• Archives of Plastic Surgery
• /
• v.49 no.1
• /
• pp.91-98
• /
• 2022

Background Predicting the need for post-traumatic reconstruction of lower extremity injuries remains a challenge. Due to the larger volume of cases in adults than in children, the majority of the medical literature has focused on adult lower extremity reconstruction. This study evaluates predictive risk factors associated with the need for free flap reconstruction in pediatric patients following lower extremity trauma. Methods An IRB-approved retrospective chart analysis over a 5-year period (January 1, 2012 to December 31, 2017) was performed, including all pediatric patients (<18 years old) diagnosed with one or more lower extremity wounds. Patient demographics, trauma information, and operative information were reviewed. The statistical analysis consisted of univariate and multivariate regression models to identify predictor variables associated with free flap reconstruction. Results In total, 1,821 patients were identified who fit our search criteria, of whom 41 patients (2.25%) required free flap reconstruction, 65 patients (3.57%) required local flap reconstruction, and 19 patients (1.04%) required skin graft reconstruction. We determined that older age (odds ratio [OR], 1.134; P =0.002), all-terrain vehicle accidents (OR, 6.698; P<0.001), and trauma team activation (OR, 2.443; P=0.034) were associated with the need for free flap reconstruction following lower extremity trauma in our pediatric population. Conclusions Our study demonstrates a higher likelihood of free flap reconstruction in older pediatric patients, those involved in all-terrain vehicle accidents, and cases involving activation of the trauma team. This information can be implemented to help develop an early risk calculator that defines the need for complex lower extremity reconstruction in the pediatric population.

• Journal of computational fluids engineering
• /
• v.13 no.2
• /
• pp.27-41
• /
• 2008

An unstructured hybrid mesh flow solver has been developed for the simulation of three-dimensional steady and unsteady incompressible flow fields. The incompressible Navier-Stokes equations with an artificial compressibility method were discretized by using a node-based finite-volume method. For the unsteady time-accurate computation, a dual-time stepping method was adopted to satisfy a divergence-free flow field at each physical time step. An implicit time integration method with local time stepping was implemented to accelerate the convergence in the pseudo-time sub-iteration procedure. The one-equation Spalart-Allmaras turbulence model has been adopted to solve high-Reynolds number flow fields. The flow solver was parallelized to minimize the CPU time and to overcome the computational overhead. This method has been applied to calculate steady and unsteady flow fields around submarine configurations and a 3-D infinite cylinder. Validations were made by comparing the predicted results with those of experiments or other numerical results. It was demonstrated that the present method is efficient and robust for the prediction of steady and unsteady incompressible flow fields.

• The Journal of Korean Institute of Communications and Information Sciences
• /
• v.15 no.3
• /
• pp.252-259
• /
• 1990

This paper present new scheme for a Side Wall Masked Isolation(SWAMI) technology which take all the advatages provided by conventional LOCOS process. A new SWAMI process incorporates a sloped sidewall by reactive ion etch and a layer of thin nitride around the side walls such that both intrinsic nitride stress and volume expansion induced stress are greatly reduced. As a fabricate results, a defect-free fully recessed zero bird's beak local oxidation process can be realized by the sloped wall anisotropic oxide isolation. No additional masking step is required. The leakage current of PN diodes of this process were reduced than PN diode of conventional LOCOS process. On the other hand, the edge junction part was larger than the flat juction part in the density of leakage current.

• Computers and Concrete
• /
• v.16 no.2
• /
• pp.261-274
• /
• 2015

This study established the standard recommended values and expansion fracture threshold values for the content of steel slag in controlled low-strength materials (CLSM) to ensure the appropriate use of steel slag aggregates and the prevention of abnormal expansion. The steel slags used in this study included basic oxygen furnace (BOF) slag and desulfurization slag (DS), which replaced 5-50% of natural river sand by weight in cement mixtures. The steel slag mortars were tested by high-temperature ($100^{\circ}C$) curing for 96 h and autoclave expansion. The results showed that the effects of the steel slag content varied based on the free lime (f-CaO) content. No more than 30% of the natural river sand should be replaced with steel slag to avoid fracture failure. The expansion fracture threshold value was 0.10%, above which there was a risk of potential failure. Based on the scanning electron microscopy (SEM) analysis, the high-temperature catalysis resulted in the immediate extrusion of peripheral hydration products from the calcium hydroxide crystals, leading to a local stress concentration and, eventually, deformation and cracking.

• Journal of the Korean Society of Systems Engineering
• /
• v.19 no.2
• /
• pp.59-73
• /
• 2023

Due to the steady growth of the online shopping market and contact-free consumption, the volume of parcels in South Korea continues to increase. However, there is a lack of manpower for delivery workers to handle the growing parcel volume, leading to frequent accidents related to delivery work. As a result, the government and local authorities strive to enhance last-mile logistics efficiency. As one of these measures, unmanned parcel storage lockers are installed and utilized to handle last-mile deliveries. However, the existing parcel storage involves the inconvenience of couriers having to put each parcel in each locker, and this is somewhat insufficient to relieve the workload of delivery workers. In this study, we propose parcel storage devices that use active loading technology to minimize the workload of delivery workers, extract operation risk factors to apply this system to actual sites, and establish risk reduction methods based on the ALARP concept. Through this study, we have laid the groundwork for improving the safety of the system by identifying and proposing mitigation measures for the risk factors associated with the proposed parcel storage devices utilizing active loading technology. When applied in practical settings in the future, this foundation will contribute to the development of a more efficient and secure system. By applying the ALARP concept, a systems engineering technique used in this research, to the development and maintenance of storage devices leveraging active loading technology, it is thought to make the development process more systematic and structured. Furthermore, through the risk management of the proposed system, it is anticipated that a systematic approach to quality management can be employed to minimize defects and provide a stable system. This is expected to be more useful than the existing unmanned parcel storage devices.

• Journal of Korean Neurosurgical Society
• /
• v.54 no.2
• /
• pp.107-111
• /
• 2013

Objective : We investigated the effectiveness of stereotactic gamma knife Radiosurgery (GKR) for radioresistant brain metastases with the impact upon histology. Methods : Between April 2004 and May 2011, a total of 23 patients underwent GKR for 67 metastatic brain tumors from 12 renal cell cancers, 5 sarcomas and 6 melanomas. The mean age was 56 years (range, 18 to 79 years). Most of the patients were classified as the Radiation Therapy Oncology Group recursive partitioning analysis class II (91.3%). The synchronous metastasis was found in 6 patients (26.1%) and metachronous metastasis in 17 patients (73.9%). We analyzed the local control rate, intracranial progression-free survival (PFS) and overall survival (OS). Results : The mean tumor volume for GKR was 2.24 cc and the mean prescription dose was 19.4 Gy (range, 10 to 24) to the tumor margin. Out of metachronous metastases, the median duration to intracranial metastasis was 3.3 years in renal cell cancer (RCC), 2.4 years in melanoma and 1.1 years in sarcoma (p=0.012). The total local control rate was 89.6% during the mean 12.4 months follow-up. The six-month and one-year local control rate was 90.2% and 83% respectively. Depending on the pathology, the control rate of RCC was 95.7%, sarcoma 91.3% and melanoma 80.5% during the follow-up. The common cause of local failure was the tumor bleeding in melanoma. The median PFS and OS were 5.2 and 8.4 months in RCC patients, 6.5 and 9.8 months in sarcoma, and 3.8 and 5.1 months in melanoma. Conclusion : The GKR can be one of the effective management options for the intracranial metastatic tumors from the radioresistant tumors. The melanoma showed a poor local control rate compared to other pathologies because of the hemorrhage.

• Radiation Oncology Journal
• /
• v.35 no.2
• /
• pp.172-179
• /
• 2017

Purpose: To evaluate the outcomes of stereotactic body radiation therapy (SBRT) for patients with liver oligo-recurrence and oligo-progression from various primary tumors. Materials and Methods: Between 2002 and 2013, 72 patients with liver oligo-recurrence (oligo-metastasis with a controlled primary tumor) and oligo-progression (contradictory progression of a few sites of disease despite an overall tumor burden response to therapy) underwent SBRT. Of these, 9 and 8 patients with uncontrollable distant metastases and patients immediate loss to follow-up, respectively, were excluded. The total planning target volume was used to select the SBRT dose (median, 48 Gy; range, 30 to 60 Gy, 3-4 fractions). Toxicity was evaluated using the Common Toxicity Criteria for Adverse Events v4.0. Results: We evaluated 55 patients (77 lesions) treated with SBRT for liver metastases. All patients had controlled primary lesions, and 28 patients had stable lesions at another site (oligo-progression). The most common primary site was the colon (36 patients), followed by the stomach (6 patients) and other sites (13 patients). The 2-year local control and progression-free survival rates were 68% and 22%, respectively. The 2- and 5-year overall survival rates were 56% and 20%, respectively. The most common adverse events were grade 1-2 fatigue, nausea, and vomiting; no grade ${\geq}3$ toxicities were observed. Univariate analysis revealed that oligo-progression associated with poor survival. Conclusion: SBRT for liver oligo-recurrence and oligo-progression appears safe, with similar local control rates. For liver oligo-progression, criteria are needed to select patients in whom improved overall survival can be expected through SBRT.

• Journal of Korean Tunnelling and Underground Space Association
• /
• v.7 no.1
• /
• pp.13-25
• /
• 2005

In general, tunnel ventilation is analyzed with the assumption of equal vehicular speed for both directions in bidirectional traffic tunnels. This practice is likely to result in minimizing the piston effects and cannot take into consideration the effects of real situations, since in most cases, speeds of vehicles moving in opposite directions are not equal. Therefore, The ultimate goal of this study is to review the effects of unequal vehicular speeds on the planning of local bidirectional tunnel ventilation. To apply unequal vehicular speed for the bidirectional tunnel ventilation plan, the following requirements are necessary; (1) Adoption of strict smoke concentration standards for 'free-flow & congested' traffic conditions, (2) Selection of an appropriate ratio of heavy directional traffic volume, and (3) Selection of reasonable stepwised magnitude of speed difference. Based on the importance of research topic, this study aims at comparing the differences of the capacity of ventilation equipment for the cases with equal and unequal vehicular speeds in local bidirectional tunnels.

• Radiation Oncology Journal
• /
• v.37 no.3
• /
• pp.193-200
• /
• 2019

Purpose: To explore the role of salvage radiotherapy (RT) for recurrent thymoma as an alternative to surgery. Materials and Methods: Between 2007 and 2015, 47 patients who received salvage RT for recurrent thymoma at Yonsei Cancer Center were included in this study. Recurrent sites included initial tumor bed (n = 4), pleura (n = 19), lung parenchyma (n = 10), distant (n = 9), and multiple regions (n = 5). Three-dimensional conformal and intensity-modulated RT were used in 29 and 18 patients, respectively. Median prescribed dose to gross tumor was 52 Gy (range, 30 to 70 Gy), with equivalent doses in 2-Gy fractions (EQD₂). We investigated overall survival (OS), progression-free survival (PFS), and patterns of failure. Local failure after salvage RT was defined as recurrence at the target volume receiving >50% of the prescription dose. Results: Median follow-up time was 83 months (range, 8 to 299 months). Five-year OS and PFS were 70% and 22%, respectively. The overall response rate was 97.9%; complete response, 34%; partial response, 44.7%; and stable disease, 19.1%. In multivariate analysis, histologic type and salvage RT dose (≥52 Gy, EQD₂) were significantly associated with OS. The high dose group (≥52 Gy, EQD₂) had significantly better outcomes than the low dose group (5-year OS: 80% vs. 59%, p = 0.046; 5-year PFS: 30% vs. 14%, p=0.002). Treatment failure occurred in 34 patients; out-of-field failure was dominant (intra-thoracic recurrence 35.3%; extrathoracic recurrence 11.8%), while local failure rate was 5.8%. Conclusion: Salvage RT for recurrent thymoma using high doses and advanced precision techniques produced favorable outcomes, providing evidence that recurrent thymoma is radiosensitive.

• Korean Journal of Head & Neck Oncology
• /
• v.4 no.1
• /
• pp.29-34
• /
• 1988

Radiation therapy is generally considered to be the treatment of choice in $T_1$ glottic cancer, maninly because of preservation of voice function and its local control rate is comparable to that of surgery. Failures from radiation therapy can be ultimately salvaged by surgery. A retrospective analysis of the treatment of 25 patients with $T_1$ glottic cancer seen at the Yonsei Cancer Center from 1980 to 1984 is presented. Radiation dose to the target volume varied from 6400 to 7000 cGy in 6-7 weeks. The local control rate is 84%. Four patients had primary failure and three of these patients had salvage surgery. Of the 3 patients who had salvage surgery, 2 were cured and aonther one was died with progression of the disease. 5-year acturial and disease free survival rate are 91.1%,78.0% respectively.