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The Treatment for The Intractable Epidural Abscess Using Tensor Fascia Lata Graft and Anterolateral Thigh Free Flap (대퇴근막 이식과 전외측 대퇴 유리 피판을 이용한 난치성 경막 외 농양의 치료)

  • Park, Byung-Chan;Ryu, Min-Hee;Kim, Tae-Gon;Lee, Jun-Ho
    • Archives of Reconstructive Microsurgery
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    • v.18 no.1
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    • pp.23-26
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    • 2009
  • Purpose: Artificial dura maters are commonly used in cranioplasty, but sometimes they can result in serious postoperative infection. Once complications such as epidural abscess or chronic draining ulcer arise, they are very difficult to treat. In this case, reclosure of dura defect using artificial dura mater may give rise to recurrence of infection. We experienced a case of intractable epidural abscess caused by use of artificial dura. To avoid repeated infection, we decided to use autologous tissue for the coverage of dura and soft tissue defect. Therefore, autologous tensor fascia lata graft and anterolateral thigh free flap were harvested at the same donor site incision to cover composite defect on the scalp and dura mater. Methods: A 13 year old male patient, who underwent the decompression cranioplasty and duroplasty, suffered from the intractable infection lesion. Twice, the epidural abscess was removed, both times the infection recurred. And eventually dura mater was exposed through the infected open wound. Nine months after dura exposed, infected aritificial dura mater was removed and extensive debridement was performed. Through a surgical incision on donor thigh, first, tensor fascia lata graft was harvested in process of the anterolateral thigh flap elevation. After the fascia lata graft was fixed over the dural defect, the anterolateral thigh flap was used to fill the dead space as well as the scalp defect. Results: Postoperatively, no recurrent infection and cerebrospinal fluid leakage are observed for a year. After the surgery, on the first and second day, venous congestion of the flap was observed, this problem was solved by thrombectomy and vein reanastomosis. And partial necrosis of flap occurred, but completely healed as conservative treatment for two weeks. Conclusion: Using the autologous tensor fascia lata graft and anterolateral thigh flap, we could obtain satisfactory results as treatment for the intractable infection lesion after duroplasty. Autologous tensor fascia lata in conjunction with anterolateral thigh flap is useful method for covering composite defect of scalp and dura mater.

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Studies on Herbage Utilization by Grazing Dairy Cows under Strip Grazing I. Changes in the sward structure affected by levels of daily herbage allowance (대상방목 체계하에서 고능력 착우유에 의한 초지 이용율에 대한 연구 I. 일당 채식 허용량의 수준에 따른 방목후 초생구조의 변화)

  • 김태환;김병호
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.14 no.2
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    • pp.99-109
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    • 1994
  • The objective of this study was to examin some animal and sward factors which determine the daily herbage intake of high yielding dairy cows at different levels of daily herbage allowance. In this paper, the principal data relevent to the changes of sward characteristics after five days of daily strip grazing at three experimental peliods were summarized. The pregrazing herbage mass and extended height increased significantly from 5,047 kg OM/ha and 341 mm in period 1 to 6,877 kg OM/ha and 446 mm in period 3, while there was not a significant difference among herbage allowance treatments(average 6,068 kg OM/ha and 410 mm). The live leaf material in the residual herbage showed a greater reduction than the dead material and leaf sheath in terms of extended height, proportion and density. The decreased rates after grazing were higher when the level of herbage allowance decreased. Live leaves were vertically distributed to 50 cm of sward height before grazing. All live lamina distributed to 25 cm were grazed in the high and medium, and to 20 cm in the low levle of herbage allowance after grazing. The depth of grazing and grazed volume of forage material were heighly affected by the levels of hehage allowance. The biomass after grazing in the high, medium and low daily herbage allowance decreased 35, 36 and 52%, respectively, compared to before grazing level. The highly significant correlations between herbage allowance and extended tiller height(r=0.79), proportion of live lamina(r=0.94) and density of live lamina(r=O.91) after grazing, respectively, were observed.

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Surgical Treatment of Thyroid Carcinoma - A Relation between Prognostic Factors and Survival Rate - (갑상선암의 외과적 치료 - 예후인자와 생존율의 관계)

  • Kim Jae-Hong;Oh Sang-Hoon;Kim Sang-Hyo;Paik Nak-Whan
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.187-199
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    • 1997
  • Thyroid carcinoma ranks low in incidence and as a cause of death when compared to carcinomas arising in the other site. With adequate surgical treatment, the prognosis of operable thyroid carcinoma is good. However, the extent of surgical resection in treatment of thyroid cancer remains still controversy. The aim of this study was to assess the results of thyroid cancer patients treated surgically and to analyze the prognostic factors affecting survival and to improve the survival rate. We retrospectively analyzed the outcome of a total of 278 thyroid cancer patients treated surgically at Inje University Paik Hospital from 1980 to 1995 and followed for 1 to 16 years. There were man in 47 and woman in 231 patients with age range of 14 to 79 years(mean 42 years). Histopathologic findings were papillary carcinoma in 233, follicular carcinoma in 33, mixed carcinoma in 7, medullary carcinoma in 2, and undifferentiated carcinoma in 3 patients, respectively. Operative procedures were unilateral lobectomy in 111, subtotal thyroidectomy in 100, and total thyroidectomy in 67 patients. Central node dissection was performed in 92, modified neck disseciton in 62, radical neck dissection in 28, and no node dissection in 96 patients. Thyroid hormone was administered for the period of 3 to 5 years to suppress endogenous TSH production. Overall 5-year survival rate according to Kaplan-Meier method was 91.1%. Independently, significant factors affecting the prognosis were age at diagnosis, tumor size, pathologic type, tumor stage, lymph node metastasis, angioinvasion, extrathyroidal extension, and 'risk' group category. but, the prognosis were not influenced by sex and capsular invasion. Patients at low risk or with small size carcinomas had long survival over 5 years with only lobectomy. Lymph node dissection was carried out with a limited type in no jugular metastasis, radical neck dissection was performed only therapeutically in proved jugular node metastasis. Fifteen patients were dead of tumor recurrence after surviving for three months to two and half years, and the cause of death was local recurrence in nine, bone metastasis in four and lung metastasis in two patients. In conclusion, more extensive surgery including total thyroidecotmy and systematic compartment-oriented dissection of the lymph node metastases in patient at high-risk group will results in better survival and lower recurrence rate.

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Severity-Adjusted LOS Model of AMI patients based on the Korean National Hospital Discharge in-depth Injury Survey Data (퇴원손상심층조사 자료를 기반으로 한 급성심근경색환자 재원일수의 중증도 보정 모형 개발)

  • Kim, Won-Joong;Kim, Sung-Soo;Kim, Eun-Ju;Kang, Sung-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.10
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    • pp.4910-4918
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    • 2013
  • This study aims to design a Severity-Adjusted LOS(Length of Stay) Model in order to efficiently manage LOS of AMI(Acute Myocardial Infarction) patients. We designed a Severity-Adjusted LOS Model with using data-mining methods(multiple regression analysis, decision trees, and neural network) which covered 6,074 AMI patients who showed the diagnosis of I21 from 2004-2009 Korean National Hospital Discharge in-depth Injury Survey. A decision tree model was chosen for the final model that produced superior results. This study discovered that the execution of CABG, status at discharge(alive or dead), comorbidity index, etc. were major factors affecting a Sevirity-Adjustment of LOS of AMI patients. The difference between real LOS and adjusted LOS resulted from hospital location and bed size. The efficient management of LOS of AMI patients requires that we need to perform various activities after identifying differentiating factors. These factors can be specified by applying each hospital's data into this newly designed Severity-Adjusted LOS Model.

Influence of Temperature and Soil moisture affecting the death to Vegetative organs of perennial weeds (답다년생잡초에 대한 영양번식기관의 사멸에 미치는 온도 및 토양분수의 영향)

  • Chang, Yung-Hee;Kusanagi, Tokuichi
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.24 no.1
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    • pp.107-118
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    • 1979
  • The critical low temperature of death under submerged soil was -5^\circ C for the underground tuber of Cyperus serotinus while the vegetative organ (tuber or bulb) of Sagittaria pygmaea and Potamogeton distinctus -6^\circ C, -7^\circ C respectively. On the critical high temperature of death in water bath with 45^\circ C. Potamogeton distinctus and Sagittaria pygmaea were 1 hour, 24 hours, but Cyperus serotinus did not die. When vegetative organs of perenivial weeds setted on the soil surface, the propagation organ of Potamegeton distinctus did not die by desication in 17% of soil moisture, but Cyperus serotinus and Sagittaria pygmaea were dead within 2 to 3 hours in 25^\circ C of soil moisture.

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A study on the Improvement Method of the Report and Reward System on an Illegal Behavior of the Emergency Exit (비상구 불법행위 신고포상제도의 개선방안에 관한 연구)

  • Kim, Myeong Sik;Lee, Tae Shik;Cho, Won Cheol
    • Journal of Korean Society of Disaster and Security
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    • v.5 no.2
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    • pp.49-59
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    • 2012
  • The safety management of the emergency exit, by directly related to the $civil^{\circ}$Øs dead in the fire situation, have limited by which the fire station take the on-side and control-centered way of business processing, it is expect to the effects in which the citizen have to concern and to take part. From 2010 years in the back-ground, it is operated nationally the report and reward system on an illegal behavior of the emergency exit, it is happened to the unfit operating situation in the mission and direction of the system up which the exit paparazzi act with intent to receive the reward payments. The study suggests solution through analyzing the illegal emergency exit operation result of sixteen counties and the Seoul metropolitan from year 2010 to 2011. Firstly, the report destination is adjusted to the multiple use establishments and the large-scale multiple use facilities over the limit level is limited under five times the report events of the same people in the minor endorsement. And the fine incomes should be invested to the disaster prevention acting related with the exit. Secondly, for upgrade of the report accuracy, a reporter is received the possible information for the confirmation of an illegal act, has become to lead the pre-monitoring act which the reporter is can to take the safety education and to guide the information about season and vulnerable business location. Finally, considering the support way about the encounter facility, the fire officer is not happen to occur the repetitive report in the same place, is related to the volunteer service system the report acts, consider as the volunteer service time, and must support them to act as the disaster prevention volunteer.

Development of In Vitro Produced Bovine Embryos after Vitrification with Various Containers (다양한 Container로 유리화 동결된 체외생산 소 수정란의 발달에 관한 연구)

  • Lee, Y.J.;Ko, D.H.;H.T., Lee;Chung, K.S.
    • Korean Journal of Animal Reproduction
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    • v.25 no.4
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    • pp.371-379
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    • 2001
  • The objective of this study was to establish an effective cryopreservation method of in vitro-produced bovine embryos. For the vitrification, in virtro-produced embryos at 8-cell, morula and blastocyst stages were exposed to freezing solution containing 5.5 M EG (EG 5.5) for 20 sec, loaded on each containers such as EM grid, OPS and Cryo-loop, and then immediately plunged into liquid nitrogen at -196$^{\circ}C$. Thawed embryos were serially diluted in 0.5, 0.25 and 0.125 M sucrose in m-HPBS, each for 1 min, and cultured in CRlaa medium supplemented with 10% FBS. Significant differences in the rates of re-expanded and hatched embryos were not observed among these embryo containers. The total cell number of expanded blastocyst cultured in vitro after vitrification was examined by Hoechst staining. There were no differences between non-vitrified (180.0 $\pm$ 5.4) and vitrified groups (178.0 $\pm$ 7.5). In addition, when the cellular injuries after vitrification were compared by double staining. There were no significant difference in the ratio of live and dead cells between non-vitrified group (176 : 4) and vitrified group (172 : 6). Therefore, these results suggest that bovine embryos can be cryopreserved easily, effectively and successfully by vitrification using various containers, such as EM grid, OPS or Cryo-loop in the presence of EG 5.5 freezing solution.

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The Study on the Fragment Ejection Velocity and Spray Angle from a High Explosive Cylindrical Warhead (실린더형 HE 탄두 폭발 시 파편의 속도 및 발사각 추정방법 연구)

  • Hwang, Changsu;Park, Younghyun;Park, Seikwon;Jung, Daehan;Lee, Moonsik;Kang, Sunbu;Kim, Deuksu
    • Journal of the Korean Society for Aeronautical & Space Sciences
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    • v.47 no.12
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    • pp.904-912
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    • 2019
  • We have studied the numerical analysis about the fragment ejection velocity and spray angle when the High Explosive warhead detonated at proximity distance at an aircraft. To study the physical quantities about the warhead components is very important to assessment the vulnerability of aircraft. Generally, the physical quantities about the components of a warhead such as the mass, length, diameter and charge to mass ratio are unknown. Therefore, it is required to estimate the physical quantities by using physical continuities of similar threats. The empirical formulas to understand the dependence among charge to mass ratio, length and diameter ratio were driven by using the physical parameters of similar threatening such as terrier, sparrow. As a result, we confirmed that the dead mass ratio was closed to 20% of warhead mass since the metal case of the proximity threat acts as a simple carrier. This implies that the effective length and diameter of High Explosive Compound is smaller than the length and diameter of warhead, and become a key to understand the large ejection gradient velocity and small spray angle of fragments within 6 degree.

Isolation and Identifieation of Entomopathogenic Nematodes from Soil and Insect (토양과 곤충 사체로부터 곤충병원성 선충의 분리 및 동정)

  • 한상미;한명세
    • Korean Journal of Environmental Biology
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    • v.17 no.3
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    • pp.321-330
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    • 1999
  • Nematodes were isolated using silkwom trap through the investigation of 100 soil samples from various biotopes in Korea. The 30 nematode strains from soil and dead insects by the pathogenicity aganinst silkworms (Bombyx mori mori) and insect pests of Calliphora vomitoria, Pseufazetia separata, Palomena angulosa, and Melolontha incana. Mortailty of the silkworm larvae and pupae were as high as 100% by nematode infection, those of insect of pests were varied from 20 to 100%. The 30 strains of entemopathogenic nematodes were classified into five groups of Rhabditidae, Diplogatroidae, Heterorhabitidae, Steinernematidae, and Tylenchida by morphological criteria. The genetic relationships among the 30 nematode strains were analyzed by various RAPD bands with twenty primers. The 30 nematode strains were classified into six major subgroups on the basis of the genetic similarity coefficient of 0.853. The grouping by RAPD was agree with those of morphological taxa in discrimination of the higher group, however, was not completely agree in the subgroup. The family Steinernematidae belong to Rhabditida was clarified as closer to the Tylenchida, rather than the other Rhabditida of Heterorhabitidae, Rhabditidae, and Diplogatroidae in genetic distance valule. From the result of the morphological classification and RAPD of the genomic DNA showed that genetic relationship analysis furnish infurmation on phylogenetic classification and relationships of entomopathogenic nematodes. The application of genetic similarity will overcome the limitation of taxonomy and classification of morphologically simple nematode. Several primers were confirmed those utility of identification for individual nematode strains, the methods of molecular genetics secured the simplicity, rapidity and accuracy on the selection of entomopathogenic nematodes.

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The Effect of 4Ca^{2+}$ on $Cd^{2+}$ -induced Physiological Toxicity in Commelina communis L.

  • Lee, Sun-Hwa;Lee, Joon-Sang
    • Korean Journal of Environmental Biology
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    • v.20 no.4
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    • pp.303-308
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    • 2002
  • 3-weeks old Commelina was transferred to and grown in Hoagland solution ($\pm$ 100 $\mu{M}$ $Cd^{2+}$, 100 $\mu{M}$ $Cd^{2+}$ + 100$\mu{M}$ $Ca^{2+}$, 100 $\mu{M}$ $Cd^{2+}$ + 200 $\mu{M}$ EGTA) for two weeks and then a number of physiological activities was investigated. $Cd^{2+}$ reduced total chlorophyll content up to 29% at a week and 75% at two weeks. In the treatment of $Cd^{2+}$$Ca^{2+}$, the total chlorophyll content was reduced to 29% at a week and 80% at two weeks. $Cd^{2+}$ reduced 24% of Fv/Fm after two weeks. In case of $Cd^{2+}$$Ca^{2+}$, Fv/Fm was reduced 55% at a week, but after two weeks, the plants were almost dead and Fv/Fm could not be measured. When EGTA was treated with $Cd^{2+}$, the value of Fv/Fm was not affected. There were no differences of water potential between the control and the treatment of $Cd^{2+}$+EGTA toy a week, but in other treatments. water potential was reduced. $Cd^{2+}$ reduced about 21% of water potential and $Cd^{2+}$$Ca^{2+}$ reduced 43% of water potential after two weeks. $Cd^{2+}$ inhibited 21% of photosynthetic activity at a week and 32% at two weeks. In case of photosynthetic activity, $Cd^{2+}$$Ca^{2+}$ inhibited 58% at a week and 73% at two weeks. $Cd^{2+}$+EGTA inhibited 15% of photosynthetic activity at a week and 21% at two weeks. Similar results were found in stomatal conductance. From the above results, it was observed that the treatment of $Ca^{2+}$ with $Cd^{2+}$ induced more reduction of a series of physiological responses than those of the treatment of $Cd^{2+}$ alone. Therefore, it could be concluded that $Ca^{2+}$ did not reduce the toxicity of $Cd^{2+}$, but enhanced $Cd^{2+}$ -induced physiological toxicities, but EGTA induced an decrease of $Cd^{2+}$ -induced physiological toxicities.