• Archives of Craniofacial Surgery
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• v.25 no.2
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• pp.71-76
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• 2024

Background: The rising incidence of dialysis-dependent end-stage renal disease (ESRD) has underscored the need for collaboration between plastic surgeons and nephrologists, particularly concerning preoperative and postoperative management for facial reconstruction. This collaboration is essential due to a scarcity of comprehensive information in this domain. Methods: A study initiated in January 2015 involved 10 ESRD cases on dialysis undergoing Mohs micrographic surgery for facial skin cancer, followed by reconstructive surgery under general anesthesia. To ensure surgical safety, rigorous measures were enacted, encompassing laboratory testing, nephrology consultations, and preoperative dialysis admission. Throughout surgery, meticulous control was exercised over vital signs, electrolytes, bleeding risk, and pain management (excluding nonsteroidal anti-inflammatory drugs). Postoperative assessments included monitoring flap integrity, hematoma formation, infection, and cardiovascular risk through plasma creatinine levels. Results: Adherence to the proposed guidelines yielded a notable absence of postoperative wound complications. Postoperative plasma creatinine levels exhibited an average decrease of 1.10 mg/dL compared to preoperative levels, indicating improved renal function. Importantly, no cardiopulmonary complications or 30-day mortality were observed. In ESRD patients, creatinine levels decreased significantly postoperatively compared to the preoperative levels (p< 0.05), indicating favorable outcomes. Conclusion: The consistent application of guidelines for admission, anesthesia, and surgery yielded robust and stable outcomes across all patients. In particular, the findings support the importance of adjusting dialysis schedules. Despite the limited sample size in this study, these findings underscore the effectiveness of a collaborative and meticulous approach for plastic surgeons performing surgery on dialysis-dependent patients, ensuring successful outcomes.

• Korean Journal of Construction Engineering and Management
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• v.15 no.1
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• pp.87-100
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• 2014

Environmental problems and the shortage of natural resources are currently gathering more attention in Korea and international countries. With these problems, it is reported that most current domestic buildings are emitting approximately 138 million tons of greenhouse gas. According to a recent report from the investigation of Korean housing population, the total number of households is approximately 12.9 millions, and the apartments that were built more than 15 years ago amounted to 3.1 millions. This shows that the rates of old apartment housings are increasing. Therefore, it is necessary to consider the deteriorated facilities and environmental improvement. Also, the construction industry is benefited by improving these housings which may need either remodeling or reconstruction. Environmental friendly buildings are a rising consideration for remodeling and reconstruction projects; it helps to determine many business matters in construction. The main purpose of this research is to improve environmental condition in apartments with comparison analysis between remodeling and reconstruction alternatives. This research is focused on characteristics of remodeling and reconstruction and it sets up the same condition with each level in order to evaluate the value of environmental friendliness and analyze its definition. The result of this research provides a unique emitting rate at a novel framework and this will cause the reduction of $CO_2$. It is analyzed that the remodeling construction can reduce the great amount of $CO_2$. Therefore, it will be a good decision guideline in selecting the most eco-friendly alternative to improve environment for building construction. Although reconstruction is a popular alternative nowadays in Korea, this research can provide a reason why decision makers should put more emphasis on remodeling as an environment-friendly alternative.

• KIEAE Journal
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• v.5 no.3
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• pp.17-24
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• 2005

Until today, rainwater management was processed without disposing the peak discharge, which was due to rainfall, to provide stability against flood damage. In this process, the natural hydrologic cycle changed quickly, and because of this, some problems that could harm human beings and the environment arose. These problems need to be addressed accordingly. One of the proposals was to carry out decentralized rainwater management through a natural hydrologic cycle on site, including utilization, infiltration, detention, and retention of rainwater. This study aims to set the direction of applicable decentralized rainwater management to housing complex in Korea. Therefore, spacial properties in urban housing complexes were analysed such as the impervious area-to-land ratio, the green area-to-land ratio, artificial land-to-land ratio etc. As the result of this study, when a housing complex was small and developed by reconstruction, the impervious area, artificial land, the green area in the artificial land-to-land ratio were high. So, direction of decentralized rainwater management of these housing complexes is available to utilize and detain rainwater. On the other hand, those of big housing complexes in land development district were low relatively. So, direction of decentralized rainwater management of these housing complexes is available to infiltrate and evaporate rainwater.

• International conference on construction engineering and project management
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• 2013.01a
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• pp.494-496
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• 2013

Cost-Benefit Analysis (CBA) is a systematic optimization process that allows users to compare different alternatives and to determine if a project is a solid investment. Many state DOTs have included CBA in their pavement management systems (PMSs) to help allocate state funds for maintenance, rehabilitation, resurfacing, and reconstruction of pavements. In a typical CBA, each pavement type has an assigned weight factor which represents the level of importance of this pavement type. To conduct an accurate CBA, it is essential to select appropriate weight factors. Arbitrarily assigning weights factors to pavements can lead to biased and inaccurate funding allocation decisions. The purpose for this paper is to outline a method to develop an ideal set of weight factors that can be utilized to conduct more accurate CBA. To this end, a matrix of all possible weight factors sets was developed. CBA was conducted for each set of weight factors to obtain a population of possible optimization solutions. Then a regression analysis was performed to establish the relationship between benefit and weight factors. Finally, a multi-objective genetic algorithm was applied to select the optimal set of weight factors. The findings from this study can be used by state DOTs to strategically manage their roadway systems in a cost effective manner.

• The Journal of Economics, Marketing and Management
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• v.3 no.2
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• pp.21-28
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• 2015

The purpose of the study was to investigate state and problems of Seongnam Jungang Market that lost competitiveness under rapidly changing logistics environment, and to give market redevelopment model, project validity and operation management plan considering commercial area and location of the market. The public market at the community that has tradition and culture of the residents provides small merchants with employment chance and to let residents buy daily necessities. The market allows farmers to sell agriculture products by themselves and to increase income. Most of public markets that open every five days help residents meet each other to exchange information. Most of public markets have been placed at local towns and rural areas to lose distribution functions remarkably at less population and quick aging.

• International conference on construction engineering and project management
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• 2013.01a
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• pp.497-501
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• 2013

An important decision-making element for the success of housing redevelopment projects is a prediction of the profitability of redevelopment. Risk factors influencing profitability were deduced through a review of the literature about profitability and a risk analysis developed by a survey of maintenance projects. In addition, a profitability prediction depending on the analysis of risk factors is necessary to judge the business feasibility of a project in the planning stages. A profitability prediction model of management and disposal method, which is calculated by proportional rate and which helps estimate contributions to profitability, is proposed to prevent difficulties in business development. The proposed model has the potential to prevent interruptions, reduce the length of projects, generate cost savings, and enable rational decision-making during the project period by allowing a judgment of profitability at the planning stage.

• Journal of the Korean Burn Society
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• v.24 no.2
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• pp.21-29
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• 2021

Purpose: Frostbite is a hazard to people exposed to cold environments. With the progression of modern industrial development and change of leisure behavior encountering cold environments, frequent accidental exposure to frostbite injury during work and human behavior is increasing, and the predisposing factors of frostbite were greatly changed than before. The purpose of this study was to make epidemiological analysis, and to review the treatment outcomes of frostbite. Methods: From March 2010 to February 2021, this study has included 27 patients with second- to third-degree frostbite injuries in Advanced Burn Reconstruction Center, Bundang Jesaeng Hosptial. A retrospective study was made about the distribution of age, gender, predisposing factors, prevalent area, type of managements, and the length of treatment period. Results: In our institution, acute management of frostbite patients has included rewarming, anticoagulation therapy (acetylsalicylic acid), and agents to improve vascular perfusion (lipo-prostaglandin E1 [Eglandin^®]). The 25 frostbite patients with second-degree frostbite (92.6%) were successfully managed by the conservative treatment alone with a mean of 20.3 days healing time. Two patients with third-degree frostbite (7.4%) also showed good outcomes after surgical reconstruction with a mean of 59 days healing time. In our clinical experiences of third-degree frostbite, definitive surgical reconstruction should be recommended to wait for more than 4~6 weeks for identification of clear demarcation of necrotic tissue caused by frostbite. In this study, 43 frostbite injuries site in 27 frostbite patients occurred. Among them, 15 patients (55.6%) had multiple-site frostbite injury. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments (40.8%), misapplying ice pack for treatment purposes (7.4%), barefoot walking on the cold ground (3.7%), and loss of consciousness in cold grounds (3.7%). The most prevalent sites of frostbite injuries revealed as the hand (58.1%), followed by the foot (32.6%), face (7.0%), and abdomen (2.3%). And in the winter season from the November to March, the incidence rate of frostbite injuries was high at 74.1%. Conclusion: This study included 27 frostbite patients with 43 frostbite sites since last decade in a single institution at the community hospital. The frostbite patients with second-degree frostbite (92.6%) were successfully healed by the conservative treatment alone with a mean of 20.3 days healing time. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments, etc. The most prevalent site of frostbite injuries was the hand (58.1%). And the most prevalent seasonal incidence of frostbite was from November to March (74.1%).

• Archives of Plastic Surgery
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• v.34 no.5
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• pp.580-586
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• 2007

Purpose: High tension electrical injuries result in major tissue(eg. bones, tendons, vessels and nerves) destruction. Therefore, the management of mutilating wrist caused by electrical injuries still represents a challenge. There are various approaches to this problem including local and regional flaps as well as pedicled distant flaps and microsurgical free tissue transfer. Although it has not gained wide acceptance, because of the technically demanding dissection of the pedicle, posterior interosseous flap is now well accepted for the reconstruction of hand and wrist in hand surgery. The principal advantages of this flap are minimal donor site morbidity, minimal vascular compromise, one stage operation. This flap also offers the advantages of ideal color match and composition. In this report, we describe our experience with the reverse posterior interosseous island flap for reconstruction of mutilating wrist with main vessel injuries. Methods: From October, 2004 to June, 2006, we treated 11 patients with soft tissue defects and main vessel injuries on the wrist that were covered with reverse posterior interosseous island flap. Results: These 11 patients were all male. The ages ranged from 27 to 67 years(mean age 41.75) and the follow-up period varied from 4 to 19 months. Complete healing of the reverse posterior interosseous island flaps were observed in 11 patients(12 flaps). The majority of these flaps showed a certain degree of venous congestion, which in a flap was treated with medical leech. 1 flap has partial necrosis owing to sustained venous congestion, requiring secondary skin graft. flap size varied from $3.5{\times}8cm$ to $10{\times}12cm$(mean size $6.4{\times}8.9m$). The donor site defect was closed directly in 5 flaps, and by skin graft in 7 flaps. Conclusion: We found that the reverse posterior interosseous island flap is reliable and very useful for reconstruction of mutilating wrist and we recommend it as first choice in coverage of soft tissue defects in the wrist with electrical arc injuries.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.30.1-30.8
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• 2019

Background: Advancements in the field of microvascular surgery and the widespread adoption of microvascular surgical techniques have made the use of osteocutaneous fibula free flaps the standard of care in the surgical management of segmental mandibular defects. Although the literature possesses abundant evidence to support the effectiveness of fibula free flaps as a reconstructive method, there are relatively few studies reporting on outcomes as objectively measured by videofluoroscopic swallowing studies (VFSS). The purpose of this study is to explore the potential correlation between early postoperative VFSS and the long-term swallowing outcomes in patients who underwent mandibular reconstruction with fibula free flaps. Methods: We performed a retrospective chart review of 36 patients who underwent mandibular reconstruction with osteocutaneous fibular free flaps between 2009 and 2012. Demographics, clinical variables, VFSS data, and diet information were retrieved. Penetration and aspiration findings on VFSS, long-term oral feeding ability, and the need for gastrostomy tube were statistical endpoints correlated with postoperative clinical outcomes. Results: Thirty-six patients were reviewed (15 females and 21 males) with a mean age of 54 years (7-81). Seventeen cases were treated for malignancy. The size of the bony defect ranged from 3 to 15 cm (mean = 9 cm). The cutaneous paddle, a surrogate for soft tissue defect, ranged from 10 to 125 ㎠ (mean = 52 ㎠). A gastrostomy tube was present in patients preoperatively (n = 8), and postoperatively (n = 14). Seventeen patients had neoadjuvant exposure to radiation. Postoperative VFSS showed penetration in 13 cases (36%) and aspiration in seven (19%). Overall, 29 patients (80.6%) achieved unrestricted diet, and this was statistically correlated with age (p = 0.037), radiation therapy (p = 0.002), and preoperative gastrostomy tube (p = 0.03). The presence of penetration or aspiration on VFSS was a strong predictor for long-term unrestricted oral diet (p < 0.001). Conclusion: Early postoperative VFSS is an excellent predictor for long-term swallowing outcomes in patients undergoing mandibular reconstruction with osteocutaneous fibula free flaps.

• The Journal of Korean Society for School & Community Health Education
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• v.4
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• pp.79-95
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• 2003

This dissertation aims to analyze various safety accidents taking place during physical education class according to physical education teacher's value orientation, to identify teacher's value orientation that can minimize safety accidents, and to provide basic materials for safe and smooth class management. For this purpose, data have been collected from 261 physical education teachers at some middle and high schools in G City in Kyung-Ki Province and Busan Metropolitan City. The materials were treated as follows: The variables on demographic characteristics of physical education teachers are determined by t-test ; The analysis of one-way ANOVA and relationship between value orientation and safety accident prevention activities was conducted through Pearson's linear correlation analysis and multiple regression; The analysis of the relationship between value orientation and actual conditions of safety accidents was conducted through logistic regression. First, there is almost no awareness difference of physical education teachers' value orientation according to demographical variables. The value orientation physical education teachers consider to be the most important is, however, mainly 'mastery of disciplinary lesson.' There is a statistically significant difference in safety accident prevention activities according to demographical variables. Teachers' focuses in class contents showed a significant difference according to teaching experience and working area, while the dependency on facility has a significant difference according to teaching experience and school type. Second, there is no correlation between physical education teacher's value orientation and safety accident prevention activities because there is virtually no statistically significant difference between them. It means that safety accident prevention activities are not related with on which teachers place emphasis among mastery of disciplinary lesson, social reconstruction, self-realization, ecological integration and value orientation on learning process. Third, the analysis of safety accident prevention activities according to physical education teachers' value orientation revealed that the lower value orientation in social reconstruction is, the more safety accidents teachers experience. It is also found that crashes among students, ball games and leg injuries are inter-related with social reconstruction in value orientation, over-motivation and unskilled motor function ; athletic sports with value orientation on learning process and safety prevention training ; unskilled motor functions with value orientation in ecological integration and disobedience to teacher's directions ; winter accidents with mastery of disciplinary lesson in value orientation. In conclusion, the research indicates that physical education teacher's value orientation according to demographical variables didn't show any significant difference, while one according to safety accident prevention activities showed significant difference. Besides, physical education teachers' value orientation is not related to safety accident prevention activities, but the relationship between value orientation and actual conditions of safety accidents showed correlations according to each variable. Especially, teachers with lower value orientation in social reconstruction experienced more safety accidents. Therefore, physical education teachers can manage physical education class more safely with more emphasis on value orientation in social reconstruction.