• Title/Summary/Keyword: Weak Point Analysis

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Scapular Free Flap (유리 견갑 피판 이식술)

  • Chung, Duke-Whan;Han, Chung-Soo;Yim, Chang-Moo
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.24-34
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    • 1996
  • There are many kinds of free flaps for management of extensive soft tissue defect of extremities in orthopaedic field. Free vascularized scapular flap is one of the most useful and relatively easy to application. This flap has been utilize clinically from early eighties by many microsurgical pioneers. Authors performed 102 cases of this flap from 1984 to 1995. We have to consider about the surgical anatomy of the flap, technique of the donor harvesting procedures, vascular varieties and anatomical abnormalities and success rate and the weak points of the procedure. This flap nourished by cutaneous branches from circumflex scapular vessels emerges from the lateral aspect of the subscapular artery 2.5-5cm from its lateral origin passing through the triangular space(bounded by subscapularis, teres minor, teres major, long head of triceps). The terminal cutaneous branch runs posteriorly around the lateral border of the scapular and divided into two major branches, those transeverse horizontally and obliquely to the fascial plane of overlying skin of the scapular body. We can utilize these arteries for scapular and parascapular flap. The vascular pedicle ranged from 5 to 10 cm long depends on the dissection, usually two venae comitantes accompanied circumflex scapular artery and its major branches. The diameter of the circumflex scapular artery is more than 1mm in adult, rare vascular variation. Surgical techniques : The scapular flap can be dissected conveniently with prone or lateral decubitus position, prone position is more easier in my experience. There are two kinds of surgical approaches, most of the surgeon prefer elevation of the flap from its outer border towards its base which known easier and quicker, but I prefer elevation of the flap from its outer border because of the lowering the possibilities of damage to vasculature in the flap itself which runs just underneath the subcutaneous tissue of the flap and provide more quicker elevation of the flap with blunt finger dissection after secure pedicle dissection and confirmed the course from the base of the pedicle. There are minimal donor site morbidity with direct skin closure if the flap size is not so larger than 10cm width. This flap has versatility in the design of the flap shape and size, if we need more longer and larger one, we can use parascapular flap or both. Even more, the flap can be used with latissimus dorsi musculocutaneous flap and serratus anterior flap which have common vascular pedicle from subscapular artery, some instance can combined with osteocutaneous flap if we include the lateral border of the scapular bone or parts of the ribs with serratus anterior. The most important shortcoming of the scapular free flap is non sensating, there are no reasonable sensory nerves to the flap to anastomose with recipient site nerve. Results : Among our 102 cases, overall success rate was 89%, most of the causes of the failure was recipient site vascular problems such as damaged recipient arterial conditions, and there were two cases of vascular anomalies in our series. Patients ages from 3 years old to 62 years old. Six cases of combined flap with latissimus dorsi, 4 cases of osteocutaneous flap for bone reconstruction, 62 parascapular flap was performed - we prefer parascapular flap to scapular. Statistical analysis of the size of the flap has less meaningful because of the flap has great versatility in size. In the length of the pedicle depends on the recipient site condition, we can adjust the pedicle length. The longest vascular pedicle was 14 cm in length from the axillary artery to the enter point cutaneous tissue. In conclusion, scapular free flap is one of the most useful modalities to manage the large intractable soft tissue defect. It has almost constant vascular pedicle with rare anatomical variation, easy to dissect great versatility in size and shape, low donor morbidity, thin and hairless skin.

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Effects of University Students' Entrepreneurial Passion on Performance through Exploration Capability and Connection Capability (대학생의 기업가 열정이 정보 탐색 및 연계 역량을 통해 창업의지에 미치는 영향에 관한 연구)

  • Yoon, Byeong seon;Kim, Chun Kyu
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.14 no.3
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    • pp.97-110
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    • 2019
  • This study analyzed various factors of influence affecting the will to start a business and established and empirically analyzed a research model to see which factors significantly affect the will to start a business. To this end, we investigated the general characteristics and experiences of individuals, conducted a study on the will to start a business, and analyzed the entrepreneurship passion for startups, the ability to find business opportunities, and the ability to connect with partner companies. The intent to start a business survey was investigated in a recertive style with a 7 point scale, and the reliability and feasibility review were analyzed through the PLS analysis method, which enables the implementation of a measurement model and a structural model. To collect valid data, the survey was conducted using an entrepreneurial curriculum class hours to collect and analyze 421 data. In summary, the results are as follows: First, college students have many opportunities to develop their capabilities through competitions held by universities and support institutions, and by utilizing them, they have no fear of starting a business. Second, the ability of students to discover product clients themselves has been improved by fostering entrepreneurship in the special lectures on startup in universities. Third, it can be seen that it has received various information on startups from support agencies to enhance its commitment to startups. The implications are as follows. First, they should foster entrepreneurship among college students by offering practical oriented courses that can broaden their understanding of startups. Second, it needs to be improved from entrepreneurial enthusiasm to a program that can grow into a company that can collaborate with partner companies and confirm its commitment to corporate establishment and product development and determine market opportunities. Third, it is necessary to establish an ecosystem of start-ups that can carry out systematic planning and performance management as it is weak to carry out projects with will to startups.

An Importance Analysis on the NCS-Based Skin Care Qualification L3 Level of Education in Life Care (라이프케어의 피부미용 NCS기반 자격 L3수준의 교육 중요도 연구)

  • Park, Chae-Young;Park, Jeong-Yeon
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.5
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    • pp.263-271
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    • 2019
  • The recent phenomenon of job "Miss Match", which is inconsistent with knowledge in the demand of educational training institutes and industries, has spread to an increase in private education costs for reeducation and employment of new hires, resulting in weak individual job competency and poor employment capability, as well as economic and material waste at the national level. To compensate for these problems, the National Competency Standards(NCS), which are available immediately in practice and look for a standard point of national job competency with the aim of fostering human resources sought by industries, were developed, and even the NCS-based qualification system was launched in line with the stream of times. This study is intended to look into the importance and priority of competency units and competency unit elements at the NCS-based qualification L3 level in the skin care field for an overall check of the NCS-based qualification level at a time when educational institutes are organizing and operating the school curriculums according to the NCS and NCS-based qualification level. And it is attempted to provide basic data for the development of curriculum in fostering professional human resources required by industries. To analyze the needs for competency units and competency unit elements at the L3 level, a survey using AHP method was carried out to a group of field experts and a group of education experts. In addition, the SPSS(Statistical Package for Social Science) ver. 21.0 and Expert Choice 2000, an AHP-only solution was used to do statistical processing through the processes of data coding and data cleaning. The findings showed that there was a partial difference of opinion between a group of field experts and a group of education experts. This indicates that the inconsistencies between educational training institutes and industrial sites should be resolved at this time of change with the aim of fostering field customized human resources with professional skills. Consequently, the solution is to combine jobs at industrial sites and standardized educations of educational institutes with human resources required at industrial sites.

Usefulness of volumetric BMD measurement by using low dose CT image acquired on L-spine Bone SPECT/CT (L-spine Bone SPECT/CT에서 획득된 저선량 CT 영상을 이용한 용적 골밀도 결과의 유용성)

  • Hyunsoo Ko;Soonki Park;Eunhye Kim;Jongsook Choi;Wooyoung Jung;Dongyun Lee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.27 no.2
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    • pp.99-109
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    • 2023
  • Purpose: CT scan makes up for the weak point of the nuclear medicine image having a low resolution and also were used for attenuation correction on image reconstruction. Recently, many studies try to make use of CT images additionally, one of them is to measure the bone mineral density(BMD) using Quantitative CT(QCT) software. BMD exams are performed to scan lumbar and femur with DXA(Dual-Energy X-Ray Absorptiometry) in order to diagnose bone disease such as osteopenia, osteoporosis. The purpose of this study is to identify the usefulness of QCT_BMD analyzed with low dose CT images on L-spine Bone SPECT/CT comparing with DXA_BMD. Materials and Methods: Fifty five women over 50 years old (mean 66.4 ± 9.1) who took the both examinations(L-spine Bone SPECT/CT with SIEMENS Intevo 16 and DXA scan with GE Lunar prodigy advance) within 90 days from April 2017 to July 2022, BMD, T-score and disease classification were analyzed. Three-dimensional BMD was analyzed with low dose CT images acquired on L-spine Bone SPECT/CT scan on Mindways QCT PROTM software and two-dimensional BMD was analyzed on DXA scan. Basically, Lumbar 1-4 were analyzed and the patients who has lesion or spine implants on L-spine were excluded for this study. Pearson's correlation analysis was performed in BMD and T-score, chi-square test was performed in disease classification between QCT and DXA. Results: On 55 patients, the minimum of QCT_BMD was 18.10, maximum was 166.50, average was 82.71 ± 31.5 mg/cm3. And the minimum of DXA-BMD was 0.540, maximum was 1.302, average was 0.902 ± 0.201 g/cm2, respectively. The result shows a strong statistical correlation between QCT_BMD and DXA_BMD(p<0.001, r=0.76). The minimum of QCT_T-score was -5.7, maximum was -0.1, average was -3.2 ± 1.3 and the minimum of DXA_T-score was -5.0, maximum was 1.7, average was -2.0 ± 1.3, respectively. The result shows a statistical correlation between QCT T-score and DXA T-score (p<0.001, r=0.66). On the disease classification, normal was 5, osteopenia was 25, osteoporosis was 25 in QCT and normal was 10, osteopenia was 25, osteoporosis was 20 in DXA. There was under-estimation of bone decrease relatively on DXA than QCT, but there was no significant differences statistically by chi-square test between QCT and DXA. Conclusion: Through this study, we could identify that the QCT measurement with low dose CT images QCT from L-Spine Bone SPECT/CT was reliable because of a strong statistical correlation between QCT_BMD and DXA_BMD. Bone SPECT/CT scan can provide three-dimensional information also BMD measurement with CT images. In the future, rather than various exams such as CT, BMD, Bone scan are performed, it will be possible to provide multipurpose information via only SPECT/CT scan. In addition, it will be very helpful clinically in the sense that we can provide a diagnosis of potential osteoporosis, especially in middle-aged patients.

An Empirical Study in Relationship between Franchisor's Leadership Behavior Style and Commitment by Focusing Moderating Effect of Franchisee's Self-efficacy (가맹본부의 리더십 행동유형과 가맹사업자의 관계결속에 관한 실증적 연구 - 가맹사업자의 자기효능감의 조절효과를 중심으로 -)

  • Yang, Hoe-Chang;Lee, Young-Chul
    • Journal of Distribution Research
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    • v.15 no.1
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    • pp.49-71
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    • 2010
  • Franchise businesses in South Korea have contributed to economic growth and job creation, and its growth potential remains very high. However, despite such virtues, domestic franchise businesses face many problems such as the instability of franchisor's business structure and weak financial conditions. To solve these problems, the government enacted legislation and strengthened franchise related laws. However, the strengthening of laws regulating franchisors had many side effects that interrupted the development of the franchise business. For example, legal regulations regarding franchisors have had the effect of suppressing the franchisor's leadership activities (e.g. activities such as the ability to advocate the franchisor's policies and strategies to the franchisees, in order to facilitate change and innovation). One of the main goals of the franchise business is to build cooperation between the franchisor and the franchisee for their combined success. However, franchisees can refuse to follow the franchisor's strategies because of the current state of franchise-related law and government policy. The purpose of this study to explore the effects of franchisor's leadership style on franchisee's commitment in a franchise system. We classified leadership styles according to the path-goal theory (House & Mitchell, 1974), and it was hypothesized and tested that the four leadership styles proposed by the path-goal theory (i.e. directive, supportive, participative and achievement-oriented leadership) have different effects on franchisee's commitment. Another purpose of this study to explore the how the level of franchisee's self-efficacy influences both the franchisor's leadership style and franchisee's commitment in a franchise system. Results of the present study are expected to provide important theoretical and practical implications as to the role of franchisor's leadership style, as restricted by government regulations and the franchisee's self-efficacy, which could be needed to improve the quality of the long-term relationship between the franchisor and franchisee. Quoted by Northouse(2007), one problem regarding the investigation of leadership is that there are almost as many different definitions of leadership as there are people who have tried to define it. But despite the multitude of ways in which leadership has been conceptualized, the following components can be identified as central to the phenomenon: (a) leadership is a process, (b) leadership involves influence, (c) leadership occurs in a group context, and (d) leadership involves goal attainment. Based on these components, in this study leadership is defined as a process whereby franchisor's influences a group of franchisee' to achieve a common goal. Focusing on this definition, the path-goal theory is about how leaders motivate subordinates to accomplish designated goals. Drawing heavily from research on what motivates employees, path-goal theory first appeared in the leadership literature in the early 1970s in the works of Evans (1970), House (1971), House and Dessler (1974), and House and Mitchell (1974). The stated goal of this leadership theory is to enhance employee performance and employee satisfaction by focusing on employee motivation. In brief, path-goal theory is designed to explain how leaders can help subordinates along the path to their goals by selecting specific behaviors that are best suited to subordinates' needs and to the situation in which subordinates are working (Northouse, 2007). House & Mitchell(1974) predicted that although many different leadership behaviors could have been selected to be a part of path-goal theory, this approach has so far examined directive, supportive, participative, and achievement-oriented leadership behaviors. And they suggested that leaders may exhibit any or all of these four styles with various subordinates and in different situations. However, due to restrictive government regulations, franchisors are not in a position to change their leadership style to suit their circumstances. In addition, quoted by Northouse(2007), ssubordinate characteristics determine how a leader's behavior is interpreted by subordinates in a given work context. Many researchers have focused on subordinates' needs for affiliation, preferences for structure, desires for control, and self-perceived level of task ability. In this study, we have focused on the self-perceived level of task ability, namely, the franchisee's self-efficacy. According to Bandura (1977), self-efficacy is chiefly defined as the personal attitude of one's ability to accomplish concrete tasks. Therefore, it is not an indicator of one's actual abilities, but an opinion of the extent of how one can use that ability. Thus, the judgment of maintain franchisee's commitment depends on the situation (e.g., government regulation and policy and leadership style of franchisor) and how it affects one's ability to mobilize resources to deal with the task, so even if people possess the same ability, there may be differences in self-efficacy. Figure 1 illustrates the model investigated in this study. In this model, it was hypothesized that leadership styles would affect the franchisee's commitment, and self-efficacy would moderate the relationship between leadership style and franchisee's commitment. Theoretically, quoted by Northouse(2007), the path-goal approach suggests that leaders need to choose a leadership style that best fits the needs of subordinates and the work they are doing. According to House & Mitchell (1974), the theory predicts that a directive style of leadership is best in situations in which subordinates are dogmatic and authoritarian, the task demands are ambiguous, and the organizational rule and procedures are unclear. In these situations, franchisor's directive leadership complements the work by providing guidance and psychological structure for franchisees. For work that is structured, unsatisfying, or frustrating, path-goal theory suggests that leaders should use a supportive style. Franchisor's Supportive leadership offers a sense of human touch for franchisees engaged in mundane, mechanized activity. Franchisor's participative leadership is considered best when a task is ambiguous because participation gives greater clarity to how certain paths lead to certain goals; it helps subordinates learn what actions leads to what outcome. Furthermore, House & Mitchell(1974) predicts that achievement-oriented leadership is most effective in settings in which subordinates are required to perform ambiguous tasks. Marsh and O'Neill (1984) tested the idea that organizational members' anger and decline in performance is caused by deficiencies in their level of effort and found that self-efficacy promotes accomplishment, decreases stress and negative consequences like depression and emotional instability. Based on the extant empirical findings and theoretical reasoning, we posit positive and strong relationships between the franchisor's leadership styles and the franchisee's commitment. Furthermore, the level of franchisee's self-efficacy was thought to maintain their commitment. The questionnaires sent to participants consisted of the following measures; leadership style was assessed using a 20 item 7-point likert scale developed by Indvik (1985), self-efficacy was assessed using a 24 item 6-point likert scale developed by Bandura (1977), and commitment was assessed using a 6 item 5-point likert scale developed by Morgan & Hunt (1994). Questionnaires were distributed to Korean optical franchisees in Seoul. It took about 20 days to complete the data collection. A total number of 140 questionnaires were returned and complete data were available from 137 respondents. Results of multiple regression analyses testing the relationships between the each of the four styles of leadership shown by the franchisor as independent variables and franchisee's commitment as the dependent variable showed that the relationship between supportive leadership style and commitment ($\beta$=.13, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.07, p<.001)were significant. However, when participants divided into high and low self-efficacy groups, results of multiple regression analyses showed that only the relationship between achievement-oriented leadership style and commitment ($\beta$=.14, p<.001) was significant in the high self-efficacy group. In the low self-efficacy group, the relationship between supportive leadership style and commitment ($\beta$=.17, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.10, p<.001) were significant. The study focused on the franchisee's self-efficacy in order to explore the possibility that regulation, originally intended to protect the franchisee, may not be the most effective method to maintain the relationships in a franchise business. The key results of the data analysis regarding the moderating role of self-efficacy between leadership behavior style as proposed by path-goal and commitment theory were as follows. First, this study proposed that franchisor should apply the appropriate type of leadership behavior to strengthen the franchisees commitment because the results demonstrated that supportive and participative leadership styles by the franchisors have a positive influence on the franchisee's level of commitment. Second, it is desirable for franchisor to validate the franchisee's efforts, since the franchisee's characteristics such as self-efficacy had a substantial, positive effect on the franchisee's commitment as well as being a meaningful moderator between leadership and commitment. Third, the results as a whole imply that the government should provide institutional support, namely to put the franchisor in a position to clearly identify the characteristics of their franchisees and provide reasonable means to administer the franchisees to achieve the company's goal.

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Evaluation of CH4 Flux for Continuous Observation from Intertidal Flat Sediments in the Eoeun-ri, Taean-gun on the Mid-western Coast of Korea (서해안 태안 어은리 갯벌의 연속관측 메탄(CH4) 플럭스 특성 평가)

  • Lee, Jun-Ho;Rho, Kyoung Chan;Woo, Han Jun;Kang, Jeongwon;Jeong, Kap-Sik;Jang, Seok
    • Economic and Environmental Geology
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    • v.48 no.2
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    • pp.147-160
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    • 2015
  • In 2014, on 31 August and 1 September, the emissions of $CH_4$, $CO_2$, and $O_2$ gases were measured six times using the closed chamber method from exposed tidal flat sediments in the same position relative to the low point of the tidal cycle in the Eoeun-ri, Taean-gun, on the Mid-western Coast of Korea. The concentrations of $CH_4$ in the air sample collected in the chamber were measured using gas chromatography with an EG analyzer, model GS-23, within 6 hours of collection, and the other gases were measured in real time using a multi-gas monitor. The gas emission fluxes (source (+), and sink (-)) were calculated from a simple linear regression analysis of the changes in the concentrations over time. In order to see the surrounding parameters (water content, temperature, total organic carbon, average mean size of sediments, and the temperature of the inner chamber) were measured at the study site. On the first day, across three measurements during 5 hours 20 minutes, the observed $CO_2$ flux absorption was -137.00 to $-81.73mg/m^2/hr$, and the $O_2$ absorption, measured simultaneously, was -0.03 to $0.00mg/m^2/hr$. On the second day using an identical number of measurements, the $CO_2$ absorption was -20.43 to $-2.11mg/m^2/hr$, and the $O_2$ absorption -0.18 to $-0.14mg/m^2/hr$. The $CH_4$ absorption before low tide was $-0.02mg/m^2/hr$ (first day, Pearson correlation coefficient using the SPSS statistical analysis is -0.555(n=5, p=0.332, pronounced negative linear relationship)), and $-0.15mg/m^2/hr$ (second day, -0.915(n=5, p=0.030, strong negative linear relationship)) on both measurement days. The emitted flux after low tide on both measurement days reached a minimum of $+0.00mg/m^2/hr$ (+0.713(n=5, p=0.176, linear relationship which can be almost ignored)), and a maximum of $+0.03mg/m^2/hr$ (+0.194(n=5, p=0.754, weak positive linear relationship)) after low tide. However, the absolute values of the $CH_4$ fluxes were analyzed at different times. These results suggest that rate for $CH_4$ fluxes, even the same time and area, were influenced by changes in the tidal cycle characteristics of surface sediments for understanding their correlation with these gas emissions, and surrounding parameters such as physiochemical sediments conditions.