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Is Diabetes a Contraindication to Lower Extremity Flap Reconstruction? An Analysis of Threatened Lower Extremities in the NSQIP Database (2010-2020)

  • Amy Chen;Shannon R. Garvey;Nimish Saxena;Valeria P. Bustos;Emmeline Jia;Monica Morgenstern;Asha D. Nanda;Arriyan S. Dowlatshahi;Ryan P. Cauley
    • Archives of Plastic Surgery
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    • v.51 no.2
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    • pp.234-250
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    • 2024
  • Background The impact of diabetes on complication rates following free flap (FF), pedicled flap (PF), and amputation (AMP) procedures on the lower extremity (LE) is examined. Methods Patients who underwent LE PF, FF, and AMP procedures were identified from the 2010 to 2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP®) database using Current Procedural Terminology and International Classification of Diseases-9/10 codes, excluding cases for non-LE pathologies. The cohort was divided into diabetics and nondiabetics. Univariate and adjusted multivariable logistic regression analyses were performed. Results Among 38,998 patients undergoing LE procedures, 58% were diabetic. Among diabetics, 95% underwent AMP, 5% underwent PF, and <1% underwent FF. Across all procedure types, noninsulin-dependent (NIDDM) and insulin-dependent diabetes mellitus (IDDM) were associated with significantly greater all-cause complication rates compared with absence of diabetes, and IDDM was generally higher risk than NIDDM. Among diabetics, complication rates were not significantly different across procedure types (IDDM: p = 0.5969; NIDDM: p = 0.1902). On adjusted subgroup analysis by diabetic status, flap procedures were not associated with higher odds of complications compared with amputation for IDDM and NIDDM patients. Length of stay > 30 days was statistically associated with IDDM, particularly those undergoing FF (AMP: 5%, PF: 7%, FF: 14%, p = 0.0004). Conclusion Our study highlights the importance of preoperative diabetic optimization prior to LE procedures. For diabetic patients, there were few significant differences in complication rates across procedure type, suggesting that diabetic patients are not at higher risk of complications when attempting limb salvage instead of amputation.

Impact of Elevated Temperature in Growing Season on Growth and Fruit Quality of Red Pepper (Capsicum annuum L.) (생육기 온도상승이 고추의 생육 및 과실품질에 미치는 영향)

  • Song, Eun Young;Moon, Kyung Hwan;Son, In Chang;Kim, Chun Hwan;Lim, Chan Kyu;Son, Daniel;Oh, Soonja
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.16 no.4
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    • pp.349-358
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    • 2014
  • This study was conducted to determine the impact of elevated temperature in growing season on the growth and fruit quality of red pepper (Capsicum annuum L.) by cultivating pepper in the temperature gradient tunnels. Plant height, stem diameter, leaf number and total leaf area, fresh weight and dry weight increased at ambient $+2^{\circ}C$ temperature, whereas each leaf area decreased as temperature increased. The plants grown under ambient $+2^{\circ}C$ temperature showed the greatest number of flower and fruit. Fruit weight, fruit length and fruit diameter decreased as the temperature increasing gradually. Total fruit number, total fruit weight and total dry fruit weight was the highest at ambient $+2^{\circ}C$ temperature. Major free sugars of red pepper fruit were fructose and glucose. Free sugar content of red pepper according to the differences in harvesting times and in growth temperature showed a little differences. The yield of red pepper fruit at ambient $+2^{\circ}C$ temperature increased by 13% compared with the control. However, the yield of red pepper fruit at ambient $+4^{\circ}C$ temperature decreased by 20% as compared to control. Non-marketable fruits (diseased fruit, malformed fruit and small sized fruit) increased as the temperature rised.

Changes of Physicochemical Properties of Salted-Fermented Anchovy Meat Engraulis japonica with Different Salt Content During Fermentation at 15℃ (식염첨가량이 다른 멸치(Engraulis japonica)육젓의 15℃ 숙성 중 이화학적 특성의 변화)

  • LEE, Jae-Dong;KANG, Kyung-Hun;KWON, Soon-Jae;YOON, Moon-Joo;PARK, Si-Young;PARK, Jin-Hyo;KIM, Jeong-Gyun
    • Journal of Fisheries and Marine Sciences Education
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    • v.27 no.5
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    • pp.1457-1469
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    • 2015
  • This study was undertaken to investigate the quality changes of salted-fermented anchovy meat made by varying the amount of salt during fermentation at $15^{\circ}C$. Anchovy (11.0-14.0 cm of length, 10.7-17.5 g of weight) added with 15-25% of salt was filled in a round form plastic container (i.d. $10.5{\times}11cm$), and then fermented at $15^{\circ}C$ for 110 days. The factors such as proximate composition, pH, color value (L, a, b), TBA value, amino-N content, salinity, hardness value, free amino acid content and sensory evaluation of salted-fermented anchovy meat were measured. Ash content, color value (redness), TBA value, amino-N content. salinity and hardness value of salted-fermented anchovy meat were increased, but color value (lightness), and moisture content were decreased during fermentation at $15^{\circ}C$. A salted-fermented anchovy meat added with 15% of salt was shown higher content of moisture, amino-N content and free amino acid, TBA value than those of 20 or 25% of salt. Ash content, salinity and hardness value were highest in a product added with 25% of salt. From the result of sensory evaluation, Addition amount of 15% salt and fermentation periods of 110 days were determined to be the most desirable palatability of salted-fermented anchovy meat.

Effects of Salt Treatment on Yield and Physiological Characteristics of Flag Leaf at Heading Stage in Winter Barley (보리 출수기 염처리가 수량 및 지잎의 생리적 특성에 미치는 영향)

  • 최원열;김영민;박종환
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.47 no.6
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    • pp.409-412
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    • 2002
  • This research was conducted to obtain the fundamental data on salt injury and different responses among cultivars in winter barley (Hordeum vulgare L.). Salts did not affect yield components including number of panicles, stem length, grain number per ear and grain yield while reduced stem dry weight and thousand seed weight significantly with increasing concentrations of salt from 60 to 180 mM. NaCl had less injury effect on barley straw dry weight and thousand seed weight than did $MgSO_4$. Chlorophyll content and relative turgidity in flag leaf were reduced when treated with both salts, while free proline in the salt-treated leaf was increased. Content of proline in salt-treated barley was about 10 folds compared to the control. Based on yield components and physiological traits of flag leaf, the tolerance to salt injury was the greatest in Baegdong, followed by Dongbori#1, Mogpo#55, and Gangbori. The results suggested that salt- stressed barley at reproductive stage had higher free proline content, and that special management in this stage must be considered because salt stress at heading stage affect flag leaf growth as well as yield components Harmfully.

Effect of Inoculation with Bradyrhizobium sp. and Lime Types on Peanut Plant at Newly Reclaimed Area -1. Content of Nutrients in Plant and Yield (야산개간지(野山開墾地)에서 근류균(根瘤菌) 접종(接種) 및 석회(石灰) 비종별(肥種別) 시용(施用)이 땅콩 생육(生育)에 미치는 영향 -1. 식물체중(植物體中) 양분함량(養分含量) 및 수량(收量))

  • Lee, Deog-Bae;Im, Geon-Jae;Kwon, Tae-Oh;Lee, Sang-Bok;So, Jae-Don
    • Korean Journal of Soil Science and Fertilizer
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    • v.24 no.3
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    • pp.210-218
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    • 1991
  • This study was carried out to investigate the influence of inoculation with Bradyrhizobia and lime types on the nutrient content and yield of peanut. Inoculation size of Bradyrhizobium sp. HCR-46 was $8.2{\times}10^7$ cells per seed. Slaked lime, magnesium lime, and calcium carbonate were applied in an amount required for neutralization of soil. 150kg of calcium sulfate was fertilized to 10a of the experimental field. Sowing space was $40{\times}25cm$ under vinyl mulching. Leaves and stems for assay were sampled at 100 day after sowing. The obrained results are as follows. 1. Number and dry weight of nodule as well as dry weight of aerial part of peanut plant increased by inoculation with B. sp. and were the highest in calcium carbonate application. 2. Inoculated with B. sp., the contents of T-N, $K_2O$, MgO, allantoin, ammonia, free amino acid and chlorophyll increased, but that of nitrate decreased. 3. The contents of T-N, free amino acid, and chlorophyll were higher in the treatment of calcium carbonate, those of $K_2O$, MgO, allantoin, ammonia were higher in magnesium lime application, and those of CaO and nitrate were higher in slaked lime fertilization than any other lime types. 4. Contents of total sugar and starch in stem at 100 days were higher in the treatment of uninoculation than inoculation with B. sp., and those were highest in the calcium sulfate application than the other lime types. 5. Inoculated with B. sp. length of main stem and number of pods increased significantiy. Yield of seed was higher in inoculation with B. sp. than in uninoculation by 64%, and in the order of carbonate, magnesium lime, slaked lime, in calcium sulfate and non-application was the contribution of soil treatments to yield increases.

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Etiological Properties and Coat Protein Gen Analysis of Potato Virus Y Occuring in Potatoes of Korea (우리나라 감자에 발생하는 PVY의 병원학적 특성 및 외피단백질 유전자 분석)

  • ;Richard M. Bostock
    • Proceedings of the Korean Society of Plant Pathology Conference
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    • 1995.06b
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    • pp.77-96
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    • 1995
  • To obtain basic informations for the improvement of seed potato production in Korea, some etiological properties of potato virus Y(PVY) distributed in the major seed potato production area(Daekwanryeong) were characterized, and the nucleotide and amino acid sequences of the coat protein gene of the PVY strains isolated were analyzed. PVY strains in Daekwonryeong, an alpine area, were identified to be two strains, PVYo and PVYN by symptoms of indicator plants, and their distribution in potato fields was similar. Major symptom on potato varieties by PVY was grouped as either mosaic alone or mosaic accompanied with veinal necrosis in the lower leaves. The symptom occurrence of the two symptoms was similar with Irish Cobbler, but Superior showed a higher rate of mosaic symptom than the other. The PVY strain which was isolated from potato cv. Superior showing typical mosaic symptoms produced symptoms of PVY-O on the indicator plants of Chenopodium amaranticolor, Nicotiana tabacum cv. Xanthi nc and Physalis floridana, but no symptom o Capsicum annum cv. Ace. Moreover, results from the enzyme-linked immunosorbent assay with monoclonal and polyclonal antibodies showed that the isolated PVY reacts strongly with PYV-O antibodies but does not react specifically with PVY-T antibodies. The purified virus particles were flexious with a size of 730$\times$11nm. On the basis of the above characteristics, the strain was identified to be a PVY-O and named as of PVY-K strain. The flight of vector aphids was observed in late May, however, the first occurrence of infected plants was in mid June with the bait plants surrounded with PVY-infected potato plants and early July with the bait plants surrounded with PVY-free potato plants. PVY infection rates by counting symptoms on bait plants (White Burley) were 1.1% with the field surrounded with PVY-free potato plants and 13.7% the fields surrounded with PVY-infected potato plants, showing the effect of infection pressure. The propagated PVY-K strain on tobacco(N. sylvestris) was purified, and the RNA of the virus was extracted by the method of phenol extraction. The size of PVY-K RNA was measured to be 9, 500 nucleotides on agarose gel electrophoresis. The double-stranded cDNAs of PVY-K coat protein(CP) gene derived by the method of polymerase chain reaction were transformed into the competent cells of E. coli JM 109, and 2 clones(pYK6 and pYK17) among 11 clones were confirmed to contain the full-length cDNA. Purified plasmids from pYK17 were cut with Sph I and Xba I were deleted with exonuclease III and were used for sequencing analysis. The PVY-K CP gene was comprised of 801 nucleotides when counted from the clevage site of CAG(Gln)-GCA(Ala) to the stop codon of TGA and encoded 267 amino acids. The molecular weight of the encoded polypeptides was calculated to be 34, 630 daltons. The base composition of the CP gene was 33.3% of adenine, 25.2% of guanine, 20.1% of cytosine and 21.4% of uracil. The polypeptide encoded by PVY-K CP gene was comprised of 22 alanines, 20 threonines, 19 glutamic acids and 18 glycines in order. The homology of nucleotide sequence of PVY-K CP gene with those of PVY-O(Japan), PVY-T(Japan), PVY-TH(Japan), PVYN(the Netherlands), and PVYN(France) was represented as 97.3%, 88.9%, 89.3%, 89.6% and 98.5%, respectively. The amino acid sequence homology of the polypeptide encoded by PVY-K CP gene with those encoded by viruses was represented as 97.4%, 92.5%, 92.9%, 92.9%, and 98.5%, respectively.

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Comparison of the Quality Characteristics between Spring Cultivars of Kimchi cabbage (Brassica rapa L. ssp. pekinensis) (봄 배추 품종별 품질 특성 비교)

  • Lee, Kwang-Hee;Kuack, Han-Seup;Jung, Ji-Won;Lee, Eun-Joon;Jeong, Da-Mi;Kang, Ki-Young;Chae, Kyung-Il;Yun, Seok-Hun;Jang, Mi-Ran;Cho, Sun-Duk;Kim, Gun-Hee;Oh, Ji-Young
    • Food Science and Preservation
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    • v.20 no.2
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    • pp.182-190
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    • 2013
  • This study investigated the quality characteristics between spring cultivars of Kimchi cabbage(Brassica rapa L. ssp. pekinesis). We measured the weight, length, width, formation index, midrib thickness and moisture contents of fresh Kimchi cabbage for characteristics of growth. And we analyzed the free sugar, amino acid, organic acid, mineral, pectin and cellulose contents of fresh Kimchi cabbage. The hardness and firmness were measured for texture of fresh Kimchi cabbage. The weight of 'K-power' cultivar was the highest than other cultivars. The 'Jeongsang' cultivars was the thinnest midrib thickness in cultivars, but it was not significantly different. The free sugar levels of spring cultivars was the highest in 'Chunkwang'. Malic acid content of 'Jeongsang' was significantly different among spring cultivars. Also amino acid content of 'K-power' and 'Chunkwang' were significantly different among spring cultivars Mineral content in 'K-power' and 'Bomaknorang' were greater than that of other cultivars. Especially Na, Ca and Mg contents of 'K-power' and 'Bomaknorang' were higher four times than that of other cultivars. Pectin content of 'Jeongsang' was higher than that of other cultivars, but it was not significantly different. Hardness and Firmness were not significantly different among spring cultivars.

Antioxidant Activity and Grain Properties of Colored Rice Derived from Insertional Mutagenesis Progenies (벼 종피색 변이체에 대한 항산화 활성 분석과 미립특성)

  • Yi, Gihwan;Lee, Hyun-Suk;Sohn, Jae-Keun;Kim, Kyung-Min
    • Journal of Life Science
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    • v.22 no.12
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    • pp.1628-1636
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    • 2012
  • This study examined the antioxidant activity of the dark purple rice seeds from the rice line, MGI079, derived from insertional mutagenesis. The contents of polyphenolic compounds were 1.3 and 1.9-fold higher in the MGI079-2-1 and MGI079-2-6 rice lines than in the donor cultivar MGI079. Flavonoid contents were 6.4-fold higher in the MGI079-2-1 line. The MGI079-2-1 line showed a 24.4-fold higher activity in DPPH free radical scavenging compared to the MGI079 line. The anthocyanin content of the MGI079-2-6 line was more than 106.4-fold higher than the MGI079 line and 1.4-fold higher than the Heugnam line. Anthocyanin content in colored rice grains was negatively correlated with Hunter's L, a, and b values, with the correlation coefficients of $-5.64^{**}$, $5.21^{**}$ and -1.15, respectively. The grain length/width of a mutant of MGI079 segregated to a medium and bold type compared to the medium type of MGI079. However, the 1,000 grain weight was decreased to 13.6~19.6 g compared to 19.8 g for MGI079. Amylose content of the endosperm was 5.6~23.8% higher than in the MGI079 line. The grain of mutants of MGI079 was distinguished by its starch characteristics. The higher antioxidant activity of the MGI079-2-1 and MGI079-2-6 lines indicated functional characteristics associated with high-value resources, so future breeding should focus on the development of pigments in colored rice in new varieties.

Oxygen Toxicity of Superoxide Dismutase-Deficient Saccharomyces cerevisiae by Paraquat (Paraquat에 의해 유도된 Superoxide Dismutase 결핍 효모의 산소 독성)

  • 김지면;남두현용철순허근
    • KSBB Journal
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    • v.10 no.5
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    • pp.561-567
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    • 1995
  • Using superoxide dismutase (SOD)-deficient mutants of Saccharomyces cerevisiae, the oxygen toxicity induced by paraquat was studied. In aerobic culture condition, yeasts lacking MnSOD (milochondrial SOD) showed more significant growth retardation than CuZnSOD (cytoplasmic SOD)-deficient yeasts. However, not so big differences in growth pattern of those mutants compared with wild type were observed under anaerobic condition. When exposed to paraquat, the growth of yeasts lacking CuZnSOD was severely affected by higher than 0.01mM of paraquat in culture medium. By the analysis of several cellular components ivolved in free radical generating and scavenging system, it was found that, under aerobic condition, the content of lipid peroxides in cell membrane as well as cellular activity of glutathion peroxidase of CuZnSOD-deficient mutants was increased in the presence of paraquat, although significant decrease of catalase activity was observed in those stratns. In MnSOD-deficient yeast, however, increment in cellular activity of glutathion peroxldase and catalase by paraquat was observed without any deterioration of membrane lipid. It implies that the lack of mitochondrial SOD could be compensated by both of glutathion peroxldase and catalase, but that only glutathion peroxidase might act for CuZnSOD in cytoplasm. In contrast, all of SOD-deficient mutants showed a significant decrease in catalase activity, but slight increase in the activities of glutathion peroxidase, when cultivated anaerobically in the medium containing paraquat. Nevertheless, any significant changes of lipid peroxides in cell membranes were not observed during anaerobic cultivation of SOD-deficient mutants. It suggests that a little amount of free radicals generated by paraquat under anaerobic condition could be sufficiently overcome by glutathion peroxidase but not by catalase.

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The Role of Pelvic Irradiation after Hysterectomy in Early Stage Cervical Carcinoma with Pelvic Nodal Metastasis (림프절 전이를 동반한 초기 자궁경부암에서 수술 후 방사선치료의 역할)

  • Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.469-475
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    • 1998
  • Purpose : To determine the role of Pelvic irradiation in stage I or IIA cervical carcinoma with pelvic nodal metastasis after hysterectomy and bilateral pelvic lymphadenectomy. Materials and Methods : This is a retrospective study of 68 cervical carcinoma patients who were found to have pelvic nodal metastasis at hysterectomy and received pelvic irradiation from 1983 to 1996 at Inje University Seoul Paik Hospital. External beam radiation therapy to pelvis was delivered using 4 MeV Linac and intracavitary irradiation was given via vaginal ovoids or cylinders. Five-year survival and disease-free survival were estimated by Kaplan-Meier Method and prognostic factors related to survival were analysed by log-rank test and Cox proportional hazards regression model. Results : Median length of follow-up was 52months. Five-year overall survival and disease-free survival (DFS) were 81.8$\%$ and 81.7$\%$ respectively. Patients with endometrial invasion had a 57.1$\%$ 5-year DFS compared to 87.5$\%$ for those without endometrial invasion (p=0.0074). Multivariate analysis revealed endometrial invasion as an only statistically significant prognostic factor for 5-year DFS. Among total 15 (22$\%$) recurrences. pelvic recurrences occurred in 4 cases and distant metastases occurred in 13 cases. Conclusion : We have been able to confirm previous results demonstrating marked decrease in local recurrence after pelvic irradiation. In view of the high proportion of distant metastasis found in this study, a trial of aggressive adjuvant systemic therapy and irradiation in early stage cervical carcinoma patients with pelvic nodal metastasis, especially with endometrial invasion, appears to be warranted.

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