• Archives of Plastic Surgery
• /
• v.41 no.3
• /
• pp.264-270
• /
• 2014

Background The technique of delayed-immediate breast reconstruction includes immediate insertion of a tissue expander, post-mastectomy radiation, followed by reconstruction. The aesthetic benefits of delayed-immediate reconstruction compared to delayed reconstruction are postulated but remain unproven. The purpose of this study was to compare aesthetic outcomes in patients following delayed and delayed-immediate autologous breast reconstruction. Methods A retrospective analysis was performed of all patients who underwent delayed or delayed-immediate autologous breast reconstruction by the senior author from 2005 to 2011. Postoperative photographs were used to evaluate aesthetic outcomes: skin quality, scar formation, superior pole contour, inferior pole contour, and overall aesthetic outcome. Ten non-biased reviewers assessed outcomes using a 5-point Likert scale. Fisher's Exact and Wilcoxon-Mann-Whitney tests were used for comparative analysis. Results Patient age and body mass index were similar between delayed (n=20) and delayed-immediate (n=20) cohorts (P>0.05). Skin and scar quality was rated significantly higher in the delayed-immediate cohort (3.74 vs. 3.05, P<0.001 and 3.41 vs. 2.79, P<0.001; respectively). Assessment of contour-related parameters, superior pole and inferior pole, found significantly improved outcomes in the delayed-immediate cohort (3.67 vs. 2.96, P<0.001 and 3.84 vs. 3.06, P<0.001; respectively). Delayed-immediate breast reconstruction had a significantly higher overall score compared to delayed breast reconstructions (3.84 vs. 2.94, P<0.001). Smoking and the time interval from radiation to reconstruction were found to affect aesthetic outcomes (P<0.05). Conclusions Preservation of native mastectomy skin may allow for improved skin/scar quality, breast contour, and overall aesthetic outcomes following a delayed-immediate reconstructive algorithm as compared to delayed breast reconstruction.

• Korean journal of food and cookery science
• /
• v.32 no.1
• /
• pp.123-135
• /
• 2016

The purpose of this study was to evaluate the effectiveness of an intervention program using dietary consult and physical exercise conducted by public health center in Chuncheon city for obese adults. This study used a pretest-posttest design. The subjects were 58 out of 90 obese adults with body mass index (BMI) greater than $25kg/m^2$ who completed all education sessions for 8 weeks. Data on dietary habits, dietary behaviors, nutritional knowledge, anthropometric parameters and biochemical indices and daily nutrient intakes assessed by a 24-hour recall were collected before and after the intervention program., in order to evaluate program effectiveness. After the intervention, there were positive changes in exercise status and dietary habits and nutrition knowledge accuracy. Especially, the answer of 'I drink a cup of milk every day' were significantly improved (p<0.001), and the answer of 'I don't overeat', which is a dietary attitude question was significantly improved (p<0.05). Dietary intakes of most of nutrients were not significantly different between pre-test and post-test. But calcium (p<0.05), potassium (p<0.05), vitamin A (p<0.01), vitamin E (p<0.05), and folic acid (p<0.05) were significantly increased in the female group after the intervention. Weight (p<0.05), BMI (p<0.01), blood pressure (p<0.001), were significantly decreased after program, but changes of skeletal muscle mass, body fat mass were not significant. Resting heart rate (p<0.01), flexibility (p<0.001), whole body reaction (p<0.05), grip strength (p<0.01) and balance (p<0.01) showed positive changes after the intervention. Blood glucose level in serum was significantly decreased (p<0.001). These results indicated that dietary education and exercise program was effective not only for weight reduction but also for the improvement of physical fitness in obese adults.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.6 no.2
• /
• pp.105-109
• /
• 2005

We heat treated pure sapphire samples at $1800^{\circ}C{\sim}100$ hours in BeO-${Al_2}{O_3}$ powder by varying BeO contents of $5{\sim}50\;wt%$ in order to quantify the BeO diffusion enhancement for corundum gem stones. We investigated the heat treated samples with visual evaluation, color coordination analysis, and surface roughness measurement. We confirmed that $Be^{2+}$ ions did not lead to orange color but to dark gray. The lightness in CIE Lab index decreased while surface roughness increased rapidly as BeO contents increased. We propose that BeO yellow color enhancement may be feasible only for $Fe^{3+}$ rich blue sapphires and sub-5% BeO content be appropriate to shorten post re- cutting process.

• Archives of Plastic Surgery
• /
• v.40 no.1
• /
• pp.19-27
• /
• 2013

Background Acellular dermal matrix (ADM) allografts and their putative benefits have been increasingly described in prosthesis based breast reconstruction. There have been a myriad of analyses outlining ADM complication profiles, but few large-scale, multi-institutional studies exploring these outcomes. In this study, complication rates of acellular dermis-assisted tissue expander breast reconstruction were compared with traditional submuscular methods by evaluation of the American College of Surgeon's National Surgical Quality Improvement Program (NSQIP) registry. Methods Patients who underwent immediate tissue expander breast reconstruction from 2006-2010 were identified using surgical procedure codes. Two hundred forty tracked variables from over 250 participating sites were extracted for patients undergoing acellular dermis-assisted versus submuscular tissue expander reconstruction. Thirty-day postoperative outcomes and captured risk factors for complications were compared between the two groups. Results A total of 9,159 patients underwent tissue expander breast reconstruction; 1,717 using acellular dermis and 7,442 with submuscular expander placement. Total complications and reconstruction related complications were similar in both cohorts (5.5% vs. 5.3%, P=0.68 and 4.7% vs. 4.3%, P=0.39, respectively). Multivariate logistic regression revealed body mass index and smoking as independent risk factors for reconstructive complications in both cohorts (P<0.01). Conclusions The NSQIP database provides large-scale, multi-institutional, independent outcomes for acellular dermis and submuscular breast reconstruction. Both thirty-day complication profiles and risk factors for post operative morbidity are similar between these two reconstructive approaches.

• Journal of the Korean Society of Physical Medicine
• /
• v.6 no.2
• /
• pp.235-246
• /
• 2011

Purpose: The aim of this study is to compare and assess the effects of lumbar stabilization exercise on the balance ability of young college studets with low back pain after having performed spinal stabilization exercise by using 3-dimensional air-balance system and gym ball. Methods: The subjects of this study were 34 low back patients in their early twenties. They were divided into two groups: 3-dimensional lumbar stabilization exercise group(N=17) and gym ball lumbar stabilization exercise group(N=17). The period of the intervention was for five weeks. VAS(Visual Analogue Scale) for pain test, ODI(Oswestry Disability Index) for ADL limitation test, Tetrax system for static balance test, and Air-balance system 3D for dynamic balance test were used as evaluation tools for this study. Results: Pain showed significant decrease in both groups after having performed the experiment, but ADL limitation of the groups did not show any remarkable difference between before and after the experiment. Dynamic balance ability in the 8-directional angle comparison test significantly increased in all directions except for the backward, left-backward, and right-backward directions. As for dynamic balance ability in the 8-directional postural test, 3D exercise group showed statistically significant reduction in every direction while gym ball exercise group did not(p<.05). However, when it comes to static balance ability in the weight distribution and stability test, there was not significantly change between pre and post test in both groups. Conclusion: This study shows 3-dimensional lumbar stabilization exercise is more effective in the lumbar stabilization of coordinated movement than gym ball exercise, which may imply that 3D air-balance system can be used for the therapeutic treatment of body imbalance for patients with low back pain.

• Proceedings of the Korea Water Resources Association Conference
• /
• 2016.05a
• /
• pp.197-197
• /
• 2016

Forecasting future drought events in a region plays a major role in water management and risk assessment of drought occurrences. The creeping characteristics of drought make it possible to mitigate drought's effects with accurate forecasting models. Drought forecasts are inevitably plagued by uncertainties, making it necessary to derive forecasts in a probabilistic framework. In this study, a new probabilistic scheme is proposed to forecast droughts, in which a discrete-time finite state-space hidden Markov model (HMM) is used aggregated with the Representative Concentration Pathway 8.5 (RCP) precipitation projection (HMM-RCP). The 3-month standardized precipitation index (SPI) is employed to assess the drought severity over the selected five stations in South Kore. A reversible jump Markov chain Monte Carlo algorithm is used for inference on the model parameters which includes several hidden states and the state specific parameters. We perform an RCP precipitation projection transformed SPI (RCP-SPI) weight-corrected post-processing for the HMM-based drought forecasting to derive a probabilistic forecast that considers uncertainties. Results showed that the HMM-RCP forecast mean values, as measured by forecasting skill scores, are much more accurate than those from conventional models and a climatology reference model at various lead times over the study sites. In addition, the probabilistic forecast verification technique, which includes the ranked probability skill score and the relative operating characteristic, is performed on the proposed model to check the performance. It is found that the HMM-RCP provides a probabilistic forecast with satisfactory evaluation for different drought severity categories, even with a long lead time. The overall results indicate that the proposed HMM-RCP shows a powerful skill for probabilistic drought forecasting.

• Archives of Plastic Surgery
• /
• v.49 no.5
• /
• pp.633-641
• /
• 2022

Introduction In chronic facial palsy, synkinetic muscle overactivity and shortening causes muscle stiffness resulting in reduced movement and functional activity. This article studies the role of multimodal therapy in improving outcomes. Methods Seventy-five facial palsy patients completed facial rehabilitation before being successfully discharged by the facial therapy team. The cohort was divided into four subgroups depending on the time of initial attendance post-onset. The requirement for facial therapy, chemodenervation, or surgery was assessed with East Grinstead Grade of Stiffness (EGGS). Outcomes were measured using the Facial Grading Scale (FGS), Facial Disability Index, House-Brackmann scores, and the Facial Clinimetric Evaluation scale. Results FGS composite scores significantly improved posttherapy (mean-standard deviation, 60.13 ± 23.24 vs. 79.9 ± 13.01; confidence interval, -24.51 to -14.66, p < 0.0001). Analysis of FGS subsets showed that synkinesis also reduced significantly (p < 0.0001). Increasingly, late clinical presentations were associated with patients requiring longer durations of chemodenervation treatment (p < 0.01), more chemodenervation episodes (p < 0.01), increased doses of botulinum toxin (p < 0.001), and having higher EGGS score (p < 0.001). Conclusions This study shows that multimodal facial rehabilitation in the management of facial palsy is effective, even in patients with chronically neglected synkinesis. In terms of the latency periods between facial palsy onset and treatment initiation, patients presenting later than 2 years were still responsive to multimodal treatment albeit to a lesser extent, which we postulate is due to increasing muscle contracture within their facial muscles.

• Clinical Pain
• /
• v.19 no.1
• /
• pp.1-7
• /
• 2020

Objective: A prospective, assessor-blinded, randomized controlled trial was conducted in patients with chronic low back pain to evaluate the efficacy of portable low power laser therapy (LPLT) and the effect when combined with exercise therapy on pain and functions. Method: 60 patients were recruited and 56 patients, excluding 4 dropouts, were randomly allocated to the LPLT group (Group 1: 19 patients), placebo laser therapy with exercise group (Group 2: 18 patients), and LPLT with exercise group (Group 3: 19 patients). Laser therapy and exercise was performed five times a week for 4 weeks. Visual analogue scale (VAS), Schober test, lumbar range of motion (ROM) measures (flexion, extension and lateral flexion), Oswestry Disability index (ODI) were measured at baseline, at 4 weeks after intervention, and at 6 weeks after 2 weeks of no intervention. Results: Statistically significant improvements were noted in all group by time interaction with respect to all outcome parameters (p<0.05). All parameters in each group improved not only in the period of treatment (4 weeks), but also in the final evaluation (6 weeks) 2 weeks after the end of treatment. Post-hoc analysis showed statistically significant difference between the LPLT with exercise group and the other groups in all outcome parameters except for the ODI at 4 weeks and at 6 weeks. Conclusion: Portable LPLT is effective treatment in reducing pain and improving lumbar ROM and with exercise is more effective than laser or exercise monotherapy for the chronic low back pain patients.

• KSCE Journal of Civil and Environmental Engineering Research
• /
• v.43 no.6
• /
• pp.801-809
• /
• 2023

Road construction projects have a long duration so cost overruns and schedule delays are occurred. However, performance assessment system that can manage and prepare for this in advance is insufficient. In addition, road construction are affected by many factors during under construction. Therefore it is necessary to conduct performance assessment considering the characteristics of roads and prepare for similar projects in the future. The purpose of this study is to provide a framework to evaluate construction phase performance and present a performance management plan using road construction information. Also, This study conducted time adjustment between the start and the finish of the project and developed performance metrics based on absolute and relative indicator. This study analyzed the cost, schedule, and changes of the road project construction process, showing the possibility of advancement of performance assessment and how to use it when planning new road construction projects.

• Smart Structures and Systems
• /
• v.33 no.2
• /
• pp.119-131
• /
• 2024

Drift angle is a significant index for diagnosing post-event structures. A common way to estimate this drift response is by using modal parameters identified under natural excitations. Although the modal parameters of shear structures cannot be identified accurately in the real environment, the identification error has little impact on the estimation when measurements from several floors are used. However, the estimation accuracy falls dramatically when there is only one accelerometer. This paper describes the susceptibility of single sensor identification to modelling error and simulations that preliminarily verified this characteristic. To make a robust evaluation from measurements of one floor of shear structures based on imprecisely identified parameters, a novel scheme is devised to approximately correct the mode shapes with respect to fictitious frequencies generated with a genetic algorithm; in particular, the scheme uses constrained minimization to take both the mathematical aspect and the realistic aspect of the mode shapes into account. The algorithm was validated by using a full-scale shear building. The differences between single-sensor and multiple-sensor estimations were analyzed. It was found that, as the number of accelerometers decreases, the error rises due to insufficient data and becomes very high when there is only one sensor. Moreover, when measurements for only one floor are available, the proposed method yields more precise and appropriate mode shapes, leading to a better estimation on the drift angle of the lower floors compared with a method designed for multiple sensors. As well, it is shown that the reduction in space complexity is offset by increasing the computation complexity.