• Tuberculosis and Respiratory Diseases
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• 제79권4호
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• pp.282-288
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• 2016

Background: Tuberculosis (TB) is a major health problem, and accurate and rapid diagnosis of multidrug-resistant (MDR) and extended drug-resistant (XDR) TB is important for appropriate treatment. In this study, performances of solid and liquid culture methods were compared with respect to MDR- and XDR-TB isolate recovery and drug susceptibility testing. Methods: Sputum specimens from 304 patients were stained with Ziehl-Neelsen method. Mycobacterium tuberculosis (Mtb) isolates were tested for recovery on $L{\ddot{o}wenstein$-Jensen (LJ) medium and the BacT Alert 3D system. For drug susceptibility testing of Mtb, isolates were evaluated on M-KIT plates and the BacT Alert 3D system. Results: The recovery rates were 94.9% (206/217) and 98.2% (213/217) for LJ medium and the BacT Alert 3D system, respectively (kappa coefficient, 0.884). The rate of drug resistance was 13.4% for at least one or more drugs, 6.0% for MDR-TB and 2.3% for XDR-TB. M-KIT plate and BacT 3D Alert 3D system were comparable in drug susceptibility testing for isoniazid (97.7%; kappa coefficient, 0.905) and rifampin (98.6%; kappa coefficient, 0.907). Antibiotic resistance was observed using M-KIT plates for 24 of the total 29 Mtb isolates (82.8%). Conclusion: The liquid culture system showed greater reduction in the culture period, as compared with LJ medium; however, drug susceptibility testing using M-KIT plates was advantageous for simultaneous testing against multiple drug targets.

• Archives of Plastic Surgery
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• 제45권4호
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• pp.325-332
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• 2018

Background Zygomaticomaxillary complex (ZMC) fractures mostly occur in the form of tripod fractures. The surgical field is accessed using a combination of three classic approaches. However, the subciliary incision may have unfavorable aesthetic results. Herein, the authors report the advantages of the extended transconjunctival approach (ETA) combined with T-bar screw reduction in minimizing scarring and complications for the treatment of ZMC fractures. Methods A total of 26 patients underwent ZMC reduction through the ETA and intraoral approach. A skin incision measuring roughly 5 to 8 mm in length was placed following the lateral canthal skin crease. After releasing the inferior crus of the lateral canthal tendon for canthotomy, the medial periosteum of the lateral orbital rim was preserved for canthal reattachment. A limited subperiosteal dissection and partial relaxing incision of the orbicularis oculi were performed to expose the fracture line of the inferior orbital rim and zygomaticofrontal suture. Reduction was performed using a T-bar screw through the transconjunctival incision and an elevator through the intraoral incision. Results The aesthetic and functional results were excellent. Successful reduction was achieved and the skin incision was less than 8 mm in 20 cases (76.9%). Only six patients had an additional skin incision (less than 5 mm) to achieve reduction. No cases of ectropion, entropion, or excessive scarring were noted. Conclusions The ETA using a T-bar screw is a useful method for maximizing aesthetic results in ZMC fractures, with the advantages of minimal scarring, faster recovery, and maintenance of pretarsal fullness.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.691-694
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• 2011

Purpose: With an increase in the population of immunocompromised patients, the incidence of maxillary sinus aspergillus infection has also escalated. Maxillary sinus aspergillosis is generally extended to the sinus antrum, base or thin orbital wall and ethmoid air cell region. We experienced a case of maxillary sinus aspergillosis which was extended directly to the soft tissue of the cheek. Methods: A 46-year-old man with acute myelogenous leukemia was consulted for the defect of the anterior wall of the maxillary sinus, and cheek. Radiologic and histologic findings were consistent with invasive maxillary sinus aspergillosis. The otolaryngology department performed debridement via endoscopic sinus surgery first. Coverage of the resulting defect in the anterior wall of the maxillary sinus and its inner layer was undergone by the plastic and reconstructive surgery department, using a pedicled superficial temporal fascia flap and a split thickness skin graft. The remaining skin defect of the cheek was covered with a local skin flap. Results: The patient went through an uneventful recovery. There was no recurrence during 6 months of follow-up. Conclusion: Maxillary sinus aspergillosis usually involves the orbit or the gingiva but in some cases it may directly invade soft tissues of the cheek. Such an atypical infection extending into the cheek may lead to a large soft tissue defect requiring coverage. Thus, any undiagnosed soft tissue defect involving the cheek or maxillofacial area, especially in immunocompromised patients, should be evaluated for aspergillosis. We present this rare case, with a review of the related literature.

• Journal of Periodontal and Implant Science
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• 제52권4호
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• pp.298-311
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• 2022

Purpose: The aim of this study was to evaluate the clinical outcomes of periodontal granulation tissue preservation (PGTP) in access flap periodontal surgery. Methods: Twenty patients (stage III-IV periodontitis) with 42 deep periodontal pockets that did not resolve after non-surgical treatment were consecutively recruited. Access flap periodontal surgery was modified using PGTP. The clinical periodontal parameters were evaluated at 9 months. The differences in the amount of granulation tissue width (GTw) preserved were evaluated and the influence of smoking was analyzed. Results: GTw >1 mm was observed in 97.6% of interproximal defects, and the granulation tissue extended above the bone peak in 71.4% of defects. At 9 months, probing pocket depth reduction (4.33±1.43 mm) and clinical attachment gain (CAG; 4.10±1.75 mm) were statistically significant (P<0.001). The residual probing depth was 3.2±0.89 mm. When GTw extended above the interproximal bone peak (i.e., the interproximal supra-alveolar granulation tissue thickness [iSUPRA-GT] was greater than 0 mm), a significant CAG was recorded in the supra-alveolar component (1.67±1.32 mm, P<0.001). Interproximal gingival recession (iGR) was significant (P<0.05) only in smokers, with a reduction in the interdental papillary tissue height of 0.93±0.76 mm. In non-smokers, there was no increase in the iGR when the iSUPRA-GT was >0 mm. The clinical results in smokers were significantly worse. Conclusions: PGTP was used to modify access flap periodontal surgery by preserving affected tissues with the potential for recovery. The results show that preserving periodontal granulation tissue is an effective and conservative procedure in the surgical treatment of periodontal disease.

• Archives of Plastic Surgery
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• 제42권6호
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• pp.761-768
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• 2015

Background Surgical scars on the palmar surface of the hand may lead to functional and also aesthetic and psychological consequences. The objective of this study was to introduce a new incision technique for periarterial sympathectomy of the hand and to compare the results of the new two-step incision technique with those of a Koman incision by using an objective questionnaire. Methods A total of 40 patients (17 men and 23 women) with intractable Raynaud's disease or syndrome underwent surgery in our hospital, conducted by a single surgeon, between January 2008 and January 2013. Patients who had undergone extended sympathectomy or vessel graft were excluded. Clinical evaluation of postoperative scars was performed in both groups one year after surgery using the patient and observer scar assessment scale (POSAS) and the Wake Forest University rating scale. Results The total patient score was 8.59 (range, 6-15) in the two-step incision group and 9.62 (range, 7-18) in the Koman incision group. A significant difference was found between the groups in the total PS score (P-value=0.034) but not in the total observer score. Our analysis found no significant difference in preoperative and postoperative Wake Forest University rating scale scores between the two-step and Koman incision groups. The time required for recovery prior to returning to work after surgery was shorter in the two-step incision group, with a mean of 29.48 days in the two-step incision group and 34.15 days in the Koman incision group (P=0.03). Conclusions Compared to the Koman incision, the new two-step incision technique provides better aesthetic results, similar symptom improvement, and a reduction in the recovery time required before returning to work. Furthermore, this incision allows the surgeon to access a wide surgical field and a sufficient exposure of anatomical structures.

• 전자공학회논문지
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• 제50권11호
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• pp.141-149
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• 2013

IoT (Internet of Things) 환경에서 IPv6 패킷 통신을 지원하기 위한 표준 기술로 IETF 6LoWPAN (IPv6 over Low power WAPN) 표준 기술이 많은 연구가 진행되고 있다. 6LoWPAN에서 패킷 전송을 위한 프로토콜로 주로 AODV (Ad-hoc Distance Vector) 라우팅 프로토콜 기술을 확장한 다양한 연구가 진행되고 있다. 특히, 제한된 자원을 가진 노드들로 구성된 6LoWPAN에서 네트워크 오류가 발생했을 때 신뢰성 있는 데이터 전송과 빠른 경로 설정 방법이 필요하다. 이를 위해, 본 논문에서는 IETF LOAD(6LoWPAN Ad Hoc On-Demand Distance Vector Routing) 을 확장한 최적 복구 경로 알고리즘인 회복력 있는 라우팅 프로토콜기법 (Resilient Routing Protocol) 을 제안한다. 좀 더 구체적으로, 최적 복구 경로 설정 알고리즘, 상세 프로토콜 신호 흐름도 및 패킷 전송의 신뢰성 검증을 위한 수학적인 모델을 제시하였다. 제안된 프로토콜 기법의 성능을 분석하기 위해 NS-3 (Network Simulation Tool) 를 통해 성능 분석하였고 성능 분석 결과 기존의 LOAD 라우팅에 비해 종단간 지연시간, 패킷 처리율, 패킷 전송율 및 제어 패킷 오버헤드 등의 성능 면에서 우수함을 증명하였다.

• 한국통신학회논문지
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• 제31권2B호
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• pp.137-145
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• 2006

본 연구는 P2P 환경에서 패칭을 이용하여 주문형 스트림을 효율적으로 서비스하기 위한 응용 계층 멀티캐스트 기법인 P2Patching을 제안한다. P2Patching은 전통적인 패칭 기법을 응용 계층 멀티캐스트 기법에 확장 적용하여 서버의 부하를 감소시키고 초기 지연을 최소화하는 멀티캐스트 트리의 구축 기법이다. 그리고 트리의 장애로부터 빠른 복구 기법과 잦은 트리의 단절로 인하여 연속적인 재생을 보장하기 위한 동적 버퍼링 기법도 제안한다. 또한, 본 논문과 유사한 $P2CAST^{[12]}$와의 몇 가지 중요한 실험에서 향상된 결과를 보여준다. 실험 결과에서는 평균 조인횟수, 서비스 요청 거부율, 트리 복원 실패율 그리고, 버퍼 스타베이션(Buffer Starvation)이 발생한 노드 수 등의 측정에서 약 16$\%$ 정도의 성능 향상을 보였으며, 특히, 버퍼 스타베이션과 평균 조인횟수에 대한 실험에 대해서는 우수한 성능 향상을 보였다.

• Archives of Reconstructive Microsurgery
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• 제19권2호
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• pp.108-111
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• 2010

Purpose: In reconstructing a defect on the dorsum of the hand, there are many cases of extensor tendons exposed or even missing. The repaired or reconstructed tendons need relevant gliding environment for good functional recovery. The anterolateral thigh flap offers a vascular fascial component with large amounts that can be used for covering exposed tendons and we report a unique case of single-stage hand dorsum and gliding surface reconstruction. Methods: A 35-year-old man had severe post-traumatic scarring in his left dorsal hand and coverage of the flap with split-thickness skin graft has been done before. After scarred skin excision and extensor tendon graft for missed part, a free anterolateral thigh adipofascial flap was used to resurface the hand dorsum and to reconstruct a two-layer gliding surface of the extensor tendons. The extensor tendons were wrapped in the fascial component with the fat layer inside. Results: He had an uneventful postoperative course without infection, dehiscence and flap necrosis. Good overall functional recovery and tendon excursion were observed. He was also satisfied with postoperative appearance. Conclusion: A free anterolateral thigh adipofascial flap was used successfully for reconstruction of a two-layer tendon gliding surface to treat a patient with severe scarring in the dorsal hand.

• 한국간담췌외과학회지
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• 제28권1호
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• pp.80-91
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• 2024

Backgrounds/Aims: Optimal intravenous fluid management during the perioperative period for patients undergoing pancreaticoduodenectomy (PD) within the framework of enhanced recovery after surgery (ERAS) is unclear. Studies have indicated that excessive total body salt and water can contribute to the development of oedema, leading to increased morbidity and extended hospital stays. This study aimed to assess the effects of an intravenous therapy regimen during postoperative day (POD) 0 to 2 in PD patients within ERAS. Methods: A retrospective interventional cohort study was conducted, and it involved all PD patients before and after implementation of ERAS (2009-2017). In the ERAS group, a targeted maintenance fluid regimen of 20 mL/kg/day with a sodium requirement of 0.5 mmoL/kg/day was administered. Outcome measures included the mmol of sodium and chloride administered, length of stay, and morbidity (postoperative pancreatic fistula, POPF; acute kidney injury, AKI; ileus). Results: The study included 169 patients, with a mean age of 64 ± 11.3 years. Following implementation of the intravenous fluid therapy protocol, there was a significant reduction in chloride and sodium loading. However, in the multivariable analysis, chloride administered (mmoL/kg) did not independently influence the length of stay; or rates of POPF, ileus, or AKI (p > 0.05). Conclusions: The findings suggested that a postoperative intravenous fluid therapy regimen did not significantly impact morbidity. Notably, there was a trend towards reduced length of stay within an increasingly comorbid patient cohort. This targeted fluid regimen appears to be safe for PD patients within the ERAS program. Further prospective research is needed to explore this area.

• 한국작물학회지
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• 제46권3호
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• pp.209-214
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• 2001

본 실험은 청수, 반탁수, 탁수에 따른 탁도처리와 관수시간에 따른 광합성, 엽록소형광, 증산량 및 회복능을 분석하여 관수스트레스에 대한 벼의 생리반응을 구명하고자 실시한 결과는 다음과 같다. 1. 광합성은 탁도가 높고, 관수 시간이 경과할수록 감소하였다. 특히 관수 36시간 전까지는 약 25%, 42시간이후에는 약 50%가 감소하였다. 증산량은 탁도 및 관수시간이 증가함에 따라 증가하였으며, 청수에서는 약 30%, 반탁수에서는 약 25%, 탁수에서는 약 20%가 증가하였다. Fv/Fm은 탁도 및 관수시간 증가에 따라 감소하였으며, 청수에서는 48시간이후에, 반탁수 및 탁수에서는 36시간이후 약 20%가 감소하였다. 전질소함량은 관수스트레스에 의해 감소하였고, 탁수처리 36시간이후부터 감소량이 켰다. 2. 관수스트레스에 따른 회복력을 나타내는 건물중은 탁도 리별 차이는 작았으나, 관수시간이 경과할수록 크게 감소하였다. 피해정도는 24시간안에는 약 25%, 42시간이후에는 각 처리구 모두에서 약 50%의 생장감소가 일어났다. 관수 48시간의 반탁수 및 탁수는 고사하였다. 광합성은 탁도에 따라서는 청수에서 약 15%, 반탁수, 탁수에서는 10%가 감소하였고, 특히 42시간이후에는 30-50% 감소하였다. 증산량은 탁도 및 관수시간에 처리간의 차이 없이 약 20%증가하였다. 3. 관수 24시간처리에서 관수처리 시 및 퇴수 후 회복기간에도 광합성과 증산량의 일시적인 감소가 일어났다