Yasser Al Omran;Ellie Evans;Chloe Jordan;Tiffanie-Marie Borg;Samar AlOmran;Sarvnaz Sepehripour;Mohammed Ali Akhavani
Archives of Plastic Surgery
/
v.50
no.3
/
pp.264-273
/
2023
The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap, and yet is less commonly utilized than other free flaps in microvascular reconstructions of the head and neck. The aim is to conduct a high-quality Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)- and Assessment of Multiple Systematic Reviews 2 (AMSTAR 2)-compliant systematic review comparing the use of the MSAP flap to other microvascular free flaps in the head and neck. Medline, Embase, and Web of Science databases were searched to identify all original comparative studies comparing patients undergoing head and neck reconstruction with an MSAP flap to the radial forearm free flap (RFFF) or anterolateral thigh (ALT) flap from inception to February 2021. Outcome studied were the recipient-site and donor-site morbidities as well as speech and swallow function. A total of 473 articles were identified from title and abstract review. Four studies met the inclusion criteria. Compared with the RFFF and the ALT flaps, the MSAP flap had more recipient-site complications (6.0 vs 10.4%) but less donor-site complications (20.2 vs 7.8%). The MSAP flap demonstrated better overall donor-site appearance and function than the RFFF and ALT flaps (p = 0.0006) but no statistical difference in speech and swallowing function following reconstruction (p = 0.28). Although higher quality studies reviewing the use of the MSAP flap to other free flaps are needed, the MSAP flap provides a viable and effective reconstructive option and should be strongly considered for reconstruction of head and neck defects.
Background Hypothenar free flaps (HTFFs) have been widely used for reconstructing palmar defects. Although previous anatomical and clinical studies of HTFF have been conducted, this technique still has some limitations. In this study, we describe some tips for large flap design that allows for easy harvesting of HTFFs with minimal donor site morbidity. Methods A total of 14 HTFF for hand defect reconstruction were recorded. The oblique flap was designed in the proximal HT area following relaxed skin tension line along the axis between fourth web space and 10 mm ulnar side of pisiform. A flap pedicle includes one or two perforators with ulnar digital artery and HT branch of basilic vein. In addition, innervated HTFF can be harvested with a branch of ulnar digital nerve. Electronic medical records were reviewed to obtain data on patients' information, operative details, and follow-up period. In addition, surgical outcome score was obtained from the patient, up to 10 points, at the last follow-up. Results Mean harvest time was 46 minutes, and two perforators were included in 10 cases. The mean flap area was 10.84 cm2. There were no problems such as donor site depression, scar contracture, keloids, wound dehiscence, numbness or neuroma pain at donor sites, and hypersensitivity or cold intolerance at flap site, either functionally or aesthetically. Conclusion Palmar defect reconstruction is challenging for hand surgeons. However, large HTFF can be harvested without complications using the oblique axis HTFF technique. We believe our surgical tips increase utility of HTFF for palmar defect reconstruction.
Miguel Angel Gaxiola-Garcia;Joseph M. Escandon;Oscar J. Manrique;Kristin A. Skinner;Beatriz Hatsue Kushida-Contreras
Archives of Plastic Surgery
/
v.51
no.2
/
pp.212-233
/
2024
This is a retrospective review of surgical management for primary lymphedema. Data were extracted from 55 articles from PubMed MEDLINE, Web of Science, SCOPUS, and Cochrane Central Register of Controlled Trials between the database inception and December 2022 to evaluate the outcomes of lymphaticovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT), and outcomes of soft tissue extirpative procedures such as suction-assisted lipectomy (SAL) and extensive soft tissue excision. Data from 485 patients were compiled; these were treated with LVA (n = 177), VLNT (n = 82), SAL (n = 102), and excisional procedures (n = 124). Improvement of the lower extremity lymphedema index, the quality of life (QoL), and lymphedema symptoms were reported in most studies. LVA and VLNT led to symptomatic relief and improved QoL, reaching up to 90 and 61% average circumference reduction, respectively. Cellulitis reduction was reported in 25 and 40% of LVA and VLNT papers, respectively. The extirpative procedures, used mainly in patients with advanced disease, also led to clinical improvement from the volume reduction, as well as reduced incidence of cellulitis, although with poor cosmetic results; 87.5% of these reports recommended postoperative compression garments. The overall complication rates were 1% for LVA, 13% for VLNT, 11% for SAL, and 46% for extirpative procedures. Altogether, only one paper lacked some kind of improvement. Primary lymphedema is amenable to surgical treatment; the currently performed procedures have effectively improved symptoms and QoL in this population. Complication rates are related to the invasiveness of the chosen procedure.
This paper is about the research on ontology design for a digital archive of seonsaengan(先生案) of the Joseon Period. Seonsaengan is the register of staff officials at each government office, along with their personal information and records of their transfer from one office to another, in addition to their DOBs, family clan, etc. A total of 176 types of registers are known to be kept at libraries and museums in the country. This paper intends to engage in the ontology design of 47 cases of such registers preserved at the Jangseogak Archives of the Academy of Korean Studies (AKS) with a focus on their content and structure including the names of the relevant government offices and posts assumed by the officials, etc. The work for the ontology design was done with a focus on the officials, the offices they belong to, and records about their transfers kept in the registers. The ontology design categorized relevant resources into classes according to the attributes common to the individuals. Each individual has defined a semantic postposition word that can explicitly express the relationship with other individuals. As for the classes, they were divided into eight categories, i.e. registers, figures, offices, official posts, state examination, records, and concepts. For design of relationships and attributes, terms and phrases such as Dublin Core, Europeana Data Mode, CIDOC-CRM, data model for database of those who passed the exam in the past, which are already designed and used, were referred to. Where terms and phrases designed in existing data models are used, the work used Namespace of the relevant data model. The writer defined the relationships where necessary. The designed ontology shows an exemplary implementation of the Myeongneung seonsaengan(明陵先生案). The work gave consideration to expected effects of information entered when a single registered is expanded to plural registers, along with ways to use it. The ontology design is not one made based on the review of all of the 176 registers. The model needs to be improved each time relevant information is obtained. The aim of such efforts is the systematic arrangement of information contained in the registers. It should be remembered that information arranged in this manner may be rearranged with the aid of databases or archives existing currently or to be built in the future. It is expected that the pieces of information entered through the ontology design will be used as data showing how government offices were operated and what their personnel system was like, along with politics, economy, society, and culture of the Joseon Period, in linkage with databases already established.
An investigation by KRNIC (Korea Network Information Center) on the real state of usage of internet has shown that 96.9% of children investigated had experiences of using internet. Especially the firstly ranked item that had been answered by children as a necessity of internet was 'Studying to solve tasks' rated by 83.9%. As seen from the research result, the need as a homework sonics is actually so dominant that it cannot be ignored when considering the profitability at the area of education contents, but any profound research has not been accomplished yet. Internet has been positioned as a more effective and fruitful learning tool, and also all activities done by users for exploring informations and choosing learning items under the on-line circumstances are based on the successive mutual reactions between users and computers. Up to now much of the web based learning circumstances has been introducing the User Interface using metaphor, and the same is found dominantly from the sites for children. But in spite of the availability of metaphor mentioned above the current status is much lack of profound researches about metaphor interface; and what is more, in the case of the site for elementary school students the gap of the ability recognizing metaphor is very large between lower classes and higher classes according to the degree of mental growth but that is used to be simply ignored, then a common concept is adapted to interface for all grades of classes and moreover for infant and kindergarten without any objections. Based on foregoing problems this research has put the main focus on the groping and presenting desirable directions on the prospect design of interface for children-oriented sites by analyzing the status of practical usage of metaphor interface in the field of the sites for children-oriented learning sites with concentration upon homework supporting domains.
The purpose of this study is to develop a on-line design tool for effectively coping with e-Business environment, or product design process into a Cyber model for traditional manufacturers which attempts new product development under such environment. It was finally developed as a model named $\ulcorner$Design Vortal Site; e-BVDS) that was based on the structure and style of internet web site. Results of the study can be described as follows ; \circled1 e-Business is based on the Internet. All processes in the context of e-Business require models whose structure and method of use are on-line styles. \circled2 In case that a traditional manufacturing business is converted into e-Business, it is better to first consider Hybrid Model that combines resources and advantages of both such traditional and digital businesses. \circled3 The product design process appropriate for e-Business environment has to have a structure and style that ensure utilization of the process as an Internet web site, active participation by product developers and interactive communication between participants in designing and designers. \circled4 $\ulcorner$e-BDVS) makes possible the use of designers around the wend like in-house designers, overcoming lack in creativity, ideas and human resources traditional business organizations face. However, the operation of $\ulcorner$e-BDVS$\lrcorner$ requires time and budget investments in securing related elements and conditions. \circled5 Cyber designers under $\ulcorner$e-BDVS$\lrcorner$ can easily perform all design projects in cyber space. But they have some limits in playing a role as designers and they have difficulty in getting rewards if such projects completed by them are not finally accepted. \circled6 $\ulcorner$e-BDVS) ensures the rapid use of a wide range of design information and data, reception of a variety of solutions and ideas and effective design development, all of which are not possible through traditional processes. However, this process may not be suitable to be used routine process or tool. \circled7 $\ulcorner$e-BDVS$\lrcorner$ makes it possible for out-sourcing or partners businesses to overcome restrictions in time and space and improve productivity and effectiveness. But such they may have to continue off-line works that can not be treated on-line.
This study attempts to investigate the personalized schemes of interface for the interactive TV sonics enhancing the satisfaction of users from the standpoints of the user and to suggest designing guidelines. In the preface, firstly, the purpose as well as structure of the study were described, the characteristics of the interactive TV and the personalization were defined. Also, it was attempted to understand the development directions of the basic media for services. In addition, the data and elements that became the ground for this study were arranged, including the elements for designing interface, the appraisal method of usability to evaluate the requirements of users, etc. Then, the interfaces of "SkyTouch", an interactive TV sonics by Skylife having the number of users reaching one million at the moment, that is the representative runner in the interactive TV, were analyzed. Then the needs central to the navigation structure and layout for the convenience of users through the evaluation of usability were examined and arranged. In addition, the designing directions of personalized interfaces were studied in the interactive TV by analyzing the web portal sites which were being carried out prior to the personalized services. Based on the data investigated and analyzed previously, the guidelines for the interface design for the personalization of the interactive TV were suggested by classifying the navigation structure and layout, and the personalized interface design was proposed according to the suggested guidelines by applying them directly to "SkyTouch" that is currently carrying out the interactive sonics although it provides limited services in an independent style.
This study began with an assumption that virtual museum exhibitions will continue to be created in the future and more knowledge is required about designing effective virtual exhibit designs. This study explored the relationship between virtual exhibitions and visitor's opinions following the viewing of the virtual exhibit in order to determine the components of a well-constructed virtual exhibit design. To address the research problem, this study explored two aspects of virtual exhibit design: 1) what are the components of a well-constructed virtual exhibit, 2) how does viewing the virtual exhibit change visitors' opinions about both physical and virtual museum experiences. The methodology of the study employed surveys, interviews and observations as instruments of data collection. Twenty-five participants were given a survey prior to their viewing of the on-line exhibit, then they were given the opportunity to view the web-site and finally surveyed regarding their opinions. From the 25 participants, six were selected for observation to record behavior exhibited while they viewed the site. In addition, five were interviewed for a better understanding of their responses to various aspects of the virtual exhibit experiences. Data from the surveys was tabulated for descriptive percentages in order to identify numerical patterns of relationship. Observation data was analyzed for simple frequencies in categories of responses and interview data was tape recorded and transcribed into text files. Based on study results, recommendations were made for the future role of interior design in virtual space that stands independent from a physical building and resides only on the Internet.
The skin on the dorsum of the foot is a source of the reliable thin and sensory cutaneous free tissue transplantation with or without tendon, bone and joint. A composite flap with attached vascularized tendon grafts for the combined loss of skin and tendon on the dorsum of the hand and foot offers an immediate one stage solution to this problem. The flap provides a very durable innervated tissue cover for the heel of the foot and the dorsum of the hand and an osteocutaneous transfer combined with the second metatarsal. The major dorsalis pedis artery is constant in size, but the first dorsal metatarsal artery is variable in size and location. The dorsal surface of the foot receives sensory innervation through the superficial peroneal nerve and the first web through the deep peroneal nerve. Authors had performed 5 dorsalis pedis free flap transplantation in the foot and hand at Department of Orthopedic Surgery, Chonbuk National University Hospital from August 1993 through August 1997 and followed up for the period of between 19 and 67 months until March 1999. The results were as follows 1. 5 cases dorsalis pedis free flap transfer to the foot(4 cases) and the hand(1 case) were performed and the recipient was foot dorsum and heel 2 cases each and hand dorsum 1 case. 2 All of 5 cases(100%) were survived from free flap transfer and recipient artery was dorsalis pedis artery(2 cases), anterior tibial artery(1 case), posterior tibial artery(1 case) and ulnar artery(1 case) and recipient veins were 2 in number except in the hand. 3. Long term follow up of the exterior and maceration was good and sensory recovery was poor 4. Donor site was covered with full thickness skin graft obtained from one or both inguinal areas at postoperative 3rd week and skin graft was taken good and no morbidity was showed.
Most traditional newspaper publishers provide online editions to counter the competition of online news providers. However, the relationship between the online and print editions of the same newspaper has not been clearly defined. Some see the online newspaper as a substitute, while others consider it a complement. A 2002 NAA online newspaper consumer survey indicated that one-third of its respondents said they were now using the print newspaper less. Others have argued that the online edition will not wipe out print consumption, and may even complement it. While the print edition offers particular advantages such as portability, less eye strain, and the tactile experience of a printed page, the online edition also offers specific advantages such as access to breaking news, continually updated information, access to old archives, etc. All these factors would tend to lower the degree of interchangeability between the products. However, recent empirical studies show that the online edition is a substitute for rather than a complement of the print edition. Still, to some print readers, the online edition provides additional value. In this paper, by capturing the two different aspects of online editions the substitute aspect and the additional value added aspect as well as other available online alternatives, we develop an analytical model to derive the optimal production and distribution strategies of both online and print editions. Confronting the "free versus fee" issue, we show that it is optimal to provide an online version of the print newspaper for free to non-print subscribers. However, the amount of free news content that the publishers need to put on the Web depends on the available alternatives on the online market. The "fee" and "free" options both have merits and demerits as well. If the publisher charges for the online version of the print newspaper, she can generate revenue from the fee charged to online readers. However, doing so will limit the size of the online audience and further reduce online advertising revenue. At the same time, by providing a high-quality online version and charging for it, the price of the print newspaper must stay low in order to lure high valued readers. On the contrary, if the publisher provides an online version of the print newspaper for free, she can obtain a larger audience for the online version. At the same time, by providing a low-quality online newspaper, the publisher can increase the print newspaper price to get more revenue from high valued offline readers, although no revenue is incoming from online version readers. Through systematic measuring of all the pros and cons, our analysis shows that the optimal option is not "fee" but "free."
본 웹사이트에 게시된 이메일 주소가 전자우편 수집 프로그램이나
그 밖의 기술적 장치를 이용하여 무단으로 수집되는 것을 거부하며,
이를 위반시 정보통신망법에 의해 형사 처벌됨을 유념하시기 바랍니다.
[게시일 2004년 10월 1일]
이용약관
제 1 장 총칙
제 1 조 (목적)
이 이용약관은 KoreaScience 홈페이지(이하 “당 사이트”)에서 제공하는 인터넷 서비스(이하 '서비스')의 가입조건 및 이용에 관한 제반 사항과 기타 필요한 사항을 구체적으로 규정함을 목적으로 합니다.
제 2 조 (용어의 정의)
① "이용자"라 함은 당 사이트에 접속하여 이 약관에 따라 당 사이트가 제공하는 서비스를 받는 회원 및 비회원을
말합니다.
② "회원"이라 함은 서비스를 이용하기 위하여 당 사이트에 개인정보를 제공하여 아이디(ID)와 비밀번호를 부여
받은 자를 말합니다.
③ "회원 아이디(ID)"라 함은 회원의 식별 및 서비스 이용을 위하여 자신이 선정한 문자 및 숫자의 조합을
말합니다.
④ "비밀번호(패스워드)"라 함은 회원이 자신의 비밀보호를 위하여 선정한 문자 및 숫자의 조합을 말합니다.
제 3 조 (이용약관의 효력 및 변경)
① 이 약관은 당 사이트에 게시하거나 기타의 방법으로 회원에게 공지함으로써 효력이 발생합니다.
② 당 사이트는 이 약관을 개정할 경우에 적용일자 및 개정사유를 명시하여 현행 약관과 함께 당 사이트의
초기화면에 그 적용일자 7일 이전부터 적용일자 전일까지 공지합니다. 다만, 회원에게 불리하게 약관내용을
변경하는 경우에는 최소한 30일 이상의 사전 유예기간을 두고 공지합니다. 이 경우 당 사이트는 개정 전
내용과 개정 후 내용을 명확하게 비교하여 이용자가 알기 쉽도록 표시합니다.
제 4 조(약관 외 준칙)
① 이 약관은 당 사이트가 제공하는 서비스에 관한 이용안내와 함께 적용됩니다.
② 이 약관에 명시되지 아니한 사항은 관계법령의 규정이 적용됩니다.
제 2 장 이용계약의 체결
제 5 조 (이용계약의 성립 등)
① 이용계약은 이용고객이 당 사이트가 정한 약관에 「동의합니다」를 선택하고, 당 사이트가 정한
온라인신청양식을 작성하여 서비스 이용을 신청한 후, 당 사이트가 이를 승낙함으로써 성립합니다.
② 제1항의 승낙은 당 사이트가 제공하는 과학기술정보검색, 맞춤정보, 서지정보 등 다른 서비스의 이용승낙을
포함합니다.
제 6 조 (회원가입)
서비스를 이용하고자 하는 고객은 당 사이트에서 정한 회원가입양식에 개인정보를 기재하여 가입을 하여야 합니다.
제 7 조 (개인정보의 보호 및 사용)
당 사이트는 관계법령이 정하는 바에 따라 회원 등록정보를 포함한 회원의 개인정보를 보호하기 위해 노력합니다. 회원 개인정보의 보호 및 사용에 대해서는 관련법령 및 당 사이트의 개인정보 보호정책이 적용됩니다.
제 8 조 (이용 신청의 승낙과 제한)
① 당 사이트는 제6조의 규정에 의한 이용신청고객에 대하여 서비스 이용을 승낙합니다.
② 당 사이트는 아래사항에 해당하는 경우에 대해서 승낙하지 아니 합니다.
- 이용계약 신청서의 내용을 허위로 기재한 경우
- 기타 규정한 제반사항을 위반하며 신청하는 경우
제 9 조 (회원 ID 부여 및 변경 등)
① 당 사이트는 이용고객에 대하여 약관에 정하는 바에 따라 자신이 선정한 회원 ID를 부여합니다.
② 회원 ID는 원칙적으로 변경이 불가하며 부득이한 사유로 인하여 변경 하고자 하는 경우에는 해당 ID를
해지하고 재가입해야 합니다.
③ 기타 회원 개인정보 관리 및 변경 등에 관한 사항은 서비스별 안내에 정하는 바에 의합니다.
제 3 장 계약 당사자의 의무
제 10 조 (KISTI의 의무)
① 당 사이트는 이용고객이 희망한 서비스 제공 개시일에 특별한 사정이 없는 한 서비스를 이용할 수 있도록
하여야 합니다.
② 당 사이트는 개인정보 보호를 위해 보안시스템을 구축하며 개인정보 보호정책을 공시하고 준수합니다.
③ 당 사이트는 회원으로부터 제기되는 의견이나 불만이 정당하다고 객관적으로 인정될 경우에는 적절한 절차를
거쳐 즉시 처리하여야 합니다. 다만, 즉시 처리가 곤란한 경우는 회원에게 그 사유와 처리일정을 통보하여야
합니다.
제 11 조 (회원의 의무)
① 이용자는 회원가입 신청 또는 회원정보 변경 시 실명으로 모든 사항을 사실에 근거하여 작성하여야 하며,
허위 또는 타인의 정보를 등록할 경우 일체의 권리를 주장할 수 없습니다.
② 당 사이트가 관계법령 및 개인정보 보호정책에 의거하여 그 책임을 지는 경우를 제외하고 회원에게 부여된
ID의 비밀번호 관리소홀, 부정사용에 의하여 발생하는 모든 결과에 대한 책임은 회원에게 있습니다.
③ 회원은 당 사이트 및 제 3자의 지적 재산권을 침해해서는 안 됩니다.
제 4 장 서비스의 이용
제 12 조 (서비스 이용 시간)
① 서비스 이용은 당 사이트의 업무상 또는 기술상 특별한 지장이 없는 한 연중무휴, 1일 24시간 운영을
원칙으로 합니다. 단, 당 사이트는 시스템 정기점검, 증설 및 교체를 위해 당 사이트가 정한 날이나 시간에
서비스를 일시 중단할 수 있으며, 예정되어 있는 작업으로 인한 서비스 일시중단은 당 사이트 홈페이지를
통해 사전에 공지합니다.
② 당 사이트는 서비스를 특정범위로 분할하여 각 범위별로 이용가능시간을 별도로 지정할 수 있습니다. 다만
이 경우 그 내용을 공지합니다.
제 13 조 (홈페이지 저작권)
① NDSL에서 제공하는 모든 저작물의 저작권은 원저작자에게 있으며, KISTI는 복제/배포/전송권을 확보하고
있습니다.
② NDSL에서 제공하는 콘텐츠를 상업적 및 기타 영리목적으로 복제/배포/전송할 경우 사전에 KISTI의 허락을
받아야 합니다.
③ NDSL에서 제공하는 콘텐츠를 보도, 비평, 교육, 연구 등을 위하여 정당한 범위 안에서 공정한 관행에
합치되게 인용할 수 있습니다.
④ NDSL에서 제공하는 콘텐츠를 무단 복제, 전송, 배포 기타 저작권법에 위반되는 방법으로 이용할 경우
저작권법 제136조에 따라 5년 이하의 징역 또는 5천만 원 이하의 벌금에 처해질 수 있습니다.
제 14 조 (유료서비스)
① 당 사이트 및 협력기관이 정한 유료서비스(원문복사 등)는 별도로 정해진 바에 따르며, 변경사항은 시행 전에
당 사이트 홈페이지를 통하여 회원에게 공지합니다.
② 유료서비스를 이용하려는 회원은 정해진 요금체계에 따라 요금을 납부해야 합니다.
제 5 장 계약 해지 및 이용 제한
제 15 조 (계약 해지)
회원이 이용계약을 해지하고자 하는 때에는 [가입해지] 메뉴를 이용해 직접 해지해야 합니다.
제 16 조 (서비스 이용제한)
① 당 사이트는 회원이 서비스 이용내용에 있어서 본 약관 제 11조 내용을 위반하거나, 다음 각 호에 해당하는
경우 서비스 이용을 제한할 수 있습니다.
- 2년 이상 서비스를 이용한 적이 없는 경우
- 기타 정상적인 서비스 운영에 방해가 될 경우
② 상기 이용제한 규정에 따라 서비스를 이용하는 회원에게 서비스 이용에 대하여 별도 공지 없이 서비스 이용의
일시정지, 이용계약 해지 할 수 있습니다.
제 17 조 (전자우편주소 수집 금지)
회원은 전자우편주소 추출기 등을 이용하여 전자우편주소를 수집 또는 제3자에게 제공할 수 없습니다.
제 6 장 손해배상 및 기타사항
제 18 조 (손해배상)
당 사이트는 무료로 제공되는 서비스와 관련하여 회원에게 어떠한 손해가 발생하더라도 당 사이트가 고의 또는 과실로 인한 손해발생을 제외하고는 이에 대하여 책임을 부담하지 아니합니다.
제 19 조 (관할 법원)
서비스 이용으로 발생한 분쟁에 대해 소송이 제기되는 경우 민사 소송법상의 관할 법원에 제기합니다.
[부 칙]
1. (시행일) 이 약관은 2016년 9월 5일부터 적용되며, 종전 약관은 본 약관으로 대체되며, 개정된 약관의 적용일 이전 가입자도 개정된 약관의 적용을 받습니다.