• Journal of Chest Surgery
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• v.45 no.6
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• pp.390-395
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• 2012

Background: Conventional open repair is a suboptimal therapy for blunt traumatic aortic injury (BTAI) due to the high postoperative mortality and morbidity rates. Recent advances in the thoracic endovascular repair technique may improve outcomes so that it becomes an attractive therapeutic option. Materials and Methods: From August 2003 to March 2012, 21 patients (mean age, 45.81 years) with BTAI were admitted to our institution. Of these, 18 cases (open repair in 11 patients and endovascular repair in 7 patients) were retrospectively reviewed and the early perioperative results of the two groups were compared. Results: Although not statistically significant, there was a trend toward the reduction of mortality in the endovascular repair group (18.2% vs. 0%). There were no cases of paraplegia or endoleak. Statistically significant reductions in heparin dosage, blood loss, and transfusion amounts during the operations and in procedure duration were observed. Conclusion: Compared with open repair, endovascular repair can be performed with favorable mortality and morbidity rates. However, relatively younger patients who have acute aortic arch angulation and a small aortic diameter may be a therapeutic challenge. Improvements in graft design, delivery sheaths, and graft durability are the cornerstone of successful endovascular repair.

• Water Engineering Research
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• v.3 no.4
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• pp.259-267
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• 2002

South Africa has developed a policy and law that calls and provides for the equitable and sustainable use of water resources. Sustainable resource use is dependent on effective resource protection. Rivers are the most important freshwater resources in the country, and there is a focus on developing and applying methods to quantify what rivers need in terms of flow and water quality. These quantified and descriptive objectives are then related to specified levels of ecological health in a classification system. This paper provides an overview of an integrated and systematic methodology, where, fer each river, and each river reach, the natural condition and the present ecological condition are described, and a level/class of ecosystem health is selected. The class will define long term management goals. This procedure requires each ecosystem component to be quantified, starting with the abiotic template. A modified flow regime is modelled for each ecosystem health class, and the resultant fluvial geomorphology and hydraulic habitats are described. Then the water chemistry is described, and the water quality changes that are likely to occur as a consequence of altered flows are predicted. Finally, the responses to the stress imposed on the biota (fish, invertebrates and vegetation) by modified flow and water quality are predicted. All of the predicted responses are translated into descriptive and/or quantitative management objectives. The paper concludes with the recognition of active method development, and the enormous challenge of applying the methods, implementing the law, and achieving river protection and sustainable resource-use.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.28 no.2
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• pp.131-134
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• 2017

Sulcus vocalis remains a surgical challenge despite many recent advances in laryngomicrosurgeries. We previously reported that 585-nm Pulsed dye laser (PDL) exerts favorable outcome in treatment of sulcus vocalis due to its therapeutic effects of collagen rearrangement and improved wound remodeling. In spite of the usefulness of PDL glottoplasty for treating sulcus vocalis, the device is no more available in the country. It prompted us to focus another angiolytic laser ; 532-nm KTP laser which has similar mechanisms of action and has been used for treatment of other laryngeal lesions elsewhere. Herein, we present a case of sulcus vocalis successfully treated with KTP laser. A patient underwent laryngomicrosurgery with angiolytic KTP laser (KTP glottoplasty) by the same surgical procedure with PDL glottoplasty. After the surgery, the patient presented improved voice outcome in time without complications.

• Archives of Reconstructive Microsurgery
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• v.16 no.2
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• pp.86-92
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• 2007

Failure of reattachment of finger is inevitable in replantation surgery and that failure rate is about 10 % are reported in many authors. Management of the failed finger replantation is challenge to microsurgeons. We report 7 cases of thumb reconstruction after failure of replantation. The reconstructive surgery composed with early debridement of soft tissue that are under gangrenous processing, extract the phalangeal bone without any soft tissues. Osteosynthesis of the extracted phalangeal bone with host phalangeal bone. The exposed bony portion covered with vascularized flaps such as reverse radial forearm pedicled flap, free radial forearm flap and neurovascular island finger flap. This procedure underwent within a week after vascular insufficiency developed. All of the flaps are survived, bone union achieved within 3 months. The function and external appearance of the reconstructed thumb were encouraging; pinch power was average 1.2 pounds. Early removal of necrotizing soft tissue followed by covering none vascular phalangeal bone which extracted from the dead phalanx with vascularized flap is one of the useful alterative solutions in failed replantation surgery in hand.

• The Journal of Asian Finance, Economics and Business
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• v.7 no.10
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• pp.769-781
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• 2020

This study attempts to examine the relationships between transformational leadership, learning orientation, firm innovativeness, and financial performance. Specifically, the moderating effect of learning orientation and firm innovativeness. The data collected from 606 SMEs in Thailand were evaluated using the structural equation modeling, typifying that quantitative research. The results revealed that transformational leadership had a positive effect on learning orientation. Similarly, transformational leadership had a positive effect on firm innovativeness. Further, the study found that transformational leadership had a positive indirect effect on financial performance through the mediation of learning orientation. The results of the study found that transformational leadership had a positive indirect effect on financial performance through the mediation of firm innovativeness. Transformational leadership and learning orientation to improve innovation within the organization, including organizations and leaders among themselves. Especially, innovative firms inculcate ideals of promise to learning, open-mindedness, and shared vision. Furthermore, practitioners can use the findings of this study when they perform their role of leaders to challenge creativity and innovation among followers. Finally, those developments would influence a procedure of evidence procurement, evidence distribution and shared explanation that escalations equally individual and administrative effectiveness owing to its influence going on products.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.1
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• pp.57-64
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• 2016

Clinical therapy that combines full-mouth rehabilitation with immediate implantation and orthognathic surgery poses a challenge to prosthodontists. This clinical report describes a multidisciplinary approach to the diagnosis and treatment of a patient presenting with skeletal discrepancy and rampant caries. The results thus achieved indicate that full-mouth rehabilitation by fixed immediate and early loading implantation accompanied by orthognathic surgery can be a predictable and effective treatment procedure.

• Proceedings of the Korean Institute of Navigation and Port Research Conference
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• v.1
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• pp.465-469
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• 2006

In recent years there has been considerable interest in the construction of super high-rise buildings. From the prior art, various procedures and devices for surveys during and after the phase of erection of a high-rise building are known. High-rise buildings are subject to strong external tilt effects caused, for instance, by wind pressures, unilateral thermal effects by exposure to sunlight, and unilateral loads. Such effects are a particular challenge in the phase of construction of a high-rise building, in as much as the high-rise building under construction is also subject to tilt effects, and will at least temporarily lose its - as a rule exactly vertical - alignment. Yet construction should progress in such a way that the building is aligned as planned, and particularly so in the vertical, when returning into an un-tilted basic state.It is essential that a straight element be constructed that theoretically, even when moving around its design centre point due to varying loads, would have an exactly vertical alignment when all biasing conditions are neutralised. Because of differential raft settlement, differential concrete shortening, and construction tolerances, this ideal situation will rarely be achieved. This paper describes a procedure developed by the authors using GPS observations combined with a network of precision inclination sensor to provide reliable coordinated points at the top of the worldwide highest-rise building under construction in Dubai.

• Archives of Plastic Surgery
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• v.34 no.2
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• pp.217-221
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• 2007

Purpose: Reconstruction of the soft tissue defect exposing Achilles tendon is a formidable challenge because of the paucity of soft tissue and relatively poor blood supply. This article describes the reconstruction of soft tissue defect exposing Achilles tendon using gracilis muscle free flap and split-thickness skin graft. Methods: From 2000 to 2005, four patients with soft tissue defect exposing Achilles tendon and infection were operated using gracilis muscle free flap and split-thickness skin graft. The defect size ranged from 3.5 to 5cm wide and 6.5 to 8cm long. The mean postoperative follow-up was twenty months. Results: All the flaps were survived without necrosis and infection. We obtained the satisfactory results with good functional and aesthetical outcomes. All cases showed good results with the characteristics of a relatively thin flap without additional debulking procedure. Conclusion: Gracilis muscle free flap with split thickness skin graft could be a good option for reconstruction of soft tissue defect of posterior ankle, exposing Achilles tendon with minimal morbidity of the donor site.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.457-460
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• 2010

Purpose: The great toe presents a reconstructive challenge for plastic surgeons. The big toe has much importance not only for the gait and the stability, but also for appearance aspects. Few reports have documented the reconstruction of big toe defects and we report a unique case of free flap reconstruction technique. Methods: A 41-year-old man with right great toe open fracture with soft tissue necrosis was referred from the orthopedic surgery department. On physical examination, there was the skin necrosis circumferentially and the fratured bone was severely fragmented. The metatarsophalangeal (MTP) joint of the big toe was intact. After the wound debridement, we harvested the innervated anterolateral thigh flap and transposed to the defected area. After five months, we finally retouched the flap by the dorsal defatting and distal debulking. Results: He had an uneventful postoperative course without infection, dehiscence and flap necrosis. He has remained asymptomatic for eight months without any recurrence such as the osteomyelitis. Finally, he kept the normal gait and posture with weight bearing on the reconstructed great toe and foot. Conclusion: The anterolateral thigh flap is described for the reconstruction of the great toe. It involves two stage procedure with the minimal donor site morbidity and provides a good cosmetic result.

• Journal of the Korea Society of Computer and Information
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• v.24 no.3
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• pp.77-86
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• 2019

The advent of Internet of Things (IoT) makes common nowadays computing environments involving programming not a single computer but several heterogeneous distributed computers together. Developing programs separately, one for each computer, increases programmer burden and testing all the programs become more complex. To address the challenge, this paper proposes an RPC-based unified programming language, UniPy, for development of MGC (eMbedded, Gateway, and Cloud) applications in IoT systems configured with popular computers such as Arduino, Raspberry Pi, and Web-based DB server. UniPy offers programmers a view of classes as locations and a very simple form of remote procedure call mechanism. Our UniPy compiler automatically splits a UniPy program into small pieces of the program at different locations supporting the necessary RPC mechanism. An advantage of UniPy programs is to permit programmers to write local codes the same as for a single computer requiring no extra knowledge due to having unified programming models, which is very different from the existing research works such as Fabryq and Ravel. Also, the structure of UniPy programs allows programmers to test them by directly executing them before splitting, which is a feature that has never been emphasized yet.