• Archives of Plastic Surgery
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• v.34 no.3
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• pp.383-387
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• 2007

Purpose: A necrotizing fasciitis is a rare, but insidiously advancing fatal soft tissue infection characterized by extensive fascial necrosis. Diagnosis & treatment of this disease are difficult. Necrotizing fasciitis tend to begin with constitutional symptoms of fever and chills. Quite a many lab studies and imaging studies such as standard radiography, computerized tomography can be used, but nothing can confine the extent of affected tissue. Aggressive surgical interventions are often required because of large skin and soft tissue deformity. However, many patients with necrotizing fasciitis are not healthy enough to overcome aggressive surgical intervention. Methods: Since 2000, we treated 10 patients with necrotizing fasciitis. In 4 patients, we used magnetic resonance imaging(MRI) as a tool for diagnosis as soon as necrotizing fascitiis was doubted. We treated patients with delayed coverage with Alloderm$^{(R)}$ & split thickness skin graft or delayed wound closure in as many cases as possible. Results: In 4 patients using preoperative MRI, diagnosis could be made in earlier stage of the disease compared to other patients. Our treatment modality was debridement and coverage with Alloderm$^{(R)}$ & split thickness skin graft. We could reconstruct deformities without significant limitation of movement in 7 cases. Conclusion: We diagnosed and treated 10 necrotizing fasciitis with MRI and Alloderm$^{(R)}$ graft, and results were good.

• Journal of Trauma and Injury
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• v.20 no.1
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• pp.1-5
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• 2007

Purpose: Grafting with autograft skin remains the most effective method for treating skin defects. When insufficient donor sites are present or patients are afraid of the operation, a skin graft is impossible. Cultured allogenic keratinocytes speed wound healing by providing cover and by producing growth factors and extracellular matrix protein. We report an application of cultured allogenic keratinocytes ($Kaloderm^{(R)}$, Tegoscience, Seoul, Korea) in the treatment of an acute partial thickness skin defect. Methods: From March 2005 to January 2006, 20 patients with a partial thickness skin defect were treated with cultured allogenic keratinocytes. The wound was covered with a sheet of cultured allogenic keratinocytes and ointment with $Bactigras^{(R)}$ gauze. The wound was inspected every two or three days. We regarded completion of epithelialization as wound healing. Results: The mean period between time of injury and time of $Kaloderm^{(R)}$ application was 7.5 days. The time taken from application of $Kaloderm^{(R)}$ to complete closure of the wounds was 7.2 days. Conclusion: In view of the favorable outcome, cultured allogenic keratinocytes are safe and effective biologic dressing materials for use in the treatment of open wounds.

• Archives of Plastic Surgery
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• v.37 no.3
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• pp.227-232
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• 2010

Purpose: Continuous irrigation method is an important step in managing wound infection. V.A.C. devices have been used in intractable wounds for reducing discharge, improving local blood flow, and promoting healthy granulation tissue. We expect synergistic effects of reduced infection and more satisfactory, accelerated wound healing when using both methods simultaneously. This study evaluated continuous irrigation combined with V.A.C. appliance for treatment of infected chronic wounds. Methods: We reviewed data from 17 patients with infected intractable chronic wounds. V.A.C. device (Group A) was used in 9 patients, and V.A.C. with antibiotics irrigation (Group B) was used in 8 patients. We placed Mepitel$^{(R)}$ on the surface of wound and placed an irrigation and aspiration tube on each side. A sponge was placed on the Mepitel$^{(R)}$ and covered with film dressing. The wound was irrigated continuously with mixed antibiotics solution at the speed of 200 cc/hr and aspirated through the wall suction at the pressure of -125 mmHg. V.A.C. applied time, wound culture and wound size were compared between the two groups. Results: No complication were seen in two groups. Compared with Group A, in the Group B, V.A.C. applied time was shortened from 32.7 days to 25.6 days and showed efficacy in the reduction rate of wound size. No statistical differences were shown in bacterial reversion. Conclusion: V.A.C. appliance with continuous irrigation is an effective new method of managing infected chronic wounds and useful to reduce treatment duration and decrease wound size. Moreover it could be applied more widely to infected wound.

• Journal of Korean Critical Care Nursing
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• v.16 no.3
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• pp.109-122
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• 2023

Purpose : This study aims to explore nursing activities after the decision to discontinue life-sustaining treatment, awareness of a good death, and perception of life-sustaining treatment decisions among nurses in intensive care units (ICUs) at tertiary general hospitals. Methods : Participants were 173 nurses working in two tertiary general hospitals. The data were collected using structured questionnaires and analyzed using an independent t-test, paired t-test, one-way ANOVA, Scheffé's test, and Pearson's correlation coefficient. Results : Participants were 173 nurses working in two tertiary hospitals. The nursing activity increase was the greatest in the spiritual domain, and the physical domain was where the activities decreased the most. There were significant associations between Awareness of good death (Clinical) and Perception of life-sustaining treatment decision(r=.26, p <.001), Awareness of good death (Closure) and Perception of life-sustaining treatment decision(r=.36, p <.001), and Awareness of good death (Personal control) and Perception of life-sustaining treatment decision(r=.49, p <.001). Conclusion : Based on the results, systematic education programs and job training are required to improve the awareness regarding good death and perception of life-sustaining treatment decision for nurses in ICUs where discontinuing life-sustaining treatment decisions are made.

• Clinical and Experimental Pediatrics
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• v.45 no.5
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• pp.609-614
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• 2002

Purpose : The purpose of our investigation was to explore the natural course, and the factors that influence the natural course, in ostium secundum atrial septal defect(ASD) diagnosed within the first 4 weeks of life. Methods : We studied patients with ASD diagnosed within the first 4 weeks of life during the period from September 1995 to September 1999 in our hospital. The diagnosis and measuring of the size of ASD was carried out by two-dimensional echocardiogram(2DE, Hewlett-Packard Sonos $2500^{(R)}$) from subcostal long and short axis views. Results : There were 61 patients - 29 males and 32 females. According to the size of their defects, we divided them into four groups; group A(less than 4 mm : 24 cases), group B(four mm-six mm : 27 cases), group C(six mm-eight mm : six cases), group D(more than eight mm : four cases). In groups A and B, 22 of 24 patients(91.7%) and 23 of 27 patients(85.2%) had each closed spontaneously. In group C, four of six patients had closed spontaneously. In group D, no patient had closed spontaneously and three of four patients had been closed surgically. There were significant differences in the rate of spontaneous closure between less than six mm group and more than six mm group in the size of the defect(P<0.05). There were no significant differences in the rate of spontaneous closure between ASD combined with simple cardiac defect and isolated secundum ASD. Conclusion : We conclude that defects smaller than six mm in diameter are very likely to close spontaneously.

• Journal of Advanced Marine Engineering and Technology
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• v.25 no.5
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• pp.1108-1114
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• 2001

The fatigue crack propagation behavior of the SA516-Grade 70 steel which is used for pressure vessels was experimentally examined under the condition of at room temperature, $150^{\circ}C$, $250^{\circ}C$ and $370^{\circ}C$ with stress ration of R=0.1 and 0.3. The fatigue crack propagation rate , da/dN, related with the stress intensity factor range, $\vartriangle$N, was influenced by the stress ration within the stable growth of fatigue crack(Region II) with an increase in $\vartriangle$N. The resistance to the fatigue crack growth at high temperature is higher in comparison with that at room temperature, and the resistance attributed to the extent of plasticity-induced by compressive residual stress according to the cyclic loads. Fractographic examinations revels that the differences of the fatigue crack growth characteristics between room and high temperatures are mainly explained by the crack and oxide-induced by high temperature.

• Journal of computational fluids engineering
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• v.21 no.2
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• pp.62-69
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• 2016

It has been highly demanded to improve the accuracy of CFD(Computational Fluid Dynamics) methods for the assessment of the hydrodynamic performance of marine propellers in cavitating and non-cavitating flows. This paper presents a validation study on the numerical simulation of the tip vortex flow of a non-cavitating marine propeller SVA VP1304. The calculations are carried out by using the Reynolds averaged Navier-Stokes(RANS) approach, where the Reynolds Stress Model(RSM) is used for turbulence closure. The present paper contains a grid dependence test for the propeller open water simulations and a special emphasis is placed on conducting a local grid adaptation on the blade tip and in the tip vortex to reasonably reproduce the velocity and the pressure in the tip vortex flow field. The numerical results are compared with the experimental validation data, which are published in the second International Symposium on Marine Propulsors 2011(SMP'11). The present numerical results show a reasonable agreement with the experiments.

• Transactions of the Korean Society of Mechanical Engineers
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• v.16 no.1
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• pp.63-69
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• 1992

Plane-strain fatigue crack growth behavior of 7075-76 aluminium alloy was investigated by using side-grooved through-thickness center cracked tension(CCT) specimens. The effect of side-groove on the stress intensity factor value was examined. The effective thickness expression of $B_{e}$= $B_{o}$-( $B_{o}$-( $B_{ o-B_{n}^{2}}$ $B_{o}$ is the most appropriate to evaluate the stress intensity factor of side-grooved CCT specimen for fatigue testing. Fatigue crack growth rates can be well described by the effective stress intensity factor range based on closure measurements, for both side-grooved and uniform thickness specimens. Provided that the thickness of specimen meets the requirements for valid plane-strain fracture toughness, uniform thickness specimen data may be assumed to approximately represent the plane strain through-thickness crack growth behavior.ehavior.r.

• Journal of the Korean Society of Safety
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• v.16 no.1
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• pp.18-24
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• 2001

The fatigue crack growth behavior of the SA516/70 steel which is used for pressure vessels was examined experimentally at room temperature, $-60^{\circ}C$,$-80^{\circ}C$ and $-100^{\circ}C$ with stress ratio of R=0.05, 0.1 and 0.3. Fatigue crack propagation rate da/dN related with stress intensity factor range ${\Delta}K$ was influenced by stress ratio in stable of fatigue crack growth (Region II) with an increase in ${\Delta}K$. The resistance of fatigue crack growth at low temperature is higher compared with that at room temperature, which is attributed to the extent of plasticity-induced by compressive residual stress according to the cyclic loads. Fractographic examinations reveal that the differences of the fatigue crack growth characteristics between room and low temperatures are mainly explained by the crack closure and the strengthening due to the plasticity induced and roughness induced.

• Proceedings of the Korean Society of Propulsion Engineers Conference
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• 2006.05a
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• pp.327-330
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• 2006

Numerical simulations were carried out to investigate the base drag characteristics of a base bleed projectile with a central propulsive jet by considering the base homing process. Overall fluid dynamic process is modeled by Wavier-Stokes equations for reacting flows with two-equation $k-\omega$ SST turbulence closure. The combustion process is modeled by finite-rate chemistry with a given partially burned exit condition of the BBU (base-bleed unit). Besides the demonstrating the capability of the present CFD solver for the base drag and the interaction of the base flow with a rocket plume, present study gives an insight into the fluid dynamics and the combustion process of the hybrid-propulsion projectile.