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Implications of abnormal abdominal wall computed tomographic angiography findings on postmastectomy free flap breast reconstruction

  • Ngaage, Ledibabari Mildred;Hamed, Raed R.;Oni, Georgette;Ghorra, Dina T.;Ang, Jolenda Z.;Koo, Brendan C.;Benyon, Sarah L.;Irwin, Michael S.;Malata, Charles M.
    • Archives of Plastic Surgery
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    • v.47 no.2
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    • pp.146-152
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    • 2020
  • Background Preoperative computed tomography angiography (CTA) of the abdominal wall vessels is used when planning free flap breast reconstruction (FFBR) because it provides a surgical road map which facilitates flap harvest. However, there are few reports on the effect of abnormal findings on the operative plan. Methods We conducted a retrospective study of all FFBRs performed at a tertiary referral center over a 6-year period (November 2011 to June 2017). One consultant radiologist reported on the findings. Details on patient demographics, CTA reports, and intraoperative details were collected. Results Two hundred patients received preoperative CTAs. Fourteen percent of patients (n=28) had abnormal findings. Of these findings, 18% were vascular anomalies; 36% tumorrelated and 46% were "miscellaneous." In four patients, findings subsequently prevented surgery; they comprised a mesenteric artery aneurysm, absent deep inferior epigastric (DIE) vessels, bilateral occluded DIE arteries, and significant bone metastases. Another patient had no suitable vessels for a free flap and the surgical plan converted to a pedicled transverse rectus abdominis musculocutaneous flap. The remaining incidental findings had no impact on the surgical plan or appropriateness of FFBR. More than one in 10 of those with abnormal findings went on to have further imaging before their operation. Conclusions CTA in FFBR can have a wider impact than facilitating surgical planning and reducing operative times. Incidental findings can influence the surgical plan, and in some instances, avoid doomed-to-fail and unsafe surgery. It is therefore important that these scans are reported by an experienced radiologist.

Development and Evaluation of a Self-Reflection Program for Intensive Care Unit Nurses Who Have Experienced the Death of Pediatric Patients (환아의 죽음을 경험한 중환자실 간호사를 위한 자기성찰 프로그램의 개발 및 평가)

  • Kang, Hyun-Ju;Bang, Kyung-Sook
    • Journal of Korean Academy of Nursing
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    • v.47 no.3
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    • pp.392-405
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    • 2017
  • Purpose: This study aims to develop a self-reflection program for nurses who have experienced the death of pediatric patients in the intensive care unit and to evaluate its effectiveness. Methods: The self-reflection program was developed by means of the following four steps: establishment of the goal through investigation of an initial request, drawing up the program, preliminary research, and implementation and improvement of the program. The study employed a methodological triangulation to evaluate the effectiveness of the program. Participants were 38 nurses who had experienced the death of pediatric patients (experimental group=15, control group=23); they were recruited using convenience sampling. The self-reflection program was provided over 6 weeks (6 sessions). Data were collected from April to August, 2014 and analyzed using t-tests and content analysis. Results: The quantitative results showed that changes in personal growth (t=-6.33, p<.001) and burnout scores (z=-2.76, p=.005) were better in the experimental group compared to the control group. The qualitative results exhibited two themes, namely "personal growth" and "professional growth", and ten sub-themes. Conclusion: The self-reflection program developed by this study was effective in helping nurses who had experienced the death of pediatric patients to achieve personal growth through self-reflection, and it was confirmed that the program can be applied in a realistic clinical nursing setting. Furthermore, it can be recommended as an intervention program for clinical nurses.

A Comparative Study on Environmental Education Curricula in the Forest Sciences of Korean and German Universities (우리나라와 독일 대학 산림과학과 환경교육 교육과정 비교 연구)

  • 박미선;김종욱
    • Hwankyungkyoyuk
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    • v.15 no.2
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    • pp.49-60
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    • 2002
  • This is a comparative study on environmental education curricula in the forest sciences of korean and german universities. The purpose of this study is to identify the developmental process, structure and content of environmental education(EE) explained by the forest sciences curricula from the two countries and to offer a simultaneous comparison, focusing on the four social variables and seven criteria of comparability in environmental education curricula. For the purpose of this study, the cross-disciplinary approach of George Z. F Bereday was employed. Environmental education curricula of two countries was analysed in the social context through the four phases of comparative procedure; the description, interpretation, juxtaposition and comparison. EE has been taught in the forest sciences of Korea and Germany since the middle 1990s. In forest sciences of two countries, EE was developed in relation to social needs and considered as a form of forest policy. Both korean and german forest sciences curricula include EE for the students to understand the theories and practices of EE as the application of the forest science. In process of EE, the students of two countries develop EE programs. German curricula have more seminars and practices than korean curricula. And various experts participate in education programs. The forest sciences of Korea focus on Environmental Interpretation which raises the quality of visitors' experiences in forest recreation. Contacting with nature(lived experiences) is a important factor in Korean EE. On the other hand, the forest sciences of Germany focus on forest education as a form of public relations and also as a form of EE. In Germany, there are various approaches to forest education; philosophy, ethics, psychology, natural science, forest policy, forest history, education and so on. Forest education includes the multiple levels.

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A Study on the Establishment of Basic Design Concept for Semi-Submersibles (해저자원(海底資源) 개발용(開發用) Semi-Submersible 설계기준(設計基準)의 정립(定立)을 위한 연구(硏究))

  • J.E.,Park;Z.G.,Kim;J.H.,Hwang;S.J.,Yim;H.S.,Choi
    • Bulletin of the Society of Naval Architects of Korea
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    • v.20 no.2
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    • pp.1-20
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    • 1983
  • In this paper design criteria for semi-submersibles, effective at the stage of basic design, are reviewed first generally. Thereafter an extensive study is focussed on essential problematic areas such as design load, heaving motion, overall structural analysis and welding technique. The necessity for this kind of research is apparent in the light of the fact that ocean exploration and exploitation becomes extended to deeper ocean and that semi-submersibles are the most favorite unit for operation under this environment. In some sense principles in naval architecture are indeed applicable to the design of semi-submersible. However, because of the difference in geometry between ships and semi-submersibles, there are significant deviations in design method. A thorough discussion is made on particular behaviours of a semi-submersible in stability, wave load, motion characteristics and structural responses. Then some calculation-procedures and design guidelines are tentatively proposed. A numerical calculation for a semi-submersible Sedco 708 is exemplified for better understanding of the concept. The structure has 4 main and another 4 secondary stabilizing columns with catamaran-type lower hull. In this example design condition is supposed to be 28m wave height, 90 knots wind speed for survival condition and seastate 6 for operational condition in water of 100m depth. The numerical result implies that the actual design of this model can be assessed close to optimum. Further intensive research is strongly required in the subject fields of dynamic stability, rational evaluation of wave load statistical basis for fatigue life judgement.

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Design of LED Bicycle Headlamp with a Horizontally Wide Viewing Angle

  • Park, Hyun Jung;Lee, Dong Kyu;Lee, Jae Min;Park, Kwang-Woo;Joo, Jae Young;Kwak, Joon Seop
    • Current Optics and Photonics
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    • v.1 no.4
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    • pp.351-357
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    • 2017
  • This paper proposes a LED bicycle headlamp with a wide viewing angle to help bicyclists see the front effectively and because of its high visibility to reduce the risks of accidents around intersections or blind spots. The wide viewing angle was determined to be $28^{\circ}$ because it can illuminate a 5 m wide area 10 m away. Therefore, the road conditions of the intersection can be observed with the bicycle handlebar tilted slightly to the left or right. The headlamp has a compact reflector with a width of 30 mm, height of 27 mm, and length of 17 mm. Owing to its size, a change in the position of a light source leads to severe changes in light distribution. Therefore, the tolerance of the source position was analyzed by a simulation. The tolerance was ${\pm}0.5mm$ at the X, Y and Z axes within a less centered aiming range of ${\pm}1^{\circ}$. Finally, the prototype of the bicycle headlamp was made and the light distribution was measured by an automotive headlamp light measurement system. The experimental results indicate that the headlamp illuminates a 5 m wide area with an edge light of 3.2 lx as well as meeting the K-mark regulation.

A Hardware Error Analysis of 3D Face Automatic Recognition Apparatus(3D-FARA) (3차원 안면자동인식기(3D-FARA)의 Hardware 오차분석)

  • Kwak, Chang-Kyu;Cho, Yong-Beum;Sohn, Eun-Hae;Yoo, Jung-Hee;Kho, Byung-Hee;Kim, Jong-Won;Kim, Kyu-Kon;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.18 no.3
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    • pp.49-56
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    • 2006
  • 1. Objectives We are going to develope 3D Face Recognition Apparatus to analyse the facial characteristics of the Sasangin. In the process, we should identify a Hardware Error Analysis of this Apparatus. 2. Methods We verified The resolution, the repetition ability, the Flatness and the Cylindericity of 3D Face Recognition Apparatus by measuring a triangular pyramid, an exact square pillar and a cylinder. 3. Results and Conclusions In this test, The resolution of 3D-FARA was $0.0368mm{\times}0.0594mm{\times}0.2748mm(X{\times}Y{\times}Z)$, the repetition ability was 0.1187mm, the Flatness was 0.17188mm. the Flatness of triangular pyramid was 1.39034mm and the Cylindericity of cylinder was 3.1306mm. In conclusion, If we use 3D-FARA, It is necessary to complement the site of top of the nose and the outline of face, which is likely to occur hardware error, by using software invention or attaching the Land mark to subject.

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A Study on Sasang Constitutional Gene Selection Using DNA Chips by Multivariate Analysis (유전자 칩 및 다변량 분석방법을 이용한 사상체질 유전자 선별에 관한 연구)

  • Kim, Pan-Joon;Seo, Eun-Hee;Lee, Jung-Hwan;Ha, Jin-Ho;Choi, Hong-Sik;Jung, Tae-Young;Goo, Deok-Mo
    • Journal of Sasang Constitutional Medicine
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    • v.18 no.3
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    • pp.131-144
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    • 2006
  • 1. Objectives This research uses the DNA chip, which includes 16,383 gene code, and various statistic prediction way that shows objectification index for the objectification of constitution diagnosis. 2. Methods Drawing blood whose constitution is confirmed, and analyze its gene information by using 1.7k DNA chip to find the gene correlation through multivariate statistical method. 3. Results and Conclusions Distinctive genes such as AK001919, U09384, NM_001805, X99962, NM_004796, AK026738, AL050148, BC002538, AK027074, AK026219, AF087962, AL390142, NM_015372, AL157466, NM_002446, AK024523, NM_014706, NM_014746 and AL137544 were related to Taeumin; AL157448, NM_005957, NM_005656, NM_017548, AK027246, NM_003025, NM_012302 and NM_005905 were represented in Soeumin, while AK026503, AF147325, NM_002076, AF147307, AK001375, NM_003740, NM_005114, AB007890, NM_005505, NM_015900, NM_014936, Z70694, AB023154, U52076, NM_004360, NM_005835, NM_017528, AF087987, NM_014897, AK021720, NM_006420, AJ277915, AK002118 and AK021918 were for Soyangin. This study figured out the possibility to develop the prediction system by sorting each constitution's gene, and research each constitution's distinctive character of manifestation pattern.

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Myofibrillogenesis in Embryonic Chick Pectoral Muscle Cultures: An Immunoelectron Microscopic Study (계배 배양 출근세포에 있어서의 근원섬유 형성과정 :면역 전자현미경적 연구)

  • 하재청;김한도김동수
    • The Korean Journal of Zoology
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    • v.35 no.2
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    • pp.149-160
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    • 1992
  • Using the protein A-gold complex, the mvoabrillogenesis and actin localization of cultured myoblast were invastisated. In the superstructural changes of mvogenic cell during differentiation, pectoral myoblasts contained large nucleus and numerous ribosomes but no myofibrils during the first 24 hr of cultures. Mvoblast initiated to differentiate at 3-day of culture contained the primitive myofibrillar structure. At 96 hr of culture, the mvofibrillar structure showed reletively discernable Z band but pools defined A, H and M bands. The feature of sarcomeric structure showed more defined form at cultur 5 day. In the aspect of actin localization, actin wvas diffusely detected throughout the cytoplasm of myogenic cell and nucleus during the proliferating stage. At 72 hr of culture, with the appearantc oi primitive mvofibrils, gold particles were observed in surrounding of myofibrils but still presented in overall of cytoplasm, especially in the surface and lumen of endoplasmic reticulum. With the gradual increase of culture time, local distribution of actin was readily detected within cytoplasm. In the 5-day specimen of cultures, gold particles precisely indicate the sites of actin localifation within the sarcomere. These results indicate the time of onset of myofibrill appearance and the biosynthetic and incorporation pathway of actin molecules into sarcomeric structure during myofibrillogenesis. Thus, in the present study, the first mvoabrillar structure was detected at culture 3 day, and the initiation of assembly into a typical sarcmeric structure was observed at culture 5 day. It seems, however, that the course of events on myofibrillogenesis of cultured myoblasts can be changed with great dependence of culture conditions including the number and groluth rate of mononucleated mvoblasts after seeding although the fundamental process shows identical appearances.

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Simplified projective transform for reconstruction of cylindrical panorama (실린더 파노라마 영상의 재구성을 위한 단순화된 사영 변환)

  • Lee Kang-Ho
    • Journal of the Korea Society of Computer and Information
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    • v.11 no.2 s.40
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    • pp.169-175
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    • 2006
  • In this paper we propose a method of reconstruction of cylindrical panorama using simplified projective transform from the panning image on the fixed camera. For the practical construction of cylindrical panorama we consider the rotation of the camera on the Y-axis only, even though considering the rotation components on all of the X,Y,Z axis on three-dimensional space for projective transform between general panoramas. The restriction mentioned above simplifies projective transform with existing 8 degrees of freedom into the one with 4 degrees of freedom. In the results, overall computation for projective transform can be decreased to the great extents in quantify, because the number of corresponding points required for inducing the transforming formula is gone down by half. Proposed algorithm from the simulation carried out in this paper shows similar performance and decreased computational quantity compared with existing algorithm. Also, it shows the construction of cylindrical panorama using simplified projective transform.

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Chemical Compositions of Corni Fructus and Separating Properties of Its Flesh by drying (산수유 열매의 화학성분과 건조에 따른 과육분리특성)

  • Lee, Young-Chul;Kim, Young-Eon;Lee, Boo-Yong;Kim, Chul-Jin
    • Korean Journal of Food Science and Technology
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    • v.24 no.5
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    • pp.447-450
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    • 1992
  • An attempt was made to investigate the some constituents and separation of flesh by drying of Corni Fructus for utilization as processing foods of Cornus officianalis S. et Z. Moisture and reducing sugar contents of Corni Fructus flesh were 40.4% and 18.6%, respectively. The content of anthocyanin was 183.0 mg/100g(dry base). The free sugars of Corni Fructus were consisted of glucose and fructose and their contents were 7.9% and 9.0%, respectively. The compositions of organic acids were malic and succinic acids which contained 1.9% and 0.5%, respectively. The titrable acidity as malic acid and pH were 3.6% and 3.19. The decrease ratio of weight and the drying temperature as the optimum conditions for the separation of flesh and seed of Corni Fructus were $30{\sim}35%$ and $60^{\circ}C$.

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