• Journal of Korean Society of Transportation
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• v.35 no.1
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• pp.25-36
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• 2017

The purpose of this study is to analyze traffic accident reduction effect of the introduction of motorcycle safety inspection. To analyze the effect of motorcycle inspection, we first estimate the number of defective motorcycles, and calculate the probability of accident occurrences caused by the defect using four year traffic accident data. Finally, we estimate the number of reduced accidents due to the introduction of the inspection and the total reduced accident cost. In this study, we analyzed three scenarios. It is analyzed that when the safety inspection system is applied to all motorcycles, 642 cases of traffic accidents and 325 million won per year of traffic accident costs are reduced. It is approximately 0.1% of 2014 total traffic accident cost of 26.5725 trillion won per year. It suggests that the cost of traffic accidents and traffic accidents due to vehicle factors are reduced when the safety inspection system is introduced.

• Journal of Veterinary Clinics
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• v.23 no.2
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• pp.211-217
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• 2006

Six patients (5 dogs, 1 cat) were referred with the complications of urinary tract injuries. Clinical signs were vomiting (4/6), oliguria (2/6) and anuria (3/6). Four females had been spayed, 1 male had cryptorchid orchiectomy and 1 male had been operated for removing calculi in the urethra. Both preoperative and intraoperative investigation were performed and they were confirmed as iatrogenic injuries in the urinary tract during surgery. Depending on the condition of the complications, urethral anastomosis, unilateral nephrectomy, ureteroneocystostomy, colonic urinary diversion, ureterourethral anastomosis, cystostomy and suture of the defect region were performed separately in individual cases. Postoperative observation revealed 50% (3 cases) survival rate of the patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.246-250
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• 2009

Congenital diaphragmatic hernias (CDH) usually cause respiratory distress soon after birth and are associated with a high mortality rate in the early postnatal period. However, there is a milder form of CDH that does not manifest during the neonatal period. The late presenting CDH is characterized by a variable clinical picture. We present the case of an otherwise healthy 5-month-old girl, who was referred for evaluation of an 1-day history of vomiting and irritability. Chest simple X-ray and CT showed bowel loops in the left thoracic cavity, which was consistent with diaphragmatic hernia. At operation, she was found to have a small left posterolateral diaphagmatic defect with viable small bowel loops in the left thoracic cavity. After surgical reposition of the hernia, the symptoms such as vomiting and irritability subsided. The lack of typical manifestation of CDH such as respiratory distress may lead to delayed diagnosis. The possibility of late presenting CDH should not be overlooked even after the neonatal period.

• Journal of the Korean Wood Science and Technology
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• v.17 no.4
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• pp.57-69
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• 1989

Roughage feeds were produced from Hyun-aspen (Populus alba $\times$ p. glandulosa) by steaming-defibration and steaming-explosion. The objectives of this work were to find proper conditions for the treatment of Hyun-aspen by analyzing the compositional change and digestibility and to investigate the change of physical properties of exploded woods. The results of this work were as follows; 1. The method of steaming-de fibration gave the best producing rate of feedstuffs when the chips were steamed (9kg/$cm^2$ under the pressure) for 10 minutes. The yield and the digestibility of feedstuffs were 84.2% and 38.1%, respectively. It is the merit of this method that feedstuffs manufactured by this method was uniformity in particle size, and facilities of fiberboard factory could be used directly, 2. For defibration of the chip by explosion, the proper condition was steamed under the pressure (20kg/$cm^2$) for 4 minutes. The yield and the digestibility of feedstuffs were 93.4% and 68.1%, respectively. The feedstuffs produced under these conditions had higher nutritional quality than rice straw and this method was considered as the best for making feedstuffs from Hyun-aspen chip. But it is defect that exploded feedstuffs was ununiformity in particle size and had unique odor. The physical properties of the feedstuffs were investigated by a light microscope and a TEM. The feedstuffs produced under the low pressure (20 kg/$cm^2$) still maintained the structure of fibers. However, the feedstuffs produced under the high pressure (28 kg/$cm^2$) resulted in higher de fib ration than these prepared under the low pressure. The highly defibrated feedstuffs recombined with solublized lignin. The crystallinity of feedstuffs was increased by 10% and micelle width increased double after treatment.

• Archives of Reconstructive Microsurgery
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• v.13 no.2
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• pp.107-116
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• 2004

Flaps are necessary, when important structures such as bone, tendon, nerve and vessel are exposed. Arterialized venous free flap is suited to the coverage of finger and hand because the thickness of venous flap is thin. Authors performed 65 cases arterialized venous free flap for the soft tissue reconstruction of the hand and finger. The size of donor defect were from $1{\times}1cm\;to\;7{\times}12cm$. The mean flap area was $9.1cm^2$. The recipient sites were finger tip in 34 cases, finger shaft in 29 cases and hand in 2 cases. The donor sites were volar aspect of distal forearm in 40 cases, thenar area in 17 cases and foot dorsum in 6 cases. The types of arterialized venous free flap were A-A type in 4 cases and A-V type in 61 cases. The length of afferent vein was from 0.5 cm to 3 cm (mean 1.7 cm) and efferent vein was from 1 cm to 10 cm (mean 2.2 cm). 58 flaps(89.2%) survived eventually. 42 flaps(64.6%) survived totally without any complication. 8 flaps(12.3%) showed the partial necrosis but they were healed without any additional operations. 8 flaps (12.3%) showed the partial necrosis requiring the additional skin graft. We had a satisfactory result by using arterialized venous free flap for the soft tissue reconstruction of finger and hand. We believe that volar aspect of distal forearm, thenar area, foot dorsum are suited as a donor site and the short length of the flap pedicle, the strong arterail inflow affect the survival rate of arterialized venous free flaps.

• Archives of Plastic Surgery
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• v.39 no.1
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• pp.36-41
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• 2012

Background : Poststernotomy mediastinitis is a rare, but life-threatening complication, thus early diagnosis and proper management is essential for poststernotomy mediastinitis. The main treatment for mediastinitis is aggressive debridement. Several options exist for reconstruction of defects after debridement. The efficacy of immediate debridement and reconstruction with a pectoralis major muscle flap designed for the defect immediately after the diagnosis of poststernotomy mediastinitis is demonstrated. Methods : Between September 2009 and June 2011, 6 patients were referred to the Department of Plastic and Reconstructive Surgery and the Department of Thoracic and Cardiovascular Surgery of Ajou University Hospital for poststernotomy mediastinitis. All of the patients underwent extensive debridement and reconstruction with pectoralis major muscle flaps, advanced based on the pedicle of the thoracoacromial artery as soon as possible following diagnosis. A retrospective review of the 6 cases was performed to evaluate infection control, postoperative morbidity, and mortality. Results : All patients had complete wound closures and reduced severity of infections based on the erythrocyte sedimentation rate and C-reactive protein levels and a reduction in poststernal fluid collection on computed tomography an average of 6 days postoperatively. A lack of growth of organisms in the wound culture was demonstrated after 3 weeks. There were no major wound morbidities, such as hematomas, but one minor complication required a skin graft caused by skin flap necrosis. No patient expired after definitive surgery. Conclusions : Immediate debridement and reconstruction using a pectoralis major muscle flap is a safe technique for managing infections associated with poststernotomy mediastinitis, and is associated with minimal morbidity and mortality.

• Archives of Plastic Surgery
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• v.36 no.2
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• pp.153-160
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• 2009

Purpose: The heterodigital or homodigital artery island flap is a popular method of reconstruction for finger defects. Sometimes, digital artery island flap has some disadvantages such as postoperative flap edema, congestion, and partial necrosis of the flap margin. However, we could decrease these disadvantages by means of venous superdrainage. The aim of this study is to report usefulness and postoperative results of venous supercharging digital artery island flaps for finger reconstruction. Methods: From March of 2005 to March of 2008, a total of eight patients with soft tissue defects of the finger underwent venous supercharging digital island flap transfer. Briefly, the flap is harvested along with dorsal vein that is then anastomosed to a recipient vein in an end - to - end fashion, after flap transfer and insetting. Using this technique, eight patients were operated on, ranging in age 23 to 52 years. Results: All the flaps survived with a success rate of 100 percent, thus fully satisfying the reconstructive requirements. No postoperative flap congestion was recognized, obviating the need to take any measures for venous engorgement, such as suture removal. Among 8 cases, it was possible to make an long - term and follow - up observation more than 6 months. In these cases, the fact that light touches and temperature sensations can be detected in all the flaps. Cold intolerance and hyperesthesia were not seen in our series. Conclusion: Providing good harmony with conventional methods and microsurgery, inclusion of a vein with the heterodigital and homodigital artery island flap allows a more reliable and safer reconstructive choice for finger defects. The venous supercharged island flap is a reliable flap with a consistent arterial structure, and with its augmented venous drainage, it is more reliable, providing single - stage reconstruction of adjacent finger defects, including the fingertip.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.714-719
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• 2009

Purpose: Recurrent ischial pressure sore is troublesome for adequate soft tissue coverage, because usually its pocket has a very large deep space and adjacent donor tissue have been scarred in the previous surgery. However, the conventional reconstructive methods are very difficult to overcome them. Modified gluteus maximus myocutaneous V - Y advancement flap from buttock can be successfully used in these circumstances. Methods: From February 2007 to October 2008, modified gluteus maximus myocutaneous V - Y advancement flaps were perfomed in 10 paraplegic patients with recurrent ischial pressure sore. The myocutaneous flap based on the inferior gluteal artery was designed in V - shaped pattern toward the superolateral aspect of buttock and was elevated from adjacent tissue. Furthermore, when additional muscular bulk was required to obliterate dead space, the flap dissection was extended to the inferolateral aspect which can included the adequate amount of the gluteal muscle. After the advanced flap was located in sore pocket, donor defect was repaired primarily. Results: The patients' mean age was 46.9 and the average follow - up period was 12.4 months. The immediate postoperative course was uneventful. But, two patients were treated through readvancement of previous flap due to wound dehiscence or recurrence after 6 months. The long - term results were satisfied in proper soft tissue bulk and low recurrence rate. Conclusions: The modified gluteus maximus myocutaneous V - Y advancement flap may be a reliable method in reconstruction of recurrent ischial pressure sore, which were surrounded by scarred tissue because of its repetitive surgeries and were required to provide sufficient volume of soft tissue to fill the large pocket.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.70-81
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• 1988

From January 1962 to March 1987, 97 patients underwent operation for mitral valve disease. Of these patients, 61 [62.9%] required mitral valve replacement. Thirty-six patients [37.1%] had mitral valve repair. The mean age was 26.9*11.6 years [range 5 months to 48 years]. There were 32 [88.9%] cases of rheumatic valve disease, 4 [11.1%] cases of congenital mitral valve disease. Valve dysfunction was classified into three types: type I [normal leaflet motion], 6 patients; type II [prolapsed leaflet], 1 patient; type III [restricted leaflet motion], 29 patients. Twenty-nine patients [80.6%] had pure or predominant stenosis and 7[19.4%] had pure regurgitation. No patient was in NYHA functional class I. Three patients [16.7%] were in functional class II, 15[83.3%] were in functional class II. The techniques used included closed mitral commissurotomy [16 patients], open mitral commissurotomy [13 patients], localized Wooler type annuloplasty [4 patients], suture repair of leaflet defect [3 patients], chordal shortening [1 patient], Carpentier ring annuloplasty [1 patient], and fenestration of fused chordae [1 patient]. There were two perioperative deaths [5.6%], related to left ventricular failure and reoperation. The survivors were followed up for 94 patient-years [mean 4.68*5.54 years]. One late death [1.1*1.1% per patient-year] occurred and was valve related. Reoperation was required in 3 patients, of whom 2 were deaths. There was 1 case [1.1*1.1% per patient-year] of thromboembolism. No patient received anticoagulant after operation. At 10 year, 92*7.4% of the patients were still alive. The actuarial survival rate of patients free of valve-related complication was 79*6.4% at 6 years, 27*12.1% at 11 years. After surgery, 18 patients [88.9%] were in NYHA functional class I or II.

• Journal of Chest Surgery
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• v.44 no.2
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• pp.108-114
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• 2011

Background: Homograft cardiac valves and valved-conduits have been available in our institute since 1992. We sought to determine the long-term outcome after right ventricular outflow tract (RVOT) reconstruction using homografts, and risk factors for reoperation were analyzed. Materials and Methods: We retrospectively reviewed 112 patients who had undergone repair using 116 homografts between 1992 and 2008. Median age and body weight at operation were 31.2 months and 12.2 kg, respectively. The diagnoses were pulmonary atresia or stenosis with ventricular septal defect (n=93), congenital aortic valve diseases (n=15), and truncus arteriosus (N=8). Mean follow-up duration was $79.2{\pm}14.8$ months. Results: There were 10 early and 4 late deaths. Overall survival rate was 89.6%, 88.7%, 86.1% at postoperative 1 year, 5 years and 10 years, respectively. Body weight at operation, cardiopulmonary bypass (CPB) time and aortic cross-clamping (ACC) time were identified as risk factors for death. Forty-three reoperations were performed in thirty-nine patients. Freedom from reoperation was 97.0%, 77.8%, 35.0% at postoperative 1 year, 5 years and 10 years respectively. Small-sized graft was identified as a risk factor for reoperation. Conclusion: Although long-term survival after RVOT reconstruction with homografts was excellent, freedom from reoperation was unsatisfactory, especially in patients who had small grafts upon initial repair. Thus, alternative surgical strategies not using small grafts may need to be considered in this subset.