• Journal of Trauma and Injury
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• v.26 no.1
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• pp.14-17
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• 2013

Purpose: The open abdomen is now the standard of care in various clinical situations, especially it is used to treat abdominal compartment syndrome. Many techniques have been reported for closure after an open abdomen, but most take a long time for complete definitive closure and are associated with various problems. We describe a technique using biologic mesh that can achieve early definitive closure after an open abdomen. Methods: A 45-year-old man presented to the emergency room with a painful hip and painful lower extremities after a fall from 80 feet. Radiologic examination revealed multiple fractures of the pelvis and low extremities. Abdominal compartment syndrome caused by a retroperitoneal hematoma developed during the orthopedic surgery. We performed exploration immediately and closed abdomen temporarily. A peritoneal graft of porcine dermal collagen with anterior myofascial approximation of the rectus abdominis muscles and sliding skin flap was performed three days after the previous surgery. Results: There were no complications related to the wound. The patient was transferred to the Department of Orthopedic Surgery seven days after the initial surgery. Conclusion: Early definitive closure using porcine dermal collagen is a feasible method that can reduce the length of hospitalization and the number of operations for an open abdomen.

• Journal of Chest Surgery
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• v.48 no.4
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• pp.265-271
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• 2015

Background: Stainless steel wiring remains the most popular technique for primary sternal closure. Recently, a multifilament cable wiring system (Pioneer Surgical Technology Inc., Marquette, MI, USA) was introduced for sternal closure and has gained wide acceptance due to its superior resistance to tension. We aimed to compare conventional steel wiring to multifilament cable fixation for sternal closure in patients undergoing major cardiac surgery. Methods: Data were collected retrospectively on 1,354 patients who underwent sternal closure after major cardiac surgery, using either the multifilament cable wiring system or conventional steel wires between January 2009 and October 2010. The surgical outcomes of these two groups of patients were compared using propensity score matching based on 18 baseline patient characteristics. Results: Propensity score matching yielded 392 pairs of patients in the two groups whose baseline profiles showed no significant differences. No significant differences between the two groups were observed in the rates of early mortality (2.0% vs. 1.3%, p=0.578), major wound complications requiring reconstruction (1.3% vs. 1.3%, p>0.99), minor wound complications (3.6% vs. 2.0%, p=0.279), or mediastinitis (0.8% vs. 1.0%, p=1.00). Patients in the multifilament cable group had fewer sternal bleeding events than those in the conventional wire group, but this tendency was not statistically significant (4.3% vs. 7.4%, p=0.068). Conclusion: The surgical outcomes of sternal closure using multifilament cable wires were comparable to those observed when conventional steel wires were used. Therefore, the multifilament cable wiring system may be considered a viable option for sternal closure in patients undergoing major cardiac surgery.

• Journal of the Korean Mathematical Society
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• v.48 no.3
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• pp.449-464
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• 2011

We show that, if R is a graded Noetherian ring and I is a proper ideal of R generated by n homogeneous elements, then any prime ideal of R minimal over I has h-height ${\leq}$ n, and that if R is a graded Noetherian domain with h-dim R ${\leq}$ 2, then the integral closure R' of R is also a graded Noetherian domain with h-dim R' ${\leq}$ 2. We also present a short improved proof of the result that, if R is a graded Noetherian domain, then the integral closure of R is a graded Krull domain.

• Advances in pediatric surgery
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• v.15 no.1
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• pp.18-26
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• 2009

The survival of Very Low Birth Weight (VLBW) infants has been improved with the advancement of neonatal intensive care. However, the incidence of accompanying gastrointestinal complications such as necrotizing enterocolitis has also been increasing. In intestinal perforation of the newborn, enterostomy with or without intestinal resection is a common practice, but there is no clear indication when to close the enterostomy. To determine the proper timing of enterostomy closure, the medical records of 12 VLBW infants who underwent enterostomy due to intestinal perforation between Jan. 2004 and Jul. 2007 were reviewed retrospectively. Enterostomy was closed when patients were weaned from ventilator, incubator-out and gaining adequate body weight. Pre-operative distal loop contrast radiographs were obtained to confirm the distal passage and complete removal of the contrast media within 24-hours. Until patients reached oral intake, all patients received central-alimentation. The mean gestational age of patients was $26^{+2}$ wks ($24^{+1}{\sim}33^{+0}$ wks) and the mean birth weight was 827 g (490~1450 g). The mean age and the mean body weight at the time of enterostomy formation were 15days (6~38 days) and 888 g (590~1870 g). The mean body weight gain was 18 g/day (14~25 g/day) with enterostomy. Enterostomy closure was performed on the average of 90days (30~123 days) after enterostomy formation. The mean age and the mean body weight were 105 days (43~136 days) and 2487 g (2290~2970 g) at the time of enterostomy closure. The mean body weight gain was 22 g/day after enterostomy closure. Major complications were not observed. In conclusion, the growth in VLBW infants having enterostomy was possible while supporting nutrition with central-alimentation and the enterostomy can be closed safely when the patient's body weights is more than 2.3 kg.

• Journal of the Korean Geotechnical Society
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• v.28 no.4
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• pp.79-89
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• 2012

This paper presents experimental and numerical studies on the closure ratio of tunnel face to reduce pressure and displacement occurring at tunnel face during tunnel excavation. In experimental study, model tests are carried out according to the closure ratio of tunnel face and tunnel depth. Model test results are analyzed and interpreted by numerical calculation in order to verify results obtained from experimental and numerical studies. It is clearly found that tunnel face stability increases with the increase of the closure ratio of tunnel face. The results also show that tunnel face is stable when the closure ratio of tunnel face is larger than 80%. This research will be very useful to develop the economical tunnel face closing system.

• Journal of Veterinary Clinics
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• v.39 no.6
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• pp.353-359
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• 2022

Several suture patterns can be used for cystotomy closure, and a continuous suture pattern is the most commonly used. In this study, the fluid-tight ability and other suitabilities of continuous appositional sutures, such as the simple continuous suture pattern (SC), running suture pattern (RN), and Ford interlocking suture pattern (FI), were compared for cystotomy closure. Cystotomy closure was performed using each suture method in 10 cases of ex vivo swine bladders in each group. Suture time, leakage site, suture length, bursting pressure (BP), bursting volume (BV), and circular bursting wall tension (CBWT) were measured. Suture time and suture length were the shortest in RN and the longest in FI. Leakage occurred in two places: the incision line directly and the hole made by the suture. Leakage occurred through the incision line in 4 bladders of the RN group and 2 bladders of the FI group, but not in the SC group, and in the rest of the bladders, leakage occurred through the suture hole. The values of BP, BV, and CBWT increased in the order of FI, SC, and RN. Suture time and suture length can be considered as factors related to healing and side effects. In this study, leakage through the incision was found in a less appositional area; therefore, leakage through the hole could be considered an indicator of better apposition. Good apposition is one of the conditions required for ideal cystotomy closure. The bursting strength representing the fluid-tight ability can be expressed as the CBWT. RN is expected to be efficient and cause a small degree of foreign body reaction; however, it is expected to be less stable. FI has the greatest fluid-tightness ability, but it has been proposed that side effects due to foreign body reactions most frequently occur in FI. In conclusion, SC, which is expected to have a sufficient degree of fluid-tightness and appropriate recovery, is preferable to other continuous appositional suturing methods for cystotomy closure.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.20 no.8
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• pp.2650-2669
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• 1996

A new low Reynolds number nonlinear second moment turbulence closure was introduced to analyze a square sectioned 180.deg. bend flow. Inclusion of nonlinear return to isotropy term and cubic mean pressure strain term has brought out a marked improvement in the level of agreement with measured velocity profiles. Optimization of present closure was performed by comparison of computed velocity profiles with the experimental ones with variation of nonlinear return to isotropy term and quadratic and cubic pressure-strain model. Progressive vortex breakdown due to the interaction of primary and secondary flows was well captured by using the optimized second moment turbulence closure.

• Speech Sciences
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• v.14 no.4
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• pp.25-39
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• 2007

The present study investigated some perceptual phonetic attributes of two Korean stop types, aspirated and lax, in medial position of an accentual phrase. The intonational pattern across syllables (Jun, 1993) is argued to depend on the type of stop (aspirated vs. lax) only in the initial position of an accentual phrase. In Kang & Dilley (2007), we showed that significant differences between aspirated and lax stops in medial position of an accentual phrase exist in closure duration, voice-onset time, and fundamental frequency (F0) values for post-stop vowels. In the present perception experiment, we investigated whether these phonetic attributes contribute to the perception of these two types of stops: The closure durations and/or F0's of post-stop vowels on accentual-phrase medial words were altered and twenty native Korean speakers then judged these words as beginning with an aspirated or lax stop. Both closure duration and F0 significantly affected judgments of stop identity. These results indicate that a wider range of acoustic cues that distinguish aspirated and lax Korean stops in production also plays a role in perception. To account for these results we suggest some phonetic and phonological models of consonant-tone interactions for Korean.

• Archives of Craniofacial Surgery
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• v.20 no.1
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• pp.3-9
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• 2019

Facial nerve palsy has an effect on a person's well-being functionally and psychologically. Therefore, comprehensive patient management is essential. One of the most common uncomfortable and potentially debilitating features is associated with the incapacity for eye closure. Restoration of eye closure is a key consideration during the surgical management of facial palsy. In this article, we introduce simple surgical methods-which are relatively easy to learn and involve the upper and lower eyelids-for achieving eye closure. Correcting upper eyelid function involves facilitating the component of eye closure that is in the same direction as gravity and is, therefore, less complicated and favorable outcomes than correction of lower lid. Aesthetic aspects should be considered to correct the asymmetry caused by facial palsy. Lower eyelid function involves a force that opposes gravity for eye closure, which makes correction of lower eyelid ectropion more challenging than surgery for the upper eyelid, particularly in terms of effecting a sustained correction. Initially, proper ophthalmic evaluation is required, including identifying the chronicity and severity of ectropion. Also, it is important to determine whether or not lateral canthoplasty is necessary. The lateral tarsal strip procedure is commonly used for lower lid correction. However, effective lower lid correction can be achieved with better cosmesis when extensive supporting techniques are applied, including those involving cheek tissue.

• Nuclear Engineering and Technology
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• v.55 no.2
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• pp.530-545
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• 2023

As an alternative to conventional management options for a lot of concrete waste from decommissioning of nuclear power plants, a set of scenarios for controlled recycling of decommissioning concrete waste as engineered barriers of a radioactive waste repository was proposed, and a comprehensive safety assessment model and framework covering both pre-and post-closure phases was newly developed. The new methodology was applied to a reference vault-type repository, and the ratios of derived concentration limits to unconditional clearance levels of eighteen radionuclides for controlled recycling were provided for three sets of dose criteria (0.01, 1, and 20 mSv/y for the pre-closure and 0.01 mSv/y for the post-closure phases). It turns out that decommissioning concrete waste whose concentration is much higher than the unconditional clearance level can be recycled even when the dose criterion 0.01 mSv/y is applied. Moreover, a case study on ABWR bio-shield shows that the fraction of recyclable concrete waste increases significantly by increasing the dose criterion for the radiation worker in the pre-closure phase or the duration of storage prior to recycling. The results of this study are expected to contribute to demonstrating the feasibility of controlled recycling of a lot of decommissioning concrete waste within nuclear sectors.