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Postmastectomy Breast Reconstruction is Safe in Patients on Chronic Anticoagulation

  • Yan, Maria;Kuruoglu, Doga;Boughey, Judy C.;Manrique, Oscar J.;Tran, Nho V.;Harless, Christin A.;Martinez-Jorge, Jorys;Nguyen, Minh-Doan T.
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.346-351
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    • 2022
  • Background Postmastectomy breast reconstruction (PMR) increases patient satisfaction, quality of life, and psychosocial well-being. There is scarce data regarding the safety of PMR in chronic anticoagulated patients. Perioperative complications can reduce patient satisfaction; therefore, it is important to elucidate the safety of PMR in these patients. Methods A retrospective case-control study of patients who underwent PMR with implants and were on chronic anticoagulation was performed at our institution. Inclusion criteria were women ≥ 18 years old. Exclusion criteria included autologous reconstructions, lumpectomy, and oncoplastic procedures. Two controls for every one patient on anticoagulation were matched by age, body mass index, radiotherapy, smoking history, type of reconstruction, time of reconstruction, and laterality. Results From 2009 to 2020, 37 breasts (20 patients) underwent PMR with implant-based reconstruction and were on chronic anticoagulation. A total of 74 breasts (40 patients) who had similar demographic characteristics to the cases were defined as the control group. Mean age for the case group was 53.6 years (standard deviation [SD] = 16.1), mean body mass index was 28.6 kg/m2 (SD = 5.1), and 2.7% of breasts had radiotherapy before reconstruction and 5.4% after reconstruction. Nine patients were on long-term warfarin, six on apixaban, three on rivaroxaban, one on low-molecular-weight heparin, and one on dabigatran. The indications for anticoagulation were prior thromboembolic events in 50%. Anticoagulated patients had a higher risk of capsular contracture (10.8% vs. 0%, p = 0.005). There were no differences regarding incidence of hematoma (2.7% vs. 1.4%, p = 0.63), thromboembolism (5% vs. 0%, p = 0.16), reconstructive-related complications, or length of hospitalization (1.6 days [SD = 24.2] vs. 1.4 days [SD = 24.2], p = 0.85). Conclusion Postmastectomy implant-based breast reconstruction can be safely performed in patients on chronic anticoagulation with appropriate perioperative management of anticoagulation. This information can be useful for preoperative counseling on these patients.

Growth and Yield Response of Perilla Plants Grown under Different Substrates in Hydroponic System (잎들깨 수경재배에서 배지 종류에 따른 식물 생육 및 수량의 반응)

  • Shin, Minju;Jeong, Ho Jeong;Roh, Mi Young;Kim, Jin Hyun;Song, Kwan Jeong
    • Journal of Bio-Environment Control
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    • v.31 no.4
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    • pp.292-299
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    • 2022
  • This study was conducted to analyze physical and chemical properties of horticultural substrates and response of hydroponically grown two cultivars of 'Namcheon' and 'Somirang' perilla by four different substrates: coir (chip:dust = 5:5), perlite, granular rockwool, and commercial mixed substrate (cocopeat:peatmoss:vermiculite:perlite: zeolite = 50:25:10:10:5). There were no significant differences in EC and pH according to substrates. Container capacity was the greatest in granular rockwool, and it showed appropriate levels in mixed substrate and coir. Air space was higher in coir and perlite than the other treatments. Bulky density reached a proper standard in all substrates excepting coir. The leaf length and width of 'Namcheon' indicated the most in mixed substrate, though the value of 'Somirang'was greatest in coir substrate. The leaf weight of both cultivars was highest in mixed substrate, and relatively low in coir and perlite. The total yield of leaves was separated by two groups: higher group, which are mixed substrate and granular rockwool, and lower group, which are coir and perlite. There was a large gap by 28% between these two groups. Therefore, this study suggests that substrates with high water holding capacity such as mixed substrate or granular rockwool are most suitable for the hydroponic cultivation of perilla, which require sufficient moisture supply to the root zone.

A Study on the Effect of Ratification of the Cape Town Agreement on Korean Deep-Sea Fishing Vessels (우리나라 원양어선의 케이프 타운 협정 비준 영향에 관한 연구)

  • RYU, Kyung-Jin
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.28 no.5
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    • pp.773-779
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    • 2022
  • Deep-sea fisheries in Korea play an essential role in supplying popular seafood and providing food security. Countries, as well as the IMO (International Maritime Organization), have attempted to establish an internationally harmonized safety standard for fishing vessels. However, starting with the adoption of 'The Torremolinos International Convention for the Safety of Fishing Vessel 1977', the '2012 Cape Town Agreement' was adopted, but the requirements for enforcement were not met. However, with the 2019 Torremolinos Declaration, the effect of the agreement became visible. Korea is also about to ratify the agreement, and deep-sea fishing vessels are subject to the agreement. The length of the hull or the gross tonnage can be selected as the criteria for applying the 2012 Cape Town Agreement, and this is also partially applied to the existing vessels. Analyzing 188 deep-sea fishing vessels registered as members of the Korea Overseas Fisheries Association to confirm the effect on the existing vessels showed that the application of gross tonnage had little impact on the ratification of the agreement. In addition, laws must be revised for the compulsorization of GMDSS facilities such as two-way VHF and radar transponders and for the safety familiarization of fishermen. In the industry, the facilities required by the agreement must be provided, and the fishermen must be familiarized with safety.

Effects of Zeolite Application on Yield and Yield Components in Rice (Zeolite 시용에 의한 벼의 증수효과 및 요인해석)

  • Kae, Bong-Myung;Sol, Kwon-Sok;Cho, Chang-Hwan
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.32 no.4
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    • pp.403-408
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    • 1987
  • The milled rice yield of the fertilized Zeolite in the sandy loam as 542 Kg/10a was increased by 11% compared with the check plat as a standard cultivation. Significant positive correlations of that were found between grain yield/plant and panicle/total weight ratio or average weight of panicle, while lower correlations between ratio of riqened grains and grain yield/ plant. But significant negative correlations were found between 1,000-grain weight of rough and 4th. 5th internode/culm length ratio. It was reavealed that there were higher direct effects for ratio of ripened grains and spikelets/panicle affecting grain yield/plant through path analysis among the yield components. Moreover, organic dry matter production at 35 days after heading were heavier by 26% in active leaves, 19% in stem + leaf sheath, and 5% in panicle, respectively. Ratio of settled spikelets on the terminal of primary rachis-branch was 47% to total spikelets, and 37% in half-upper of that, moreover many spikelets settled on the terminal of rachis. Therefore, it was recognized that there were a dominant effect of apical glumous flower by fertilized Zeolite.

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Medium optimization for growth of Bacillus amyloliquefaciens ISP-5 strain and evaluation of plant growth promotion using lettuce (Bacillus amyloliquefaciens ISP-5 균주의 배지 최적화 및 상추를 이용한 식물 생장 촉진 평가)

  • Kang-Hyun Choi;Sun Il Seo;Haeseong Park;Ji-hwan Lim;Pyoung Il Kim
    • Journal of Plant Biotechnology
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    • v.49 no.4
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    • pp.356-361
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    • 2022
  • Bacillus sp. is a useful strain for agriculture because it promotes plant growth and controls plant pathogens through a variety of mechanisms. In this study, we obtained a microbial preparation with a high number of viable cells by culturing newly isolated soil bacteria on an optimized medium. Subsequently, we applied this preparation to lettuce to enhance its growth and yield. First, B. amyloliquefaciens ISP-5 was isolated from soil. Next, optimization of culture medium was carried out using 5 L scale fermenters. When culturing B. amyloliquefaciens ISP-5 on this optimized medium, the number of viable cells was approximately 1000 times higher than that obtained from culturing on the commercial medium. Afterwards, the plant growth promotion properties of the ISP-5 strain were evaluated using lettuce as a test plant. Foliar spray treatment of lettuce was carried out by inoculating half the standard concentration suspension (0.5 × 107 cfu/ml). As a result, leaf width increased by 8.6% and leaf length increased by 12.9% compared to the control group. Live weight also increased by 24.2% and dry weight by 23.9%. Considering the results from field test, B. amyloliquefaciens ISP-5 showed potential as a plant growth-promoting bacteria.

Design Optimization to achieve an enhanced flatness of a Lab-on-a-Disc for liquid biopsy (액체생검용 Lab-on-a-Disc의 평탄도 향상을 위한 최적화)

  • Seokkwan Hong;Jeong-Won Lee;Taek Yong Hwang;Sung-Hun Lee;Kyung-Tae Kim;Tae Gon Kang;Chul Jin Hwang
    • Design & Manufacturing
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    • v.17 no.1
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    • pp.20-26
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    • 2023
  • Lab-on-a-disc is a circular disc shape of cartridge that can be used for blood-based liquid biopsy to diagnose an early stage of cancer. Currently, liquid biopsies are regarded as a time-consuming process, and require sophisticated skills to precisely separate cell-free DNA (cfDNA) and circulating tumor cells (CTCs) floating in the bloodstream for accurate diagnosis. However, by applying the lab-on-a-disc to liquid biopsy, the entire process can be operated automatically. To do so, the lab-on-a-disc should be designed to prevent blood leakage during the centrifugation, transport, and dilution of blood inside the lab-on-a-disc in the process of liquid biopsy. In this study, the main components of lab-on-a-disc for liquid biopsy are fabricated by injection molding for mass production, and ultrasonic welding is employed to ensure the bonding strength between the components. To guarantee accurate ultrasonic welding, the flatness of the components is optimized numerically by using the response surface methodology with four main injection molding processing parameters, including the mold & resin temperatures, the injection speed, and the packing pressure. The 27 times finite element analyses using Moldflow® reveal that the injection time and the packing pressure are the critical factors affecting the flatness of the components with an optimal set of values for all four processing parameters. To further improve the flatness of the lab-on-a-disc components for stable mass production, a quarter-disc shape of lab-on-a-disc with a radius of 75 mm is used instead of a full circular shape of the disc, and this significantly decreases the standard deviation of flatness to 30% due to the reduced overall length of the injection molded components by one-half. Moreover, it is also beneficial to use a quarter disc shape to manage the deviation of flatness under 3 sigma limits.

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A Study on the Calculation of Dynamic Yellow Signal Time Based on Approach Speed and Collision Points (접근속도와 상충지점 기반 동적황색신호시간 산정 연구)

  • Hyunho Son;Sanghoon Sung;Choulki Lee;Hyeon Soo Lee
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.22 no.4
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    • pp.14-34
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    • 2023
  • The purpose of this study was to calculate the appropriate yellow-signal time for intersections, to find out the relationship between the approach speed and intersection width when calculating the time, and to secure safety by minimizing conflicts and dilemma sections in intersections that change according to the signal operation. For this purpose, 6,824 data points from 5 intersections were collected and analyzed. The main results of the study are as follows. First, the approach speed of individual vehicles in different lanes was analyzed, and the width of an intersection was defined by considering the conflict in each direction. Second, we developed a multiple regression model based on the approach speed and conflict points, which compensated for the problems of an existing formula. Third, a standard table is presented for applying the appropriate yellow-signal time according to the approach speed and intersection width based on a development formula. A method is also presented to determine the safety of the length of the dilemma according to the change in the yellow-light time by presenting a calculation table that can cross-analyze the yellow-signal time and a dilemma section using the relationship.

Cone Resistivity Penetrometer for Detecting Thin-Layered Soils (협재층 탐지를 위한 선단비저항 콘)

  • Yoon, Hyung-Koo;Jung, Soon-Hyuck;Kim, Rae-Hyun;Lee, Jong-Sub
    • Journal of the Korean Geotechnical Society
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    • v.26 no.8
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    • pp.15-25
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    • 2010
  • The thin-layered sand seam in clay affects the soil behavior. Although the standard cone penetrometer (A: $10cm^2$) have been used to evaluate the thin-layered soil, the smaller diameter cone penetrometer have been commonly recommended because of the high resolution. The purpose of this study is the development and application of the Cone Resistivity Penetrometer (CRP), which detects qc, fs, and electrical resistivity at cone tip for the evaluation of thin layered soils. Two sizes of the CRP are developed for the laboratory and field test. The projected areas of CRP for the laboratory and field tests are $0.78cm^2$ (d: 1.0 cm) and $1.76cm^2$ (d: 1.5 cm), repectively. The length of friction sleeve is designed in consideration of ratio of the projected area to the friction sleeve area. The application tests are carried out by using the artificially prepared thin-layered soils in the laboratory. In addition, the field tests are conducted at the depth of 6 to 15 m in Kwangyang. In the laboratory test, the measured electrical resistivity and cone tip resistance detect the soil layers. Moreover, in the field test the CRP investigates the three thin-layered soils. This study suggests that the CRP may be a useful tool for detecting thin-layered in soft soils.

An Experimental Study on the Load-settlement Behavior and Settlement-reducing Effect of the Disconnected Piled Raft Foundation (말뚝보강기초의 하중-침하량 거동 및 침하감소효과에 대한 실험적 연구)

  • Lee Yeong-Saeng;Hong Seung-Hyeun
    • Journal of the Korean Geotechnical Society
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    • v.22 no.4
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    • pp.95-104
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    • 2006
  • For the interests in the economical and safe design of foundation system, the concern on the piled raft or disconnected piled raft foundation system is increasing now. In this study, the behavior and the effects of the disconnected piled raft foundation not studied actively in this country were examined using the triaxial compression tests in place of laboratory model tests. The triaxial test samples were prepared with Jumunjin standard sand and the carbon rods, which simulate the ground soil and piles respectively. After the sample in which carbon rods were arranged was laid inside the triaxial chamber, the confining pressure was applied and then loading test was conducted. To analyze the reinforcing effects of the disconnected piled raft foundation, a few number of tests were carried out by changing the number, the diameter and the length of the model piles. As a result of this study, in the disconnected piled raft foundation system, even though the number of pile is few and the diameter of pile is small, the settlement of the foundation system decreased greatly.

Effects of Concentrate Feeding Level after Sexual Maturity on the Growth and Breeding Performances, Blood Composition, and Ultrasonic Carcass Traits in Hanwoo Cows (성 성숙기 이후 농후사료 급여수준이 한우 암소의 성장과 번식능력, 혈액성상 및 초음파 도체성적에 미치는 영향)

  • Jeong, Chan Sung;Jang, Sun Sik;Lee, Sung Sill;Moon, Yea Hwang
    • Journal of agriculture & life science
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    • v.50 no.4
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    • pp.113-125
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    • 2016
  • This study was conducted to investigate the effect of low feeding level of concentrate after sexual maturity(14 month old) on the growing and breeding performances in Hanwoo cows. Eighteen cows(average body wt. 251kg) were alloted to two groups by completely randomized design, and fed a commercial formula feed by 0.8%(T1) and 1.2%(T2) of body weight for 30 months of total experimental period(feeding trial of 20 months, breeding trial of 10 months). When the results of this experiment compared to the Korean feeding standard for Hanwoo(2012), the reason of low growing performance in T1 was induced from low protein intake rather than energy. The change of body size by feeding levels was significantly appeared at chest width and body length, particularly chest width of cows in T1 was rather reduced by 3.7% in the final than the initial measurement. Ovarian size of T1 was only 63% of T2, and pregnancy rate(33.3% : 77.8%) and birth wight of calf(22.5kg : 29.5kg) were also seriously repressed by low intake of dietary protein after sexual maturity in Hanwoo cow. It was appeared that the growing and breeding performances of Hanwoo cows were more affected by the level of dietary protein rather than energy in the feeding after sexual maturity.