In this study we have analyzed processes of generalization in which students have geometrically solved cubic equation $x^3+ax=b$, regarding geometrical solution of cubic equation $x^3+4x=32$ as examples. The result of this research indicate that students could especially re-interpret the geometric solution of the given cubic equation via dynamically understanding the variables in dynamic geometry environment. Furthermore, participants could simultaneously re-interpret the given geometric solution and then present a different geometric solutions of $x^3+ax=b$, so that the level of generalization could be improved. In conclusion, the study could provide useful pedagogical implications in school mathematics that the dynamic geometry environment performs significant function as a means of students-centered exploration when understanding variables and enhancing the level of generalization in problem solving.
Various vascularized free flaps have been used for midfacial reconstruction after ablative head and neck cancer surgery. The most common donor sites for free flap include latissimus dorsi, rectus abdominis, and radial forearm. Between 1994 and 2004, 14 patients underwent free flap operation after head and neck cancer ablation, and were reviewed retrospectively. Among 14 free flaps, 8 were latissimus dorsi myocutaneous flaps, 3 rectus abdominis myocutaneous flaps and 3 radial forearm flaps, respectively. The overall survival rate of the flap was 100%. Complications were wound dehiscence(5 cases) and ptosis(1 case). We designed multiple dimensionally folded free flap for midfacial reconstruction. For 3-dimensional flap needs, we used latissimus dorsi myocutaneous flap. 2-Dimensional flap was latissimus dorsi or rectus abdominis myocutaneous flap and 1-dimensional flap was radial forearm flap. In this study we produced an algorithm for midfacial reconstruction. Large volume with many skin paddle defects were best reconstructed with latissimus dorsi myocutaneous flap or rectus abdominis myocutaneous flap. Radial forearm flap was used for reconstruction of small volume and little skin paddle defects.
Purpose: The Rectus abdominis muscle free flap is utilized in various reconstruction surgeries due to easiness in harvesting, consistency of vascular pedicle and reduced donor site morbidity. But rarely, femoral nerve injury during rectus abdominis harvesting can be resulted. We report a case of femoral nerve injury after rectus muscle harvesting and discuss the injury mechanism with the follow-up process of this injury. Methods: To reconstruct the defect of middle cranial base after wide excision of cystic adenocarcinoma of the external ear, rectus muscle free flap was havested in usual manner. To achieve a long vessel, inferior epigastric artery was dissected to the dividing portion of femoral artery and cut. Results: One week after the surgery, the patient noted sensory decrease in the lower leg, weakness in muscle strength, and disabilities in extension of the knee joint resulting in immobilization. EMG and NCV results showed no response on stimulation of the femoral nerve of the left leg, due to the defects in femoral nerve superior to the inguinal ligament. With routine neurologic evaluations and physical therapy, on the 75th day after the operation, the patient showed improvement in pain, sensation and muscle strength, and was able to move with walking frame. In 6 months after the operation, recovery of the muscle strength of the knee joint was observed with normal flexion and extension movements. Conclusion: Rarely, during dissection of the inferior epigastric artery, injuries to the femoral nerve can be resulted, probably due to excessive traction or pressure from the blade of the traction device. Therefore, femoral nerve injury can be prevented by avoiding excessive traction during surgery.
Background The extended latissimus dorsi flap is important for breast reconstruction. Unfortunately, donor site seroma is the most common complication of extended latissimus dorsi flap for breast reconstruction. Although using fibrin sealant in the donor site reduces the rate of seroma formation, donor site seroma remains a troublesome complication. The purpose of this study was to analyze the effectiveness of the combination of quilting sutures and fibrin sealant in the latissimus dorsi donor site for the prevention of seroma. Methods Forty-six patients who underwent breast reconstruction with extended latissimus flap were enrolled in the study. The patients received either fibrin sealant (group 1, n=25) or a combination of fibrin sealant and quilting sutures (group 2, n=21) in the extended latissimus dorsi donor site. Outcome measures were obtained from the incidence, volume of postoperative seroma, total drainage amount, indwelling period of drainage, and duration of hospital stay. Results The incidence of seroma was 76% in group 1 and 42.9% in group 2 (P=0.022). We also found significant reductions in seroma volume (P=0.043), total drainage amount (P=0.002), indwelling period of drainage (P=0.01), and frequency of aspiration (P=0.043). The quilting sutures did not affect the rate of drainage, tube reinsertion, or hospital stay. Conclusions The use of quilting sutures combined with fibrin sealant on the latissimus dorsi flap donor site is helpful for reducing the overall seroma volume, frequency of aspiration, and total drainage amount.
Lee, Woo Yeon;Kim, Min Jung;Lew, Dae Hyun;Song, Seung Yong;Lee, Dong Won
Archives of Plastic Surgery
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v.43
no.5
/
pp.430-437
/
2016
Background Accurate breast volume assessment is a prerequisite to preoperative planning, as well as intraoperative decision making in breast reconstruction surgery. The use of three-dimensional surface imaging (3D scanning) to assess breast volume has many advantages. However, before employing 3D scanning in the field, the tool's validity should be demonstrated. The purpose of this study was to confirm the validity of 3D-scanning technology for evaluating breast volume. Methods We reviewed the charts of 25 patients who underwent breast reconstruction surgery immediately after total mastectomy. Breast volumes using the Axis Three 3D scanner, water-displacement technique, and magnetic resonance imaging (MRI) were obtained bilaterally in the preoperative period. During the operation, the tissue removed during total mastectomy was weighed and the specimen volume was calculated from the weight. Then, we compared the volume obtained from 3D scanning with those obtained using the water-displacement technique, MRI, and the calculated volume of the tissue removed. Results The intraclass correlation coefficient (ICC) of breast volumes obtained from 3D scanning, as compared to the volumes obtained using the water-displacement technique and specimen weight, demonstrated excellent reliability. The ICC of breast volumes obtained using 3D scanning, as compared to those obtained by MRI, demonstrated substantial reliability. Passing-Bablok regression showed agreement between 3D scanning and the water-displacement technique, and showed a linear association of 3D scanning with MRI and specimen volume, respectively. Conclusions When compared with the classical water-displacement technique and MRI-based volumetry, 3D scanning showed significant reliability and a linear association with the other two methods.
Kim, Soo Jung;Song, Seung Yong;Lew, Dae Hyun;Lee, Dong Won
Archives of Plastic Surgery
/
v.44
no.5
/
pp.413-419
/
2017
Background In breast reconstruction using implants after unilateral mastectomy, it is challenging to create a natural, ptotic contour, and asymmetry is a potential drawback. To achieve breast symmetry and an ideal shape for both breasts, we performed contralateral augmentation in patients undergoing breast reconstruction with implants. Methods Patients underwent unilateral mastectomy and 2-stage reconstruction. During the second stage of the procedure, contralateral augmentation mammoplasty was performed. Preoperatively, we obtained the patients' demographic information, and we then assessed breast volume, the volume and dimensions of the inserted implants, and complications. Breast symmetry was observed by the surgeon and was assessed by measuring the disparity between the final volume of each breast. Results Contralateral augmentation was performed in 52 cases. When compared to patients who did not undergo a contralateral balancing procedure, patients who received contralateral augmentation were younger, thinner, and had smaller breasts. During implant selection for contralateral augmentation, we chose implants that were approximately 1 cm shorter in width, 1 level lower in height, and 1 or 2 levels lower in projection than the implants used for reconstruction. The postoperative breast contours were symmetric and the final volume discrepancy between each breast, which was measured by 3-dimensional scanning, was acceptable. Conclusions We demonstrate that contralateral augmentation can be recommended for patients who perceive their breasts to be small and not beautiful in order to achieve an ideal and beautiful shape for both breasts. Furthermore, this study offers guidelines for selecting the implant that will lead to the optimal aesthetic outcome.
Background Composite grafts are frequently used for facial reconstruction. However, the unpredictability of the results and difficulties with large defects are disadvantages. Adipose-derived stem cells (ADSCs) express several cytokines, and increase the survival of random flaps and fat grafts owing to their angiogenic potential. Methods This study investigated composite graft survival after ADSC injection. Circular chondrocutaneous composite tissues, 2 cm in diameter, from 15 New Zealand white rabbits were used. Thirty ears were randomly divided into 3 groups. In the experimental groups (1 and 2), ADSCs were subcutaneously injected 7 days and immediately before the operation, respectively. Similarly, phosphate-buffered saline was injected in the control group just before surgery in the same manner as in group 2. In all groups, chondrocutaneous composite tissue was elevated, rotated 90 degrees, and repaired in its original position. Skin flow was assessed using laser Doppler 1, 3, 6, 9, and 12 days after surgery. At 1 and 12 days after surgery, the viable area was assessed using digital photography; the rabbits were euthanized, and immunohistochemical staining for CD31 was performed to assess neovascularization. Results The survival of composite grafts increased significantly with the injection of ADSCs (P<0.05). ADSC injection significantly improved neovascularization based on anti-CD31 immunohistochemical analysis and vascular endothelial growth factor expression (P<0.05) in both group 1 and group 2 compared to the control group. No statistically significant differences in graft survival, anti-CD31 neovascularization, or microcirculation were found between groups 1 and 2. Conclusions Treatment with ADSCs improved the composite graft survival, as confirmed by the survival area and histological evaluation. The differences according to the injection timing were not significant.
Park, Sung-woon;Seo, Yoon-jeong;Choi, Hyun-jeong;Lew, Jae-hwan
The Journal of Internal Korean Medicine
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v.38
no.3
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pp.327-335
/
2017
Objective: The goal of this preclinical study was to compare the dyslipidemic effect of pravastatin with that of herbal medicine in rats. Methods: In total, 40 rats were divided into 4 groups: Normal (10 rats), Control (10 rats), Statin alone (10 rats), and the MO-PM-S group (10 rats), which was given the powder of the cortex of Magnolia officinalis Rehd. et Wils., the root of Polygonum multiflorum Thunb, and pravastatin. The Control group, the Statin alone group, and the MO-PM-S group were all given a high-fat (45%) diet that made them obese. After 2 weeks of drug administration, the dyslipidemic effect of pravastatin was compared with that of herbal medicine in rats by analyzing the lipid profiles, measuring the body weights, and taking biopsies (liver, aorta). Results: The herbal medicine and the statin complex group got a much lower TG level and a slightly higher HDL-cholesterol level than the other groups. However, it got a higher total cholesterol and LDL-cholesterol level than the other groups. In biopsies, 30% of the Statin alone group and 10% of the MO-PM-S group showed mild histopathologic findings in the liver. Conclusion: The cortex of the Magnolia officinalis Rehd. et Wils. and the root of Polygonum multiflorum Thunb have dyslipidemic effects from the perspective of a TG level and HDL-cholesterol. However, the herbal mixture has a raising effect on both the LDL-cholesterol and the total cholesterol levels. Therefore, we cannot conclude that the herbal mixture helps to prevent dyslipidemia. In liver biopsies, the group administered with both the herbal mixture and the statin showed less histopathologic findings than the group administered with statin alone. This means that the herbal mixture helps to prevent fatty degeneration of the liver.
Objective: Physical inactivity contributes to mortality rates and is now the fourth most frequent cause of death worldwide. Red ginseng is a medicinal herb that is often used as an ergogenic aid. In this study, red ginseng was administered to rats to test whether it affected their ability to exercise. Methods: Forty-five rats were randomly distributed and divided into five groups: normal (N, n=5), control (C, n=10), the group to which only red ginseng was administered (H, n=10), the group to which only amino acid complex was administered (A, n=10), and the group to which both red ginseng and amino acid complex were administered (HA, n=10). Once a day for three weeks, 333.3 mg/kg body weight per day (b.w./day) of red ginseng and 750 mg/kg b.w./day of amino acid preparation were administered to rats. After three weeks, body weight, swimming time, and the weight of the anterior tibialis muscle of rat were measured. Blood was taken for analysis using the cardiac puncture method. Results: The swimming time of group H (921.3±199.26 sec) showed significant improvement compared to that of group C (798.48±156.37 sec) (p<0.05). Conclusion: Red ginseng has improved swimming time in rat and can be used as an effective ergogenic aid.
The Journal of the Korean Society for Microbiology
/
v.12
no.1
/
pp.33-49
/
1977
These studies were carried out to detect the presence of mycotoxin fungi and detoxification of toxins in various kinds of grain and foodstuffs in Korea. The experiments were divided into three parts: mycologic, toxicologic and electron microscopic study. The resuIts were summarized as follows: 1. From the 210 various, samples(local grains, 150 samples; rice-cakes, 50 samples; meju, 10 samples), 1,205 colonies or fungi were isolated. In 1,127 of 1,205 colonies, it was possible to identify 21 genera. Among the identified strains, the predominant genera were Aspergillus sp.(28.5%), Penicillium sp.(27.1%) and Mucor sp.(7.8%). 2. In cytotoxicity test on HeLa cells, 25 strains showed severe toxic effects among the 240 strains of experiments. 3. In histopathologic test on mice, 21 strains showed severe toxic effect to mouse liver cells among the 240 tested strains. 4. In electron microscopic studies of HeLa cells and mouse liver cells from animal which had been treated with crude toxin, the liver cells showed the cytoplasmic change: dillatation or vacuolization of endoplasmic reticulum, swelling of mitochondria and disappearance of mitochondrial cristae, increased number of lipid and glycogen particles. Nucleus and nucelar envelope alterations, were also noted. 5. In the detoxification study with ultraviolet irradiation, 90% of the toxic substances were denatured by the ultraviolet light irradiation for 24 hours. 6. As a mass screening, the cytotoxicity test of HeLa cells and histopathologic study of mice liver cells treated with culture filtrates, employed and feasible to detect mycotoxin producing fungi.
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