• Annals of Surgical Treatment and Research
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• v.95 no.6
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• pp.324-332
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• 2018

Purpose: We present our experience involving the management of this disease, identifying prognostic factors affecting treatment outcomes. Methods: The patients treated for Fournier gangrene at our institution were retrospectively reviewed. Data collected included demographics, extent of soft tissue necrosis, predisposing factors, etiological factors, laboratory values, and treatment outcomes. The severity index and score were calculated. Multivariate regression analysis was used to determine the association between potential predictors and clinical outcomes. Results: A total of 41 patients (male:female = 33:8) were studied. The mean age was 54.4 years (range, 24-79 years). The most common predisposing factor was diabetes mellitus (n = 19, 46.3%). Sixteen patients (39.0%) were current smokers. Seven patients had chronic kidney disease. The most frequent etiology was urogenital lesion (41.5%). The mortality rate was 22.0% (n = 9). Multivariate regression analyses showed that extension of necrosis beyond perineal/inguinal area and pre-existing chronic kidney disease were significant and independent predictors of mortality. Extension of necrosis beyond perineal/inguinal area was a significant predictor of increased duration in the intensive care unit and hospital stay. In addition, pre-existing chronic kidney disease was a significant predictor of flap reconstruction in the wound. Conclusion: Fournier gangrene with extensive soft tissue necrosis and pre-existing chronic kidney disease was associated with poor prognosis and complexity of patient management. Early recognition of dissemination and premorbid renal function is essential to reduce mortality and establish a management plan for this disease.

• Korean Medical Education Review
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• v.21 no.1
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• pp.1-12
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• 2019

This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors' roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.

• Clinical and Experimental Pediatrics
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• v.61 no.12
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• pp.397-402
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• 2018

Purpose: Transcatheter device closure of patent ductus arteriosus (PDA) is challenging in early infancy. We evaluated PDA closure in infants less than 6 months old. Methods: We performed a retrospective review of infants less than 6 months of age who underwent attempted transcatheter device closure in our institution since 2004. To compare clinical outcomes between age groups, infants aged 6-12 months in the same study period were reviewed. Results: A total of 22 patients underwent transcatheter PDA closure during the study period. Patient mean age was $3.3{\pm}1.5months$, and weight was $5.7{\pm}1.3kg$. The duct diameter at the narrowest point was $3.0{\pm}0.8mm$ as measured by angiography. The most common duct type was C in the Krichenko classification. Procedural success was achieved in 19 patients (86.3%). Major complications occurred in 5 patients (22.7%), including device embolization (n=1), acquired aortic coarctation (n=2), access-related vascular injury requiring surgery (n=1), and acute deterioration requiring intubation during the procedure (n=1). Two patients had minor complications (9.1%). Twenty-four infants aged 6-12 months received transcatheter device closure. The procedural success rate was 100%, and there were no major complications. The major complication rate was significantly higher in the group less than 6 months of age (P=0.045). There was a trend toward increased major complication and procedural failure rates in the younger age group (P<0.01). Conclusion: A relatively higher incidence of major complications was observed in infants less than 6 months of age. The decision regarding treatment modality should be individualized.

• Journal of Chest Surgery
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• v.52 no.5
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• pp.335-341
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• 2019

Background: The endovascular approach to aortic disease treatment has been increasingly utilized in the past 2 decades. This study aimed to determine the long-term results of using the Seal thoracic stent graft. Methods: We retrospectively reviewed the outcomes of patients who underwent thoracic endovascular aortic repair or a hybrid procedure using the Seal thoracic stent graft (S&G Biotech, Seongnam, Korea) from January 2008 to July 2018 at a single institution. We investigated in-hospital mortality and the incidence of postoperative complications. We also investigated the mid-term survival rate and incidence of aorta-related complications. Results: Among 72 patients with stent grafts, 15 patients underwent the hybrid procedure and 21 underwent emergency surgery. The mean follow-up period was $37.86{\pm}30.73$ months (range, 0-124 months). Five patients (6.9%) died within 30 days. Two patients developed cerebrovascular accidents. Spinal cord injury occurred in 2 patients. Postoperative renal failure, postoperative extracorporeal membrane oxygenation support, and pneumonia were reported in 3, 1, and 6 patients, respectively. Stent-related aortic complications were observed in 5 patients (6.8%). The 1- and 5-year survival and freedom from stent-induced aortic event rates were 81.5% and 58.7%, and 97.0% and 89.1%, respectively. Conclusion: The use of the Seal thoracic stent graft yielded good mid-term results. Further studies are needed to examine the long-term outcomes of this device.

• Archives of Plastic Surgery
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• v.46 no.5
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• pp.449-454
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• 2019

Background Most patients with head and neck cancer successfully undergo oncologic resection followed by free or local flap reconstruction, depending on the tumor's size and location. Despite effective curative resection and reconstruction, head and neck cancer patients still face a high risk of recurrence and the possibility of a second primary cancer. Moreover, surgeons hesitate to perform sequential reconstruction following curative resection for several reasons. Few large-scale studies on this subject are available. Therefore, we retrospectively evaluated the outcome of sequential head and neck reconstruction to determine the possible risks. Methods In total, 467 patients underwent head and neck reconstruction following cancer resection at our center from 2008 to 2017. Of these cases, we retrospectively reviewed the demographic and clinical features of 58 who had sequential head and neck reconstruction following resection of recurrent cancer. Results Our study included 43 males (74.1%) and 15 females (25.9%). The mean age at the initial operation was $55.4{\pm}15.3years$, while the mean age at the most recent operation was $59.0{\pm}14.3years$. The interval between the first and second operations was $49.2{\pm}62.4months$. Twelve patients (20.7%) underwent surgery on the tongue, and 12 (20.7%) had procedures on the oropharynx. Thirty-four patients (58.6%) received a sequential free flap reconstruction, and 24 patients (41.4%) were treated using locoregional flaps. No cases of flap failure occurred. Conclusions Our findings suggest that patients who need additional operations with recurrent head and neck cancer could optimally benefit from sequential curative resections and reconstructions.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.15 no.4
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• pp.1502-1520
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• 2021

This paper attempts to investigate Korean youth Not in Education, Employment and Training (NEET) and how daily activities and community participation may influence their positive emotions and job search desire. First, we conducted a focus group interview with 16 NEETs who participated in the Kakao NEET Company project. The project allowed participants to experience employment by founding a virtual company in which each participant selected a daily activity to perform as part of the company's operations. Second, the interview responses were categorized and assigned emotional values using the card sorting technique and multi-dimensional analysis (MDS). A total of 11 emotional values were derived through this process. Finally, a social network analysis was conducted in order to measure the density of relations among the emotional values. Results suggest that immersion, confidence, belongingness were the three highest values evaluated by participants. Furthermore, network diagrams imply that the stronger participants perceived social support and belongingness with others, the stronger their responsibility grew, further leading them to establish steady goals. In particular, the high eigenvector score for "desire for job" suggests that emotional values are sequentially connected to the immersion-social support-responsibility-goal-job desire. This sequence suggests that digital services that are developed with the aim to enhance social values such as the Kakao NEET Project may engender motivation and confidence in youth NEETs. The overall results suggest that a systematic approach to policymaking should be considered in order to provide fundamental solutions and expand opportunities for social participation and emotional comfort, as social isolation due to low self-esteem has been reported as one of the reasons for NEETs' failure in the labor market.

• Journal of Korean Neurosurgical Society
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• v.64 no.3
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• pp.386-405
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• 2021

Recent advancements in basic research on the process of secondary neurulation and increased clinical experience with caudal spinal anomalies with associated abnormalities in the surrounding and distal structures shed light on further understanding of the pathoembryogenesis of the lesions and led to the new classification of these dysraphic entities. We summarized the changing concepts of lesions developed from the disordered secondary neurulation shown during the last decade. In addition, we suggested our new pathoembryogenetic explanations for a few entities based on the literature and the data from our previous animal research. Disordered secondary neurulation at each phase of development may cause corresponding lesions, such as failed junction with the primary neural tube (junctional neural tube defect and segmental spinal dysgenesis), dysgenesis or duplication of the caudal cell mass associated with disturbed activity of caudal mesenchymal tissue (caudal agenesis and caudal duplication syndrome), failed ingression of the primitive streak to the caudal cell mass (myelomeningocele), focal limited dorsal neuro-cutaneous nondisjunction (limited dorsal myeloschisis and congenital dermal sinus), neuro-mesenchymal adhesion (lumbosacral lipomatous malformation), and regression failure spectrum of the medullary cord (thickened filum and filar cyst, low-lying conus, retained medullary cord, terminal myelocele and terminal myelocystocele). It seems that almost every anomalous entity of the primary neural tube may occur in the area of secondary neurulation. Furthermore, the close association with the activity of caudal mesenchymal tissue in secondary neurulation involves a wider range of surrounding structures than in primary neurulation. Although the majority of the data are from animals, not from humans and many theories are still conjectural, these changing concepts of normal and disordered secondary neurulation will provoke further advancements in our management strategies as well as in the pathoembryogenetic understanding of anomalous lesions in this area.

• Journal of Internet of Things and Convergence
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• v.8 no.2
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• pp.71-78
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• 2022

Recently, the number of people wishing to return to farming is increasing, However, the lack of farming experience and management information of returnees is one of the main reasons for increasing the probability of agricultural failure. This study proposes an interface to support early facility cultivation management decision-making for returnees who want facility cultivation. The proposed interface is designed with UML(Unified Modeling Language) and provides key decision-making information such as land/crop suitability, land/facility costs, and management costs according to input data such as cultivation areas, selected crops, and cultivation types selected by the user. Through the proposed interface, facility cultivators can effectively and quickly acquire initial decision-making information for facility cultivation in the desired target area.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.22 no.4
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• pp.73-79
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• 2022

The Python language widely used in artificial intelligence (AI) projects is an interpreter language, and errors occur at runtime. In order to prevent project failure due to errors, it is necessary to handle exceptions in code that can cause exceptional situations in advance. In particular, in AI projects that require a lot of resources, exceptions that occur after long execution lead to a large waste of resources. However, since exception handling depends on the developer's experience, developers have difficulty determining the appropriate exception to catch. To solve this need, we propose an approach that recommends exceptions to catch to developers during development by learning the existing exception handling statements. The proposed method receives the source code of the try block as input and recommends exceptions to be handled in the except block. We evaluate our approach for a large project consisting of two frameworks. According to our evaluation results, the average AUPRC is 0.92 or higher when performing exception recommendation. The study results show that the proposed method can support the developer's exception handling with exception recommendation performance that outperforms the comparative models.

• Steel and Composite Structures
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• v.43 no.1
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• pp.19-30
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• 2022

The static strength and fatigue crack resistance of the aircraft skin structures depend on the materials used and joint type. Most of the commercial aircraft's skin panel structures are made from aluminium alloy and carbon fibre reinforced epoxy. In this study, the fatigue resistance of four joint configurations (metal/metal, metal/composite, composite/composite and composite/metal) with riveted, adhesive bonded, and hybrid joining techniques are investigated with experiments and finite element analysis. The fatigue tests were tension-tension because of the typical nature of the loads on aircraft skin panels susceptible of experimenting fatigue. Experiment results suggest that the fatigue life of hybrid joints is superior to adhesive bonded joints, and these in turn much better than conventional riveted joints. Thanks to the fact that, for hybrid joints, the adhesive bond provides better load distribution and ensures load-carrying capacity in the event of premature adhesive failure while rivets induce compressive residual stresses in the joint. Results from FE tool ABAQUS analysis for adhesive bonded and hybrid joints agrees with the experiments. From the analysis, the energy release rate for adhesive bonded joints is higher than that of hybrid joints in both opening (mode I) and shear direction (mode II). Most joints show higher energy release rate in mode II. This indicates that the joints experience fatigue crack in the shear direction, which is responsible for crack opening.