• Title/Summary/Keyword: T/C ratio

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Complex oncologic resection and reconstruction of the scalp: Predictors of morbidity and mortality

  • Tecce, Michael G.;Othman, Sammy;Mauch, Jaclyn T.;Nathan, Shelby;Tilahun, Estifanos;Broach, Robyn B.;Azoury, Said C.;Kovach, Stephen J.
    • 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.

Optimum Carbonation Reforming Period of Recycled Aggregate Based on the Microscopic Carbonation Conduct (미시적 탄산화 거동에 기초한 순환 골재의 최적 탄산화 개질 기간)

  • Shin, Jin-Hak;Kim, Han-Sic;Ha, Jung-Soo;Chung, Lan
    • Journal of the Korea Concrete Institute
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    • v.28 no.3
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    • pp.329-340
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    • 2016
  • Increase in demotion and repair works on buildings in the construction market generates a large amount of construction waste. Recycling of construction waste is important for saving of resources, preservation of environment and constant advance of the construction industry. Accordingly, the environmental and economic value of recycled aggregate, which is produced after waste concrete is crushed, is increasingly highlighted. It is generally known that compared to concrete made of ordinary aggregate, concrete made of recycled aggregate has low quality, and the low quality is dependent on the amount of the bonding heterogeneous (cement paste and mortar) as well as the amount of the pores within the bonding heterogeneous. Reports on carbonation mechanism shows that the pores of cement-based materials are filled up by the progress of carbonation. Therefore, this study aims at an estimation of the period for optimum carbonation reforming appropriate for the thickness of the bonding heterogeneous of recycled aggregate, based on carbonation mechanism, with a view to improving the product quality by means of filling up the pores of the bonding heterogeneous of recycled aggregate. This study drew the carbonation depth according to the passage of age by calculating the bonding ratio and bonding thickness of the bonding heterogeneous as against the particle size distribution of recycled aggregate as well as by chemical quantitative analysis according to the age of accelerated carbonation of mock-up samples imitating bonding heterogeneous. Based on the correlation between the age of accelerated carbonation and carbonation depth, this study also proposed the estimated period of carbonation reforming of recycled aggregate appropriate for the thickness of the bonding heterogeneous.

Hysteretic Behavior Evaluation of a RC Coupling Beam using a Steel Fiber and Diagonal Reinforcement (강섬유와 묶음철근 보강을 통한 고성능 연결보의 이력거동 평가)

  • Oh, Hae Cheol;Lee, Kihak;Han, Sang Whan;Shin, Myoungsu;Jo, Yeong Wook
    • Journal of the Korea Concrete Institute
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    • v.27 no.3
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    • pp.291-298
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    • 2015
  • In this paper, a bundled diagonal reinforcement using high performance steel fiber was proposed to enhance the construct ability and seismic performance. Experiments of coupling beam was composed of four specimens and the hysteretic behavior evaluated for reverse cyclic loading to specimens using high performance steel fiber. The main variables of the experiment is a amount of stirrup and bundled reinforcement, depending on whether the mix of steel fiber. Specimen which criteria was applied 100% of stirrup and bundled diagonal reinforcement of ACI318 criteria. With this, by appling same diagonal reinforcement, two specimens were created by adjusting stirrup of 75%, 50%. So, a total of four specimens were produced. When coupling beam was placed concrete, this experiment was mixed in a content of steel fiber 1%. All the specimens were produced by aspect ratio 3.5(l/h=1050/300) to a half-scale. In this result, two specimens as reduced to stirrup of 75%, 50% was no significant difference in the strength, stiffness and energy dissipation capacity, respectively compared to the stirrup of 100%.

Mechanism of Strength Development in Ultra High Strength Concrete Using the Electric Arc Furnace Oxidizing Slag as Fine Aggregate (초고강도 콘크리트에서 전기로 산화 슬래그 잔골재 사용에 의한 강도 증진 기구)

  • Lee, Seung-Heun;Lim, Doo-Sub;Lee, Seung-Hoon;Lee, Joo-Ha
    • Journal of the Korea Concrete Institute
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    • v.25 no.1
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    • pp.3-9
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    • 2013
  • In ultra high strength concrete, when electric arc furnace oxidizing slag is substituted for sea sand as fine aggregate, compressive strength was improved about 15 MPa. To figure out the cause of the improvement in compressive strength, this study considered the dissolution characteristics of Ca component in fine aggregate and examined the microstructure, porosity, microhardness, and Ca/Si mole ratio on the interface of fine aggregate and paste. And to examine the mechanism of strength improvement resulted from the shape of fine aggregate, this study measured the surface roughness of fine aggregate with AFM. According to the result of this experiment, the mechanisms of strength improvement in ultra high strength concrete resulted from the use of electric arc furnace oxidizing slag as fine aggregate can be divided into chemical and physical mechanisms. In the chemical mechanism, the soluble Ca component contained in electric arc furnace oxidizing slag is dissolved and forms a hydrate between fine aggregate and paste to improve the interlocking strength of fine aggregate-paste. Also, it makes the microstructure around the fine aggregate. And in the physical mechanism, electric arc furnace oxidizing slag has a twice greater surface roughness than sea sand, so the interlocking strength between fine aggregate and paste increases, which contributes to the development of compressive strength.

Proposal of A Method to Enhance Pumping Efficiency of Cementitious Materials by Injecting Activation Agent to Slip-Layer and its Lab-Scale Experimental Verification (시멘트계 재료의 펌프압송성능 향상을 위한 윤활층 활성화제 주입 방법 제안 및 소규모 실험검증)

  • Lee, Jung-Soo;Yoo, Yong-Sun;Han, Jin-Gyu;Park, Chan-Kyu;Kwon, Seung-Hee
    • Journal of the Korean Recycled Construction Resources Institute
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    • v.5 no.4
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    • pp.442-449
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    • 2017
  • In this study, a method to inject small amount of activation agent from the outside of the pipeline to the inside wall of the pipe was newly proposed to enhance pumping efficiency of cementitious materials. The activation agent is injected into the slip-layer, which is generally formed in the vicinity of the inside wall of the pipe during pumping cementitous materials. Through the injections, it is expected to decrease viscosity of slip-layer, namely, the friction between the mateirals and the pipe. The proposed method was verified by lab-scale pumping tests with mortars having water to cement ratio of 47%. The tests were performed with two different type of activation agents(superplasticizer and anionic surfactant) and three different amount of the agents(0.14, 0.28, 0.42% of the mortar volume). The compressive strength were measured with and without injecting the activation agent, and the internal pressures of pipeline were measured. When the anionic surfactant was used, there was no change in the compressive strength. As the amount of anionic surfactant increased, the pumping pressure decreased up to 71.4% at the maximum.

Association Study in Endothelin 1 (EDN1) Gene Polymorphism and Excess or Deficiency Syndrome in Korean Asthmatic Patients (한국인 기관지 천식 허증(虛證), 실증(實證) 환자와 EDN1 유전자 다형성과의 상관성 연구)

  • Yoem, Yu-rim;Kim, Kwan-il;Baek, Hyun-jung;Kim, Mi-a;Lee, Beom-joon;Kim, Jin-ju;Kim, Su-kang;Chung, Joo-ho;Jung, Hee-jae;Jung, Sung-ki
    • The Journal of Internal Korean Medicine
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    • v.37 no.1
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    • pp.47-64
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    • 2016
  • Objectives: In the present study, a genetic analysis was conducted to investigate the association of the expression of SNPs of EDN1 gene polymorphism with the clinical phenotype in bronchial asthma patients with either excess or deficiency syndrome.Methods: Ninety-four healthy control subjects and 52 asthma patients were included in this study. The asthma patients were divided into two groups: those with deficiency syndrome and those with excess syndrome. We searched the exonic and promoter areas of the EDN1 gene in the NCBI website SNPs with <0.01 minor allele frequency (MAF) and <0.01 heterozygosity. Pro programs were performed to obtain the odds ratio, 95% confidence interval, and p-value. Multiple logistic regression models were conducted to analyze the genetic data.Results: In our genotype and allele analyses, there were significant differences in the codominant 2 model of the rs3087459 SNP genotype and also in the CGG haplotype between the control group and the asthma group. Genotype and allele analyses were conducted between the deficiency and excess syndrome group. There were significant differences in the dominant and log-additive model and also in the frequency of C-alleles of rs3087459 SNP genotype. There were significant differences in codominant 1, dominant and log-additive model and T-allele of rs5370 SNP genotype. The AGG haplotype also revealed significant differences.Conclusions: EDN1 SNPs (rs3087459, rs5370) showed a significant association with symptomatic excess syndrome in Korean asthmatic patients.

Effects of Dietary Chelated Fe and Yeast Fe on Growth Performance and Body Composition in Broiler Chicks (유기태 철과 효모철의 첨가급여가 육계의 성장 및 체조성에 미치는 영향)

  • Na S.J.;Oh J.I.;Uuganbayar D.;Jung D.K.;Kim H.Y.;Moon S.T.;Yang C.J.
    • Korean Journal of Poultry Science
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    • v.33 no.2
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    • pp.113-119
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    • 2006
  • This study was carried out to investigate the effects of dietary Saccharomyces cerevisiae (wild yeast mutant) and Saccharomyces cerevisiae hFeHLC (ferritin containing yeast) and chelated Fe on growth performance and body composition of broiler chicks. A total of 252 (1-day old) 'Ross' broiler chicks were allotted to seven dietary treatments: I) control without iron supplementation, 2) 0.1% wild yeast mutant (YM03), 3) 1.0% wild yeast mutant, 4) 0.1% ferritin containing yeast (YF04), 5) 1.0% ferritin containing yeast, 6) 0.01% chelated Fe and 7) 0.1% chelated Fe. The highest weight gain obtained from broilers fed 0.01% chelated Fe was 2,121g, the lowest weight gain obtained from broilers fed control diet was 2.087g. The growth performance results were not significantly different in weight gain, feed intake and feed conversion ratio of broilers diets containing wild yeast, ferritin containing yeast and chelated Fe supplementation and control diets (P>0.05). The lowest iron content in meat was for control 30.51 mg/dL and the highest Fe content was for 0.1% ferritin containing yeast 41.58 mg/dL, but these were not significantly different (P>0.05).

Effect of Nutritional Environment in Ginseng Field on the Plant Growth of Ginseng (Panax ginseng C. A. Meyer) (인삼재배지의 영양환경이 인삼의 생육에 미치는 영향)

  • Jin, Hyun-O;Kim, Ung-Jin;Yang, Deok-Chun
    • Journal of Ginseng Research
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    • v.33 no.3
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    • pp.234-239
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    • 2009
  • This study aims to establish the directions for the optimal nutrient contents determined by soil and leaf analyses. The study is to be used as a source for basic information in investigating the effects of nutritional environment on ginseng growth at the fields of Ansung region in Gyeonggi province. The physical property of soil porosity is closely related to ginseng growth, with more than 50% of good growth in the field. The optimal range of chemical properties in soil was analyzed as 0.20-0.28% T-N, 500-900 mg/kg Av.P$_2$O$_5$, and 2.3-3.5 cmol$^+$/kg Exch.Ca. The optimal range of inorganic nutrient contents in leaves was also analyzed. P value was less than 0.25%, and Mg was more than 0.22%. Other elements were not found clearly. The ratios of N/P, N/Mg, K/Mg, and Ca/P of leaves with good growth in the field showed 10<, 10-13, <14, 1<, respectively. In addition, the Ca:Mg:K ratio of the Exch.cation (cmol$^+$/kg) may be useful as an indicator in the assessment of plant growth in ginseng.

The Clinical Analysis on 32 Cases of Dementia (치매환자(患者) 32례(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Lee, Y.W.;Kang, H.J.;Cho, M.R.;Jin, C.S.;Hong, S.;Kim, J.S.
    • The Journal of Internal Korean Medicine
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    • v.19 no.1
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    • pp.301-317
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    • 1998
  • A clinical analysis was carried out for 32 patients who were treated in Dept. of Dong-shin Oriental Medicine Hospital from 10st January to 16st May in 1998 and ruled out as dememtia. The results were summarized as follows. 1. In the distribution of sex, female was more than male. And the age of seventies(17 cases, 53.125%) was highest in the frequency of age. 2. In the distribution of having history of drinking and smoking were each 4 cases(12.5%) and 7 cases(21.875%). 3. In the distribution of seasons, the ratio of spring and winter were each 16 cases(50.0%), 15 cases(46.875%), that of summer and fall were comparatively low. 4. In the period from onset to admission, the period within a week had 20 cases(62.5%) as top, and the most period of treatment was 2 and 3 weeks(28.125%). 5. The number of cases that had preceding disease was 35 cases(71.875%), a major portion of preceding diseases were hypertension, diabetes mellitus, stroke. 6. The most common symptom was disorientation(78.125%), and the next common symptom was motor desability(71.875%), and memory disturbance, verbal disturbance was each 59.375 and 47.1%. 7. In the distribution of the CT scan films, 15 cases(46.875%) showed cerebral infarction and that of another 5cases (15.625%) showed cerebral hemorrhage, that of another 2 cases(6.25%) showed brain atrophy. 8. In the lipid density of blood, T-Cholesterol, TG, HDL-Cholesterol, LDL- Cholesterol was within normal limit. 9. In the MMSE-K, the most score was from 16 point to 20 point, and second only was from 11 point to 15 point, and the next was from 6 point to 10 point. 10. In the Ischemic score, 20 cases(62.5%) was diagnosed as brain vascular type dementia, and mixed type dementia was 9 cases(28.125%), Alzheimer type dementia was 3 cases(9.375%). 11. The most used recipes were a sort of recipes to activate of flow the vital energy and the blood, to remove the phlegm(41 cases 33.9%), especially DODAMHOALHEL TANG (12 cases, 9.9%), ANSINCHUNGNOITANG (8 case, 6.6%) was the most used recipe. 12. In the judgement of efficacy, 17 cases(53.125%) showed excellent efficacy, 10 cases(31.25%) showed good efficacy, 5 cases(15.625%) showed no change and that according to MMSE-K, 4 case(18.18%) showed excellent efficacy, 15 cases(68.18%) showed good efficacy, 15 cases(68.18%) showed no change.

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Measuring Myun Health Worker's Performance by Time-Activity Approach (시간활동 접근법에 의한 면 보건요원의 업무량 분석)

  • Kim, Han-Joong;Kim, Moon-Shik
    • Journal of Preventive Medicine and Public Health
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    • v.10 no.1
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    • pp.34-43
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    • 1977
  • This study attempts to examine the performances of Myun Health Workers-the frontline workers in the Korean rural health care delivery system. The time-activity approach was mainly utilized as a measuring tool. This study was undertaken in September 1976 with 35 Myun Health Workers at the Kang Wha County. The pretested time-activity approach sheets were filled out daily for one month by those Myun Health Workers themselves. Statistical means and variances of analysis were utilized for statistical method in comparing some activities and functions converged into time distribution Findings: 1. The workers's average working hours derived in this study is 8 hours and 48 minutes per day, which takes half an hour longer than normal schedule. 2. They spend 56% working hour for direct services, in other words, the main function, 22% for supportive function, and 22% for other activities, the unrelated health services. 3. Considering the total working hours of main function, out-center activity is far more than in-center services with the ratio of 70% to 30% respectively, which proves, therefore, that the main activity of the workers is home visiting. 4. It takes 20 minutes purely for home visiting and takes 14 minutes for transportation. 5. This research also indicates that such factors as characteristics of the health workers and myun influence in shaping the structures of the worker's function and activity: a. The workers whose working site is located in myun office spend 15% among total working hours in carring out official myun activities, which is incidentally unrelated to health services, while the health subcenter have no rooms for administrative jobs for myun office. b. The workers whose office is in health subcenter contribute much time in doing main function and those working in special project distribute more time in performing supportive function. c. The types of workers are another dominant factor to influence the components of worker's functions and activities. MCH workers and MPW I spend much time for manipulating main function. d. MPW II, whose function is reorganized by special project in 2 myuns shows different pattern of time distribution compared to the TB worker orFP worker in the ordinary area. MPW II distributes their time evenly in performing MCH program, T.B. Program, F.P. program and education activity, while the unipurpose workers engage in carring out only their dominant role. e. Another variables which involve the variation of the worker's activity can be illustrated with the variables like target population, size of myun and convenience for transportation, among which the latter two are remarkable factors in determining the time for out-center service.

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