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Revisit of the Extended Indications and Clinical Utilities of Arterialized Venous Flap for Hand Reconstruction (수부 재건을 위한 동맥화 정맥 피판의 확장된 적응증과 임상적 유용성의 재조명)

  • Woo, Sang-Hyun;Kim, Kyung-Chul;Lee, Gi-Jun;Ha, Seung-Han;You, Sun-O;Kim, Joo-Sung
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.1-13
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    • 2005
  • Purpose: The purpose of this study is to present extended indications for the use of arterialized venous flaps in reconstructing soft tissue, tendon, nerve, blood vessel, and composite tissue defects of the hand of various sizes based on researches and clinical experiences of the authors. Moreover, procedures to achieve complete flap survival and postoperative results are presented. Materials & methods: This study is based on 154 cases of arterialized venous flaps performed to reconstruct the hand during the past 11 years. The most common cause of injury was industrial accidents with 125 cases. One hundred thirty patients or 84% of the cases had emergency operation within 2 weeks of the injury. The flaps were categorized depending on the size of the flap. Flaps smaller than $10\;cm^2$ were classified as small (n=48), those larger than $25\;cm^2$ classified large (n=42) and those in between medium (n=64). Classified according to composition, there were 88 cases (57.1 %) of venous skin flaps, 28 cases of innervated venous flaps, 15 cases of tendocutaneous venous flaps, which incorporated the palmaris longus tendon, for repair of extensor tendons of the fingers, and 17 cases of conduit venous flaps to repair arterial defect. There were 37 cases where multiple injuries to multiple digits were reconstructed. Moreover, there were 6 cases of composite tissue effects that involved soft tissue, blood vessels and tendons. The donor sites were ipsilateral forearm, wrist and thenar area, foot dorsum, and medial calf. The recipient sites were single digit, multiple digits, first web space, dorsum and palm of hand, and wrist. Results: There were seven cases (4.5%) of emergent re-exploration due to vascular crisis, and 3 cases of flap failure characterized by more than 50% necrosis of the flap. The survival rate was 98.1 % (151/154). In small flaps, an average of 1.01 afferent arteries and 1.05 efferent veins were microanastomosed, and in large flaps, an average of 1.88 afferent arteries and 2.19 efferent veins were anastomosed. In 8 cases where innervated flaps were used for reconstructing the palm of the hand, the average static two-point discrimination was $10\;(8{\sim}15)\;mm$. In 12 cases where tenocutaneous flaps were used, active range of motion at the proximal interphalangeal joint was 60 degrees, 20 degrees at the distal interphalangeal joint, and 75 degrees at the metacarpophalangeal joint. Conclusion: We conclude that the arterialized venous flap is a valuable and effective tool in the reconstruction of hand injuries, and could have a more comprehensive set of indications.

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Immediate Toe-to-Hand Transfer in Acute Hand Injuries (급성 수부 손상시 즉시 족지 전이술)

  • Woo, Sang-Hyun;Kim, Hak-Soo
    • Archives of Reconstructive Microsurgery
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    • v.11 no.1
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    • pp.19-28
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    • 2002
  • From 1994-2001, 25 mutilated digits were reconstructed with immediate toe-to-hand transfer in acute hand injury in 21 patients. There were 15 cases of great toe-to-hand transfer(partial great toe transfer 8 cases, modified wrap-around procedure 2 cases, and trimmed great toe transfer 2 cases) for thumb reconstruction, 2 cases of second toe transfer for index reconstruction, and 4 cases of simultaneous two toe-to-hand transfer(great toe & second toe transfer 1 case, bilateral second-toe transfer 2 cases, combined second & third toe transfer 1 case) for reconstruction of multiple digit amputations. Two cases of emergency exploration(2/25, 8%) were successfully salvaged. The incidence of emergency exploration and postoperative infection was not significantly different from that of the elective toe-to-hand transfer cases. Duration of industrial insurance coverage was 225 days, which is much shorter than that of elective cases. Among 43% of patients maintained their original job even after injury and immediate toe-to-hand transfer. The subjective satisfaction self- assessment scores of aesthetic appearance and function on the new reconstructed thumb were 80 and 88 in average, respectively, over a total score of 100. These were higher than those of reconstruction of other digits, but lower than those of elective reconstruction. The donor site after harvest of the great toe was mostly unsatisfied in a view of appearance. Immediate toe-to-hand transfer provides many advantages over elective procedure in acute hand injuries such as single stage reconstruction, shortened convalescent period, early return to work and efficient socio-economic factor. Furthermore because there were no significant differences in success rate, frequency of complications or ultimate functional result, immediate toe-to-hand transfer is a safe and reliable procedure in case of limited indications for acute digits loss.

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Design of Synchronous Quaternary Counter using Quaternary Logic Gate Based on Neuron-MOS (뉴런 모스 기반의 4치 논리게이트를 이용한 동기식 4치 카운터 설계)

  • Choi Young-Hee;Yoon Byoung-Hee;Kim Heung-Soo
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.42 no.3 s.333
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    • pp.43-50
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    • 2005
  • In this paper, quaternary logic gates using Down literal circuit(DLC) has been designed, and then synchronous Quaternary un/down counter using those gates has been proposed The proposed counter consists of T-type quaternary flip flop and 1-of-2 threshold-t MUX, and T-type quaternary flip flop consists of D-type quaternary flip flop and quaternary logic gates(modulo-4 addition gates, Quaternary inverter, identity cell, 1-of-4 MUX). The simulation result of this counter show delay time of 10[ns] and power consumption of 8.48[mW]. Also, assigning the designed counter to MVL(Multiple-valued Logic) circuit, it has advantages of the reduced interconnection and chip area as well as easy expansion of digit.

The Sex-Related Differences of Relationships between 2D : 4D Ratio and Electroencephalographic Coherence in Patients with Schizophrenia Compared with Controls (조현병 환자에서 성별에 따른 검지 대 약지의 길이 비율과 뇌파 동시성의 관련성)

  • Choi, Byungha;Lee, Yu Sang;Han, Eun-Seun;Kim, Seongkyun;Jeong, Jaeseung;Lee, Seungyeoun;Kim, Bum Joon
    • Korean Journal of Biological Psychiatry
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    • v.21 no.4
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    • pp.151-160
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    • 2014
  • Objectives Prenatal testosterone is known to influence both cerebral laterality and 2nd to 4th digit ratio (2D : 4D). Epigenetic changes are thought to play some role in it. We studied sex-related differences between 2D : 4D and cerebral laterality in patients with schizophrenia and controls to examine the effects of prenatal testosterone in the development of schizophrenia. Methods Forty one men (18 schizophrenic patients and 23 controls) and 40 women (17 schizophrenic patients and 23 controls) were recruited from one psychiatric hospital in Korea. The 2D : 4D and electroencephalographic (EEG) coherence in 19 channels (66 pairs of interhemispheric coherence and 54 pairs of intrahemispheric coherence) were measured. The sex-related statistical analyses between 2D : 4D and EEG coherence in controls and patients with schizophrenia were performed using multiple regression. Results In male patients, the relationship between 2D : 4D and right intrahemispheric EEG coherence showed mainly positive correlation in delta and theta frequency bands, while it showed negative correlation in male controls. In female patients, the relationship between 2D : 4D and interhemispheric EEG coherence showed stronger positive correlation in alpha and beta frequency bands, while it showed weaker positive correlation in female controls. Conclusions Low prenatal testosterone may play certain roles in altered correlation between 2D : 4D and cerebral laterality in schizophrenia and the development of schizophrenia by epigenetic mechanism.

Convergence study on the change of cognitive function through the intentional finger movement (의식적 손가락 움직임이 인지기능 변화에 미치는 융합연구)

  • Kim, Kyung-Yoon;Bae, Seahyun
    • Journal of the Korea Convergence Society
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    • v.10 no.5
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    • pp.95-102
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    • 2019
  • This study was to investigate the effect of eye movement and intentional finger movement on cognitive ability. Normal adult subjects were randomly divided into two groups: saccadic eye movement(SEM) and intentional finger movement(IFM). After 2 weeks of intervention, Digit span was used for short-term memory test and N-back was used for working memory test. As a result, the short-term memory of the IFM group increased significantly over time, and the follow-up test showed difference between group. The IFM group's the execution time, the error count and the accuracy rate of n-back item showed significant effects over time. The SEM group's the execution time and the accuracy of n-back item showed significant effects over time. In conclusion, the IFM method, which is a multiple stimulus that can activate the cerebral cortex more extensively than the single stimulus SEM, may be more useful as an intervention method of cognitive function improvement.

Association of heavy metal complex exposure and neurobehavioral function of children

  • Minkeun Kim;Chulyong Park;Joon Sakong;Shinhee Ye;So young Son;Kiook Baek
    • Annals of Occupational and Environmental Medicine
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    • v.35
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    • pp.23.1-23.14
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    • 2023
  • Background: Exposure to heavy metals is a public health concern worldwide. Previous studies on the association between heavy metal exposure and neurobehavioral functions in children have focused on single exposures and clinical manifestations. However, the present study evaluated the effects of heavy metal complex exposure on subclinical neurobehavioral function using a Korean Computerized Neurobehavior Test (KCNT). Methods: Urinary mercury, lead, cadmium analyses as well as symbol digit substitution (SDS) and choice reaction time (CRT) tests of the KCNT were conducted in children aged between 10 and 12 years. Reaction time and urinary heavy metal levels were analyzed using partial correlation, linear regression, Bayesian kernel machine regression (BKMR), the weighted quantile sum (WQS) regression and quantile G-computation analysis. Results: Participants of 203 SDS tests and 198 CRT tests were analyzed, excluding poor cooperation and inappropriate urine sample. Partial correlation analysis revealed no association between neurobehavioral function and exposure to individual heavy metals. The result of multiple linear regression shows significant positive association between urinary lead, mercury, and CRT. BMKR, WQS regression and quantile G-computation analysis showed a statistically significant positive association between complex urinary heavy metal concentrations, especially lead and mercury, and reaction time. Conclusions: Assuming complex exposures, urinary heavy metal concentrations showed a statistically significant positive association with CRT. These results suggest that heavy metal complex exposure during childhood should be evaluated and managed strictly.

Digital Replantation in Industrial Punch Injuries (천공 펀치 기계에 의한 수지 절단부의 재접합술)

  • Lee, Kyu-Cheol;Lee, Dong-Chul;Kim, Jin-Soo;Ki, Sae-Hwi;Roh, Si-Young;Yang, Jae-Won
    • Archives of Reconstructive Microsurgery
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    • v.19 no.1
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    • pp.12-20
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    • 2010
  • Purpose: Industrial punch accidents involving fingers cause segmental injuries to tendons and neurovascular bundles. Although multiple-level segmental amputations are not replanted to regain function, most patients with an amputated finger want to undergo replantation for cosmetic as much as functional reason. The authors describe four cases of digital amputation by an industrial punch that involved the reinstatement of the amputated finger involving a joint and neurovascular bundle. Amputated segments were replanted to restore amputated surfaces and distal segments. Methods: A single institution retrospective review was performed. Inclusion criteria of punch injuries requiring replantation were applied to patients of all demographic background. Injury extent (size, tissue involvement), operative intervention, pre- and postoperative hand function were recorded. Result: Four cases of amputations were treated at our institute from 2004 to 2008 from industrial punch machine injury. Average patient age was 32.5 years (25~39 years) and there were three males and one female. Sizes of amputated segments ranged from $1.0{\times}1.0{\times}1.2\;cm^3$ to $3{\times}1.5{\times}1.6\;cm^3$. Tenorrhaphy was conducted after fixing fractured bone of the amputated segments with K-wire. Proximal and distal arteries and veins were repaired using the through & through method. The average follow-up period was thirteen months (2~26 months), and all replanted cases survived. Osteomyelitis occurred in one case, skin grafting after debridement was performed in two cases. Because joints were damaged in all four cases, active ranges of motion were much limited. However, a secondary tendon graft enhanced digit function in two cases. The two-point discrimination test showed normal values for both static and dynamic tests for three cases and 9 mm and 15 mm by dynamic and static testing, respectively, in one case. Conclusion: Though amputations from industrial punch machines are technically challenging to replant, our experience has shown it to be a valid therapy. In cases involving punch machine injury, if an amputated segment is available, the authors recommend that replantation be considered for preservation of finger length, joint mobility, and overall functional recovery of the hand.

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Factors Associated with Cancer Screening Participation, Korea (암 검진 수검에 영향을 주는 요인)

  • Kwak, Min-Son;Park, Eun-Chul;Bang, Jin-Young;Sung, Na-Young;Lee, Ji-Young;Choi, Kui-Son
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.4
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    • pp.473-481
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    • 2005
  • Objectives : We wanted to identify those factors associated with stomach, colon, breast and cervix cancer screening. Methods : A population-based telephone survey was conducted for 2 weeks (the 9th-23th of July, 2004) by trained interviewers with using a questionnaire. 2,598 respondents (females aged 30 years or over, and the males aged 40 years or over) were selected by random-digit dialing that was based on the 2000 Population and Housing Census. The data on socio-demographic, health behavior and enabling factors were collected. 2,571 respondents were included in analysis. The cancer screening rate was classified into 2 categories : the life time screening rate and the screening rate with recommendations. Results : For the 2,571 respondent s, the life time screening rate was as follows: 52.0% (Stomach), 25.3% (Colon), 55.9% (Breast) and 76.8% (Cervix). The screening rate with recommendation was as follows : 3 9.2% (Stomach), 20.6% (Colon), 42.5% (Breast) and 58.3% (Cervix). On a multiple logistic regression analysis of the life time screening, statistically significant relationships were observed for the screening intention, the health exam, the disease history, the age of the patients and the cancer screening rates. On a multiple logistic regression analysis of the screening with recommendation, statistically significant relationships were observed for the screening intention, the health exam, the age of the patients, the concern about the risk of cancer, the voluntary health insurance for cancer and the cancer screening rates. Conclusions : The results of this study suggest that the cancer screening intention, the health exam and the age of the patients are the most important factors to participate in life time cancer screening and also screening with recommendations. A positive association was also observed for the concern about the risk of cancer, the voluntary health insurance for cancer. It is hoped that this study will be a base line data for suggesting the representative cancer screening rate in Korea.

Secure Certificates Duplication Method Among Multiple Devices Based on BLE and TCP (BLE 및 TCP 기반 다중 디바이스 간 안전한 인증서 복사 방법)

  • Jo, Sung-Hwan;Han, Gi-Tae
    • KIPS Transactions on Computer and Communication Systems
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    • v.7 no.2
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    • pp.49-58
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    • 2018
  • A certificate is a means to certify users by conducting the identification of the users, the prevention of forgery and alteration, and non-repudiation. Most people use an accredited certificate when they perform a task using online banking, and it is often used for the purpose of proving one's identity in issuing various certificates and making electronic payments in addition to online banking. At this time, the issued certificate exists in a file form on the disk, and it is possible to use the certificate issued in an existing device in a new device only if one copies it from the existing device. However, most certificate duplication methods are a method of duplication, entering an 8-16 digit verification code. This is inconvenient because one should enter the verification code and has a weakness that it is vulnerable to security issues. To solve this weakness, this study proposes a method for enhancing security certificate duplication in a multi-channel using TCP and BLE. The proposed method: 1) shares data can be mutually authenticated, using BLE Advertising data; and 2) encrypts the certificate with a symmetric key algorithm and delivers it after the certification of the device through an ECC-based electronic signature algorithm. As a result of the implementation of the proposed method in a mobile environment, it could defend against sniffing attacks, the area of security vulnerabilities in the existing methods and it was proven that it could increase security strength about $10^{41}$ times in an attempt of decoding through the method of substitution of brute force attack existing method.

Effects of phonological awareness and phonological processing on language skills in 4- to 6-year old children with and without language delay (4~6세 일반아동 및 언어발달지연 아동의 음운인식 및 음운처리 능력이 언어 능력에 미치는 영향)

  • Kim, Shinyoung;Son, Jinkyeong;Yim, Dongsun
    • Phonetics and Speech Sciences
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    • v.12 no.1
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    • pp.51-63
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    • 2020
  • Phonological awareness is a metalinguistic awareness ability of phonology and is known to predict language skills, such as reading and vocabulary skills. The purpose of this study was to investigate the relationship between phonological awareness, phonological processing, and language skills in 4- to 6-years-old typically developing (TD) children and children with language delay (LD). A total of 32 children (TD=18, LD=15) participated in this study. They performed a phonological awareness task consisting of counting, deletion, and discrimination at syllable level. Nonword Repetition, Digit Backward, Receptive & Expressive Vocabulary Test, and Grammaticality Judgment Task were performed to analyze the correlation between phonological awareness, phonological processing, and language ability. A multiple stepwise regression analysis was performed to examine the phonological awareness subtasks that predict language ability. In the TD group, the syllable categorization task significantly predicted the receptive vocabulary and the performance of the Grammaticality Judgment Task. The LD group showed that the syllable counting task significantly predicted the receptive vocabulary, the expressive vocabulary, and the performance of the Grammaticality Judgment Task. The results showed that the phonological awareness performance was significantly different between the two groups. Further, correlation analysis and regression analysis showed different results for each group. The result of the phonological awareness performance predicted the language ability of each group significantly, suggesting the importance of the meta-linguistic awareness ability of phonology.