• Archives of Craniofacial Surgery
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• v.21 no.4
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• pp.229-236
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• 2020

Background: Oncologic resection of the scalp confers several obstacles to the reconstructive surgeon dependent upon patient-specific and wound-specific factors. We aim to describe our experiences with various reconstructive methods, and delineate risk factors for coverage failure and complications in the setting of scalp reconstruction. Methods: A retrospective chart review was conducted, examining patients who underwent resection of fungating scalp tumors with subsequent soft-tissue reconstruction from 2003 to 2019. Patient demographics, wound and oncologic characteristics, treatment modalities, and outcomes were recorded and analyzed. Results: A total of 189 patients were appropriate for inclusion, undergoing a range of reconstructive methods from skin grafting to free flaps. Thirty-three patients (17.5%) underwent preoperative radiation. In all, 48 patients (25.4%) suffered wound site complications, 25 (13.2%) underwent reoperation, and 47 (24.9%) suffered from mortality. Preoperative radiation therapy was an independent risk factor for wound complications (odds ratio [OR], 2.85; 95% confidence interval [CI], 1.1-7.3; p=0.028) and reoperations (OR, 4.45; 95% CI, 1.5-13.2; p=0.007). Similarly, the presence of an underlying titanium mesh was an independent predictor of wound complications (OR, 2.49; 95% CI, 1.1-5.6; p=0.029) and reoperations (OR, 3.40; 95% CI, 1.2-9.7; p=0.020). Both immunosuppressed status (OR, 2.88; 95% CI, 1.2-7.1; p=0.021) and preoperative radiation therapy (OR, 3.34; 95% CI, 1.2-9.7; p=0.022) were risk factors for mortality. Conclusion: Both preoperative radiation and the presence of underlying titanium mesh are independent risk factors for wound site complications and increased reoperation rates following oncologic resection and reconstruction of the scalp. Additionally, preoperative radiation, along with an immunosuppressed state, may predict patient mortality following scalp resection and reconstruction.

• The Journal of Korean Academy of Prosthodontics
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• v.36 no.6
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• pp.858-866
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• 1998

Soldering is the usual method used to correct an unstable fixed partial denture framework at patient's try-in; However, presoldering base metal alloys is technique-sensitve and results are unstable because it is difficult to maintain uniform heat distribution and to prevent oxidation of an alloy. A cast-joining technique has been developed by Weiss and Munyon for repair, correction and addition to base metal framework. This joining technique eliminates the problem with presoldering of non-precious frameworks. The object of this study was to 1) compare the relative flexure strength and the joining effectiveness of Ni-Cr-Be cast in two pieces and 'pre-soldered' versus in two pieces and 'cast-joined'. 2) determine the effect of increasing the number of retentive grooves on the face of the cast and 3) determine the effect of the relative matched position of groove patterns on flexure strength. The joining effectiveness can be expressed by the ratio of the mean flexure stress of soldered or cast-joined specimens to that of one-piece cast. Resin rods 3mm in diameter were used as pattern of specimens for one-piece casted, presoldered, and cast-joined groups. Cast-joined specimens had two different patterns of retentive grooves on the joined faces. Type A had cross-shaped grooves 1mm in depth. 0.6mm in width. Type B was the same except for the addition of one more retentive groove. In the experiment connecting cast-joined specimens, half of specimens with type A pattern had their patterns on the faces of paired casts matched with each other as mirror image. With the rest pairs, it was proceeded that one of paired casts turned 45 degrees so that the patterns crossed. Half of specimens with type B pattern also had the patterns matched as mirror image; However, here, one of paired casts turned 90 degrees with the other pairs. Retentive groove in this study lacked the intentional undercuts, in contrast with the suggestion of Weiss and Munyon. The specimens were subjected to four-point flexural loading in an Instron testing machine. The midspan flexural stress was calculated at the point of initial plastic strain as determined from a strip-chart recorder or at the point of failure if this occured at a lower stress level. Within the scope of this study, the following results were obtained. 1. The presoldered group showed flexural strength at least 2 times higher than the cast-joined groups. Its joining effectiveness was 82%. 2. In cast-joined groups, the flexural strength of joints with type B patterns exhibited 1.5 times that of joints with type A patterns. Joining effectivenesses were 38% for type B patterns, 25-26% for type A patterns. 3. The relative matched position of groove patterns did not have any significant effect on flexural strength of the cast-joined specimens with either type A patterns or type B patterns(p>.05).

• Journal of the Korea Concrete Institute
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• v.28 no.1
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• pp.59-65
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• 2016

Commercial synthetic resins with great amount of hydrogen atoms were investigated for neutron shielding aggregates. Total three types of resins were considered in this study: high density polyethylene (HDPE), polypropylene (PP), and ultra molecular weight polyethylene (UPE). When these resins replaced 20, 40, 60 vol% of fine aggregates, mechanical properties were first evaluated including compressive and tensile strengths, and then image/microstructure analyses such as cross-section analysis, SEM, and X-ray CT were performed. The results showed that the compressive and tensile strengths decreased with the increase of replacement ratio of HDPE and PP, which was found through image analysis that it was closely related to the distribution of resins at the failure surface of test specimens. The strength reduction of UPE was quite small compared to HDPE and PP but it abruptly increased when the replacement level exceeded 60 vol%. The results of microstructure analyses indicated that the replacement level significantly affected the amount of air void so that it is critical to determine the reasonable amount of UPE to make cementitous materials for neutron shielding.

• Journal of the Korea Concrete Institute
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• v.25 no.3
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• pp.261-269
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• 2013

In this study, it was developed eco-friendly inorganic binding material concrete using ground granulated blast furnace slag and alkali activator (water glass, sodium hydroxides). Eight reinforced concrete beam using inoganic binding material concrete were constructed and tested under monotonic loading. The major variables were mixture ratio of alkali activator, type of admixture and admixture. Experimental programs were carried out to improve and evaluate the flexural performance of such test specimens, such as the load-displacement, the failure mode, the maximum load carrying capacity, and ductility capacity. All the specimens were modeled in scale-down size. The eco-friendly concrete using inorganic binding material encouraged alkali activation reaction was rapidly hardening speed and showed possibility as a high strength concrete. Also, the RC beams using new materials showed similar behavior and failed similarly with RC beam used portland cement. It is thought that eco-friendly inorganic binding material concrete can be used with construction material and product as a basic research to replace cement concrete. If there is application to structures in PC member as well as production of 2nd concrete product, it could be improved the productivity and reduction of construction duration etc.

• The Journal of Small Business Innovation
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• v.19 no.3
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• pp.1-16
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• 2016

Korean government had used public 'credit guarantee schemes' (CGS) as a counter-cyclical measure. However, it is still controversial about the effectiveness of policy financing on the SMEs. Criticism on policy financing involves the argument that supporting enterprises hampers competition and innovation of SMEs by increasing their dependence on the government and delays the exit of marginal firms. In this paper, we investigate how to effectively build up the rationale of running public CGSs. At the same time, we propose the ways to coexist of public credit guarantee and market-based private finance system for SMEs. First, CGS, as a counter-cyclical function, must coexist with the private financial system by compensating the market failure caused by pro-cyclical behavior of the private financial market. Second, CGS has the comparative advantages, compared to both the interest rate policy of the central bank and fiscal policy of the government. The credit guarantee is the symptomatic treatment that could revitalize the economy shortly by providing liquidity. Also, knowing that CGS is provided based on the leverage ratio defined by outstanding guarantee divided by capital fund, public 'credit guarantee' (CG) has an advantage that is free from the risk of government deficit. Third, the reason for existence of the CGS should be founded in supporting services for SMEs, available only in a public sector that is difficult to expect from private banks. In this regard, it is desirable to strengthen the publicness of credit guarantee over the support for start-ups, growing companies, the improvement of productivity, increase of exports, a long-term investment in facilities, the employment-creating businesses, and innovative enterprises.

• Journal of the Korean Electrochemical Society
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• v.10 no.2
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• pp.110-115
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• 2007

Solid oxide fuel cell(SOFC) has high fuel flexibility due to its high operating temperatures. Hydrocarbonaceous fuels such as diesel has several advantages such as high energy density and established infrastructure for fuel cell applications. However diesel reforming has technical problems like coke formation in a reactor, which results in catastrophic failure of whole system. Performance degradation of diesel autothermal reforming (ATR) leads to increase of undesirable hydrocarbons at reformed gases and subsequently degrades SOFC performance. In this study, we investigate the degradation of SOFC performance(OCV, open circuit voltage) under hydrocarbon(n-Butane) feeds and characteristics of diesel performing under various ratios of reactants($H_2O/C,\;O_2/C$ molar ratios) for improvement of SOFC performance. Especially we achieved relatively high performance of diesel ATR under $H_2O/C=0.8,\;O_2/C=3$ condition.

• Tuberculosis and Respiratory Diseases
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• v.81 no.4
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• pp.311-318
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• 2018

Background: The aim of this study was to examine the influence of body mass index (BMI) on the development of acute kidney injury (AKI) in critically ill patients in intensive care unit (ICU). Methods: Data of patients admitted to medical ICU from December 2011 to May 2014 were retrospectively analyzed. Patients were classified into three groups according to their BMI: underweight (< $18.5kg/m^2$), normal ($18.5-24.9kg/m^2$), and overweight (${\geq}25kg/m^2$). The incidence of AKI was compared among these groups and factors associated with the development of AKI were analyzed. AKI was defined according to the Risk, Injury, Failure, Loss of kidney function, and End-stage (RIFLE) kidney disease criteria. Results: A total of 468 patients were analyzed. Their mean BMI was $21.5{\pm}3.9kg/m^2$, including 102 (21.8%) underweight, 286 (61.1%) normal-weight, and 80 (17.1%) overweight patients. Overall, AKI occurred in 82 (17.5%) patients. The overweight group had significantly (p<0.001) higher incidence of AKI (36.3%) than the underweight (9.8%) or normal group (15.0%). In addition, BMI was significantly higher in patients with AKI than that in those without AKI ($23.4{\pm}4.2$ vs. $21.1{\pm}3.7$, p<0.001). Multivariate analysis showed that BMI was significantly associated with the development of AKI (odds ratio, 1.893; 95% confidence interval, 1.224-2.927). Conclusion: BMI may be associated with the development of AKI in critically ill patients.

• Clinical and Experimental Pediatrics
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• v.46 no.11
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• pp.1080-1084
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• 2003

Purpose : To compare perinatal characteristics, clinical courses, and overall morbidity between respiratory distress syndrome(RDS) with patent ductus arteriosus(PDA) and RDS without PDA in neonates. Methods : Eighty-three neonates who were diagnosed and treated for RDS in the neonatal intensive care unit(NICU) from Jan. 2000 to Dec. 2002 were included in this study. RDS was complicated with PDA(group A) in 17 patients and not complicated in 66(group B). PDA was diagnosed by echocardiogram in neonates with congestive heart failure symptom, cardiac murmur or chest X-ray findings of cardiomegaly or pulmonary edema. A retrospective study was undertaken of the perinatal characteristics and overall morbidity in group A and group B. Results : The birth weight and gestational periods of group A were less compared with group B. There was more perinatal asphyxia in group A. Incidence of overall morbidity such as bronchopulmonary dysplasia, intraventricular hemorrhage and death was higher in group A. Intravenous indomethacin was administered in 17 PDA infants. Conclusion : The perinatal characteristics in the two groups showed a significant difference. Incidence of overall morbidity in the two groups showed significant differences, however, there is no simple conclusion to draw because we didn't do multifactorial analyses to rule out other many risk factors affecting morbidity, such as gestational weeks or birth weight.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6491-6496
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• 2012

Background: The influence of parental socio-economic status on childhood cancer treatment outcome in low-income countries has not been sufficiently investigated. Our study examined this influence and explored parental experiences during cancer treatment of their children in an Indonesian academic hospital. Materials and Methods: Medical charts of 145 children diagnosed with cancer between 1999 and 2009 were reviewed retrospectively. From October 2011 until January 2012, 40 caretakers were interviewed using semi-structured questionnaires. Results: Of all patients, 48% abandoned treatment, 34% experienced death, 9% had progressive/relapsed disease, and 9% overall event-free survival. Prosperous patients had better treatment outcome than poor patients (P<0.0001). Odds-ratio for treatment abandonment was 3.3 (95%CI: 1.4-8.1, p=0.006) for poor versus prosperous patients. Parents often believed that their child's health was beyond doctor control and determined by luck, fate or God (55%). Causes of cancer were thought to be destiny (35%) or God's punishment (23%). Alternative treatment could (18%) or might (50%) cure cancer. Most parents (95%) would like more information about cancer and treatment. More contact with doctors was desired (98%). Income decreased during treatment (55%). Parents lost employment (48% fathers, 10% mothers), most of whom stated this loss was caused by their child's cancer (84% fathers, 100% mothers). Loss of income led to financial difficulties (63%) and debts (55%). Conclusions: Treatment abandonment was most important reason for treatment failure. Treatment outcome was determined by parental socio-economic status. Childhood cancer survival could improve if financial constraints and provision of information and guidance are better addressed.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.6 no.1
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• pp.45-50
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• 2012

Thoracolumbar orthosis has been used for the rehabilitation of the patients with senile kyphosis. Recently, a number of different thoracolumbar orthosis designs have been introduced but its biomechanical effectiveness still remain unknown. In this study, we compared the pressure distribution on the surface of the trunk and stresses on the orthosis in relation to changes in connecting frame designs (Type 1, one-connecting frame type; Type 2, two-connecting frame type; Type 3, all-in-one type) using finite element (FE) models under different motions of the trunk. The results showed that Type 3 distributed the pressure on the trunk most evenly followed by Type 2 and Type 1 and the difference between Type 1 and Type 2 was negligible. ROM was limited most effectively by Type 3 ($8.5{\sim}9.4^{\circ}$), followed by Type 2 ($11.3{\sim}13.9^{\circ}$) and Type 1 ($12.1{\sim}15.4^{\circ}$). The ratio between the peak von Mises stress and yield strength of each material remained less than 20% regardless of orthosis type indicating low likelihood of component failure. In conclusion, our study found that all-in-one type of orthosis was the most effective design for the conservative treatment of spinal deformity in terms of function and comfort.