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Superior Gluteal Artery Perforator Turn-Over Flap Coverage for Lumboscaral Soft Tissue Defect in Ambulatory Patient (보행 환자에서의 위볼기동맥천공지뒤집기피판을 이용한 허리엉치 부위 연부조직 결손의 치료)

  • Moon, Suk-Ho;Kim, Dong-Seok;Oh, Deuk-Young;Lee, Jung-Ho;Rhie, Jong-Won;Seo, Je-Won;Ahn, Sang-Tae
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.712-716
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    • 2010
  • Purpose: Extensive lumbosacral defects after removal of spinal tumors have a high risk of wound healing problems. Therefore it is an effective reconstructive strategy to provide preemptive soft tissue coverage at the time of initial spinal surgery, especially when there is an instrument exposure. For soft tissue reconstruction of a lumbosacral defect, a variation of the gluteal flap is the first-line choice. However, the musculocutaneous flap or muscle flap that is conventionally used, has many disadvantages. It damages gluteus muscle and causes functional disturbance in ambulation, has a short pedicle which limits areas of coverage, and can damage perforators, limiting further surgery that is usually necessary in spinal tumor patients. In this article, we present the superior gluteal artery perforator turn-over flap that reconstructs complex lumbosacral defects successfully, especially one that has instrument exposure, without damaging the ambulatory function of the patient. Methods: A 67 year old man presented with sacral sarcoma. Sacralectomy with L5 corpectomy was performed and resulted in a $15{\times}8\;cm$ sized complex soft tissue defect in the lumbosacral area. There was no defect in the skin. Sacral stabilization with alloplastic fibular bone graft and reconstruction plate was done and the instruments were exposed through the wound. A $18{\times}8\;cm$ sized superior gluteal artery perforator flap was designed based on the superior gluteal artery perforator and deepithelized. It was turned over 180 degrees into the lumbosacral dead space. Soft tissue from both sides of the wound was approximated over the flap and this provided in double padding over the instrument. Results: No complications such as hematoma, flap necrosis, or infection occurred. Until three months after the resection, functional disturbances in walking were not observed. The postoperative magnetic resonance imaging scan shows the flap volume was well maintained over the instrument. Conclusion: This superior gluteal artery perforator turn-over flap, a modification of the conventional superior gluteal artery perforator flap, is a simple method that enabled the successful reconstruction of a lumbosacral defect with instrument exposure without affecting ambulatory function.

Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology

  • Jung, Pil Young;Yu, Byungchul;Park, Chan-Yong;Chang, Sung Wook;Kim, O Hyun;Kim, Maru;Kwon, Junsik;Lee, Gil Jae;Korean Society of Traumatology (KST) Clinical Research Group
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.1-12
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    • 2020
  • Purpose: Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods: Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results: Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80-90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100-110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient's initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions: This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.

formation Mechanisms of 1:1 Clay Minerals by Biotite Weathering In a Granitic Gneiss (흑운모의 풍화작용에 의한 1:1 점토광물의 형성 메커니즘)

  • 이석훈;김수진
    • Journal of the Mineralogical Society of Korea
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    • v.15 no.3
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    • pp.221-230
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    • 2002
  • Weathering of biotite shows a biotite-vermiculite-kaolinite sequence at the early stage, but presents biotite-kaolinite sequence without a significant intermediate phase (vermiculite) at the late stage from the weathering profile of the granitic gneiss. Secondary 1:1 phyllosilicates are kaolinite and halloysite which show different weathering textures originated by a different formation mechanism. Kaolinitization began from the edges of biotite and propagated toward the interior of grain along a multilayered front. $10 \AA$ layers of biotite are interleaving with $7\AA$ layers of kaolinite and c-axis of two phases is consistent. Kaolinite pseudomorph of biotite is isovolumetric, compared to the biotite boundary and includes many band-like porosities parallel to the cleavage. Platy kaolinite formed by 1:1 layer fur layer replacement of biotite. Halloysitization proceeded outward from the grain edges which were foliated as fine flakes and bent at the right angle for cleavage Halloysites were extensively fanning out and greatly increased the volume of grain. This indicated that halloysite tubes were formed by epitaxial overgrowth on the surface of biotite with import of Si and Al from the external solution by dissolution of plagioclase. These halloysites have abnormally high Fe content ( ~11%).

[O2/N2] Plasma Etching of Acrylic in a Multi-layers Electrode RIE System (다층 RIE Electrode를 이용한 아크릴의 O2/N2 플라즈마 건식 식각)

  • Kim, Jae-Kwon;Kim, Ju-Hyeong;Park, Yeon-Hyun;Joo, Young-Woo;Baek, In-Kyeu;Cho, Guan-Sik;Song, Han-Jung;Lee, Je-Won
    • Korean Journal of Materials Research
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    • v.17 no.12
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    • pp.642-647
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    • 2007
  • We investigated dry etching of acrylic (PMMA) in $O_2/N_2$ plasmas using a multi-layers electrode reactive ion etching (RIE) system. The multi-layers electrode RIE system had an electrode (or a chuck) consisted of 4 individual layers in a series. The diameter of the electrodes was 150 mm. The etch process parameters we studied were both applied RIE chuck power on the electrodes and % $O_2$ composition in the $N_2/O_2$ plasma mixtures. In details, the RIE chuck power was changed from 75 to 200 W.% $O_2$ in the plasmas was varied from 0 to 100% at the fixed total gas flow rates of 20 sccm. The etch results of acrylic in the multilayers electrode RIE system were characterized in terms of negatively induced dc bias on the electrode, etch rates and RMS surface roughness. Etch rate of acrylic was increased more than twice from about $0.2{\mu}m/min$ to over $0.4{\mu}m/min$ when RIE chuck power was changed from 75 to 200 W. 1 sigma uniformity of etch rate variation of acrylic on the 4 layers electrode was slightly increased from 2.3 to 3.2% when RIE chuck power was changed from 75 to 200 W at the fixed etch condition of 16 sccm $O_2/4\;sccm\;N_2$ gas flow and 100 mTorr chamber pressure. Surface morphology was also investigated using both a surface profilometry and scanning electron microscopy (SEM). The RMS roughness of etched acrylic surface was strongly affected by % $O_2$ composition in the $O_2/N_2$ plasmas. However, RIE chuck power changes hardly affected the roughness results in the range of 75-200 W. During etching experiment, Optical Emission Spectroscopy (OES) data was taken and we found both $N_2$ peak (354.27 nm) and $O_2$ peak (777.54 nm). The preliminarily overall results showed that the multi-layers electrode concept could be successfully utilized for high volume reactive ion etching of acrylic in the future.

Optimization of Tank Model Parameters Using Multi-Objective Genetic Algorithm (I): Methodology and Model Formulation (다목적 유전자알고리즘을 이용한 Tank 모형 매개변수 최적화(I): 방법론과 모형구축)

  • Kim, Tae-Soon;Jung, Il-Won;Koo, Bo-Young;Bae, Deg-Hyo
    • Journal of Korea Water Resources Association
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    • v.40 no.9
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    • pp.677-685
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    • 2007
  • The objective of this study is to evaluate the applicability of multi-objective genetic algorithm(MOGA) in order to calibrate the parameters of conceptual rainfall-runoff model, Tank model. NSGA-II, one of the most imitating MOGA implementations, is combined with Tank model and four multi-objective functions such as to minimize volume error, root mean square error (RMSE), high flow RMSE, and low flow RMSE are used. When NSGA-II is employed with more than three multi-objective functions, a number of Pareto-optimal solutions usually becomes too large. Therefore, selecting several preferred Pareto-optimal solutions is essential for stakeholder, and preference-ordering approach is used in this study for the sake of getting the best preferred Pareto-optimal solutions. Sensitivity analysis is performed to examine the effect of initial genetic parameters, which are generation number and Population size, to the performance of NSGA-II for searching the proper paramters for Tank model, and the result suggests that the generation number is 900 and the population size is 1000 for this study.

The Study of Diffusion and Outlook for Smart Phone in Smart Nomad Era (스마트 노매드 시대 스마트폰의 확산과 전망에 대한 연구)

  • Nam, Chong-Hoon
    • Journal of Digital Contents Society
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    • v.11 no.3
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    • pp.315-322
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    • 2010
  • This study focused on mobile trend in diffusion of smart phone. Presently, it has been evolved from digital nomad to smart nomad. Smart nomad era is based on digital technology with mobility and being smart. Smart nomad that is made up high-end device and intellectual content has changed structure of industry and life style. Smart phone is a core key in smart nomad era. In 2010 smart phone has been distributed about 2.5 hundreds million which is 20% of whole mobile phone sales and the volume of smart phone sales will be getting bigger and bigger in near future. Although, there are various reasons for success of smart phone market, this research focused 4 reasons: first, development of mobile device, second, evolution of mobile content distribution, third, support of government system, fourth, success of Docomo i-mode and Apple i phone. Smart phone will grow up more rapidly. Smart phone eco-system will be more competitive in the world. In Korea, smart phone eco-system also will be very competitive. For success in the middle of this competitive environment, Korea should lead the competitive phase with development of ability of creation software and content, construction of various partnership and evolution of next generation technology and service.

Advanced Water Treatment of High Turbidity Source by Hybrid Process of Ceramic Ultrafiltration and Photocatalyst: 1. Effects of Photocatalyst and Water-back-flushing Condition (세라믹 한외여과 및 광촉매 혼성공정에 의한 고탁도 원수의 고도정수처리: 1. 광촉매 및 물역세척 조건의 영향)

  • Cong, Gao-Si;Park, Jin-Yong
    • Membrane Journal
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    • v.21 no.2
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    • pp.127-140
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    • 2011
  • The effects of $TiO_2$ photocatalyst coating bead concentration, water-back-flushing period (FT), and back-flushing time (BT) were investigated in hybrid process of ceramic ultrafiltration and photocatalyst for advanced drinking water treatment in this study. Photocatalyst coating bead concentration was changed in the range of 10~40 g/L, FT in 2~10 min and BT in 6~30 sec. Then, we observed the effects on resistance of membrane fouling $(R_f)$, permeate flux (J) and total permeate volume $(V_{\Upsilon})$ during total filtration time of 180 min. As decreasing photocatalyst coating bead concentration, $R_f$ increased and J decreased. $V_{\Upsilon}$ was the highest value of 8.85 L at 40 g/L of photocatalyst coating bead concentration. At FT change experiment, $R_f$ decreased and J increased as decreasing FT. Then $R_f$ decreased and J increased according to increasing BT at BT change experiment. Because at NBF (no back-flushing) dramatic membrane fouling reduced membrane pore size, turbid and dissolved organic matters ($UV_{254}$ absorbance) could be removed efficiently. Therefore, treatment efficiencies of turbidity and dissolved organic matters were the highest at NBF. Then by cleaning effect of photocatalyst coating bead, the treatment efficiencies of turbidity and dissolved organic matters increased as decreasing FT and increasing BT.

Advanced Water Treatment of High Turbidity Source by Hybrid Process of Ceramic Ultrafiltration and Photocatalyst: 2. Effect of Photo-oxidation and Adsorption (세라믹 한외여과 및 광촉매 혼성공정에 의한 고탁도 원수의 고도정수처리: 2. 광산화와 흡착의 영향)

  • Cong, Gao-Si;Park, Jin-Yong
    • Membrane Journal
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    • v.21 no.2
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    • pp.201-211
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    • 2011
  • The effects of humic acid (HA), photo-oxidation and adsorption were investigated in hybrid process of ceramic ultrafiltration and photocatalyst for drinking water treatment. UF, photocatalyst, and UV radiation processes were investigated in viewpoints of membrane fouling resistance $(R_f)$, permeate flux (J), and total penneate volume $(V_{\Upsilon})$ at 2 and 4 mg/L of HA respectively. As decreasing HA, $R_f$ decreased dramatically and J increased, and finally $V_{\Upsilon}$ was the highest at 2 mg/L HA. Average treatment efficiencies of turbidity decreased as increasing HA, but treatment efficiency of HA was the highest at 4 mg/L HA. It was because most of HA was removed by membrane and some HA passing through the membrane was adsorbed or photo-oxidized by photocatalyst at low HA, and therefore treated water quality was almost same at 2 and 4 mg/L HA, but feed water quality was higher at 4 mg/L. At effect experiment of photo-oxidation and adsorption, J of UF + $TiO_2$ + UV process was maintained at the highest, and ultimately $(V_{\Upsilon})$ after 180 minutes' operation was the highest. As results of comparing the treatment efficiencies of turbidity and HA, photocatalyst adsorption had more important role than photo-oxidation when HA increased from 2 to 4 mg/L.

Development of the Algofithm for Gaussian Mixture Models based Traffic Accident Auto-Detection in Freeway (GMM(Gaussian Mixture Model)을 적용한 영상처리기법의 연속류도로 사고 자동검지 알고리즘 개발)

  • O, Ju-Taek;Im, Jae-Geuk;Yeo, Tae-Dong
    • Journal of Korean Society of Transportation
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    • v.28 no.3
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    • pp.169-183
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    • 2010
  • Image-based traffic information collection systems have entered widespread adoption and use in many countries since these systems are not only capable of replacing existing loop-based detectors which have limitations in management and administration, but are also capable of providing and managing a wide variety of traffic related information. In addition, these systems are expanding rapidly in terms of purpose and scope of use. Currently, the utilization of image processing technology in the field of traffic accident management is limited to installing surveillance cameras on locations where traffic accidents are expected to occur and digitalizing of recorded data. Accurately recording the sequence of situations around a traffic accident in a freeway and then objectively and clearly analyzing how such accident occurred is more urgent and important than anything else in resolving a traffic accident. Therefore, in this research, existing technologies, this freeway attribute, velocity changes, volume changes, occupancy changes reflect judge the primary. Furthermore, We pointed out by many past researches while presenting and implementing an active and environmentally adaptive methodology capable of effectively reducing false detection situations which frequently occur even with the Gaussian Mixture model analytical method which has been considered the best among well-known environmental obstacle reduction methods. Therefore, in this way, the accident was the final decision. Also, environmental factors occur frequently, and with the index finger situations, effectively reducing that can actively and environmentally adaptive techniques through accident final judgment. This implementation of the evaluate performance of the experiment road of 12 incidents in simulated and the jang-hang IC's real-time accident experiment. As a result, the do well detection 93.33%, false alarm 6.7% as showed high reliability.

Determination of Phosphatidylcholine in Korea Functional Foods Containing Lecithins using HPLC with Evaporative Light-Scattering Detector (ELSD) (ELSD를 이용한 레시틴중의 포스파티딜콜린의 분석)

  • Lee Chang-Hee;Bahn Kyeong-Nyeo;Cho Tae-Yong;Lee Ju-Yeon;Lee Young-Ja;Chae Gae Yong
    • Journal of Food Hygiene and Safety
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    • v.20 no.4
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    • pp.267-271
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    • 2005
  • Lecithin is a naturally occurring group of phospholipids found in nearly every living cell and has been widely used as the ingredient of functional foods. Lecithin has high content of phosphatidylcholine(PC), pharmaceutical material which promotes metabolism through the cell membrane. This study was carried out to improve the present inconvenient analytical method of PC in law for health & functional foods. The commodities used in this experiment, were two kinds of egg yolk and eight kinds of soybean lecithin functional foods. PC was separated with isocratic elution with hexane : isopropanol : D.W (30:60:8) through silica column (2.1$\times$150 mm) by HPLC with Evaporative Light-Scattering Detector (ELSD). The flow rate of the eluent was 0.5 ml/mim and infect volume was 10ul. The neubilizer temperature of detector was $60^{\circ}C$, drift tube temperature of that was $75^{\circ}C$ and gas flow was 30 psi. Quantification was carried out by external standardization. Limit of quantification was 0.15ppm. Lecithin contents of egg yolk and soybean Products were > $66\%$ and > $81\%$), respectively. Phosphatidylcholine contents of egg yolk and soybean products were > $74\%$ and > $18\%$, respectively.