• Archives of Plastic Surgery
• /
• v.46 no.5
• /
• pp.462-469
• /
• 2019

Background Incisional hernia is a common complication following visceral organ transplantation. Transplant patients are at increased risk of primary and recurrent hernias due to chronic immune suppression and large incisions. We conducted a retrospective review of patients with a history of liver or kidney transplantation who underwent hernia repair to analyze outcomes and hernia recurrence. Methods This is a single center, retrospective review of 19 patients who received kidney and/or liver transplantation prior to presenting with an incisional hernia from 2011 to 2017. All hernias were repaired with open component separation technique (CST) with biologic mesh underlay. Results The mean age of patients was $61.0{\pm}8.3years\;old$, with a mean body mass index of $28.4{\pm}4.8kg/m^2$, 15 males (78.9%), and four females (21.1%). There were seven kidney, 11 liver, and one combined liver and kidney transplant patients. The most common comorbidities were hypertension (16 patients, 84.2%), diabetes (9 patients, 47.4%), and tobacco use (8 patients, 42.1%). Complications occurred in six patients (31.6%) including hematoma (1/19), abscess (1/19), seroma (2/19), and hernia recurrence (3/19) at mean follow-up of $28.7{\pm}22.8months$. With the exception of two patients with incomplete follow-up, all patients healed at a median time of 27 days. Conclusions This small, retrospective series of complex open CST in transplant patients shows acceptable rates of long-term hernia recurrence and healing. By using a multidisciplinary approach for abdominal wall reconstruction, we believe that modified open CST with biologic mesh is a safe and effective technique in the transplant population with complex abdominal hernias.

• Archives of Plastic Surgery
• /
• v.49 no.1
• /
• pp.91-98
• /
• 2022

Background Predicting the need for post-traumatic reconstruction of lower extremity injuries remains a challenge. Due to the larger volume of cases in adults than in children, the majority of the medical literature has focused on adult lower extremity reconstruction. This study evaluates predictive risk factors associated with the need for free flap reconstruction in pediatric patients following lower extremity trauma. Methods An IRB-approved retrospective chart analysis over a 5-year period (January 1, 2012 to December 31, 2017) was performed, including all pediatric patients (<18 years old) diagnosed with one or more lower extremity wounds. Patient demographics, trauma information, and operative information were reviewed. The statistical analysis consisted of univariate and multivariate regression models to identify predictor variables associated with free flap reconstruction. Results In total, 1,821 patients were identified who fit our search criteria, of whom 41 patients (2.25%) required free flap reconstruction, 65 patients (3.57%) required local flap reconstruction, and 19 patients (1.04%) required skin graft reconstruction. We determined that older age (odds ratio [OR], 1.134; P =0.002), all-terrain vehicle accidents (OR, 6.698; P<0.001), and trauma team activation (OR, 2.443; P=0.034) were associated with the need for free flap reconstruction following lower extremity trauma in our pediatric population. Conclusions Our study demonstrates a higher likelihood of free flap reconstruction in older pediatric patients, those involved in all-terrain vehicle accidents, and cases involving activation of the trauma team. This information can be implemented to help develop an early risk calculator that defines the need for complex lower extremity reconstruction in the pediatric population.

• Archives of Plastic Surgery
• /
• v.48 no.6
• /
• pp.607-613
• /
• 2021

Background Breast reconstruction using an extended latissimus dorsi (eLD) flap can supplement more volume than reconstruction using various local flaps after partial mastectomy, and it is a valuable surgical method since the reconstruction area is not limited. However, when performing reconstruction, the surgeon should consider latissimus dorsi (LD) volume reduction due to postoperative chemotherapy (POCTx) and postoperative radiotherapy (PORTx). To evaluate the effect of POCTx and PORTx on LD volume reduction, the effects of each therapy-both separately and jointly-need to be demonstrated. The present study quantified LD volume reduction in patients who underwent POCTx and PORTx after receiving breast-conserving surgery (BCS) with an eLD flap. Methods This study included 48 patients who received immediate breast reconstruction using an eLD flap from January 2013 to March 2017, had chest computed tomography (CT) 7-10 days after surgery and 10-14 months after radiotherapy completion, and were observed for more than 3 years postoperatively. One surgeon performed the breast reconstruction procedures, and measurements of breast volume were obtained from axial CT views, using a picture archiving and communication system. A P-value <0.05 was the threshold for statistical significance. Results The average volume reduction of LD at 10-14 months after completing POCTx and PORTx was 64.5% (range, 42.8%-81.4%) in comparison to the volume measured 7-10 days after surgery. This change was statistically significant (P<0.05). Conclusions Based on the findings of this study, when harvesting an eLD flap, surgeons should anticipate an average LD volume reduction of 64.5% if chemotherapy and radiotherapy are scheduled after BCS with an eLD flap.

• Journal of the Korea Society of Computer and Information
• /
• v.29 no.4
• /
• pp.105-114
• /
• 2024

The purpose of this study was to identify factors influencing maladaptive perfectionism, self-leadership, and social support on nursing students' clinical practice stress. Participants were 150 nursing students who were enrolled at four universities in Chungcheongbukdo. Data were collected using questionnaire by from 03 to 30 November, 2022. The measurement tools consisted of the Almost Perfect Scale-Revised, Self Leadership Questionnaire-Revidsed, Scale of Social Support, and Clinical Practice Stress Scale-Revised. Results revealed that higher levels of maladaptive perfectionism were associated with increased clinical practice stress. Decreased self-leadership, satisfaction with nursing major, number of clinical practice in other regions, and social support was also associated with increased clinical practice stress. Findings indicate that specific characteristics such as maladaptive perfectionism and decrease of social support can lead to increase clinical practice stress. In this paper, we propose that active considerations for these psychological characteristics are important when reducing clinical practice stress for nursing students.

• Journal of Veterinary Clinics
• /
• v.24 no.4
• /
• pp.503-508
• /
• 2007

Although canine facial nerve paralysis(FNP) occurs similarly in humans, there is no properly recognized therapy using Western medicine for idiopathic causes. To elucidate therapeutic measures by acupuncture(AP) on canine FNP, we examined the therapeutic effect of injection-AP on the artificially induced canine FNP. Twelve dogs on artificially induced canine FNP were divided into a control group(4 dogs), an experimental dexamethasone-treated group(dexamethasone group, 4 dogs) and an experimental bee venom-treated group(apitoxin group, 4 dogs). Saline (1 ml) was intramuscularly injected into the head muscle after the induction of FNP in the control group. On the other hand, injection-AP with dexamethasone was performed on such acupoints as LI04, LI20, ST02, ST07, TH17, SI18, GB03 and GB34, twice per week after induction of FNP in the dexamethasone group. In addition, injection-AP with $100{\mu}g$ of apitoxin was performed on the same acupoints as the dexamethasone group twice per week after the induction of FNP in the apitoxin group, respectively. The changes of the clinical symptoms of FNP with each treatment during the experimental period were recorded by using clinical scores, respectively. The changes of serum creatine kinase(CK) activities along with each treatment were determined using an autoanalyzer. The significant differences of clinical scores were detected on day 14(p<0.05) in the apitoxin and dexamethasone groups, compared with those in the control group, respectively. However, significant difference was not detected between the apitoxin and dexamethasone groups. Significant differences of serum CK activities were detected on day 7(p<0.05) and day 14(p<0.05) in the dexamethasone and apitoxin groups, compared with those in the control group, respectively. However, significant difference was not detected between the dexamethasone and apitoxin groups. In condition, injection-APs with apitoxin and dexamethasone were all effective for treatment of canine FNP and the therapeutic effect by injection-AP with apitoxin was similar to that of injection-AP with dexamethasone.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
• /
• v.12 no.3
• /
• pp.65-74
• /
• 2017

There have been questions how entrepreneurs think, act and why individuals become entrepreneurs. The trait-based explanation of entrepreneurial activities has been main stream. However, the trait-based theory has been criticized because it assumes that entrepreneurial traits are inherited, stable and enduring over time. This research accepts the cognitive theory to see how entrepreneurs learn or accept others' values, how entrepreneurial perceptions of opportunity impact entrepreneurial actions and how individuals acquire the social legitimation of the formation of entrepreneurial activities. In order to capture the attitudes, activities and motivations of people who are involved in entrepreneurial activities, the author uses the GEM Korea 2016 data. The data from the Global Entrepreneurship Monitor(GEM) has been well known for the data to capture individuals early-stage entrepreneurial activities. This paper used the sample from the APS(Adult Population Survey) of the GEM which was completed by a representative sample of two thousand adults in Korea by the qualified survey vendor, with strict procedures and oversight by the GEM central data team. The hypotheses are tested with logit regression analysis to estimate the probability of the influence of perceptual variables such as individual perception in social learning, the opportunity recognition in the environment, and social legitimation in the entrepreneurial activities. Based on the results, individuals tend to have high entrepreneurial activities if individuals have high self-efficacy. Also, the existence of role models around the entrepreneurs encourages the individuals involve in entrepreneurial activities more however the perception of opportunity in the environment is not strongly associated with entrepreneurial activities. The media exposure of successful entrepreneurs is more important than others' perception of entrepreneurs on the desirable career option or respect from communities. This paper can contribute to the cognitive processes, particular perception about oneself, as well as perception which is impacted by a community or a society.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
• /
• v.16 no.5
• /
• pp.1-14
• /
• 2021

Innovation and Scale-up of Start-up companies are becoming important national tasks. In the past, it was spread the start-up policy paradigm such as 'Start-up America', 'Start-up Chile', 'Start-up Britain' to overcome the recession globally. However as the economic recovery has become more visible recently in advanced economies, it is shifting from a start-up support policy to a scale-up oriented policy paradigm such as 'Scale-up America', Scale-up UK', 'Scale-up Denmark'. It is necessary to enter the scale-up phase beyond the start-up phase to increase the number of high-quality jobs and to continue economic growth. Therefore, it is necessary to grow the start-up into a strong medium-sized company and to lay the foundation for survival. Therefore, the purpose of this study is to consider the antecedent factors that influence the scale-up aspiration for the start-up firm to grow into a scale-up company, and empirically identifies the differences between the stages of economic development and entrepreneurs in the country. In order to accomplish the purpose, this study predicted scale-up by aspiration which is a predictor of scale-up behavior because it is difficult to achieve visible growth in a short period of time due to the characteristics of start-up companies. In order to empirically explore these relationships, the data were collected from nascent entrepreneurs who have less than 3.5 years of the Adult Population Survey(APS) among the subjects surveyed by the Global Entrepreneurship Monitor(GEM) and the national economic development stage are divided into Innovation-driven, Efficiency-driven, Factor-driven type economies. For the test hypotheses, this study adopted the multi-level model analysis for comparison between national economic development stages and using the R 3.5.0 program. The results of this study are as follows. There is difference between the national economic development and the entrepreneur in the relationship between innovation orientation of entrepreneurs and scale-up aspirations. As the economy of the country develops, the innovation activity of the entrepreneur becomes more active. Since start-ups are heavily influenced by entrepreneurs, there is a difference in the degree of aspiration depending on how innovative an entrepreneur is in the same environment. In terms of the relationship between innovation orientation and scale-up aspiration, the fear of failure was found to differ between national economic development and entrepreneurs. The fear of failure differ from country to country, and this is one of the important factors affecting entrepreneurial activities. It is expected that the factors influencing the growth of the start-up companies which are identified through the results of these studies, will be used to create a suitable scale-up ecosystem according to the national economic development stage.