• Archives of Plastic Surgery
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• v.50 no.3
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• pp.315-324
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• 2023

Hemoglobinopathies such as sickle cell disease (SCD) are traditionally considered a relative contraindication to free tissue transfer, due to concerns that erythrocyte sickling will increase the risk of microvascular thrombosis and flap failure. This article describes a case report with the successful use of free tissue transfer in a patient with SCD and provides a systematic literature review on free tissue transfer in SCD. A retrospective chart review was performed of a patient with SCD who underwent free tissue transfer at the authors' institution. A systematic literature review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed using the keywords "free tissue transfer," "free flap," or "microsurgery" and "sickle cell" on PubMed, Ovid/Medline, and Scopus. A 29-year-old male with delayed presentation of an electrical burn to the face and scalp underwent wound closure with a free anterolateral thigh flap. Key management principles included red blood cell transfusion to keep hemoglobin S under 30% and hemoglobin greater than 10 g/dL, maintenance of hydration, normothermia, adequate analgesia, and postoperative anticoagulation. Systematic literature review identified 7 articles describing 13 cases of free tissue transfer in 10 patients with SCD, with combined complete free flap success in 10 of the 13 flaps. Free tissue transfer can be successfully performed in patients with SCD. However, evidence on the optimal management of this unique patient population in the perioperative period after free tissue transfer is limited to case reports in the literature.

• Nuclear Engineering and Technology
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• v.56 no.3
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• pp.803-811
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• 2024

Nuclear accidents such as Fukushima Daiichi have highlighted the potential of passive safety systems to replace or complement active safety systems as part of the overall prevention and/or mitigation strategies. In addition, passive systems are key features of Small Modular Reactors (SMRs), for which they are becoming almost unavoidable and are part of the basic design of many reactors available in today's nuclear market. Nevertheless, their potential to significantly increase the safety of nuclear power plants still needs to be strengthened, in particular the ability of computer codes to determine their performance and reliability in industrial applications and support the safety demonstration. The PASTELS project (September 2020-February 2024), funded by the European Commission "Euratom H2020" programme, is devoted to the study of passive systems relying on natural circulation. The project focuses on two types, namely the SAfety COndenser (SACO) for the evacuation of the core residual power and the Containment Wall Condenser (CWC) for the reduction of heat and pressure in the containment vessel in case of accident. A specific design for each of these systems is being investigated in the project. Firstly, a straight vertical pool type of SACO has been implemented on the Framatome's PKL loop at Erlangen. It represents a tube bundle type heat exchanger that transfers heat from the secondary circuit to the water pool in which it is immersed by condensing the vapour generated in the steam generator. Secondly, the project relies on the CWC installed on the PASI test loop at LUT University in Finland. This facility reproduces the thermal-hydraulic behaviour of a Passive Containment Cooling System (PCCS) mainly composed of a CWC, a heat exchanger in the containment vessel connected to a water tank at atmospheric pressure outside the vessel which represents the ultimate heat sink. Several activities are carried out within the framework of the project. Different tests are conducted on these integral test facilities to produce new and relevant experimental data allowing to better characterize the physical behaviours and the performances of these systems for various thermo-hydraulic conditions. These test programmes are simulated by different codes acting at different scales, mainly system and CFD codes. New "system/CFD" coupling approaches are also considered to evaluate their potential to benefit both from the accuracy of CFD in regions where local 3D effects are dominant and system codes whose computational speed, robustness and general level of physical validation are particularly appreciated in industrial studies. In parallel, the project includes the study of single and two-phase natural circulation loops through a bibliographical study and the simulations of the PERSEO and HERO-2 experimental facilities. After a synthetic presentation of the project and its objectives, this article provides the reader with findings related to the physical analysis of the test results obtained on the PKL and PASI installations as well an overall evaluation of the capability of the different numerical tools to simulate passive systems.

• The Korean Nurse
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• v.30 no.3
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• pp.49-65
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• 1991

This study was carried out to assess the problems with the pregnant women, and check out the risk-factors in the high-risk pregnancies, using a simplified antepartum risk-scoring system, which was revised from Edwards' scoring system to be suitable for Korean situaition. This instrument was included 4 categories, demographic, obstetric, medical and miscellaneous factors. This survey was based on the 1300 pregnant women who were admitted, $x^2$-test, F-test, Pearsons correation, using statistical package SAS in NAS computer system, KIST. The results of the study were as follows; 1. 1313 infants were deliveried of these 560 infants(42.7%) were born to mothers with risk-scores > 7, and 753 infants(57.3%) were born to mothers risk-scores <7. 2. Maternal age" parity, education level, of the demographic factors were significant relation statistically to identify the high risk pregnancies($X^2$=20.88, 42.87, 15.60 P < 0.01). 3. C-section, post term, incompetent cervix, uterine anomaly, polyhydramnios, congenital anomaly, sensitized RH negative, abortion, preeclampsia, excessive size infant, premature, low birth weight infanl, abnormal presentation, perinatal loss, multiple pregnancy, of the obstetric factors were significant relation statistically to identify the high risk-pregnancies. ($X^2$ = 175.96, 87.5, 16.28, 21.78, 9.46, 8. 10, 6.75, 22.9, 64.84, 6.93, 361.43, 185.55, 78.65, 45.52, P < 0.01). 4. Abnormal nutrition, anemia, UTI, other medicalcondition(pulmonary disease, severe influenza), heart disease, V.D., of the miscellaneous and medical factors, were significant relation statistically to identify the high risk-pregnancies. 5. Premature, low birth weight infant, contracted pelvis, abnormal presentation, of the risk factors were significantly related with Apgar score at 1 '||'&'||' 5 minute after birth and neonatal body weight. 6. Apgar score at 1 '||'&'||' 5 minute after, birth and neonatal body weight were significantly negative correlated with risk-score. 7. There were statistically significant difference between risk-score and Apgar score at 1 '||'&'||' 5 minute after birth, 3 group(0-3, 4-6, above 7), and neonatal body weight, 2 group(below 2.5kg, the other group) (F=104.65, 96.61, 284.92, P<0.01). 8. Apgar score at 1 '||'&'||' 5 minute after birth(below 7), and neonatal body weight(below 2.5kg), were significant relation statistically with risk score.($x^2$=65.99, 60.88, 177.07, P<0.01) were 60.8 %, 60% . 9. Correct classifications of morbid infants(l '||'&'||' 5 minute Apgar score < 7) were 77.8%, 83.8% and that of nonmorbid infants(l '||'&'||' 5 minute Apgar score > 7) were 60.8%, 60%. 10. There were statistically significant difference between dislribution of maternal risk-score among the morbid infants(l '||'&'||' 5 minute Apgar score < 7) and non morbid infants(l '||'&'||' 5 minute Apgar score> 7) ($x^2$=64.8, 58.8, P < 0.001). 11. There were statistically significant difference between distribution of morbid infants(l '||'&'||' 5 minute Apgar score < 7) and fetal death. 12. The predictivity for classifying high.risk cases was 12 % and for classifying low-risk cases was 98.3 % in 5 minute Apgar score. Suggestions for further studies are as follows; 1. Contineous prospective studies, using this newly revised scoring system are strongly recommended in the stetric service. 2. Besides risk facto~s used in this study, assessmenl of risks by factors in another scoring system and paralled studies related to perinatal outcome are strongly recommended.

• Journal of Chest Surgery
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• v.24 no.7
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• pp.674-684
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• 1991

The surgical treatment of tetralogy of Fallot [TOF] was initiated by Blalock and Taussig in 1945 with the establishment of the subclavian artery to pulmonary artery anastomosis. In an imaginative and daring effort, in 1954, Lillehei and collaborators [1955] using controlled cross-circulation, carried out the first intracardiac repair of TOF by closing the ventricular septal defect [VSD] and relieving the pulmonary stenosis under direct vision. Nowadays, total correction is the ideal operation for treatment of TOF and is accomplished with extracorporeal circulation. And the results of surgery for TOF have steadily improved over the years, thanks to important contributions of many surgeons. Nevertheless because of its protean physiologic and anatomic presentation, TOF continues to offer challenges to cardiologist and cardiac surgeons. Thirty two cases of TOF have undergone total corrective surgery using extracorporeal circulation in the Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, Inje University, from Oct. 1985 to Feb. 1990. Clinical considerations were applied to these cases and the results were obtained as follows. 1. The heart lung machine used for extracorporeal circulation was SarnsO 7000, 5-head roller pump, and the number and type of oxygenators were 10 of bubble type and 22 of membrane type. The mean bypass time was 148.9 minutes and the mean aortic cross clamp time was 123.8 minutes. The GIK [glucose-insulin-potassium] solution was used as cardioplegic solution for myocardial protection during operation. 2. 20 cases were male and 12 were female, the mean age was 8 years old and the mean body weight was 25Kg. 3. The preoperative symptoms were cyanosis [29 cases], squatting [27 cases] and etc. The mean values of preoperative Hb., Hct., and SaO2 were 16.5 gm /dl, 50.3%, and 78.5%. 4. Combined anomalies were noticed in 16 cases [50%]. Among them 10 cases were PFO and 6 cases were ASD. 5. The degree of aorta overriding were 25% in 5 cases, 25 ~ 50% in 22 cases and above 50% in 5 cases. The dPA/Ao [ratio of diameter of pulmonary artery trunk to ascending aorta] were below 25% in 5 cases, 25 ~ 50% in 10 cases, 50 ~ 70% in 6 cases and above 75% in 11 cases. 6. The types of RVOT [right ventricular outflow tract] stenosis were valvular and infundibular in 14 cases [43.6%], diffuse hypoplastic type in 12 cases [37.5%], infundibular in 5 cases, and valvular and supravalvular in 1 case. 7. One stage radical corrective surgery was applied to the all cases. In widening of the RVOT, 3 types of patches were used: MVOP [monocusp ventricular outflow patch, Polystan BioprosthesesO] in 3 cases, knitted Dacron vessel patches in 2 cases, and double layer with bovine pericardium and woven Dacron prosthesis in 26 cases. 8. Postoperative complications were occurred in 15 cases. Among them, low output syndrome were occurred in 10 cases [31.3%] and 2 of them were expired postoperatively.

• Journal of the Korean Society of Earth Science Education
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• v.16 no.2
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• pp.247-260
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• 2023

In this study, when applying the 'geological structure' content element of high school earth science I developed according to the 2015 curriculum to the STEAM program using a web-based expert system using 3D data of Google Earth and drones, the creative problem-solving ability of high school students, attitudes toward STEAM, and the results of this study are as follows. First, after applying the STEAM program, high school students' creative problem-solving ability showed meaningful results at the p<.001 level. Second, STEAM attitudes showed a significant value at the p<.001 level, confirming that they had a positive impact on high school students' attitudes towards STEAM. It was judged that web-based class activities using Google Earth and drones were useful for integrated thinking such as learners' sense of efficacy and value recognition for usefulness of knowledge. High school students' satisfaction with the STEAM program was 3.251, showing a slightly high average. It was confirmed that web-based class activities such as drones and Google Earth had a positive impact on learners' class satisfaction. However, it was interpreted that the lack of time for class activities limited the ability of the learners to increase their interest in class. The proposal of this research is as follows. First of all, in consideration of the production of presentation materials and practical training in the STEAM program, activities such as block time and advance instruction for class understanding before class are necessary. Secondly, in order to revitalize STEAM education in the high school curriculum, we judge that research on the development of various integrated education programs that can be applied to the high school grade system is necessary.

• Journal of Radiation Protection and Research
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• v.30 no.3
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• pp.121-130
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• 2005

Geographical Information System(GIS) was established to display the calculation results which show the concentration change with time and regions in case of an accidental release of radionuclides from Kori Nuclear Power Plants. GIS included the commercial program, ArcView(ESRI), and a basic digital map of 1:5000 scale lot 20km by 20km around Kori area. The object for the presentation was $^{131}I$ concentration in rice which is one of staple foodstuffs. Provided by deposited $^{131}I$ concentrations, ECOREA-II code computed the $^{131}I$ concentration of the soil and the plant in the area divided by In unit cells in total, in which the concentrations also varied with time. The results were introduced into the attributed data of previously designed polygon cells in ArcView. In order to display the concentration change with time by monotonic color, the RGB value for ArcView color lamp was controlled. This display definitely helped the concentration change around Kori area be acceptable to public.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.168-177
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• 2007

Purpose : The purpose of this study was to investigate whether hypercalciuria patients with hematuria show different renal indices compared to non-hypercalciuria patients with hematuria. Methods : We retrospectively reviewed the medical records of patients with gross or microscopic hematuria whose blood chemistry and 24 hour urine chemistry were examined. After excluding the patients with more than $4 mg/m^2/day$ proteinuria or the patients with urinary calcium excretion between 3 and 4 mg/kg/day, we divided the patients into two groups: a hypercalciuria group whose calcium excretion was more than 4 mg/kg/day(n=30) and a non hypercalciuria group whose calcium excretion was less than 3 mg/kg/day(n=41). The urinary excretion, clearance, and fractional excretion(FE) of Na, K, Cl, Ca, P, urea, and creatinine were calculated and compared between the two groups. Results : The hypercalciuria group had more calcium excretion($6.1{\pm}2.9$ vs $1.5{\pm}0.9 mg/kg/day$), more urea excretion($341{\pm}102$ vs $233{\pm}123 mg/kg/day$), greater glomerular filtration rate(GFR) ($93.7{\pm}31.1$ vs $79.5{\pm}32.0 mL/min$) but lower FENa($1.0{\pm}0.4%$ vs $1.3{\pm}0.6%$) than the nonhyper-calciuria group, although the urinary sodium excretion was similar between the two groups. Conclusion : The greater urea excretion and GFR in hypercalciuric patients suggest that they might be on a higher protein diet than the non-hypercalciuria group. The increased glomerular filtration of sodium and calcium induced by the higher GFR in hypercalciuria would have increased their delivery to the distal tubule, where sodium is effectively reabsorbed but calcium is not, which is suggested by the lower FENa but higher FECa in hyercalciuria. It is recommended that the diet of hematuria patients be reviewed in detail at initial presentation and during treatment.

• Korean Journal of Radiology
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• v.24 no.11
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• pp.1102-1113
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• 2023

Objective: To elucidate the use of radiological studies, including nuclear medicine, and biopsy for the diagnosis and staging of prostate cancer (PCA) in clinical practice and understand the current status of PCA in Asian countries via an international survey. Materials and Methods: The Asian Prostate Imaging Working Group designed a survey questionnaire with four domains focused on prostate magnetic resonance imaging (MRI), other prostate imaging, prostate biopsy, and PCA backgrounds. The questionnaire was sent to 111 members of professional affiliations in Korea, Japan, Singapore, and Taiwan who were representatives of their working hospitals, and their responses were analyzed. Results: This survey had a response rate of 97.3% (108/111). The rates of using 3T scanners, antispasmodic agents, laxative drugs, and prostate imaging-reporting and data system reporting for prostate MRI were 21.6%-78.9%, 22.2%-84.2%, 2.3%-26.3%, and 59.5%-100%, respectively. Respondents reported using the highest b-values of 800-2000 sec/mm² and fields of view of 9-30 cm. The prostate MRI examinations per month ranged from 1 to 600, and they were most commonly indicated for biopsy-naïve patients suspected of PCA in Japan and Singapore and staging of proven PCA in Korea and Taiwan. The most commonly used radiotracers for prostate positron emission tomography are prostate-specific membrane antigen in Singapore and fluorodeoxyglucose in three other countries. The most common timing for prostate MRI was before biopsy (29.9%). Prostate-targeted biopsies were performed in 63.8% of hospitals, usually by MRI-ultrasound fusion approach. The most common presentation was localized PCA in all four countries, and it was usually treated with radical prostatectomy. Conclusion: This survey showed the diverse technical details and the availability of imaging and biopsy in the evaluation of PCA. This suggests the need for an educational program for Asian radiologists to promote standardized evidence-based imaging approaches for the diagnosis and staging of PCA.

• Nuclear Engineering and Technology
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• v.46 no.3
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• pp.439-446
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• 2014

An amphibious inspection robot system (hereafter AIROS) is being developed to visually inspect the in-containment refueling storage water tank (hereafter IRWST) strainer in APR1400 instead of a human diver. Four IRWST strainers are located in the IRWST, which is filled with boric acid water. Each strainer has 108 sub-assembly strainer fin modules that should be inspected with the VT-3 method according to Reg. guide 1.82 and the operation manual. AIROS has 6 thrusters for submarine voyage and 4 legs for walking on the top of the strainer. An inverse kinematic algorithm was implemented in the robot controller for exact walking on the top of the IRWST strainer. The IRWST strainer has several top cross braces that are extruded on the top of the strainer, which can be obstacles of walking on the strainer, to maintain the frame of the strainer. Therefore, a robot leg should arrive at the position beside the top cross brace. For this reason, we used an image processing technique to find the top cross brace in the sole camera image. The sole camera image is processed to find the existence of the top cross brace using the cross edge detection algorithm in real time. A 5-DOF robot arm that has multiple camera modules for simultaneous inspection of both sides can penetrate narrow gaps. For intuitive presentation of inspection results and for management of inspection data, inspection images are stored in the control PC with camera angles and positions to synthesize and merge the images. The synthesized images are then mapped in a 3D CAD model of the IRWST strainer with the location information. An IRWST strainer mock-up was fabricated to teach the robot arm scanning and gaiting. It is important to arrive at the designated position for inserting the robot arm into all of the gaps. Exact position control without anchor under the water is not easy. Therefore, we designed the multi leg robot for the role of anchoring and positioning. Quadruped robot design of installing sole cameras was a new approach for the exact and stable position control on the IRWST strainer, unlike a traditional robot for underwater facility inspection. The developed robot will be practically used to enhance the efficiency and reliability of the inspection of nuclear power plant components.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.3207-3210
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• 2014

Background: Inflammatory breast cancer (IBC) is an aggressive form of locally advanced breast cancer characterized by rapidly progressive breast erythema, pain and tenderness, oedema and paeu d'orange appearance. It accounts for 1-3% of all newly diagnosed cases of breast cancer in the west. Data on IBC from India are lacking. The aim of our study was to assess the clinical-pathological parameters and outcome of IBC at, All India Institute of Medical Sciences, a large tertiary care centre. Materials and Methods: We screened 3,650 breast cancer cases registered from January 2004 to December 2012 and found 41 cases of IBC. Data included demographics as well as clinical, radiological and histopathological characteristics, and were collected from clinical case records using the International Classification of Diseases code (C-50). Patients who presented with IBC as a recurrence, or who had a neglected and advanced breast cancer that simulated an IBC were excluded from this study. Results: The median age was 45 years (range 23-66). The median duration of symptoms was 5 months. The American Joint Committee on Cancer stage (AJCC) distribution was Stage III - 26 and IV - 15 patients. Estrogen receptor (ER), progesterone receptor (PR) positivity and human epidermal growth factor receptor 2 (HER2/neu) positivity were 50%, 46% and 60%, respectively. Triple negativity was found in 15% of the cases. All the non metastatic IBC patients received anthracycline and/ or taxane based chemotherapy followed by modified radical mastectomy, radiotherapy and hormonal therapy as indicated. Pathological complete remission rate was 15%. At a median follow-up of 30 months, the 3 year relapse free survival and overall survival were 30% and 40%respectively. Conclusion: IBC constituted 1.1% of all breast cancer patients at our centre. One third of these had metastatic disease at presentation. Hormone positivity and Her2 neu positivity were found in 50% and 60% of the cases, respectively.