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Replantation of the Great Toe (족무지 재접합술)

  • Kim, Joo Sung;You, Sun O;Yoon, Jun O;Kim, Jin Sam;Woo, Sang Hyun;Lee, Gi Jun
    • Archives of Reconstructive Microsurgery
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    • v.13 no.1
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    • pp.7-13
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    • 2004
  • Purpose: The purpose of this study was to present the clinical analysis of the results and our experience of the replantation surgery of the great toe. Materials and Methods: Between March 1995 and December 2002, twelve great toes, amputated from the distal phalanx to proximal phalanx were replanted. The complete types were 5 cases and incomplete types were 7 cases. The guillotine injuries were 4 cases and the crushing injuries were 8 cases. Results: Replantation in eleven out of the twelve amputations survived. The cases of revision were 3 cases due to venous thrombosis. Patients were followed up for a mean period of 2.2 years. The mean total active motion of the first MTP joint was $80^{\circ}$. The fusion of IP joint was carried in 7 cases due to the amputation of the IP joint level. The shortening of the replanted great toes was present, with average 0.9cm. The two point discrimination was 7-8mm except 2 cases with loss of nerve. Conclusion: Although replantation of the great toe remains to be controversial, replantation of the great toe should be considered in well-motivated patients because successful replantation regains an important component of the foot and good functional, cosmetic results.

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Managing Information as Records Asset : Public Records Policies in the Digital Transformation Era (디지털 전환 시대의 공공기록정책 기록자산으로서 정보의 관리)

  • Seol, Moon-won
    • The Korean Journal of Archival Studies
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    • no.63
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    • pp.5-36
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    • 2020
  • The E-government Act is in the complete revision process to promote the digital information preservation of the administrative information systems although the preservation of digital information in public sectors is now being regulated by the Public Records Act. In this challenging situation reconstruction of the public records policies has become a task that can no longer be delayed. The current public records policies are insufficient to manage various forms of digital information. The purpose of this study is to suggest the directions of the public records policies in digital transformation era. To this end, it analyze the recent changes in public records policies in the U.K. and Australia as leading models. The analysis derives four trends such as; i) extending management policies from declared records to all information, ii) adopting digital continuity policy, iii) managing information as records asset, and iv) establishment of information governance systems at national level.

Issues and Solutions of Restructuring Private Universities (사립대학의 구조조정을 둘러싼 쟁점과 합리적 해결 방안)

  • Choe, Ho-Seong
    • Journal of Fisheries and Marine Sciences Education
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    • v.24 no.6
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    • pp.901-919
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    • 2012
  • The purpose of this study is to conceptualize some issues around university restructuring in Korea, and explore rational-practical solutions ensuring the survival of higher education institutes confronting many challenges like rapid decreasing rate of birth, global open market of higher education system, and the phenomena of concentration on capital city area etc.. In order to achieve study goals, higher education policies and provisions of past governments from DaeJung Kim's to current MeongBak Lee's were analyzed, and also characteristics and directions of university restructuring of each government were identified. Through this analysis, it was evident that the main concern of university restucturing discourse was primarily focused on how to make public universities have high level of competitiveness. On the other hand, private universities had been totally alienated from university restructuring discourse since 1990's, despite their historical and great contributions to national development of our country. Based on some criticisms of educational policies of national government and partial revision proposal of the higher education act initiated by a few assemblymen, this study suggested eight solutions for developmental restructuring of private universities; constructing comprehensive framework of university restructuring, keeping market-friendly restructuring principle to allow universities take an autonomous position, revising methods, criteria and indexes of university evaluation, reducing the number of enrolling students, not the number of universities and colleges, a new policy to develop local universities allying with universities located at capital city area, differentiating private universities into two types of semi- or quasi-national university and complete autonomous university, legislating financial supports to private universities, and lastly, equal treatment of public and private universities in pursuit of half price tuition.

History and Law of Child-care in Korea (한국 보육의 역사 및 관련법과 현황)

  • Cho, Bok Hee;Kang, Hee Kyung;Kim, Yang Eun;Han, You Me
    • Korean Journal of Childcare and Education
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    • v.9 no.5
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    • pp.381-405
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    • 2013
  • This study aims to prepare basic resources for the development of child-care by figuring out the main characteristics of child-care history, laws, and current status in Korea. First of all, in the section of child-care history, the overall trend of child-care affaires were examined by classifying it into stage 1-Child Welfare Act, stage 2-Early Childhood Education Promotion Act, stage 3-Initial Period of Child-Care Act and stage 4-Complete Revision of Child-Care Act. Second, as for child-care related laws, basic laws such as Infant and Child-Care Act, and related laws such as Early Childhood Education Act and Child Welfare Act and other related laws such as Equal Employment Opportunity and Work Family Balance Assistance Act, act on Support for Disabled Children's Welfare and Social Welfare Services Act, the information related to child-care was specified. Third, as for current status of child-care, general status, status of child-care centers and children, and types of child-care centers were examined respectively.

The Revision of Sajik Ritual System during the early Ming Dynasty and the Debates about National Sajik Altar Alteration during the early Joseon Dynasty (명 초 사직단 제도 개정과 조선 초 사직단 논쟁)

  • Baik, So-Hun
    • Journal of architectural history
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    • v.24 no.5
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    • pp.21-32
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    • 2015
  • Sajik, the altar of land and grain was treated as one of the most important national ritual facilities by the Joseon dynasty and the Ming dynasty because it symbolized the legitimacy of a dynasty, and its architectural ordonnance was arranged strictly by the government. But when the Joseon government considered to reconstruct its national Sajik altar in Hanyang during the Sejong period, they found the new architectural ordonnance for local Sajik altars recorded in "Hongwulizhi(洪武禮制)" had been published by the Ming government was hard to adopt, because it was too narrow and totally different from the traditional style. Above all things, they doubt of there was other architectural ordonnance for kingdoms, not for local governments. King Sejong ordered to investigate the origin form and former examples, and tried to get other ritual documents of authority published by the Ming government such as "Damingjili(大明集禮)". After several academic researches and intense debates, they decided to create a new architectural ordonnance for their national Sajik altar, its form was in accord with the traditional style and its size was in accord with the new ordonnance. But they did not know there had already been the architectural ordonnance for the kingdom in the Ming dynasty. Because the first emperor of the Ming dynasty had changed its Sajik ritual system several times, even the whole country of the Ming dynasty also had gone through chaos on this issue even after his death. Consequentially, the official documentation works had been made partially, there was no a complete document on this issue even in the Ming government.

Predicting Arachnoid Membrane Descent in the Chiasmatic Cistern in the Treatment of Pituitary Macroadenoma

  • Ko, Hak Cheol;Lee, Seung Hwan;Shin, Hee Sup;Koh, Jun Seok
    • Journal of Korean Neurosurgical Society
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    • v.64 no.1
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    • pp.110-119
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    • 2021
  • Objective : Preoperative prediction of the arachnoid membrane descent in pituitary surgery is useful for achieving gross total removal and avoiding cerebrospinal fluid leakage resulting from tearing of the arachnoid membrane in the chiasmatic cistern. In this study, we analyzed the patterns of arachnoid membrane descent during or after pituitary tumor surgery and identified the factors related to this descent. Methods : Analysis was restricted to pituitary macroadenomas not extending into the third ventricle or over the internal carotid artery. To minimize confounding factors, patients who underwent revision surgery, those who had a torn arachnoid during operation or small medial diaphragma sellae (DS) opening, and subtotal resections were excluded. We enrolled 41 consecutive patients in this retrospective analysis. The degree of arachnoid descent was categorized using intraoperative videos. Preoperative magnetic resonance findings, including tumor height, suprasellar extension, and variables including DS area and medial opening size, tumor composition, and displacement of the pituitary stalk and gland were evaluated to determine their correlations with arachnoid membrane descent. Results : Arachnoid membrane descent was significantly correlated with DS area and medial opening size. Based on T2-weighted images (T2WI) magnetic resonance (MR) images, tumor composition was significantly associated with arachnoid membrane descent. Other factors were not significantly correlated with arachnoid membrane descent. Conclusion : T2WI of tumor composition and preoperative MR imaging of DS area and medial opening provided valuable information regarding arachnoid membrane descent. These parameters may serve as fundamental measures to facilitate complete resection of pituitary macroadenomas.

Chemical Accident Response Plan: A Comparative Study between Regions in Korea (화학사고 대응계획: 국내 지역간 비교연구)

  • Min-Je Choi;Gyu-Sun Cho
    • Industry Promotion Research
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    • v.9 no.1
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    • pp.57-64
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    • 2024
  • In 2015, the paradigm of hazardous chemical substance management in Korea shifted from the workplace to the regional level due to the complete revision of the Chemicals Control Act. Although regional chemical accident response plans were established in 2020, there were slight differences in the scope and criteria of each local government. Therefore, this study compared and analyzed chemical accident response plans established in four different regions to provide insights into effective chemical accident response plans. Based on publicly available information, the current status of accident preparedness, chemical accident response systems, and resident evacuation response and education/training were compared and analyzed. The results showed that there were not significant differences in the accident preparedness and response systems between the regions. However, there was a lack of discussion on the preparedness system linked to the characteristics of each workplace in each region. Additionally, there were differences in education and training for residents between regions. In the future, each local government needs to establish a response organization that fits the characteristics of their region and develop strategies for agile and effective accident response through cooperation with relevant agencies.

Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review

  • Tsung-Chun Huang;Jian-Jr Lee;Kuo-Hui Yang;Chia-Huei Chou;Yu-Chen Chang
    • Archives of Plastic Surgery
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    • v.50 no.6
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    • pp.557-562
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    • 2023
  • Augmentation mammoplasty is one of the most popular cosmetic surgeries, but there is a high reoperation rate (29.7%) commonly due to capsular contracture, implant malpositioning, infection, and unsatisfactory size. Although infection only accounts for 2% of cases, its management is very challenging, especially with nontuberculous mycobacteria (NTM) infection. Breast prosthetic NTM infection is a rare but is a disastrous condition with an incidence of approximately 0.013%. Immediate salvage reimplantation is usually not suggested, and most studies recommend a gap of 3 to 6 months after combination antibiotics therapy before reimplantation. However, delayed reimplantation often leads to great psychological stress and struggle between the doctor and patient. We present the case report of successful reimplantation in treating prosthetic NTM infections in a 28-year-old female. We discuss a novel technique "transaxillary capsulorrhaphy" to correct the bottoming-out deformity. One year after the combination of antibiotics and surgery, the follow-up computed tomography scan showed complete remission of NTM without recurrence. We discuss the surgical technique in detail. The 1-year follow-up assessment (photos and dynamic video) revealed good cosmesis and reliable correction using the new technique. This report is the first formal description and discussion of one-stage reimplantation following NTM infections. Transaxillary capsulorrhaphy allows for a successful salvage operation when an implant is displaced. This approach provides highly favorable result in eastern women undergoing revision augmentation mammoplasty. This study reflects level of evidence V, considering opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.

Improvement of Fontan Circulatory Failure after Conversion to Total Cavopulmonary Connection (완전 대정맥-폐동맥 연결수술로 전환 후의 폰탄순환장애 개선)

  • Han Ki Park;Gijong Yi;Suk Won Song;Sak Lee;Bum Koo Cho;Young hwan Park
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.559-565
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    • 2003
  • By improving the flow pattern in Fontan circuit, total cavopulmonary connection (TCPC) could result in a better outcome than atriopulmonary connection Fontan operation. For the patients with impaired hemodynamics after atriopulmonary Fontan connection, conversion to TCPC can be expected to bring hemodynamic and functional improvement. We studied the results of the revision of the previous Fontan connection to TCPC in patients with failed Fontan circulation. Material and method: From October1979 to June 2002, eight patients who had failed Fontan circulation, underwent revision of previous Fontan operation to TCPC at Yonsei University Hospital. Intracardiac anomalies of the patients were tricuspid atresia (n=4) and other functional single ventricles (n=4). Mean age at TCPC conversion was 14.0$\pm$7.0 years (range, 4.6~26.2 years) and median interval between initial Fontan operation and TCPC was 7.5 years (range, 2.4~14.3 years). All patients had various degree of symptoms and signs of right heart failure. NYHA functional class was 111 or IV in six patients. Paroxysmal atrial fibrillation (n:f), cyanosis (n=2), intraatrial thrombi (n=2), and protein losing enteropathy (PLE) (n=3) were also combined. The previous Fontan operation was revised to extracardiac conduit placement (n=7) and intraatrial lateral tunnel (n=1). Result: There was no operative death. Major morbidities included deep sternal infection (n=1), prolonged pleural effusion over two weeks (n=1), and temporary junctional lachyarrhythrnia (n=1). Postoperative central venous Pressure was lower than the preoperative value (17.9$\pm$3.5 vs. 14.9$\pm$1.0, p=0.049). Follow-up was complete in all patients and extended to 50,1 months (mean, 30.3$\pm$ 12.8 months). There was no late death. All patients were in NYHA class 1 or 11. Paroxysmal supraventricular tachycardia developed in a patient who underwent conversion to intraatrial lateral tunnel procedure, PLE was recurred in two patients among three patients who had had PLE before the convertsion. There was no newly developed PLE. Conclusion: Hemodynamic and functional improvement could be expected for the patients with Fontan circulatory failure after atriopulmonary connection by revision of their previous circulation to TCPC. The conversion could be performed with low risk of morbidity and mortality.

A Study on Development of Energy Education Materials for Middle School Students (중학교용 에너지 교육 자료 개발 연구)

  • 최돈형;이양락
    • Hwankyungkyoyuk
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    • v.7 no.1
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    • pp.46-87
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    • 1994
  • Our country has been consuming a huge amount of energy in the course of industrialization and its demand is expected to increase enormously in the future. However, the deposits of energy resources are so limited that the settlement of energy problem comes up the essential subject. To solve the energy problem, it is requested that new resources to gain energy stably should be developed and also energy should be economized and used effectively. The effective use of energy and an the wisdom of economy in energy are requested to everybody and these things should be habitualized from very young age through education. Nevertheless, almost every school in our country hasn’t been concerned about energy education. Even though they have a concern, they are very short of the energy education materials and the quality of the materials is not so good. Therefore it is very meaningful to the settlement of energy problem of the country to make the students who will lead our country to make the students who will lead our country in the future realize the seriousness of energy problem and to provide them the necessary knowledge and methods to solve this problem so that they practice those things in everyday life. Having these necessities, this research, supported by The Korea Energy Management Corporation(KEMCO), was performed for 8 months from April 17, 1994 to December 17, 1994. Many peoples participated in this study such as 30 staffs of researchers and authors, 5 staffs of photographers and illustrators, and 3 VCR program producers developing an energy education material set for middle school students that includes a printed material for student, a diskette for computer simulation, a teacher's guidebook, VCR material and its guidebook. The following main development direction was established : First, the material for student should be consisted of units that let students know the seriousness of energy problem. Second, the focus should be put on the necessary method and practice to economize energy actually in real life based on the basic knowledge learned in elementary school. Third, material for student should be consisted of modules to be student activity-oriented teaching-learning rather than lecture-oriented one. The activity, to maximize student's interests, should be presented in various forms such as experiments, investigation, play, data interpretation, computer simulation, visits, expression and appreciation, etc. To develop the energy education materials for middle school students, a research plan was made first. After literature review about domestic and foreign energy education materials, several research trips home and abroad, and discussion meetings, the basic theory of energy education such as the principle, objective, contents, teaching-learning method, and evaluation method was established. Material for student was developed through the following procedures : The activities in the existing energy education materials were analysed and were divided into four categories related to energy using places of home, school, community, and country, and which were again divided into three categories related to time of past, present, and future, Considering these division, nine modules which are structure units of material for student were chosen, Each module comprises 2-4 activities. Totally 31 activities were designed in this way. The syllabi were made out for each activity and writing was asked for to experts related to each activity after several discussions and revision. To complement the draft, another several discussions and revision were also made on it and then pictures and illustrations were asked for. All these procedures complete the material for student, titled ; Energy Inquiry of Middle School Students', which totals 129 pages and is all in color. As the manuscript of material for student was fixed, writing for teacher's guidebook was asked for to the same writers. The draft of teacher's guidebook was also complemented through the several concentrated works and discussions. Teacher's guidebook focused on the teaching-learning principle and methods of energy education and on the concrete instruction cases for effective instruction of material for student. It is organized with two parts : the one is 'general outline' which introduces theoretical contents and the other is 'details' which are practically helpful to teaching-learning. It is totally 131 pages including both 'general outline' and 'details'. The VCR material and its guidebook consist of contents that cultivate the good attitude trying to economize energy and raise student's interests with a purpose of strong motivation to recognize the necessity of economy and practice it. After establishing development direction of VCR material through discussion meetings and research trips, its script was made by relevant experts. Then the script was also reviewed two times. The drafted VCR material made by a video material developing expert was examined and modified by previews twice. After completion of VCR material, the VCR guidebook was made. All these procedures led to the development of VCR material which runs 20 minutes in VHS type. The VCR guidebook shows a production purpose of the program, structure of contents, evaluation methods, and contents of the program in detail to give help to instructors when they use this VCR material, When these energy education materials are used, it is desirable that the VCR material should be presented first to induce student's motive, and then material for student is introduced Since the material for student is composed of activity-oriented modules and each module is independent one another in general, and each activity is, too. the necessary module or activity can be chosen and utilized in any order according to school or class conditions. This energy education materials will contribute to the development of student's ability to solve energy problem in everyday life and teacher's ability to teach the fundamental knowledge and method in solving energy problem.

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