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The pedicled anterolateral thigh flap for trochanteric pressure sore reconstruction: Technical notes to optimize surgical outcomes

  • Hifny, Mahmoud A.
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.114-120
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    • 2021
  • Background The pedicled anterolateral thigh (ALT) flap has become more popular for the reconstruction of soft-tissue defects in neighboring areas. Nonetheless, few studies in the literature have explored the use of this flap for trochanteric ulcer reconstruction. The aim of our study is to present the author's experience of utilizing the ALT flap, with a focus on technical elements regarding the flap design and the tunneling method to maximize the reach of the flap. Methods The medical records of patients who received pedicled ALT flaps for the reconstruction of trochanteric pressure sores were retrospectively reviewed. The patients' demographic data, operative details, and postoperative complications were evaluated. Results Between October 2018 and December 2019, 10 consecutive patients (age range, 13-45 years) underwent 11 pedicled ALT myocutaneous flaps for trochanteric pressure sore reconstruction. Each flap was designed around the most distal cutaneous perforator that was included in the proximal third of the skin paddle. The flaps ranged in size from 11×6 to 14×8 cm. The ALT flap was transposed through a lateral subcutaneous tunnel in five patients, while the open tunnel technique was used in six patients. All flaps survived, and no vascular compromise was observed. Conclusions The pedicled ALT flap is a safe and reliable option for reconstructing trochanteric pressure sores. An appropriate flap design and a good choice of the tunneling method are crucial for successful flap transposition.

Identification of Contract Foodservice Management Companies' Push, Pull, and Interactive Push-Pull Factors for Internationalization by In-Depth Interview (심층면접을 활용한 위탁급식업체 국제화 추진, 유인 및 상호작용 요인 항목 선정)

  • Lee, Hyun-A;Han, Kyung-Soo
    • Journal of the Korean Society of Food Culture
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    • v.24 no.4
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    • pp.401-412
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    • 2009
  • The aims of study were to provide basic data for the internationalization of Contract Foodservice Management Companies (CFMC) and to gain a better understanding of internal push-and-pull factors through in-depth interviews. The interviewees were managers of four large CFMCs and one small-to-medium CFMC. The non-structured interview format employed an interview guide of open-ended questions. All interviews were digitally recorded and notes were taken simultaneously by an interview assistant. The narrative data analysis involved transcription, coding, classification by categories, and content analysis. Eighty-eight codes were generated from the interview analyses, and the subordinate variables uncovered included seven push factors, eight pull factors, one interactive factor, and 10 internal dynamics. These factors will be useful in further studies of the internal operations of specific CFMCs, and more generally, the practical condition of the industry.

Comparison of characteristic aroma compounds in Korean wild chive (Allium monanthum Maxim.) cultivated in open-fields or greenhouses (노지와 시설 재배 달래의 특징적인 향기 성분 비교)

  • Jang, Boa;Baek, Hyung-Hee
    • Korean Journal of Food Science and Technology
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    • v.54 no.2
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    • pp.126-133
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    • 2022
  • The objective of this study was to analyze volatile and aroma-active compounds in Korean wild chive (Allium monanthum Maxim.) cultivated in open-fields or greenhouse systems using solvent-assisted flavor evaporation-gas chromatography (GC)-mass spectrometry and GC-olfactometry. Aroma-active compounds were evaluated using aroma extract dilution analysis (AEDA). Twenty-two aroma-active compounds with log2 flavor dilutions (FD) of 1-10 were detected in Korean wild chive, which was cultivated in an open-field or a greenhouse. 2-Isopropyl-3-methoxypyrazine ("earthy"), 2-sec-butyl-3-methoxypyrazine ("earthy", "musty"), and dipropyl disulfide ("sulfurous") were the most predominant aroma-active compounds with log2FD of 9-10; this was followed by dimethyl trisulfide ("onion-like") and (E)-1-propenyl propyl disulfide ("fresh onion-like"). The "sulfurous", "earthy", "pungent", and "cabbage-like" aroma notes were strong in Korean wild chive. More intense "pungent" odors were detected in Korean wild chive cultivated in an open-field, whereas more intense "cabbage-like" odors were detected in Korean wild chive cultivated in a greenhouse.

Social Bookmarking Use in University Courses: Student Perceptions and Behaviors (대학 수업에서 소셜 북마킹의 활용: 학생 인식 및 행태를 중심으로)

  • Park, Ok-Nam;Jung, Young-Sook
    • Journal of the Korean Society for information Management
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    • v.26 no.2
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    • pp.65-82
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    • 2009
  • This exploratory study describes the social bookmarking perceptions and behaviors of students in university courses. Although an emerging discussion regarding the value of social bookmarking tools exists, how users adopt tools in practice is not well known. Students were asked to utilize the bookmarking tool del.icio.us to store information relating to course projects. They were also asked to comment how they employed del.icio.us for course projects. The study analyzed student perceptions and behaviors when using social bookmarking tools for university coursework. The study noted that the use of tags, notes, and networking within these social bookmarking tools remained less active and social bookmarking services in Web 2.0 as shared collaboration, shared communities, and vertical search were less present. Utilizing social bookmarking tools to facilitate personal information management includes the activities of information use, information re-use, and mobility.

First Record of Six Marine Ciliate Species of Genus Strombidium (Ciliophora: Spirotricha: Oligotrichia) from Korea with Ecological Notes

  • Lee, Eun-Sun;Xu, Dapeng;Shin, Mann-Kyoon;Kim, Young-Ok
    • Animal Systematics, Evolution and Diversity
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    • v.28 no.3
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    • pp.192-207
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    • 2012
  • To supply the morphological and ecological information of oligotrich ciliates in Korea, water samples were seasonally collected in Gwangyang Bay and Jinhae Bay from August, 2010 to February, 2012 and processed by quantitative protargol staining method. As a result, six species belonging to the genus Strombidium Clapar$\grave{e}$de and Lachmann, 1859 are identified: Strombidium emergens Kahl, 1932; S. dalum Lynn et al., 1988; S. epidemum Lynn et al., 1988; S. tressum Lynn et al., 1988; S. bilobum Lynn and Gilron, 1993; S. pollostomum Lynn and Gilron, 1993. These six species were newly reported from Korean coastal waters. Strombidium emergens is a middle sized Strombidium ($20-50{\mu}m$ in length) and has open and deep oral groove to girdle portion. Strombidium dalum is a small sized Strombidium (${\geq}20{\mu}m$ in length), that has torch-like spiral anterior membranelles and an inverted triangles-shaped macronucleus on the posterior pole. The small sized S. epidemum has conspicuous trichites surrounding the girdle portion and ventral membranelles distinctly separated from anterior membranelles. The small sized S. tressum has torch-like spiral and extremely long trichites among the cilia of anterior membranelles. The middle sized S. bilobum has a bilobed macronucleus. Strombidium pollostomum is also a small sized Strombidium but its ventral membranelles are continuously connected with anterior membranelles. The five species except S. emergens occurred frequently over the wide range of water temperatures and salinities.

Development of smart-phone contents for mobile linear algebra (모바일 선형대수학 스마트폰 콘텐츠 개발과 활용)

  • Kim, Kyung-Won;Lee, Sang-Gu
    • Communications of Mathematical Education
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    • v.27 no.2
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    • pp.121-134
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    • 2013
  • Linear Algebra are arguably the most popular math subjects in colleges. We believe that students' learning and understanding of linear algebra can be improved substantially if we incorporate the latest advanced information technologies in our teaching. We found that the open source mathematics program 'Sage' (http://sagemath.org) can be a good candidate to achieve our goal of improving students' interest and learning of linear algebra. In particular, we developed a simple mobile content which is available for Sage commands on common cell phones in 2009. In this paper, we introduce the mobile Sage which contains many Sage functions on a smart-phone and the mobile linear algebra content model(lecture notes, and video lectures, problem solving, and CAS tools) and it will be useful to students for self-directed learning in college mathematics education.

A Qualitative Study on the Treatment Process Experiences of Patients with Whiplash Associated Disorder Treated with Traditional Korean Medicine - Based on the Grounded Theory Approach - (교통사고 상해 증후군 환자들에 대한 한의치료 경험의 질적 연구 -근거이론 접근방법으로 -)

  • Im, Se Hoon;Lee, Seung Hoon;Lee, Seung Min;Nam, Dong Woo;Kim, Yong Suk
    • Journal of Acupuncture Research
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    • v.33 no.4
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    • pp.73-92
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    • 2016
  • Objectives : The purpose of this study is to understand the treatment process experiences of patients with whiplash associated disorder treated with Traditional Korean Medicine. Methods : This study was based on grounded theory. We recruited a total of 10 participants between the ages of 19 and 65, who were hospitalized at Kyung Hee University Korean Medicine Hospital and received treatment after traffic accidents from January to October 2014. Data was collected from in-depth interviews and notes, and was analyzed using open coding, axial coding and selective coding. Results : The core category of the phenomenon: 'The experiences of the treatment process for patients with whiplash associated disorder treated with Traditional Korean Medicine', was elicited as 'The selection of Traditional Korean Medicine treatment over other treatments for holistic healing that supplement for the deficiencies of Western medical treatment'. Conclusion :' The experiences of treatment process for patients with whiplash associated disorder treated with Traditional Korean Medicine', was elicited as 'The selection of the Traditional Korean Medicine treatment over other treatments for holistic healing that complements deficiency of the Western medical treatment'.

Notes on fine-scale spatial distribution of three Cephalanthera species (Orchidaceae) that grow in sympatry in Korea: Implications for maintenance of species boundaries (동소적으로 서식하는 은대난초속 3종(난과)의 미세 공간 분포에 대한 참고 사항: 종의 경계 유지에 대한 암시)

  • Chung, Mi Yoon;Lopez-Pujol, Jordi;Chung, Myong Gi
    • Korean Journal of Plant Taxonomy
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    • v.47 no.4
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    • pp.289-296
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    • 2017
  • The three self-compatible, terrestrial orchids Cephalanthera erecta, C. falcata, and C. longibracteata flower synchronously in sympatric populations. Cephalanthera erecta and C. longibracteata, which have white flowers that do not fully open, are predominantly autogamous, whereas the food-deceptive C. falcata, whose bright yellow flowers open completely, is predominantly outcrossing. The formation of hybrids rarely occurs between species owing to strong prepollination barriers (floral isolation). If these three species have evolved toward the prevention of interspecific hybridization, we can expect that the spatial distribution patterns of the three species would be characterized as spatial segregation (i.e., 'spatial repulsion') from each other. To test this prediction, we studied the three Cephalanthera species in sympatric populations showing coincident flowering within Yeonwhasan Provincial Park (YPP, Gyeongsangnam Province, South Korea). We found strong spatial aggregation in each population and spatial independence in the interspecific spatial distribution, differing from previous studies. We further hypothesize that Cephalanthera species in sympatry within YPP are distributed somewhat randomly in space, perhaps due to the sharing of similar mycorrhizal fungi.

Concomitant open distal clavicle excision is associated with greater improvement in range of motion without increased risk of acromial stress fracture after reverse total shoulder arthroplasty: a retrospective cohort study

  • Ajay C. Kanakamedala;Dhruv S. Shankar;Neil Gambhir;Matthew R. Boylan;Michael Boin;Matthew G. Alben;Mandeep S. Virk;Young W. Kwon
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.357-365
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    • 2023
  • Background: The purpose of this study was to evaluate the effect of concomitant open distal clavicle excision (DCE) on postoperative clinical outcomes and incidence of acromial and scapular stress fractures (ASFs) in patients with symptomatic acromioclavicular joint osteoarthritis (ACJ OA) undergoing reverse total shoulder arthroplasty (RTSA). Methods: A single-surgeon retrospective cohort study was conducted including patients who underwent primary elective RTSA with or without DCE from 2015 to 2019 with a minimum 6-month follow-up period. Shoulder active range of motion (AROM) and visual analog scale (VAS) pain were recorded preoperatively and postoperatively. ASFs and other adverse events were identified using postoperative notes and/or radiographs. Characteristics and outcomes were compared between the RTSA and RTSA-DCE groups. Results: Forty-six RTSA patients (mean age, 67.9±8.7 years; 60.9% male; mean follow-up, 24.9±16.6 months) and 70 RTSA-DCE patients (mean age, 70.2±8.9 years; 20.0% male; mean follow-up, 22.7±12.9 months) were included. There were no significant intergroup differences in rates of ASF (RTSA, 0.0% vs. RTSA-DCE, 1.4%; P=1.00), stress reactions (RTSA, 8.7% vs. RTSA-DCE, 11.4%; P=0.76), reoperation, revision, or infection (all P>0.05), or in pre-to-postoperative reduction in VAS pain (P=0.17) at latest follow-up. However, the RTSA-DCE group had greater pre-to-postoperative improvement in flexion AROM (RTSA, 43.7°±38.5° vs. RTSA-DCE, 59.5°±33.4°; P=0.03) and internal rotation (IR) AROM (P=0.02) at latest follow-up. Conclusions: Concomitant DCE in RTSA improves shoulder flexion and IR AROM, alleviates shoulder pain, and does not increase the risk of ASFs. Level of evidence: III.

The Research on Pedagogical Content Knowledge in Mathematics Teaching (수학과 내용 교수 지식(PCK)의 의미 및 분석틀 개발에 관한 연구)

  • Choe, Seung-Hyun;Hwang, Hye-Jeang
    • Journal of the Korean School Mathematics Society
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    • v.11 no.4
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    • pp.569-593
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    • 2008
  • Since 2005 KICE-TLC has focused on the development of supporting programs for teaching consultation and pedagogical content knowledge(PCK). The purpose of this year's research was to explore types of pedagogical content knowledge(PCK, hereafter) for effective teaching mathematics topics drawn from the amended national mathematics curriculum announced in February, 2007. Based on this year's PCK research, we will develop mathematics teaching consulting program from 2009 research by field testing of developed mathematics PCK. The major source of data for this study was transcripts of audiotapes of the group discussions that took place during the regular weekly meetings where we compared and analyzed three teachers' classes. We also conducted open-ended interviews with the three teachers and collected reflective notes written by participants. This research provided teachers with an opportunity to think about what is important in the teaching of a topic and why, and to consider possibilities for future development. This research highlights the importance of teacher meetings where teachers share their expertises and insights through reflection and dialogue. By introducing the concept of PCK, examining, analyzing and modelling it in pre-service and in-service teacher education practice, we can contribute to extend teachers' professional learning. Finally, just like quality student learning, quality teaching and teacher education practices require critical reflection and careful scaffolding.

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