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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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Narrative Inquiry : Practical experience of an Introduction to Engineering (공학입문 교과 실행경험에 관한 내러티브 탐구)

  • Park, Kyung-Moon;Kim, Taehoon
    • 대한공업교육학회지
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    • v.34 no.2
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    • pp.128-160
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    • 2009
  • Narratively I have described interactions between two teachers performing an introduction to the engineering class with various situations such as place, teacher, student and subject. I have specifically illuminated a three-dimensional narrative inquiry space embracing the culture of the university, the college of engineering and the ABEEK(Accreditation Board of Engineering Education of Korea)program. The result of the study is as follows: First, in order to stimulate the students' motivation, the teachers have to make not only their class PowerPoint slides match the size of the classroom, but the content of the slides must be condensed with core concepts. They also should utilized some video clips to empower students' interest in the subject within their classrooms. Second, the teachers should do various class activities in the classroom. Instead of spending most of the class time with his/her explanation, it would be advantageous for the teachers to allow the students to perform a task in class. Third, the teachers should ask their students about assignments which are helping students' understanding of the subject and planning of their future. Lastly, the teachers need to design the mid-term and the final tests inducing the students' motivation. Those tests also must test students' creativity and insight of the subject. Thus, the test should consist of an interpretive exercise and an essay type of item thus reducing the multiple choice types of items. There are several limitations to the study. First it is difficult to generalize what we found here because it is a case study. Second, we could not study in depth the effect of the interaction between the two teachers who were performing the introduction to the engineering course during the academic semester. Third, this study just probed into the difficulties of teaching the course. Hence, we have to understand more by focusing on each issue such as adapting to a new learning environment as a student from abroad, a practical experience boosting the students' interest in the introduction to the engineering course, also a practical experience on process based learning-versus result based learning, and an effective management of the student team presentation etc.

Optimization of Solvent Extraction Process on the Functional Components from Portulaca oleracea Using a Response Surface Methodology (쇠비름의 유용성분 환류추출공정의 최적화)

  • Jo, In-Hee;Kim, Tae-Yeon;Ma, Ji-Bock;Lee, Jin-Ju;Lee, Hyo-Jeong;Choi, Yong-Hee
    • Current Research on Agriculture and Life Sciences
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    • v.29
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    • pp.83-89
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    • 2011
  • Various functional and useful components in Portulaca oleracea were extracted with ethanol and the optimum solvent conditions were set by monitoring of response surface methodology(RSM). A central composite design for optimization was applied to investigate the effects of the three independent variables of extraction temperature, ethanol concentration, and extraction time, on dependent variables including total phenolics, electron-donating ability, brown clolor and total flavonoids of Portulaca oleracea. The content of total phenol was essentially unaffected by extraction time or extraction temperature, but it was highly influenced by ethanol concentration. The maximum total phenol content was 31.70mg/mL obtained at 45.84% of ethanol concentration, $79.66^{\circ}C$, and after 2.67hr of extraction. Electron-donating ability (EDA) was affected by ethanol concentration and the maximum EDA was 74.67mg/mL at 52.95% ethanol concentration, $52.33^{\circ}C$ and 4.84hr of extration time. The browning color was rarely affected by extraction time but, it was highly influenced by ethanol concentration and extraction temperature. The maximum extent of browning color was obtained at 97.75% of ethanol concentraion, $65.88^{\circ}C$ and 2.93hr of extraction time. The content of total flavonoid was significantly influenced by extraction time, and the maximum total flavonoid level was 58.28mg/mL obtained at 96.62% ethanol concentration, $61.87^{\circ}C$ after 3.70hr of extraction. As a result, The optimal conditions for effective extraction were predicted as follows, 70.3% of ethanol concentration, $62.1^{\circ}C$ of extraction temperature and 3.3hr of extraction time.

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Integrated Management Data Warehouse Development Process of Research Expenses in Enterprise Environment (엔터프라이즈 환경의 연구비 통합관리 데이터 웨어하우스 개발 프로세스)

  • Choi, Seong-Man;Yoo, Cheol-Jung;Chang, Ok-Bae
    • The KIPS Transactions:PartD
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    • v.11D no.1
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    • pp.183-194
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    • 2004
  • The existing management job of research expenses has been divided into three parts: budget planning, budget draw-up, and exact settlement of budget. However, it caused some problems. Under this current circumstance it is required to obtain research expenses steadily, to operate efficiently and to use them clearly to solve such problems. As a result of a study on data warehouse development process of existing system integration company (Inmon, IBM) to reflect current trend described above, data warehouse development process of Inmon uses systematic and gradual access as a classical development cycle method. It causes overlap and feedback to the previous step in the process of each step Is requested. And another problem that it is difficult to toil what function refers and corrects data because functions and data are separated during performing development process at data warehouse development process of IBM is caused. Integrated management data warehouse development process of research expenses in the enterprise environment which applies UML at planning and analysis step, design step and implement and test step is suggested in this paper. Information retrieval agent uses existing budget plan DB, budget draw-up DB and budget settlement DB to find out information that a user wants to know. Information retrieval agent collects and saves information at integration database and information integration agent extracts, transports, transforms and loads the data. Information integration agent reduces a user's efforts to access to a number of information sources and check each of them. It also screens out data that a user may not need. As a result, integrated management data warehouse development process of research expenses in the enterprise environment reflects a user's requirements as much as possible and provides various types of information to make a decision which is needed to establish the policy of research expense management. It helps an end user approach his/her desired analysis information quickly and get various data from the comprehensive viewpoint rather than the fragmentary viewpoint. Furthermore, as it integrated three systems into one, it is possible to share data, to integrate the system, to reduce operating expenses and to simplify supporting environment for the decision making.

Theme-Based Integrative Education Program Development of Industrial Specialized High School (공업계열 특성화 고등학교의 주제 중심 통합형 교육 프로그램 개발)

  • Yoon, Ji A;Lee, Chang Hoon;Kim, Ki Soo
    • 대한공업교육학회지
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    • v.38 no.1
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    • pp.163-194
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    • 2013
  • This study aims at giving examples that can be applied in the real education field, and it develops theme-based integrative education program for Industrial Specialized high school students. It analyzed the models of many scholars about the development of education course, and devised developmental models and procedures of the theme-based integrative education program of engineering specialized high school from those. As a result, it used and reorganized ADDIE model which is the systematic education course development model and the theme-based integrative education development model of Frazee and Rudnitski(1995) as the basic structure, and came to devise theme-based integrative education program of engineering specialized high school while referring to creative engineering design education program development model by Lee Chang-hoon. This study that is theme-based integrative education program for engineering-specialized high school students and is the result of this study has the following characters. First, This theme-based integrative education program that is developed for engineering-specialized high school students can be applied and the initial example that approach the Theme-Based. Second, This Education Program included the Activity project that is "Making Maglev" for the third grade at the engineering-specialized high school and One of the Program's aim is to bring up their attitude that engaged to in the class having the Interest. Third, Theme-based integrative education program for engineering-specialized high school is composed the workbook for the students and the teaching guidance plan for the teachers. Workbook for the students is composed four Units;"Brief about the Maglev","Basic principles about the Maglev","Intensive principles about the Maglev", Activity project about the Maglev". And each unit is made by Learning Purpose, Introducing, Learning Contents(Deepen Learning, Reading Magazines), Assesment etc. Teaching guidance plan for the teachers include that Summary, Purpose, Time Planing & Streaming Map for the class, contents associated Maglev, prerequisite learning, constructure of the education program, flow chart, learning activity, assesment(self-appraiser and peer review).

A Study on Constituents of the New Apprenticeship Concept for the Promotion of Industrial Growth Potential (산업 성장잠재력 제고를 위한 신도제제도의 개념 요소에 대한 연구)

  • Yin, Zi Long;Rho, Tae Chun;Choi, Won Sik
    • 대한공업교육학회지
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    • v.38 no.1
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    • pp.1-27
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    • 2013
  • The purpose of this study was to find out the areas and their constitute elements of new apprenticeship through the expert of vocational education to improve the growth potential in the field of industry. Through the three times Delphi research process final composing areas and elements(total 6 areas and 41 sub-elements) of new apprenticeship were extracted. Followings are specific study results of 41 sub-elements for the 6 areas. In area A(Technology Skill aspect) total nine sub-elements were deducted as follows. Technology skill's field appling ability, new technology skill's acquisition, quality assurance ability, research development ability, material management using ability, problem solving ability, core technology skill understanding ability, idea's imagery expressing ability, creative design ability. In area B(Institutional aspect) total five sub-elements were deducted as follows. Flexible human material support, precise division of works, objective result assessment, institutionalization of responsibilities and liabilities between teacher and student, institutionalization of duty invention reward. In area C(Affective aspect) total eight sub-elements were deducted as follows. Manners and cooperation between teacher & student and peer, values for job, basic attitude for technology, job ethic sense, respect of other organization, active action to organization change, attitude of technology successor, service mind. In area D(Self-improvement aspect) total nine sub-elements were deducted as follows. Self evaluation and reflection, cultivate of organization understanding, career planning and developing ability, sound philosophy of life, communication ability, decision making ability, prepare of individual competence enhance system, self-control ability improvement, reaction of unexpected situation. In area E(Knowledge aspect) total four sub-elements were deducted as follows. Basic knowledge of relevant area, knowledge of new technology & preceding technology, fusion and relocation of knowledge, practical knowledge. In area F(Environmental aspect) total six sub-elements were deducted as follows. Awareness of business environment, understanding of education and practice environment, understanding of apprenticeship's business demand, connectivity of region community, adapt ability of labor market's change, awareness of society environment change.

Dose Distribution of Co-60 Photon Beam in Total Body Irradiation (Co-60에 의한 전신조사시 선량분포)

  • Kang, Wee-Saing
    • Progress in Medical Physics
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    • v.2 no.2
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    • pp.109-120
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    • 1991
  • Total body irradiation is operated to irradicate malignant cells of bone marrow of patients to be treated with bone marrow transplantation. Field size of a linear accelerator or cobalt teletherapy unit with normal geometry for routine technique is too small to cover whole body of a patient. So, any special method to cover patient whole body must be developed. Because such environments as room conditions and machine design are not universal, some characteristic method of TBI for each hospital could be developed. At Seoul National University Hospital, at present, only a cobalt unit is available for TBI because source head of the unit could be tilted. When the head is tilted outward by 90$^{\circ}$, beam direction is horizontal and perpendicular to opposite wall. Then, the distance from cobalt source to the wall was 319 cm. Provided that the distance from the wall to midsagittal plane of a patient is 40cm, nominal field size at the plane(SCD 279cm) is 122cm$\times$122cm but field size by measurement of exposure profile was 130cm$\times$129cm and vertical profile was not symmetric. That field size is large enough to cover total body of a patient when he rests on a couch in a squatting posture. Assuming that average lateral width of patients is 30cm, percent depth dose for SSD 264cm and nominal field size 115.5cm$\times$115.5cm was measured with a plane-parallel chamber in a polystyrene phantom and was linear over depth range 10~20cm. An anthropomorphic phantom of size 25cm wide and 30cm deep. Depth of dose maximum, surface dose and depth of 50% dose were 0.3cm, 82% and 16.9cm, respectively. A dose profile on beam axis for two opposing beams was uniform within 10% for mid-depth dose. Tissue phantom ratio with reference depth 15cm for maximum field size at SCD 279cm was measured in a small polystyrene phantom and was linear over depth range 10~20cm. An anthropomorphic phantom with TLD chips inserted in holes on the largest coronal plane was bilaterally irradiated by 15 minute in each direction by cobalt beam aixs in line with the cross line of the coronal plane and contact surface of sections No. 27 and 28. When doses were normalized with dose at mid-depth on beam axis, doses in head/neck, abdomen and lower lung region were close to reference dose within $\pm$ 10% but doses in upper lung, shoulder and pelvis region were lower than 10% from reference dose. Particulaly, doses in shoulder region were lower than 30%. On this result, the conclusion such that under a geometric condition for TBI with cobalt beam as SNUH radiotherapy departement, compensators for head/neck and lung shielding are not required but boost irradiation to shoulder is required could be induced.

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Reviews of Radiation Protection and Shielding for Computed Tomography in Foreign Countries (외국의 컴퓨터 단층촬영 장치의 방어시설 문헌 조사)

  • Jahng, Geon-Ho;Yang, Dal-Mo;Sung, Dong-Wook;Lee, Kwang-Yong;Kim, Hyeog-Ju
    • Progress in Medical Physics
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    • v.19 no.4
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    • pp.276-284
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    • 2008
  • A computed tomography (CT) is a powerful system for the effectively fast and accurate diagnosis. The CT system, therefore, has used substantially and developed for improving the performance over the past decade, resulting in growing concerns over the radiation dose from the CT. Advanced CT techniques, such as a multidetector row CT scanner and dual energy or dual source CT, have led to new clinical applications that could result in further increases of radiation does for both patients and workers. The objective of this study was to review the international guidelines of the shielding requirements for a CT facility required for a new installation or when modifying an existing one. We used Google Search Engine to search the following keywords: computed tomography, CT regulation or shield or protection, dual energy or dual source CT, multidetector CT, CT radiation protection, and regulatory or legislation or regulation CT. In addition, we searched some special websites, that were provided for sources of radiation protection, shielding, and regulation, RSNA, AAPM, FDA, NIH, RCR, ICRP, IRPA, ICRP, IAEA, WHO (See in Table 1 for full explanations of the abbreviations). We finally summarized results of the investigated materials for each country. The shielding requirement of the CT room design was very well documented in the countries of Canada, United States of America, and United Kingdom. The wall thickness of the CT room could be obtained by the iso-exposure contour or the point source method. Most of documents provided by international organizations were explained in importance of radiation reduction in patients and workers. However, there were no directly-related documents of shielding and patient exposure dose for the dual energy CT system. Based international guidelines, the guideline of the CT room shielding and radiation reduction in patients and workers should be specified for all kinds of CT systems, included in the dual energy CT. We proposed some possible strategies in this paper.

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Comparison of Germination Characteristics and Daily Seed Germinating Pattern in Fine-textured Fescues (세엽형 훼스큐속 잔디의 발아특성 및 일일 발아패턴 비교)

  • Kim, Kyoung-Nam;Park, So-Hyang
    • Horticultural Science & Technology
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    • v.28 no.4
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    • pp.567-573
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    • 2010
  • Research was initiated to investigate early establishment characteristics and germination pattern of fine-textured fescues (FF). Six varieties from Chewings fescue ($Festuca$ $rubra$ L. ssp. $commutata$ Gaud., CF), creeping red fescue ($F.$ $rubra$ L. ssp. $rubra$ Gaud., CRF), hard fescue ($F.$ $ovina$ ssp. $longifolia$ Thuill., HF) and sheep fescue ($F.$ $ovina$ L., SF) were evaluated in the study. An alternative environmental condition requiring a FF germination test by International Seed Testing Association (ISTA) was applied in the experiment, consisting of 8-hr light at $25^{\circ}C$ and 16-hr dark at $15^{\circ}C$ (ISTA conditions). Daily and cumulative germination patterns were measured and analyzed on a daily basis. Significant differences were observed in germination pattern, days to the first germination, days to 50% germination, days to 60% germination, and germination rate. The final germination percentage was variable with species and varieties, being 40.25 to 82.00% at the end of study. There were considerable variations in early germination characteristics and germination pattern among FF species. The first germination in all entries except HF was initiated between 5 and 6 DAS (days after seeding) under ISTA conditions, while HF between 6 and 7 DAS, being 1 day later. It was 8 to 10 DAS in days to the 50% germination, which was 2 to 4 days after the first germination date. Days to the 60% germination were 9.10 to 14.80 DAS under ISTA conditions, being 5.70 days in differences among the entries. CF 'Jamestown II' and 'Shadow II' and HF 'Aurora Gold' were the fast varieties. The slowest one was HF 'Rescue 911'. Among FF species, turf establishment speed was becoming faster in CRF, SF, HF and CF in this order. Information on differences in germination characteristics and pattern from this study would be usefully applied for golf course design and construction, when established with FF.

Distribution and remediation design of heavy metal contamination in farm-land soils and river deposits in the vicinity of the Goro abandoned mine (고로폐광산 주변 농경지 토양 및 하천 퇴적토의 중금속 오염 분포 및 복원 대책 설계)

  • 이민희;최정찬;김진원
    • Economic and Environmental Geology
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    • v.36 no.2
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    • pp.89-101
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    • 2003
  • River deposits and farmland soils were analyzed to investigate the pollution level of heavy metals in the vicinity of the Goro abandoned Zn-mine. Surface (0-40 cm) and subsurface (40-100 cm) soils were collected around a main river located at the lower part of the Goro mine, and analyzed by ICP-MS for Cd, Cu, Pb, Zn and Cr after 0. 1N HCI extraction and by AAS for As after IN HCI extraction. Concentrations of cadmium and lead at the surface river deposits close to the mine were over the Soil Pollution Warning Limit (SPWL), and 43% of sample sites (6 of 14 samples) were over SPWL for As suggesting that river deposits were broadly contaminated by arsenic. Results from farmland soil analysis showed that surface soils were contaminated by heavy metals, while only arsenic was over SPWL at 50% of sampling sites. Main pollution mechanism around the Goro mine was the discharge of mine tailing and waste rocks from the storage site to the river and to adjacent farmland during flood season. Pollution Grades for sample locations were prescribed by the Law of Soil Environmental Preservation, suggesting that the pollution level of heavy metals around the Goro mine was serious, and the remediation operation fur arsenic and the isolation of mine tailing and waste rocks from river and farmland should be activated to protect further contamination. The area needed to clean up was estimated from pollution distribution data and the remediation methods such as a soil washing method and a soil improvement method were considered as the further remediation operation for arsenic contaminated soils and river deposits around the Goro abandoned mine.