• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.4
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• pp.460-463
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• 2014

Chemotherapy-induced peripheral neuropathy (CIPN) which is one of the common chemotherapy related toxicity poses a significant clinical challenge. Here we conducted a prospective pilot study to evaluate the efficacy of acupuncture on CIPN. Patients with CIPN were administered acupuncture procedure with continuation of previous conventional medication. Acupuncture procedures were conducted three times per week for 3 weeks. We assessed patients with Common Terminology Criteria for Adverse Events (CTCAE) v4.0, Visual Analog Scale (VAS), Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Neurotoxicity (FACT/GOG-Ntx) at the time of baseline and every week after the acupuncture procedures. Total 5 patients were included and treated with acupuncture. CTCAE grades were the same of 2 in all patients. VAS mean value changed from 5.2 to 3.2, and FACT/GOG-Ntx total score that suggests the higher relates to better quality of life changed from 93.3 to 110 as mean value at the end of the 3rd week, though this index difference did not show any statistically significant difference. This pilot study suggests that acupuncture procedure may have a role for CIPN treatment. Launching a more larger and properly controlled study will be required to ascertain the efficacy of acupuncture.

• Journal of Chest Surgery
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• v.39 no.2 s.259
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• pp.145-149
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• 2006

The surgical management of patients with transposition of the great arteries, ventricular septal defect, and pulmonary stenosis remains a challenge. The Rastelli operation or Lecompte operation is the preferred surgical procedure, but its long-term results are not optimal because of a warped left ventricular outflow tract through a space-occupied intraventricular tunnel and a contrived right ventricular outflow tract. We performed a half-turned truncal switch operation as an alternative surgical procedure in a 3-year-old boy (weighing 9.6 kg) with this anomaly. Postoperative echocardiography showed laminar flow through straight and nonobstructive aortic and pulmonary ventricular outflow tracts.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.28 no.2
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• pp.74-85
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• 2019

The aesthetic restoration of dental implants in the anterior maxilla is a challenge for clinicians because it requires proper harmony in three following conditions; reconstruction of hard tissue, soft tissue, and aesthetic prosthesis. A newer technique, VIP-CT (Vacularized Interpositional Periosteal Connective Tissue) graft has been introduced as an alternative to these technique which allows the clinicians perform large volume soft tissue augmentation in esthetic sites with a single procedure. The advantages of the VIP-CT graft technique are that it allows the reconstruction of large soft tissue deficiency, with little constriction postoperatively. Furthermore, it facilitates improved hard tissue augmentation due to the additional blood supply and improved bone healing by mesenchymal cells. Moreover, this technique reduces patient discomfort and treatment time. This clinical report describes the procedure of bone augmentation during immediate implantation in facial dehiscence defect, especially Vascularized Interpositional Periosteal Connective Tissue(VIP-CT) graft for aesthetic anterior soft tissue.

• Computers and Concrete
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• v.29 no.4
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• pp.219-235
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• 2022

Strengthening slender reinforced concrete (RC) columns is a challenge. They are susceptible to overall buckling that induces bending moment and axial compression. This study presents the precise three-dimensional finite element modeling of slender RC columns strengthened with fiber-reinforced polymer (FRP) composites sheets with various patterns under concentric or eccentric compression. The slenderness ratio λ (height/width ratio) of the studied columns ranged from 15 to 35. First, to determine the optimal modeling procedure, nine alternative nonlinear finite element models were presented to simulate the experimental behavior of seven FRP-strengthened slender RC columns under eccentric compression. The models simulated concrete behavior under compression and tension, FRP laminate sheets with different fiber orientations, crack propagation, FRP-concrete interface, and eccentric compression. Then, the validated modeling procedure was applied to simulate 58 FRP-strengthened slender RC columns under compression with minor eccentricity to represent the inevitable geometric imperfections. The simulated columns showed two cross sections (square and rectangular), variable λ values (15, 22, and 35), and four strengthening patterns for FRP sheet layers (hoop H, longitudinal L, partial longitudinal L_w, and longitudinal coupled with hoop LH). For λ=15-22, pattern L showed the highest strengthening effectiveness, pattern L_w showed brittle failure, steel reinforcement bars exhibited compressive yielding, ties exhibited tensile yielding, and concrete failed under compression. For λ>22, pattern L_w outperformed pattern L in terms of the strengthening effectiveness relative to equivalent weight of FRP layers, steel reinforcement bars exhibited crossover tensile strain, and concrete failed under tension. Patterns H and LH (compared with pattern L) showed minor strengthening effectiveness.

• Advances in aircraft and spacecraft science
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• v.10 no.3
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• pp.223-243
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• 2023

There is a burgeoning demand for minimizing the mass of satellites because of its direct impact on reducing launch-to-orbit cost. This must be done without compromising the structure's efficiency. The present paper introduces a relatively low-cost and easily implementable approach for optimizing structural mass to a maximum natural frequency. The natural frequencies of the satellite are of utmost pertinence to the application requirements, as the sensitive electronic instrumentation and onboard computers should not be affected by the vibrations of the satellite structure. This methodology is applied to a realistic model of Al-Azhar University micro-satellite in partnership with the Egyptian Space Agency. The procedure used in structural design can be summarized in two steps. The first step is to select the most favorable primary structural configuration among several different candidate variants. The nominated variant is selected as the one scoring maximum relative dynamic stiffness. The second step is to use perforation patterns reduce the overall mass of structural elements in the selected variant without changing the weight. The results of the presented procedure demonstrate that the mass reduction percentage was found to be 39% when compared to the unperforated configuration that had the same plate thickness. The findings of this study challenge the commonly accepted notion that isogrid perforations are the most effective means of achieving the goal of reducing mass while maintaining stiffness. Rather, the study highlights the potential benefits of exploring a wider range of perforation unit cells during the design process. The study revealed that rectangular perforation patterns had the lowest efficiency in terms of modal stiffness, while triangular patterns resulted in the highest efficiency. These results suggest that there may be significant gains to be made by considering a broader range of perforation shapes and configurations in the design of lightweight structures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.1
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• pp.50-54
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• 2012

According to Luhr's classification, a fracture in the mandible with a width of less than 15-20 mm is considered to be an atrophic mandibular fracture and its incidence is very rare. Because of the reduced cross-sectional area and smaller contact area of the fractured ends as well as the poorly vascularized bony structure and delayed bone healing, an atrophic mandibular fracture is a great challenge for oral and maxillofacial surgeons. Surgeons tend to perform closed reduction, because open reduction is considered a non-life-saving surgery among elderly patients. Thus, most of them have limited experience in surgical management. According to recent reports, open reduction yields a good result, and the Association for Osteosynthesis (AO) group has recommended open reduction. This is a case report of our two experiences of open reduction and rigid fixation of atrophic mandibular fractures by the AO principle. Articles were also reviewed here.

• Archives of Plastic Surgery
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• v.43 no.6
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• pp.604-607
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• 2016

"A smile is happiness you'll find right under your nose"- Tom Wilson. This quote holds true just for patients, not for surgeons. The correction of the nose always poses a challenge to the cosmetic surgeon. Deformities of the external and internal nose may be congenital or acquired and may be secondary to soft tissue and/or osseo-cartilaginous abnormalities, leading to aesthetic and/or functional consequences. Alar flare poses a common problem, sometimes alone and sometimes in conjunction with other external deformities. Alar base reduction is generally considered when the interalar distance exceeds the intercanthal distance. It has been well documented that this simple additional procedure brings about a substantial enhancement in the nose. Various techniques have been described and used in the past, each having their benefits and drawbacks, with the modified Weir wedge excision, Aufricht nasal sill excision, and Bernstein V-Y advancement being the common ones. We hereby describe a technique that is simple yet effective in achieving the desired results and at the same time aims at preventing relapse to obtain satisfactory long term results.

• Archives of Reconstructive Microsurgery
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• v.24 no.2
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• pp.68-74
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• 2015

Purpose: The reconstruction of femur and tibia defects following tumor resection remains a surgical challenge. The clinical outcome of free vascularized fibula graft (VFG) reconstruction with locking plate for massive femur and tibia defects of more than 10 cm that were secondary to skeletal tumor resection is reported. Materials and Methods: Thirteen patients with a mean follow-up of 3.3 years were reviewed. Seven patients received vascularized fibula grafts in the femur and six in the tibia. The mean bony defect of the femur and tibia was more than 10 cm and the length of the grafted fibula was more than 15 cm. All defects were stabilized with long locking plates. Results: All patients were free of disease at final follow-up; All VFGs were transferred successfully. All patients had a successful outcome with bony union. Stress fractures of the grafted fibula had occurred but the locking plate stabilized the fracture and healed until the last follow-up. All patients were able to walk without a brace after a mean of 9 months postoperatively. Conclusion: VFG with locking plate is a reliable reconstructive procedure for massive femur and tibia defects.

• Structural Engineering and Mechanics
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• v.17 no.3_4
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• pp.429-444
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• 2004

The ambient vibration measurement is a kind of output data-only dynamic testing where the traffics and winds are used as agents responsible for natural or environmental excitation. Therefore an experimental modal analysis procedure for ambient vibration testing will need to base itself on output-only data. The modal analysis involving output-only measurements presents a challenge that requires the use of special modal identification technique, which can deal with very small magnitude of ambient vibration contaminated by noise. Two complementary modal analysis methods are implemented. They are rather simple peak picking (PP) method in frequency domain and more advanced stochastic subspace identification (SSI) method in time domain. This paper presents the application of ambient vibration testing and experimental modal analysis on large civil engineering structures. A 15 storey reinforced concrete shear core building and a concrete filled steel tubular arch bridge have been chosen as two case studies. The results have shown that both techniques can identify the frequencies effectively. The stochastic subspace identification technique can detect frequencies that may possibly be missed by the peak picking method and gives a more reasonable mode shapes in most cases.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.190-194
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• 2016

Double outlet right ventricle (DORV) and transposition of the great arteries (TGA) with ventricular septal defect (VSD) and pulmonary stenosis (PS) are complex heart diseases, the treatment of which remains a surgical challenge. The Rastelli procedure is still the most commonly performed treatment. Aortic root translocation including an arterial switch operation is advantageous anatomically since it has a lower possibility of conduit blockage and the left ventricle outflow tract remains straight. This study reports successful aortic root transpositions in two patients, one with DORV with VSD and PS and one with TGA with VSD and PS. Both patients were discharged without postoperative complications.