledochal cyst was undertaken among 39 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and the case registration form for each patient during the five year period of 1997 to 2001. Three hundred and forty eight patients were registered from 32 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:3.4. The age of patients on diagnosis was $49.0{\pm}44.4$ months. The geographic distribution was 34.8% in Seoul and Kyoungki-do, 33.3% in Kyoungsang-do, 17.9% in Cholla-do, and 8.5% in Choongchung-do, in order of frequency. The three common clinical presentations were abdominal pain (63.8%), vomiting (35.3%), and jaundice (29.1%). Only seven patients (2%) presented with classic triad, and 25 patients were diagnosed by antenatal ultrasonographic examination. According to the Todani Classification, 238 patients (7l.3%) were type 1, 3 (0.9%) type 11, and 93 (27.8%) type IV. At the time of the operation, three important associated conditions were choledocholithiasis in 45 patients (15.1%), liver fibrosis (Grade 1-4) in 35, and previous operative procedure for biliary diseases in 10. Associated anomalies were observed in 13 patients (3.8%). Three hundred thirty nine (98.8%) of 343 lesions were treated by Cyst excision and Roux-Y hepaticoiejunostomy. One hundred seventy-six patients had an anomalous arrangement of the pancreatobiliary ductal system (APBD): APBD was not in 92 patients, biliary duct joined to the pancreatic duct in 51, and pancreatic duct joined to the biliary duct in 26. There were 8.5% early, and 7.7% late phase operative complications. The major complications were bleeding, anastomotic leakage, and acute pancreatitis. The combination of acute abdomen and choledochal cyst may suggest spontaneous rupture. Because of the development of late intrahepatic bile duct stones, long term follow up after cyst excision and hepaticojejunostomy is required. The optimal time of surgical intervention should also be considered in the situation of routine use of antenatal ultrasonographic examination. This is the first review of the choledochal cyst in Korea and provides baseline data for future comparisons.

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Effect of Aqueous Phase Composition on the Stability of a Silica-stabilized Water-in-oil Emulsion (유화제로서 실리카를 이용한 유중수형 에멀젼의 안정성에 미치는 수상부 조성의 영향)

  • Kim Jin-Hwang;Kim Song-I;Kyong Kee-Yeol;Lee Eun-Joo;Yoon Moung-Seok
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.30 no.3 s.47
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    • pp.353-359
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    • 2004
  • The extent of silica flocculation can be modified by varying the silica concentration, aqueous phase pH, salt and polvmer concentration. High volume fraction W/O emulsion stabilized by hydrophobic silica was established with various aqueous phase conditions for cosmetic application. By increasing the silica concentration up to $1.0\;wt\%,$ the size of droplet decreased. A high silica concentration increased the viscosity of continuous oil phase by network formation, which resulted in target size of droplet. The stability of W/O emulsion is improved as increasing the aqueous phase pH. At low and intermediate pH, the emulsions became more stable by adding salt $(0.083\;mol\;dm^{-3}\;MgSO_4).$ At high PH, the presence of salt caused significant destabilization. The gelation behavior of the emulsion indicates that the effect of salt on silica-stabilized emulsion is derived from an electrostatic attraction. The addition of xanthan gum in aqueous phase increased the mono-dispersity of the W/O emulsion by making water more hydrophobic and hindering the recombination of droplets. In conclusion, these results indicate that very stable emulsifier-free, finely dispersed W/O emulsion can be achieved for cosmetic application by changing the aqueous phase composition.

Effect of TGF-${\beta}$ Supplementation on In Vitro Maturation of Hanwoo COCs (Cumulus Oocytes Complexes) (TGF- ${\beta}$ 첨가가 한우 난포란의 체외성숙에 미치는 영향)

  • Choi, Sun-Ho;Lee, Hye-Hyun;Yeon, Seong-Heum;Han, Man-Hye;Kim, Hyun-Jong;Cho, Sang-Rae;Woo, Jae-Seok;Baek, Kwang-Soo;Ryu, Il-Sun;Son, Dong-Soo
    • Development and Reproduction
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    • v.8 no.2
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    • pp.119-122
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    • 2004
  • It is well known that unidentified factors in sera, hormones and growth factors promote the proliferation of granulosa cells and nuclear maturation of bovine COCs in vitro. Attemps had been developed the simple composition of culture media and similar system to in vivo conditions has been applied. In the present study, we investigated the effect of TGF-${\beta}$ on in vitro maturation and in vitro development of Hanwoo COCs. When the COCs were matured in TCM 199 containing 0.1, 1 or 10 ng/ml TGF-${\beta}$ for 24 hrs, metaphaseⅡ of COCs were obtained 95.8%, 100% of matured COCs, respectively and there were no differences among the concentrations of TGF-${\beta}$. Matured COCs with TGF-${\beta}$ cultured in maturation medium after in vitro fertilization, developmental rate to blastocyst were 0~0.8%. Matured COCs with TGF-${\beta}$ were cultured in TCM 199+10% FBS, 0.8% BSA, 0.1% PVA, blastocyst formation were showed in 12.4%, 12.8%, 8.5% of those and cultured in IVMD or IVD without serum were 38.4%, 34.8%, respectively. There were significant differences among the media (P<0.05). TGF-${\beta}$ is available for i vitro maturation of bovine COCs, but further investigation would be need for finding the synergistic autocrine/paracrine fashion of other growth factors in early bovine development.

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The Suitable Region and Site for 'Fuji' Apple Under the Projected Climate in South Korea (미래 시나리오 기후조건하에서의 사과 '후지' 품종 재배적지 탐색)

  • Kim, Soo-Ock;Chung, U-Ran;Kim, Seung-Heui;Choi, In-Myung;Yun, Jin-I.
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.11 no.4
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    • pp.162-173
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    • 2009
  • Information on the expected geographical shift of suitable zones for growing crops under future climate is a starting point of adaptation planning in agriculture and is attracting much concern from policy makers as well as researchers. Few practical schemes have been developed, however, because of the difficulty in implementing the site-selection concept at an analytical level. In this study, we suggest site-selection criteria for quality Fuji apple production and integrate geospatial data and information available in public domains (e.g., digital elevation model, digital soil maps, digital climate maps, and predictive models for agroclimate and fruit quality) to implement this concept on a GIS platform. Primary criterion for selecting sites suitable for Fuji apple production includes land cover, topography, and soil texture. When the primary criterion is satisfied, climatic conditions such as the length of frost free season, freezing risk during the overwintering period, and the late frost risk in spring are tested as the secondary criterion. Finally, the third criterion checks for fruit quality such as color and shape. Land attributes related to these factors in each criterion were implemented in ArcGIS environment as relevant raster layers for spatial analysis, and retrieval procedures were automated by writing programs compatible with ArcGIS. This scheme was applied to the A1B projected climates for South Korea in the future normal years (2011-2040, 2041-2070, and 2071-2100) as well as the current climate condition observed in 1971-2000 for selecting the sites suitable for quality Fuji apple production in each period. Results showed that this scheme can figure out the geographical shift of suitable zones at landscape scales as well as the latitudinal shift of northern limit for cultivation at national or regional scales.

Detection Characteristics of PSL and TL Methods in Spices Irradiated with Different Radiation Sources (조사선원에 따른 향신료의 PSL과 TL 검지 특성)

  • Kim, Kyu-Heon;Kwak, Ji-Young;Kim, Jung-Ki;Hwang, Cho-Rong;Lee, Jae-Hwang;Park, Yong-Chjun;Kim, Jae-I;Jo, Tae-Yong;Lee, Hwa-Jung;Lee, Sang-Jae;Han, Sang-Bae
    • Journal of Radiation Industry
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    • v.7 no.1
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    • pp.15-21
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    • 2013
  • The detection characteristics of irradiated spices were investigated depending on radiation sources and doses by photostimulated luminescence (PSL) and Thermoluminescence (TL). 6 kinds of spices (turmeric, onion powder, red pepper, basil, parsley, black pepper) were irradiated at 0 to 10 kGy under ambient conditions by both a $^{60}Co$ gamma irradiator and an electron beam (EB) accelerator, respectively. The PSL analysis showed negative results for non-irradiated spices, while irradiated spices gave intermediate and positive value, which presented the limited potential of PSL technique. In TL measurement, TL glow curves on non-irradiated samples appeared at about $300^{\circ}C$ with low intensity. All irradiated samples were easily distinguishable through radiation-specific strong TL glow curves with maximum peak in range of $150{\sim}200^{\circ}C$. TL ratio ($TL_1/TL_2$) obtained by a re-irradiation step could verify the detection result of $TL_1$ glow curves, showing ratios lower than 0.1 in the non-irradiated sample and higher than 0.1 in irradiated ones. Therefore, in PSL measurement, the identification of irradiated spices showed more clear results in electron beam irradiated samples. TL analysis showed obvious difference between non-irradiated and irradiated samples in gamma ray and electron beam irradiated samples.