• Archives of Plastic Surgery
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• 제37권5호
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• pp.667-670
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• 2010

Purpose: The management of urethral defect represents one of the most challenging clinical problems in uroplastic surgery. Especially for defect after Fournier's Gangrene, optimal management is still a hard problem. During extensive urethral reconstruction, to overcome the poor vascularity due to periurethral scarred tissue and limitation of the choice of local flap, we report our experience with one-stage reconstruction of urethral defect using a longitudinal tubed flap of scrotal skin. Methods: A 72-year-old man with several years of diabetes mellitus history visited for swelling and pain of scrotal area. After diagnosis of Fournier's Gangrene, radical debridement was performed and 6 cm of urethral defect on border of penile-scrotal ventral area was made. Rectangular scrotal skin flap ($6{\times}2.5\;cm$) based on external spermatic fascia was elevated and tubed longitudinally. After transfer the flap to the defect area, end-to-end anastomosis was performed bilaterally. Results: 4 weeks after the operation, the patient started voiding him-self and urethrography showed good fluence of contrast agent. Long term evaluation reveals stable performance characteristics without any complications. Conclusion: We suggest a one-stage reconstruction of extensive urethral defect using a longitudinal tubed flap of scrotal skin. Advantages of this procedures are simple, one-stage reconstruction with the reliable scrotal skin flap based on external spermatic fascial vasculature, and no donor morbidity.

• 한국물환경학회지
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• 제23권3호
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• pp.319-323
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• 2007

The Advanced Oxidation Process (AOP) is being increasingly used to oxidize complex organic constituents in treated effluents from domestic wastewater treatment plants. Generally, ${NO_3}^--N$ concentrations ranges between 5 and 8 mg/L for biologically well-treated effluents. However, nitrate ions, ${NO_3}^-$, affects on oxidation as not only a well-known strong absorber of UV light below 250 nm of wavelength but also as an OH radical scavenger. The objective of this study was to evaluate the AOP systems for degradation of 2,4-DCP, and to delineate the effect of nitrate ions on UV oxidation of 2,4-DCP by conducting a bench-scale operation at various reaction times and initial concentrations of $H_2O_2$. The experimental results indicated that 2,4-DCP could be completely oxidized by $UV/H_2O_2$ process with an initial $H_2O_2$ concentration of 20 mg/L at a retention time of 1.0 min or longer. Nitrate ions did not show any adverse effect on 2,4-DCP oxidation at this high $H_2O_2$ concentration, and the practical initial $H_2O_2$ concentration and reaction time for the 80% oxidation turned out to be 5 mg/L and 1.0 min, respectively.

• 한국멀티미디어학회논문지
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• 제13권4호
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• pp.526-534
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• 2010

본 논문에서는 노출 시간을 달리해 촬영한 두 장의 HDR 사진을 LCD, CRT 같은 LDR 장치에 출력할 수 있도록 융합하는 알고리즘에 대해 기술하였다. 제안된 기법은 레이디언스 맵을 만들지 않고 직접 입력 영상에 대해 계산된 가중치를 이용해 융합한다. 가중치는 처음에는 화소 단위로 만들어져 추후 가우시안 함수로 혼합된다. 이러한 작업은 급격한 가중치 변화로 발생할 수 있는 스파클 잡음을 방지하고 두 영상 정보의 연결 부분을 부드럽게 만드는데 기여한다. 색상 정보의 융합은 RGB와 이들의 평균값과의 차이를 이용해 두 영상의 색차 정보를 가중평균하여 이루어진다. 본 알고리즘은 두 원본 영상에서 포화되지 않은 부분을 잘 표현하고 포화, 불포화 영역간의 연결이 부드러운 특징이 있다. 제안된 기법은 2장의 사진만을 사용하고 영상에 따라 자동으로 내부 인자를 조절하기 때문에 향후 이중 노출이나 이중 센서 셀을 이용한 HDR 카메라에 내장하여 자동화 처리가 가능한 장점이 있다.

• Archives of Reconstructive Microsurgery
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• 제5권1호
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• pp.46-55
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• 1996

The purpose of this study is to investigate if there is a higher rate of free flap failure in cases of vein grafts compared to non-vein graft, and to analyze the clinical usefulness and necessity in elective free flap surgery. We have used 24 vein grafts in 208 free flaps from May, 1986 until August, 1995. Vein grafts were from 2cm to 50cm in length between the recipient and donor vessels. Reconstructed sites were 10 lower extremities, 8 head and neck, 4 hand, and 2 trunk. Vein grafts were used 14 for arterial, 6 venous, 4 in both arterial and venous anastomoses. We intentionally used long vein grafts longer than 5cm for improved blood flow in cases of peripheral vascular disease, radionecrotic wounds, lower leg trauma. Short vein grafts of about 3cm in length were used to overcome the shortage of vascular length in cases of unexpected vessel anomaly, short donor vessel, and difficult access to recipient vessels after radical neck dissection. All veins were carefully handled with ligation of very small branches and were transferred to the recipient site without irrigation. 8 flaps were failed out of a total of 208 free flaps, however there was no failure among the 24 cases that needed vein grafts between the donor and recipient vessels. Success rates between non-vein grafts free flaps and vein graft free flaps were 95.6%(8/184) and 100%(0/24). Even though the vein grafts increase the operation time and the number of anastomoses, they do not result in any increased failure rate of free flap surgery(4.4% versus 0%). In addition to the reducing tension between recipient and donor vessels, the surgeon can select better recipient vessels with excellent blood flow so that vein grfats in microsurgery can provide a high success rate of free flaps.

• Journal of Korean Neurosurgical Society
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• 제29권11호
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• pp.1445-1450
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• 2000

Objectives : The Objective of this study was to analyze the prognostic factors affecting survival in the patients with glioblastomas. Methods : We retrospectively studied 55 consecutive patients with glioblastomas who were admitted to neurosurgery department from January 1988 to March 1998. Fifteen pateients were excluded from the analysis because of follow-up loss and surgical motality. There were 24 male and 16 female patients, with a mean age of 51 years. Surgery consisted of biopsy in 4(10.0%) patients, subtotal resection in 9(22.5%) patients and gross total resection in 27(67.5%) patients. Nine(22.5%) patients received second operation. Twenty-eight(70%) received postoperative radiation therapy. Various levels of radiation dose were used, 6,000 rad over 7 weeks in most cases. The variable factors were examined for their relationship with survival ; age at the time of diagnosis, gender, duration of neurological symptoms, preoperative neurological state(Karnofsky performance score), extent of surgical resection, location of tumor, reoperation, and postoperative radiotherapy and chemotherapy. Result : The mean survival time was 55 weeks, three(7.5%) of the 40 patients survived more than two years. Survival time with biopsy only cases was 24 weeks, for those with subtotal resection 43 weeks, and for those with gross total resection 67 weeks. A mean survival time from the time of reoperation was 42 weeks. Statistically significant survival factors in glioblastoma were extent of surgical resection, postoperative radiotherapy and reoperation. Summary : Results of our series support the views that the extent of surgery, reoperation and postoperative radiation are important prognostic factors. We also recommend radical tumor removal, postoperative radiotherapy and reoperation, if possible.

• Radiation Oncology Journal
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• 제12권3호
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• pp.369-376
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• 1994

This is a retrospective analysis of 64 patients who was treated with postoperative radiation therapy after radical hysterectomy and bilateral pelvic lymphadenectomy (53 patients) or total abdominal hysterectomy(11 patients) for uterine cervix cancer between May 1980 and September 1991 at the Department of Radiation Oncology, Kyung Hee University Hospital. Most patients were FIGO IB (31 Patients) and IIA (25 patients), and median period of follow-up was 5.1 years. Of these patients,24 received adjuvant whole pelvis irradiation of 6000 cGy and 40 received 5000-5500 cGy whole pelvis irradiation and/or intracavitary radiation (7 Patients). The actuarial overall and relapse free 5 year survival rate were $71.0\%$, $68.3\%$ respectively. The survival rates by stage were $79.1\%$ in stage I, and $61.2\%$ in stage II. Treatment failure was noted in 18 of 64 patients ($28.1\%$), Iocoregional failure in 8 ($12.5\%$), distant metastasis in 8 ($12.5\%$), paraaortic node metastasis in 1 and one patient and concurrent locoregional and distant metastasis. The univariate analysis of prognostic factors affecting to overall survival rate represented lymph node status, the number and site of metastatic lymph node, parametrial invasion, the thichness of cervical wall invasion, and size of cancer mass. Histology, vessel invasion, endometrial extension, hemoglobin level. resection margin status, age, radiation dose were not significant prognostic factors. Complication relating to operation and postoperative radiation were variable according to radiation therapy method: 6000 cGy RT group 8/24($33.3\%$), 5000-5500 cGy+ICR 3/7 ($42.9\%$), 5000-5500 cGy external RT only group 3/33 ($9.1\%$). In conclusion, the results suggest that postoperative radiotherapy is necessary in high risk patients for locoregional control and improving survival rate, and higher dose does not improve results but only increases complication.

• The Korean Journal of Pain
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• 제11권1호
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• pp.41-46
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• 1998

Background: Preoperative analgesia may prevent nociceptive inputs generated during surgery from sensitizing central neurons and therefore may preempt postoperative pain. Although preemptive analgesia has shown to decrease postinjury pain in animals, studies in human are not consistent. We studied whether epidural morphine injection before surgical incision could affect postoperative pain and analgesic demands, compared with injection after removal of specimen. Methods: Forty patients scheduled for radical subtotal gastrectomy were randomly assigned to one of two groups for prospective study in a double-blind manner. Group 1 received an epidural injection of 3 mg of morphine in 8 ml of 0.9% saline before surgical incision, and Group 2 after removal of specimen. Postoperative pain relief was provided with I.V. patient controlled analgesia (PCA) system. Numerical rating scales for pain and mood, Prince Henry Hospital scores for pain, cumulative PCA analgesic consumptions, and incidence of side effects were assessed at 2, 6, 12, 24, 48 hours after operation. Results: Cumulative PCA analgesic consumption in group 1 was significantly less than in group 2 at 2, 6 hours after surgery. Pain scores and the incidence of side effects were similar in both groups. Conclusions: Preoperative analgesia with epidural morphine showed little difference in patient controlled analgesic consumption after upper abdominal surgery compaired to intraoperative morphine.

• 지식경영연구
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• 제17권2호
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• pp.27-50
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• 2016

Korean manufacturing industry have recently faced the catch-up of China in the mass commodity product, such as automotive, display, and smart phone in terms of market as well as technology. Accordingly, discussion on the importance of achieving catch-up in complex product systems (CoPS) has been increasing as a new innovation engine for the industry. In order to achieve successful catch-up of CoPS, we explored emerging technologies of CoPS, which are featured by the characteristics of radical novelty, relatively fast growth and self-sustaining, through the study of emerging technologies of gas turbine for power generation. We found that emerging technologies of the gas turbine are technologies for combustion nozzle and composition of electrical machine for increasing power efficiency, washing technology for particulate matter, cast and material processing technology for enhancing durability from fatigue, cooling technologies from extremely high temperature, interconnection operation technology between renewable energy and the gas turbine for flexibility in power generation, and big data technology for remote monitoring and diagnosis of the gas turbine. We also found that those emerging technologies resulted in technological progress of the gas turbine by converging with other conventional technologies in the gas turbine. It indicates that emerging technologies in CoPS can be appeared on various technological knowledge fields and have complementary relationship with conventional technologies for technology progress of CoPS. It also implies that latecomers need to pursue integrated learning that includes emerging technologies as well as conventional technologies rather than independent learning related to emerging technologies for successful catch-up of CoPS. Our findings provide an important initial theoretical ground for investigating the emerging technologies and their characteristics in CoPS as well as recognizing knowledge management strategy for successful catch-up of latecomers. Our findings also contribute to the policy development of the CoPS from the perspective of innovation strategy and knowledge management.

• Journal of Gastric Cancer
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• 제1권1호
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• pp.17-23
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• 2001

Purpose: The purpose of this study is to analyze the clinicopathologic characteristics of gastric cancer patients and to evaluate the survival and prognostic factors and effect of immunochemosurgery for gastric cancer patients. Materials and Methods: The clinicopathologic characteristics were analyzed for 12,277 consecutive patients who underwent operation for gastric cancer from 1970 to 1999. We also evaluated the survival and prognostic factors for 9,262 consecutive patients from 1981 to 1996. The prognostic significance of treatment modality [surgery alone, surgery+chemotherapy, surgery+immunotherapy+chemotherapy (immunochemosurgery)] were evaluated in stage III gastric cancer. Results: The 5-year survival rate (5-YSR) of overall patients was $55.8\%$, and that of patients who received curative resection was $64.8\%$. The 5-YSRs according to TNM stage were $92.9\%$ for Ia, $84.2\%$ for Ib, $69.3\%$ for II, $45.8\%$ for IIIa, $29.6\%$ for IIIb and $9.2\%$ for IV. Regarding adjuvant treatment modality, significant survival difference was observed in stage III patients. The 5-year survival rates were $44.8\%$ for immunochemosurgery group, $36.8\%$ for surgery+chemotherapy group and $27.2\%$ for surgery alone group. Curative resection, depth of invasion and lymph node metastasis were the most significant prognostic factors in gastric cancer. Conclusion: Consequently, early detection and curative resection with radical lymph node dissection, followed by immunochemotherapy especially in patients with stage III gastric cancer should be recommended as a standard treatment principle for patients with gastric cancer.

• Journal of Gastric Cancer
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• 제14권3호
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• pp.156-163
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• 2014

Purpose: Information regarding antimicrobial prophylaxis (AMP) for gastric cancer surgery is limited. The present study investigated the efficacy of single-dose AMP for the prevention of surgical site infection (SSI) in patients undergoing gastrectomy for gastric carcinoma. Materials and Methods: Between 2011 and 2013, 1,330 gastric carcinoma surgery patients were divided into two AMP administration groups depending on the duration of treatment. Postoperative outcomes including morbidity and SSI were compared between the two groups overall and in matched patients. Risk factors for SSI were analyzed. Results: The extended group (n=1,129) received AMP until postoperative day 1 and the single-dose group (n=201) received single-dose AMP only during an operation. Postoperatively, there were no significant differences between the two groups with respect to overall morbidity, mortality, or length of hospital stay. The SSI rate of the single-dose group was not significantly different from that of the extended group overall (4.5% vs. 5.5%, respectively, P=0.556) or in matched patients (4.5% vs. 4.0%, respectively, P=0.801). There was no increase in the SSI rate of the single-dose group compared to the extended group in subgroups based on different clinicopathological and operative factors. Univariate and multivariate analyses revealed male gender, open surgery, and operating time (${\geq}180$ minutes) as independent risk factors for SSI. Conclusions: Single-dose AMP showed no increase in the postoperative SSI rate compared to postoperative extended use in patients undergoing gastrectomy for gastric carcinoma. The efficacy of single-dose AMP requires further investigation in randomized clinical trials specific to gastric cancer surgery.