• Archives of Plastic Surgery
• /
• v.51 no.2
• /
• pp.212-233
• /
• 2024

This is a retrospective review of surgical management for primary lymphedema. Data were extracted from 55 articles from PubMed MEDLINE, Web of Science, SCOPUS, and Cochrane Central Register of Controlled Trials between the database inception and December 2022 to evaluate the outcomes of lymphaticovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT), and outcomes of soft tissue extirpative procedures such as suction-assisted lipectomy (SAL) and extensive soft tissue excision. Data from 485 patients were compiled; these were treated with LVA (n = 177), VLNT (n = 82), SAL (n = 102), and excisional procedures (n = 124). Improvement of the lower extremity lymphedema index, the quality of life (QoL), and lymphedema symptoms were reported in most studies. LVA and VLNT led to symptomatic relief and improved QoL, reaching up to 90 and 61% average circumference reduction, respectively. Cellulitis reduction was reported in 25 and 40% of LVA and VLNT papers, respectively. The extirpative procedures, used mainly in patients with advanced disease, also led to clinical improvement from the volume reduction, as well as reduced incidence of cellulitis, although with poor cosmetic results; 87.5% of these reports recommended postoperative compression garments. The overall complication rates were 1% for LVA, 13% for VLNT, 11% for SAL, and 46% for extirpative procedures. Altogether, only one paper lacked some kind of improvement. Primary lymphedema is amenable to surgical treatment; the currently performed procedures have effectively improved symptoms and QoL in this population. Complication rates are related to the invasiveness of the chosen procedure.

• Composites Research
• /
• v.34 no.3
• /
• pp.192-198
• /
• 2021

Due to enormous market growing of electric vehicles without combustion engine, reducing unwanted BSR (buzz, squeak, and rattle) noise is highly demanded for vehicle quality and performance. Particularly, innerbelt weatherstrips which not only block wind noise, rain, and dust from outside, but also reduce noise and vibration of door glass and vehicle are required to exhibit high damping properties for improved BSR performance of the vehicle. Thermoplastic elastomers (TPEs), which can be recycled and have lighter weight than thermoset elastomers, are receiving much attention for weatherstrip material, but TPEs exhibit low material damping and compression set causing frictional noise and vibration between the door glass and the weatherstrip. In this study, high damping EPDM (ethylene-propylene-diene monomer)/PP (polypropylene) thermoplastic vulcanizates (TPV) were investigated by varying EPDM/PP ratio and ENB (ethylidene norbornene) fraction in EPDM. Viscoelastic properties of TPV materials were characterized by assuming that the material damping is directly related to the viscoelasticity. The optimum material damping factor (tanδ peak 0.611) was achieved with low PP ratio (14 wt%) and high ENB fraction (8.9 wt%), which was increased by 140% compared to the reference (tanδ 0.254). The improved damping is believed due to high fraction of flexible EPDM chains and higher interfacial slippage area of EPDM particles generated by increasing ENB fraction in EPDM. The stick-slip test was conducted to characterize frictional noise and vibration of the TPV weatherstrip. With improved TPV material damping, the acceleration peak of frictional vibration decreased by about 57.9%. This finding can not only improve BSR performance of electric vehicles by designing material damping of weatherstrips but also contribute to various structural applications such as urban air mobility or aircrafts, which require lightweight and high damping properties.

• The korean journal of orthodontics
• /
• v.38 no.3
• /
• pp.159-174
• /
• 2008

Objective: The purpose of this study was to investigate whether cortical punching could stimulate the expression of OPG, RANK, and RANKL during tooth movement by immunohistochemistry. Methods: 34 sprague-dawley rats (15 weeks old) were allocated into 3 groups: TMC group (experimental group; Tooth Movement with Corticotomy, n = 16), TM group (control group; Tooth Movement only group, n = 16), and non-treatment group (n = 2). 20 gm of orthodontic force was applied to rat incisors by inserting elastic bands. The duration of force application was 1, 4, 7 and 14 days. A microscrew (diameter 1.2 mm) was used for cortical punching of the palatal side of the upper incisors in the TMC group. Results: Distributions of OPG, RANK, and RANKL were evaluated by immunohistochemistry. OPG, RANK and RANKL were observed on experimental and control groups. On the compression side, the degree of the expression of OPG decreased in both groups. The expression of RANK was most prominent in the experimental group of day 4. The expression of RANKL was most intensive and extensive in the experimental group of day 7. However, the expression of OPG was decreased in the experimental and control groups compared to the non treatment group. The expression of OPG, RANK and RANKL after force application were decreased at day 14. Conclusions: These findings suggested that cortical punching might stimulate remodeling of alveolar bone during a 2 week period of tooth movement without any pathologic change.

• Journal of Korean Tunnelling and Underground Space Association
• /
• v.21 no.6
• /
• pp.897-908
• /
• 2019

The objective of this study is to evaluate the field support performance of highperformance lattice girder (BK-Lattice Girder) by using numerical analysis. Three types (50, 70, 95-type) of existing and high performance lattice girders were applied to the cross section of highway 2, 3, and 4 lane tunnels to compare the supporting performance. The numerical analysis was the finite element method and the lattice girder was modeled in three dimensions with an elasto-plastic frame. The ground was modeled as a spring receiving only compression. The load was applied as a concentrated load on the central ceiling of the tunnel section. The yield strengths of the lattice girders were determined from the numerical results to compare the supporting performance of lattice girder. In case of 50-type, the yield strengths of high-performance lattice girders were increased by 6.7~10.0% compared with those of the existing lattice girders. In the case of 70-type, the high-performance lattice girders increased yield strengths by 12.1~14.9% than the existing lattice girder. In the case of 95-type, the high-performance lattice girders increased yield strengths by 13.3~20.0% than the existing lattice girder. As a result of numerical analysis, it was considered that the high-performance lattice girder supported better than the existing lattice girder when only the lattice girders were constructed.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.8 no.2
• /
• pp.115-120
• /
• 2009

Purpose: To evaluate the outcomes of three different surgical approaches in treating a distal radius fracture with dorsal communition. Materials and Methods: From April, 2006 to May, 2009, 49 patients over age of 60years old with unstable dorsal communition distal radius fracture were analyzed. We compared maintainability of reduction by radiological follow-up observations and clinical outcomes using Mayo wrist scores. One-Way ANOVA test was performed to examine the statistical correlation between the methods. Results: All three approaches provided satisfactory post-op reduction results. However, follow-up observations showed significant loss of reduction in the external fixation only group compared to the added bone graft group and the volar anatomical locking plate group (P<0.05). Mayo wrist score was indifferent between the three groups. Conclusion: Treatment of a distal radius fracture with severe dorsal communition using an external fixation only appears to be insufficient in maintaining reduction of a cancellous bone defect.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.6
• /
• pp.763-771
• /
• 2000

Objectives : Thoracolumbar burst fractures(TBLF) result in not only compressive deformity of vertebral body but also spinal cord compression by bony fragments. Many thoracolumbar burst fractures demand both anterior decompression and intervertebral fusion. Most of spinal surgeons use anterior instrumentation for anteior intervertebral bony fusion. The use of Z-plate has been increased recently, however there has been only a few reports regarding its clinical long-term strength. We studied nineteen patients with TBLF to find out the long-term stability of Z-plate. Methods : We have operated 19 patients from March 1996 to August 1998. They were treated with anterior decompression through either a transthoracic, retroperitoneal extrapleural or retroperitoneal approach. Retropulsed bony fragments were removed completely by corpectomy. Iliac bone graft was used for interbody fusion in all of the cases. They were evaluated by plain X-ray films including flexion and extention lateral films. Cobbs angle was used to evaluate kyphotic and lateral wedging deformity. Results : Burst fractured sites were T11 in two, three T12, nine L1, and five L2. Mean follow-up duration was fifteen months. Preoperative average kyphotic angle was 23.7 degree. Immediate postoperative kyphotic angle was 10.2 degree. Follow-up resluts of average kyphotic angles revealed 14 degrees. Four patients(21%), including two spinal 3-column injury, showed increasement of kyphotic angle more than 5 degree or breakage of intrumentation. Two patients showed the difference of kyphotic angle more than 3 degree. Five patients(26%) revealed lateral wedging deformity more than 3 degrees. Postoperative complications were two meralgia parestheticas, one pulmonary atelectasis and two donor site infections. Four of the eight patients, who initially showed incomplete spinal cord deficits, were nerologically improved by Frankel's grade. Conclusion : Z-plate fixation and iliac bone graft after anterior decompression in thoracolumbar burst fractures is a safe and easy method. Immediate postoperative results revealed excellent correction of posttraumatic kyphosis, but long-term follow-up evalution showed insufficient strength. Therefore we believe that use of Z-plate should be carefully decided, especially in the case of large lumbar fracture or 3-column injury.

• Journal of KIISE:Computer Systems and Theory
• /
• v.29 no.5
• /
• pp.245-256
• /
• 2002

Shadows are important elements in producing a realistic image. Generation of exact shapes and positions of shadows is essential in rendering since it provides users with visual cues on the scene. It is also very important to be able to create soft shadows resulted from area light sources since they increase the visual realism drastically. In spite of their importance. the existing shadow generation algorithms still have some problems in producing realistic shadows in real-time. While image-based rendering techniques can often be effective1y applied to real-time shadow generation, such techniques usually demand so large memory space for storing preprocessed shadow maps. An effective compression method can help in reducing memory requirement, only at the additional decoding costs. In this paper, we propose a new image-barred shadow generation method based on image warping. With this method, it is possible to generate realistic shadows using only small sizes of pre-generated shadow maps, and is easy to extend to soft shadow generation. Our method will be efficiently used for generating realistic scenes in many real-time applications such as 3D games and virtual reality systems.

• Journal of Chest Surgery
• /
• v.37 no.11
• /
• pp.911-917
• /
• 2004

Background: There are limited number of reports on May-Thurner syndrome (Iliac vein compression syndrome) in Korea, We analysed the clinical features, diagnostic modalities and endovascular treatment of May-Thurner syndrome. Material and Method: We reviewed 12 cases of May-Thurner syndrome between March 2001 and June 2003. Mean age was $57.6\pm2$ years. We were used in venography, color doppler and computed tomographic angiography as diagnostic modalities and in thrombolysis, thrombectomy, angioplasty and stent insertion as endovascular treatment. Result: Clinical features showed edema of lower extremities in 4 patients, pain of lower extremities in 1 patient, edema with pain in 5 patients, and all in 1 patient. In one patient, he did not have any pain and any edema of lower extremities but was diagnosed as May-Thurner syndrome using venography due to varicose veins on lower extremities. Diagnostic modalities included venography, computed tomographic angiography in all patients with clinical presentation except in one patient and color doppler was only performed only in 4 patients. Four kinds of endovascular treatment were performed for May-Thurner syndrome, angioplasty in 11 patients, stent insertion in 10 patients, thrombectomy in 9 patients and thrombolysis for 7 patients. Nine patients were followed up and we can show good blood flow in Left iliac vein for 7 of 9 patients. Conclusion: it is necessary to recognize the possibility of May-Thurner syndrome in Deep vein thrombosis patients and we should use a variety of modalities to diagnose May-Thurner syndrome. Finally, endovascular treatment is a safe and effective therapy for May-Thurner syndrome.

• Journal of Biomedical Engineering Research
• /
• v.32 no.3
• /
• pp.218-229
• /
• 2011

Companding algorithms have been used to enhance speech recognition in noise for cochlea implant users. The efficiency of using companding for digital hearing aid users is not yet validated. The purpose of this study is to evaluate the performance of the companding for digital hearing aid users in the various hearing loss cases. Using HeLPS, a hearing loss simulator, two different sensorinerual hearing loss conditions were simulated; mild gently sloping hearing loss(HL1) and moderate to steeply sloping hearing loss(HL2). In addition, a non-linear compression was simulated to compensate for hearing loss using national acoustic laboratories-non-linear version 1(NAL-NL1) in HeLPS. In companding, the following four different companding strategies were used changing Q values(q1, q2) of pre-filter(F filter) and post filter(G filter). Firstly, five IEEE sentences which were presented with speech-shaped noise at different SNRs(0, 5, 10, 15 dB) were processed by the companding. Secondly, the processed signals were applied to HeLPS. For comparison, signals which were not processed by companding were also applied to HeLPS. For the processed signals, log-likelihood ratio(LLR) and cepstral distance(CEP) were measured for evaluation of speech quality. Also, fourteen normal hearing listeners performed speech reception threshold(SRT) test for evaluation of speech intelligibility. As a result of this study, the processed signals with the companding and NAL-NL1 have performed better than that with only NAL-NL1 in the sensorineural hearing loss conditions. Moreover, the higher ratio of Q values showed better scores in LLR and CEP. In the SRT test, the processed signals with companding(SRT = -13.33 dB SPL) showed significantly better speech perception in noise than those processed using only NAL-NL1(SRT = -11.56 dB SPL).

• Journal of the Institute of Electronics Engineers of Korea SP
• /
• v.42 no.5 s.305
• /
• pp.95-102
• /
• 2005

When images compressed with block-based compression techniques are transmitted over a noisy channel, unexpected block losses occur. In this paper, we present a post-processing-based block recovery scheme using Haar wavelet features. No consideration of the edge-direction, when recover the lost blocks, can cause block-blurring effects. The proposed directional recovery method in this paper is effective for the strong edge because exploit the varying neighboring blocks adaptively according to the edges and the directional information in the image. First, the adaptive selection of neighbor blocks is performed based on the energy of wavelet subbands (EWS) and difference of DC values (DDC). The lost blocks are recovered by the linear interpolation in the spatial domain using selected blocks. The method using only EWS performs well for horizontal and vertical edges, but not as well for diagonal edges. Conversely, only using DDC performs well diagonal edges with the exception of line- or roof-type edge profiles. Therefore, we combined EWS and DDC for better results. The proposed methods out performed the previous methods using fixed blocks.