• Archives of Plastic Surgery
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• 제37권3호
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• pp.277-280
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• 2010

Purpose: The resection of locally advanced or recurred breast cancers frequently result in large chest wall defects and it leads to a great challenges to cover. Generally simple skin grafts are not a practical option for patients because of their poor cosmetic appearance and prognosis. The latissimus dorsi and rectus abdominis musculocutaneous flap have traditionally been recommended for closure of these large defects. Though the cosmetic result of reconstruction using these flaps is often excellent, but has significant drawbacks. Therefore, we thought that chest wall reconstruction using the external oblique musculocutaneous flap can be an alternative method for extensive chest wall defect related to large, locally advanced breast carcinoma. Methods & Results: We present a case of a 50-year-old Korean female, refered to our department with a left breast tumor for 10 months. CT demonstrate a large tumor on the left anterior chest wall and multiple nodules of varying size in the cervical areas and liver. FDG-PET showed areas of hot uptake throughout the left chest wall, mediastinum and liver. Biopsy was consistent with invasive ductal carcinoma (Grade III). The initial tumor was considered inoperable, so a series of chemotherapy was initiated. Though the size of the breast mass was slightly decreased, the patient continued to suffer from purulent discharge, unpleasant odor and contact bleeding of the mass, the salvage mastectomy was performed. Conclusion: We could reconstruct $23{\times}16\;cm$ sized large chest wall defect, resulting from the resection of a locally advanced breast carcinoma, using an external oblique musculocutaneous flap successfully. Immediate postoperatively checked flap was healthy. Overall result was good without any significant complications and discharged 3 weeks after operation.

• 한국물환경학회지
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• 제23권3호
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• pp.348-355
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• 2007

We investigated temporal changes of composition, habitat area, growth rate and elements content of hydrophytes at the artificial vegetation island (AVI) in Kyungan Stream within Lake Paldang. We also assessed nutrient removal rate through cutting off the emergent part of hydrophytes. The kinds of hydrophytes have increased from four species (P. australis, P. japonica, T. angustifolia and the Z. latifolia) at initial stage of installation to more than 29 species for 6-year operation. P. japonica was most dominant species at the AVI in 2006. The habitat area of have increased about 2.5 times compared to the initial planting area, occupying 63% of AVI's vegetation area. The incoming species of S. fluviatilis and B. frondosa have adapted successively and expanded habitat area in the AVI. The relative growth rate of P. japonica and P. australis was highest in spring sprouting period. Their hights and weights have increased until summer, by the time they were cutting off the emergent part. They started regrowth immediately after cutting and continued to grow until September and withered away in November. The carbon contents of P. japonica and P. australis have increased during growth phase, on the contrary, the nitrogen and phosphorus contents have decreased. By cutting off and removing the emergent part (leaves and branches) of hydrophytes twice from AVI, $17.6gN/m^2/y$ of nitrogen and $1.3gP/m^2/y$ of phosphorus was removed from AVI in 2006.

• Journal of Chest Surgery
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• 제18권1호
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• pp.46-53
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• 1985

A single aortic valve replacement using the lonescu-Shiley bovine pericardial xenograft valve was performed in 66 consecutive patients during the period from February, 1979 to June, 1984. They were 49 males and 17 females with ages ranging from 9 to 61 [mean, 31.113.1] years, and 9 of them were children younger than 15 years of age. Twenty-seven patients [40.9%] required the combined operative procedures to either other valvular lesions or congenital defects. There were 9 early deaths within 30 days of surgery [operative mortality rate, 13.6%] and 2 late deaths thereafter [late mortality rate, 3.0%; or 1.75%/patient-year]. The 57 early survivors were followed for a total duration of 114.2 patient-years [mean, 24.016.0 months]. Four patients experienced thromboembolic complication with no death [3.50%/patient-year]; one died from intracranial bleeding related to anticoagulation [0.88%/patient-year]; one recovered from prosthetic valve endocarditis [0.88%/patient-year]; and four developed aortic regurgitant murmur with none or minimal cardiac symptoms and they were classified into cases of tissue valve failure [3.50%/patient-year]. The actuarial survival rate was 82.34.7% at 6 years, and the actuarial probabilities of freedom from thromboembolism and valve failure were 93.33.9% and 89.15.8% at postoperative 6 years respectively Symptomatic improvement was excellent in most late survivors at the follow-up end with the mean of NYHA Classes of 1.040.19 while the one was 2.290.67 at the time of operation. Excluding the higher operative mortality rates, these clinical results are fully comparable with the ones of reports from the major institutions using the porcine aortic or the bovine pericardial tissue valves and warrants the continued use of the xenograft valve in the aortic position. The importance of more detailed preoperative evaluation of the myocardial function and the need of improved myocardial preservation during surgery for the improved early clinical results were discussed.

• Archives of Reconstructive Microsurgery
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• 제15권2호
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• pp.65-69
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• 2006

Purpose: We performed vastus lateralis (VL) muslce or myocutaneous flap for close of the trochanteric skin defect usually happened in paraplegia and report our 6 cases. Materials and Methods: Between March 2004 and August 2005 we performed 4 cases of VL muscule flap with skin graft and 2 cases of VL myocutaneous flap for close of the trochanteric skin defect in 6 paraplegia patients. There were 5 men and 1 woman and mean age was 52.2 years and mean diameters of skin defect was $8.3{\times}8.3\;cm$. The mean follow up period was 18 months. The survival of flap, complications, healing time and patient's satisfaction were evaluated. Results: All flaps were survived except 1 case of margin necrosis. In 2 cases, blood-serous discharges were continued after operation which might be due to dead space and treated with $2{\sim}3$ times debridement and delayed close. Mean time to heal the skin defect was 7.6 weeks. No infection and recurrence in follow up periods. Cosmetic results judged by patients are that 3 cases are good and 3 cases are fair. Conclusion: VL muscle and myocutaneous flap is good treatment method among the numerous methods in treatment-failed cases of trochanteric skin defects of paraplegia patients. This surgical procedure is simple, constant blood supply, good pliability, cosmetic results and also appliable to other skin defect of pelvis girdle like sacrum and ischium.

• Archives of Reconstructive Microsurgery
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• 제2권1호
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• pp.13-19
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• 1993

Although the etiology of $Kienb\"{o}ck's$ disease is clearly related to avascular changes in the lunate, but the actual cause leading to this vascular impairment has remained elusive. Therefore, a great many different surgical procedures have been proposed for the correction of the multiple factors leading to lunate collapse or for the treatment of the lunatomalacia. The treatment modalities includes lunate excision, intercarpal arthrodesis, lunate implant resection arthroplasty, joint levelling operation(e.g ulnar lengthening & radial shortening), pronater quadratus pedicle graft and vascular loop graft. In the period from Jan. 1981 to Dec. 1992, we performed operative treatment in 19 cases of $Kienb\"{o}ck's$ disease. Among them, 6 cases were treated with vascular loop graft. We analysed all patients who were treated with vascular loop graft after followed up of 4 year 6 months, on an average(range from 1 year to 8 year 10 months). The results analysed are as follows, 1. All cases were stage III according to Lichtman's classification. 2. Ulnar variance was -1.5(range$-2{\sim}0$), on an average. 3. The average age of patients were 37.7years old(range 31-41). 4. Postoperatively, there were considerable restoration of range of motion and complete relief of pain in all cases, but continued decrease of grip power in one case. 5. Decreased sclerosis, loss of fragmentation and new bone formation were appeared in the last follow up film, in all cases. The vascular loop graft considered as a useful method for the treatment of the $Kienb\"{o}ck's$ disease.

• Archives of Reconstructive Microsurgery
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• 제2권1호
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• pp.29-41
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• 1993

고려대학교 의과대학 정형외과학 교실에서 광범위한 연부조직결손을 동반한 감염된 경골결손 34례에 대하여 생비골 및 생피부편이식을 시행하고 얻은 결과는 다음과 같다. 1. 국소염증이 완전히 조절되지 않은 상태에서도 생비골 및 생피부편 이식이 가능하였다. 2. 생비골 및 생피부편 이식술을 동시에 시행함으로써, 생피부편의 임상상태로 생비골 이식의 성공여부를 간접적으로 알 수 있었다. 3. 추시기간동안 이식된 비골은 비후되었으며, 이식골의 흡수는 없었다. 4. 경골을 부분절제한 경우에는 이식비골의 골절은 발생되지 않았다. 5. 이식된 비골의 비후는 수술부위의 국소염증 상태에 영향을 받는 것으로 사료되었다.

• The Korean Journal of Pain
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• 제5권2호
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• pp.229-233
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• 1992

Recently a non-electronic, disposable and portable infusor, Baxter $Infusor^{(R)}$, has developed for delivering not only a continuous drug infusion but also extradoses of medication on a demand basis. The present study examined the impact of two methods of pain management on recovery in 20 patients undergoing upper abdominal surgery for stomach cancer. One group, 10 patients, received IV meperidine in the recovery room and IM meperidine on the ward on a PRN basis(PRN group). In the other group, 10 patients, a loading dose of nalbuphine 0.1mg/kg was given when the patient first complained of pain in the recovery room and patient controlled analgesia with IV nalbuphine, 0.5mg/kg day for continuous infusion, was initiated and continued for 72 hours(PCA group). The devices for PCA group was Baxter Infusor with patient control module which had flow rate 0.5ml/hr and lockout time was 15 min. As results of this study, the patients of PCA group get less pain than PRN group on operation day, the first and second days after surgery. VAPS values are $6.47{\pm}1.64$ vs $4.44{\pm}1.38$, $5.02{\pm}1.22$ vs $2.62{\pm}0.93$ and $3.22{\pm}1.47$ vs $2.02{\pm}0.71$ respectively pertaining to PRN and PCA groups(p<0.05). In conclusion, PCA group with IV nalbuphine provided more effective postoperative analgesia than PRN group with conventional meperidine IM.

• 한국항공운항학회지
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• 제25권3호
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• pp.123-134
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• 2017

In order to advance into the MRO industry, the Aviation maintenance organization with suitable for the standards for personnel, facilities and operations should be first approved by FAA and EASA. The purpose of study is designed to arrange the standards required for personnel, facility, operation rule for approval of Repair Station maintenance organizations certified by FAA PART 145 of the US Federal Aviation Regulation. Also to consider the following differences through the comparative analysis with domestic AMO certification of the information in the Management, Maintenance Process, and Quality System for approval of maintenance organization authorized, the additional EASA PART 145. As a comparative analysis on maintenance organization certification in the country between FAA and EASA, this study could show us that domestic maintenance organization, certified manual contents are used by applying just many of the FAA system. And we could know that as part of the EASA maintenance organization certification process, airmen personnel were relatively systematically segmented and controlled. For domestic maintenance organization certification, operational as policy implications we would like to present policy implications such as the implication of rating system of Aviation Mechanic License like EASA, the financial support of the training center to resolve the shortage of the FAA or EASA license holders, operational organization as "CAMO" for systematic aviation mechanic certified system should be required, continued construction of hangar or MRO for airworthiness repair under Governmental support, and varied application of DER system from FAA accordingly.

• Journal of Biosystems Engineering
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• 제39권4호
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• pp.267-273
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• 2014

Purpose: This study was conducted to develop a web-based business management system to ensure the efficient operation and transparent management of government-subsidized agricultural machinery rental businesses. Methods: An MS_SQL2000 database management system (DBMS) solution was utilized in the system for high system compatibility and integrated management. This system was targeted to be compatible with Internet Explorer 6.0 or later and to ensure security and seamless web operations. The system administrator is able to manage a fleet of agricultural machinery, including various inventory codes, release and return, fleet registry, and business performance. Users (farmers) may search the database of rental machinery and reserve them. Results: With respect to rental reservations, the system administrator can manage the fleet by setting the rental status to Approved, Released, or Returned. Through the web, the administrator can also create a database that includes machinery specifications, features, and rental rates. In addition, business performance data can be analyzed using a diverse array of tools to streamline the rental business. Without having to go to the rental office, users can save time and money by searching for and renting agricultural machinery through the information available on the website, including availability, specifications, and rental fees. After deploying the system, the time required to analyze monthly performance and create reports was dramatically reduced from 20 days per person to one day per person. Conclusions: Since 2014, AMRB has been installed and is operating in agricultural machinery rental businesses in 31 cities and counties in South Korea. This study recommends continued expansion and dissemination of AMRB for the systematic and efficient management of agricultural machinery rental businesses.

• Journal of Nutrition and Health
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• 제28권5호
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• pp.415-425
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• 1995

This study was performed to investigate the effect of dietary protein level on the metabolic changes of Ca and skeletons in postmenopausal women, using ovariecotomized rats as an animal model. The female rats of 200∼250g were fed either 8%(L) or 50%(H) casein diet for 15 weeks(1st experiment). At 15th week, the rats of each diet group were undergone ovariectomy or sham-operation and they were continued to feed the same experimantal diet for 9 more months(2nd experiment). Ca metabolism, kidney function and bone composition were determined at the end of 1st experiment, 3rd and 9th month of 2nd experiment. After 1st experiment, high protein group showed higher urinary Ca and protein excretion, however, there was no difference in GFR and urinary hydroxyproline excretion. The weights, ash and Ca content of femur, scapular and vertebra tended to be higher in high protein groups which tells that high protein promoted skeletal growth. In 2nd experiment, high protein group showed higher urinary Ca and protein excretion and lower Ca absorption and balance. GFR was not affected by dietary protein and ovariectomy but increased with time, as well as kidney weight which shows the continuous development of kidney at this age of 15 month in rats. There were no difference in urinary hydroxyproline, serum ALP, and PTH among experimental groups. The weights of femur, scapular, 4th vertebra increased with time, showing the skeleton continues to grow at this age in rats. However, Ca contents, Ca/wt, Ca/ash were decreased with time and tended to be lower in high protein group especially in femur. In conclusion, prolonged feeding of high protein diet deteriorated Ca metabolism and induced bone loss as time after menopause is extended.