• Archives of Plastic Surgery
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• v.36 no.5
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• pp.578-582
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• 2009

Purpose: In extensive deep burn of the lower limb, due to less amount of soft tissue, bone is easily exposed. When it happens, natural healing or reconstruction with skin graft only is not easy. Local flap is difficult to success, because adjacent skins are burnt or skin grafted tissues. Muscle flap or free flap are also limited and has high failure rate due to deep tissue damage. The authors acquired good outcome by performing one - stage operation on bone exposed soft tissue defect with AlloDerm$^{(R)}$(LifeCell, USA), an acellular dermal matrix producted from cadaveric skin. Methods: We studied 14 bone exposed soft tissue defect patients from March 2002 to March 2009. Average age, sex, cause of burn, location of wound, duration of admission period, and postoperative complications were studied. We removed bony cortex with burring, until conforming pinpoint bone bleeding. Then rehydrated AlloDerm$^{(R)}$(25 / 1000 inches, meshed type) was applicated on wound, and thin split thickness(6 ~ 8 / 1000 inches) skin graft was done at the immediately same operative time. Results: Average age of patients was 53.6 years(25 years ~ 80 years, SD = 16.8), and 13 patients were male(male : female = 13 : 1). Flame burn was the largest number. (Flame burn 6, electric burn 3, contact burn 4, and scalding burn 1). Tibia(8) was the most affected site. (tibia 8, toe 4, malleolus 1, and metatarsal bone 1). Thin STSC with AlloDerm$^{(R)}$ took without additional surgery in 12 of 14 patients. Partial graft loss was shown on four cases. Two cases were small in size under $1{\times}1cm$, easily healed with simple dressing, and other two cases needed additional surgery. But in case of additional surgery, granulation tissue has easily formed, and simple patch graft on AlloDerm$^{(R)}$ was enough. Average duration of admission period of patients without additional surgery was 15 days(13 ~ 19 days). Conclusion: AlloDerm$^{(R)}$ and thin split thickness skin graft give us an advantage in short surgery time and less limitations in donor site than flap surgery. Postoperative scar is less than in conventional skin graft because of more firm restoration of dermal structure with AlloDerm$^{(R)}$. We propose that AlloDerm$^{(R)}$ and thin split thickness skin graft could be a solution to bone exposured soft tissue defects in extensive deep burned patients on lower extremities, especially when adjacent tissue cannot be used for flap due to extensive burn.

• Tunnel and Underground Space
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• v.8 no.4
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• pp.307-320
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• 1998

Tunnel lining is the final support of a tunnel and reflects the results of the interaction between ground and support system. Recently it is very difficult to support and manage the tunnel because the cracks on tunnel lining cause many problems in supporting and managing tunnels. Therefore the analysis of the cracks is quite strongly required. In this study, mechanical behaviour of a tunnel lining was examined by model tests and by numerical analyses. Especially the model test was examined for double linings including shotcrete and concrete lining. The model tests were carried out under various conditions taking different loading shapes, horizontal stresses, thicknesses of linings and double lining, vault opening behind the concrete lining and rock-like medium surrounding the lining. Due to horizontal stress, compressive stress prevailed on the lining. Thus the bearing capacity of the lining increased. The existence of a vault opening behind the concrete lining reduced the bearing capacity by the similar amount of reduction of concrete lining thickness. Rock-like medium cast around the side wall of the lining restrained the deflection of the lining, and the bearing capacity for cracking and failure increased vary much. In numerical analyses a algorithm which can analysis the double lining by introduction of interface element was developed. And the results of the numerical analyses were compared with the results of the model tests.

• Journal of Trauma and Injury
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• v.21 no.2
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• pp.115-119
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• 2008

Purpose: Abrupt abstinence from alcohol in cause of chronic alcohol addiction can trigger alcohol withdrawal syndrome. The authors studied the effect of post-operative alcohol withdrawal syndrome in patients who require intensive care due to trauma. Methods: For the study group, we selected 70 patients who had undergone emergency surgery from May 2003 to March 2007 due to trauma and who had been treated with prophylactic thiamine. Data was collected retrospectively. We excluded those who extended their hospital stay for other than traumatic causes, those who died within 3 days of surgery after trauma, those who transferred to other institutions, and those who received a psychiatric diagnosis. Patient groups were determined by the existence or the non-existence of withdrawal syndrome. Age, sex, injury mechanism, mortality, complications, durations of hospital stay and intensive care, use of mechanical ventilator, and sedative use were investigated. A Chi-square test and The Mann-Whitney method were used for statistical analysis in this study. Results: Twenty-four (24) patients from the 58 who had an ISS of 16 or more showed alcohol withdrawal syndrome, and men were shown to be affected with the syndrome significantly more than women. Although ISS was higher in the group with alcohol withdrawal syndrome, statistically, the difference was not significant (P<0.08). The total hospital stay in the patient group with alcohol withdrawal syndrome was on average 10 days longer. However, the difference was not significant (P<0.054). The duration of intensive care in the patient group with alcohol withdrawal syndrome was significantly longer (P<0.029). The patients with alcohol withdrawal syndrome showed no significant difference in the duration of mechanical ventilator use (P<0.783), or in the duration of sedative use (P<0.284). Respiratory distress, pneumonia, upper airway infection, sepsis, acute renal failure, and mortality in the alcohol withdrawal syndrome group were investigated, but no statistically significant difference were noted. Conclusion: We found that the duration of intensive care in chronic alcohol abusers was longer due to the development of alcohol withdrawal syndrome. We also discovered that, when the patients overcame the symptoms of alcohol withdrawal syndrome after intensive care, no difference was found in the frequency of developing complications, the morbidity, and the mortality. Therefore, we conclude that intensive care in trauma patients who are chronic alcohol abusers decreases the incidence of complications found in patients with post-operative alcohol withdrawal syndrome and does not adversely impact the prognoses for those patients.

• Journal of Genetic Medicine
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• v.4 no.1
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• pp.22-37
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• 2007

The autosomal dominant spinocerebellar ataxias (SCAs) are a group of neurodegenerative diseases, clinically and genetically heterogeneous, characterized by degeneration of spinocerebellar pathways with variable involvement of other neural systems. At present, 27 distinct genetic forms of SCAs are known: SCA1-8, SCA10-21, SCA23, SCA25-28, DRPLA (dentatorubral-pallidoluysian atrophy), and 16q-liked ADCA (autosomal dominant cerebellar ataxia). Epidemiological data about the prevalence of SCAs are restricted to a few studies of isolated geographical regions, and most do not reflect the real occurrence of the disease. In general a prevalence of about 0.3-2 cases per 100,000 people is assumed. As SCA are highly heterogeneous, the prevalence of specific subtypes varies between different ethnic and continental populations. Most recent data suggest that SCA3 is the commonest subtype worldwide; SCA1, SCA2, SCA6, SCA7, and SCA8 have a prevalence of over 2%, and the remaining SCAs are thought to be rare (prevalence <1%). In this review, we highlight and discuss the SCA7. The hallmark of SCA7 is the association of hereditary ataxia and visual loss caused by pigmentary macular degeneration. Visual failure is progressive, bilateral and symmetrical, and leads irreversibly to blindness. This association represents a distinct disease entity classified as autosomal dominant cerebellar ataxia (ADCA) type II by Harding. The disease affectsprimarily the cerebellum and the retina by the moderate to severe neuronal loss and gliosis, but also many other central nervous system structures as the disease progresses. SCA7 is caused by expansion of an unstable trinucleotide CAG repeat in the ATXN7 gene encoding a polyglutamine (polyQ) tract in the corresponding protein, ataxin-7. Normal ATXN7 alleles contain 4-35 CAG repeats, whereas pathological alleles contain from 36->450 CAG repeats. Immunoblott analysis demonstrated that ataxin-7 is widely expressed but that expression levels vary among tissues. Instability of expanded repeats is more pronounced in SCA7 than in other SCA subtypes and can cause substantial lowering of age at onset in successive generations termed ‘anticipation’ so that children may become diseased even before their parents develop symptoms. The strong anticipation in SCA7 and the rarity of contractions should have led to its extinction within a few generations. There is no specific drug therapy for this neurodegenerative disorder. Currently, therapy remains purely symptomatic. Cellular models and SCA7 transgenic mice have been generated which constitute valuable resources for studying the disease mechanism. Understanding the pathogenetic mechanisms of neurodegeneration in SCAs should lead to the identification of potential therapeutic targets and ultimately facilitate drug discovery. Here we summarize the clinical, pathological, and genetic aspects of SCA7, and review the current understanding of the pathogenesis of this disorder. Further, we also review the potential therapeutic strategies that are currently being explored in polyglutamine diseases.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.4
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• pp.191-200
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• 2017

Smart work is an alternative form to enable seamless business collaboration without time and space limitations using ICT. However, smart work implementation has not produced tangible achievements and sometimes has resulted in failure. This study examined users' resistance against smart work, which is regarded as one of the most important elements for the successful implementation of smart work. The study classified elements which cause users' resistance into the work's innovative characteristics and the user characteristics based on the model of innovation resistance. It also set the degree of freedom in spatial and temporal dimension as moderating factors. This empirical research results showed that low work efficiency, unfavorable evaluation methods, and high degree of satisfaction in the way of working affected smart work users' resistance. In addition, temporal freedom had a moderating effect on the relationship between users' characteristics and their resistance. On the contrary, spatial freedom affected the relationship between their works' innovative characteristics and their resistance. The study results suggest that organizations need to set up business processes and evaluation methods first to adopt Smart work successfully.

• Journal of the Korea institute for structural maintenance and inspection
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• v.24 no.1
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• pp.35-42
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• 2020

Torsional behavior due to the plane irregularities of the piloti building can cause excessive story drift in the torsionally outermost column, which can lead to shear failure of the column. As a seismic retrofit method that can control the torsional behavior of the piloti building, the expansion of RC wall, steel frame or steel brace may be used, but such methods may hinder the openness of the piloti floor. Therefore, in this study, linear dynamic analysis and nonlinear static analysis for piloti buildings retrofitted by knee brace were performed, and seismic performance evaluation and torsion control effect of knee brace were analyzed. The results showed that the shear force of the column increased when the piloti building retrofitted by knee brace, but it was effective in controlling the torsional deformation. In case of retrofit between knee brace and column by 30°, the shear force of the column increased less than that of 60°, and the lateral displacement of column was decreased in the order of □, ◯ and Ｈ in cross-section.

• Archives of Craniofacial Surgery
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• v.12 no.2
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• pp.116-120
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• 2011

Purpose: Scalp avulsion is a life-threatening injury that may cause trauma to the forehead, eyebrows, and periauricular tissue. It is difficult to treat scalp avulsion as it may lead to severe bleeding. Therefore, emergency scalp replantation surgery is necessary, and we must consider the function, aesthetics, and psychology of the patients. A case of scalp avulsion leading to massive bleeding was encountered by these authors, which led to a failure to achieve the proper operation conditions in an adequate time period. Methods: A 49-year-old female was hospitalized due to having had her head caught in a rotatory machine, causing complete scalp avulsion which included the dorsum of the nose, both eyebrows, and ears. Emergent microsurgical replantation was performed, where a superficial temporal artery and a vein were anastomosed, but the patient's vital signs were too unstable for further operation due to excessive blood loss. Three days after the microanastomosis, venous congestion developed at the replanted scalp, and a medicinal leech was used. Leech therapy resolved the venous congestion. A demarcation then developed between the vitalized scalp tissue and the necrotized area. Debridement was performed 2 times on the necrotized scalp area. Finally, split-thickness skin graft with a dermal acellular matrix ($Matriderm^{(R)}$) was performed on the defective areas, which included the left temporal area, the occipital area, and both eyebrows. Results: The forehead, vertex, right temporal area, and half of the occipital area were successfully replanted, and the hair at the replanted scalp was preserved. As stated above, two-thirds of the scalp survived; the patient could cover the skin graft area with her hair, and could wear a wig. Conclusion: Complete scalp avulsion needs emergent replantation with microsurgical revascularization, but it often leads to serious vital conditions. We report a case with acceptable results, although the microanastomosed vessel was minimal due to the patient's unstable vital signs.

• Journal of The Korean Society of Clinical Toxicology
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• v.12 no.2
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• pp.92-96
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• 2014

Dabigatran is the first oral direct thrombin inhibitor approved by the US Food and Drug Administration (FDA) for prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. Because dabigatran is excreted mainly by the kidneys, serum levels of dabigatran can be elevated to a supratherapeutic range in patients with renal failure, predisposing to emergent bleeding. We describe the case of a 66-year-old man taking dabigatran 150 mg twice daily for atrial fibrillation and cerebral infarction who presented with hematochezia and disseminated intravascular coagulation. Laboratory evaluation showed a hemoglobin level of 6.3 g/dL, platelets of $138,000/mm^3$, activated partial thromboplastin time (aPTT) of 10 s, and an international normalized ratio (INR) of 8.17. Colonoscopy showed a bleeding anal fissure. Hemostasis was provided by hemoclips and packed red blood cells and fresh frozen plasma were transfused. Since then, there was no further hematochezia, however, bleeding including oral mucosal bleeding, hematuria, and intravenous site bleeding persisted. At presentation, his serum creatinine was 4.96 mg/dL (baseline creatinine, 0.9 mg/dL). Dabigatran toxicity secondary to acute kidney injury was presumed. Because acute kidney injury of unknown cause was progressing after admission, he was treated with hemodialysis. Fresh frozen plasma transfusion was provided with hemodialysis. At 15 days from admission, there was no further bleeding, and laboratory values, including hemoglobin, partial thromboplastin time, and prothrombin time were normalized. He was discharged without bleeding. After 2 months, he undergoes dialysis three times per week and no recurrence of bleeding has been observed.

• Journal of the Korean Society of Hazard Mitigation
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• v.11 no.1
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• pp.51-57
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• 2011

Irregular distributions of limestone cavity in Gang-Won province area may cause unexpected accidents from reduced serviceability or failure of structure. It is requested that an appropriate ground reinforcement method should be used to improve bearing capacity of structure, and the method should also be satisfied with environmental requirements. Among several methods used for foundation constructions in cavity area, Rod Jet Pile(RJP) method has been widely used. While the RJP method was used to improve bearing capacity for the railway bridge foundations, water pollutions of drinking water as well as fishery located adjacent to this project area were occurred. The main reason of the water pollution was cement runoff used in cement mortar during injecting material in RJP method. Laboratory tests were performed to prevent water pollution. The compaction mortar method using low movable material was selected for this project. The quality of water at a fishery adjacent to the site and the compressive strength of cores taken from the construction site were measured. Test results show that the water pollutions was minimized, and the average compressive strength of foundation material was over 5 MPa. As a result of this study, compaction mortar method can be used to ensure the bearing capacity of foundation and to prevent environment pollutions.

• Journal of the Korea Organic Resources Recycling Association
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• v.27 no.2
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• pp.67-73
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• 2019

In this study, to optimize the production and utilization of biogas for organic waste resources, the precision monitoring of on-site facilities and the energy balance by facility were analyzed, and the solutions for field problems were investigated, and the design and operation guidelines for pretreatment facilities and generators were presented. Gas pre-treatment is required to solve frequent failures and efficiency degradation in operation of high quality refining facilities, and processing processes such as desulfurization, dehumidification, deoxidization, dust treatment, volatile organic compounds, etc. Since these processes are substances that are also eliminated from the high-quality process, quantitative guidelines are not presented in the gas pretreatment process, but are suggested to operate during the processing process as a qualitative guideline. In particular, dust, siloxane, and volatile organic compounds are the main cause of frequent failure of high-quality processes if they are not removed from the gas pretreatment process. Design of the biogas high-quality process. The operation guidelines provide quality standards [Methane content (including propane) of 95% or more] with 90% or more utilization of the total gas generation, two systems, and a margin of 10% or more. It also proposed installing gas equalization tank, installing thermal automatic control system for controlling equalization of auxiliary fuel, installing dehumidification device at the back of high quality for removing moisture generated in the process of gas compression, installing heat-resisting facilities to prevent freezing of facilities in winter and reducing efficiency, and installing membrane facilities in particular.