• Archives of Plastic Surgery
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• v.36 no.3
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• pp.351-355
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• 2009

Purpose: Cervical necrotizing fasciitis tends to involve the deep soft tissues and spread caudally to the anterior chest and mediastinum, often resulting in major complications and death. It may rapidly spread into the thorax along fascial planes, and the associated diagnostic delay results in this descending necrotizing mediastinitis. So, aggressive multidisciplinary therapy with surgical drainage is mandatory. We present a very rare case of descending necrotizing mediastinitis with literature review. Methods: A 53 years old male visited our department 7 days after trauma in neck. His premorbid conditions and risk factors of necrotizing fasciitis were concealed hepatoma, trauma history, chronic liver disease, and nutrition deficit. Computed tomographic scans of the head and neck region were performed in this patient : signs of necrotizing fasciitis, were seen in the platysma, sternocleidomastoid, trapezius muscle and strap muscles of the neck. Fluid accumulations involved multiple neck spaces and mediastinum. At the time, he diagnosed as necrotizing fasciitis on his neck and anterior chest. Necrotic wound was excised serially and we treated this with the Vacuum - assisted closure(VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge and achieving additional 3 pieces drainage tubes in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was utilized for a period of 12 days. Results: We obtained satisfactory results from wide excision, abscess drainage with the VAC system, and then split thickness skin graft. The postoperative course was uneventful. Conclusion: The refined technique using the VAC system can provide a means of simple and effective management for the descending necrotizing mediastinitis, with better cosmetic and functional results. Finally, the VAC system has been adopted as the standard treatment for deep cervical and mediastinal wound infections as a result of the excellent clinical outcome.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.1
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• pp.618-624
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• 2017

In Seoul and most metropolitan cities, urban trains are delayed due to high congestion during commute times. The delay effect of passengers boarding and disembarking is also significant. In this study, a wide passenger door system was developed as a way to improve the scheduled speed of urban trains by decreasing the passengers' flow time. The door size was defined experimentally to shorten the entrance time. The optimum door size was also determined to improve the stop precision performance of the train while considering the interference effect with peripheral devices. Because the change in door size changes the structural characteristics of the vehicle, the structural stability of a train was analyzed numerically. A prototype of the wide door system was made, and the proposed design was verified using functional and endurance tests. The systematic development process can be used as design data for door size definition and system production when applying a wide door to improve the scheduled speed.

• Nutrition Research and Practice
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• v.5 no.5
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• pp.412-420
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• 2011

The aim of the present study was to investigate the hypocholesterolemic effect and potential of tyramine derivatives from Lycii Cortex Radicis (LCR), the root bark of lycium (Lycium chenese Miller) in reducing lipid peroxidation. The activities of enzymes, hepatic 3-hydroxy 3-methylglutaryl (HMG) CoA reductase and acyl-CoA:cholesterol acyltransferase (ACAT) and LDL oxidation were measured in vitro and animal experiments were also performed by feeding LCR extracts to rats. The test compounds employed for in vitro study were trans-N-p-coumaroyltyramine (CT) and trans-N-feruloyltyramine (FT), LCR components, N-(p-coumaroyl)serotonin (CS) and N-feruloylserotonin (FS) from safflower seeds, ferulic acid (FA) and 10-gingerol. It was observed that FT and FS at the concentration of 1.2 mg/mL inhibited liver microsomal HMG CoA reductase activity by ~40%, but no inhibition of activity was seen in the cases of CT, CS, FA and 10-gingerol. Whereas, ACAT activity was inhibited ~50% by FT and CT, 34-43% by FS and CS and ~80% by 10-gingerol at the concentration of 1 mg/mL. A significant delay in LDL oxidation was induced by CT, FT, and 10-gingerol. For the animal experiment, five groups of Sprague-Dawley male rats were fed high fat diets containing no test material (HF-control), 1 and 2% of LCR ethanol extract (LCR1 and LCR2), and 1% of extracts from safflower seed (Sat) and ginger (Gin). The results indicated that total cholesterol level was significantly lower in Saf, LCR2 and Gin groups, and HDL cholesterol level was lower only in Gin group when compared with HF-control group; while there was no difference in the serum triglyceride levels among the five experimental groups. The level of liver cholesterol was significantly lower in LCR1 and LCR2 groups than HF-control Serum levels of TBARS were significantly lower only in LCR2 group when compared with HF-control group. From the observed results, we concluded that LCR can be utilized as a hypocholesterolemic ingredient in combination with ginger, especially for functional foods.

• Journal of Korean Neurosurgical Society
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• v.63 no.2
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• pp.188-201
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• 2020

Objective : The purpose of this study was to suggest that computed tomography angiography (CTA) is valuable as the only preliminary examination for mechanical thrombectomy (MT). MT after single examination of CTA including noncontrast computed tomography (NCCT) and maximum intensity projection (MIP) improves door-to-puncture time as well as results in favorable outcomes. Methods : A total of 157 patients who underwent MT at Dong Kang Medical Center from April 2015 to March 2019 were divided into two groups based on the examination performed prior to MT : CTA group who underwent CTA with NCCT and MIP, and NCCT+magnetic resonance image (MRi) group who underwent MRI including perfusion images after NCCT. In the two groups, time to CTA imaging or NCCT+MRi imaging after symptom onset, and time to arterial puncture and reperfusion were characterized as time-related outcomes. The evaluation of vascular recanalization after MT was defined as a modified thrombolysis in cerebral infarction (mTICI) scale. National Institutes of Health Stroke Scale (NIHSS) was assessed at the time of the visit to the emergency room and modified Rankin Scale (mRS) was assessed after 90 days. Results : Typically, there were 34 patients in the CTA group and 33 patients in the NCCT+MRi group. A significantly shorter delay for door-to-puncture time was observed (mean, 86±22.1 vs. 176±47.5 minutes; <0.01). Also, a significantly shorter door-to-imege time in the CTA group was observed (mean, 13±6.8 vs. 93±30.8 minutes; p<0.01). Moreover, a significantly shorter onset-to-puncture time was observed (mean, 195±128.0 vs. 314±157.6 minutes; p<0.01). Reperfusion result of mTICI ≥2b was 100% (34/34) in the CTA group and 94% (31/33) in the NCCT+MRi group, and mTICI 3 in 74% (25/34) in the CTA group and 73% (24/33) in the NCCT+MRi group. Favorable functional outcomes (mRS score ≤2 at 90 days) were 68% (23/34) in the CTA group and 60% (20/33) in the NCCT+MRi group. Conclusion : A single-phase CTA including NCCT and MIP images was performed as a single preliminary examination, which led to a reduction in the time of the procedure and resulted in good results of prognosis. Consequently, it is concluded that this method is of sufficient value as the only preliminary examination for decision making.

• Korean Journal of Construction Engineering and Management
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• v.6 no.5 s.27
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• pp.89-101
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• 2005

The early phase of construction projects, communication among the related participants has great influence on the further transaction of the projects. However, important decision making are made by the experience of the field managers in practice without the method for systematic analysis. For example, in building construction project, selection process for construction method has been executed by decision making of some architects dependent on their experience. As a result, there have been frequent construction method alterations during the construction process and delay of duration, addition of cost, etc have followed accordingly. The main reasons of such a mal-functional transaction are due to the absent of the reasonal procedure of decision making reflecting the characteristics of construction project. Therefore, there is a need for an supporting tool and production design for the selection of rational construction method. The objective of this study is to propose production design process and decision making model in relation to various influent factors at the early phase of construction projects. To achieve these objectives, this study 1)analyzes the prior theory about production design, 2)we have studied about selection process for optimal construction method through constraint analysis in structural works, 3)performs a case study to embody the problems of the production design, and 4)proposes a cooperative committee model for supporting production design by analyzing the results of case study and interviewing experts. It is anticipated that the effective tool of proposed model would be able to improve communication among the related participants and systematically accumulate data that might be used in similar construction projects.

• Korean Journal of Clinical Pharmacy
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• v.22 no.4
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• pp.356-366
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• 2012

Background: Chemotherapy-induced peripheral neuropathy (CIPN) involving sensory and motor nerve damage or dysfunction is a common and serious clinical problem that affects many patients receiving cancer treatment. This condition may pose challenges for the clinician to diagnose and manage, particularly in patients with coexisting conditions or disorders that involve the peripheral nervous system. Many chemotherapeutic agents used today are associated with the development of serious and dose-limiting CIPN that can adversely affect the administration of planned therapy and can impair quality of life by interference with the patients' activities of daily living. The most important clinical objective in the evaluation of patients with CIPN is to determine their level of functional impairment involving activities of daily living. These findings are used to make medical decisions to continue, modify, delay, or stop treatment. The most commonly reported drugs to cause CIPN include taxanes, platinum agents, vinca alkaloids, thalidomide, and bortezomib. We aimed to determine PN incidence during cisplatin, carboplatin and oxaliplatin administration. Methods: We collected data from 125 patients who received at least one cycle of cisplatin, carboplatin or oxaliplatin. They completed a self-reported questionnaire and items related to their disease and peripheral neuropathy. The investigators filled in part of items about disease and treatment. Patient Neurotoxicity Qeustionnaire developed by Bionumerik company were applied for PN assessment. Results: The incidences of sensory neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 23%, 56% and 50%. The incidences of motor neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 18%, 42% and 19%. The incidences of severe neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 13%, 28% and 14%. The incidences of PN were associated with cumulative dose but not age, gender and concurrent illness. 19.2% of the patients (24/125) were prescribed with gabapentin, nortriptyline or gabapentin plus nortriptyline to reduce these peripheral symptoms and 75% of the patients answered the drug were effective. Conclusion: Incidence of PN after cisplatin or oxaliplatin administration is cumulative dose-related. Physician-based assessments under-reported the incidence and severity of CIPN. To overcome this limitation, diagnostic tools specifically designed to assess peripheral neuropathy severity associated with chemotherapy must be developed.

• Archives of Reconstructive Microsurgery
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• v.6 no.1
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• pp.96-102
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• 1997

The gracilis that is frequently used as a donor of free muscle trasfer is appropriate in the muscular shape and vascular position. This muscle is belonged to the second type of muscle group by the classification of the pattern of muscular nutrient vessel. The adductor branch or first perforating branch of deep femoral artery which supplies the proximal 1/3 of this muscle is a dominant one and this is used for the microscopic anastomosis of muscle or musculocutaneous flap. The minor vascular pedicles which enter the distal 1/3 of this of this muscle are branches of the superficial femoral artery and it is 0.5mm in diameter, 2cm in length with two venae comitantes. These minor pedicles supplies distal half of the gracilis muscle. This island musculocutaneous flap using distal vascular pedicle can be used to cover the defect of soft tissue around the distal femoral supra-condylar area, knee joint and proximal tibial condyle area which cause limitation of motion of knee joint, or in the cases that usual skin graft is impossible. The important operative procedure is as follows; The dissection is carried proximally and distally and the entire gracilis muscle including proximal and distal pedicle is completely dissected. After temporary blocking of the proximal vascular pedicle, the adequate muscle perfusion by the distal pedicle is identified and it is rotated to the recipient site around knee joint. The advantages of this procedure are simple, no need of microscopic vascular anastomoses and no significant functional loss of donor site. Especially in the cases of poor condition of the recipient vessel, this procedure can be used effectively. From 1991 to 1996, we performed 4 cases; complete survival of flap in 3 cases and partial survival of flap with partial necrosis in 1 case. This procedure is though to be useful in the small sized soft tissue defect of distal femoral supra-condylar area, knee joint and proximal tibial condylar area, especially in the defect of anterior aspect which expected to cause limitation of motion of knee joint due to scar contracture. But the problems of this procedure are the diameter of distal vascular pedicle is small and the location of distal vascular pedicle is not constant. To reduce the failure rate, identify the muscular perfusion of distal vascular pedicle after blocking the proximal pedicle, or strategic delay will be helpful.

• Korean Journal of Food Science and Technology
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• v.38 no.3
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• pp.348-354
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• 2006

Baking quality of dough made of flour substituted with insoluble ${\beta}-glucan$ (10, 20, and 30%), functional food material produced from Agrobacterium spp. R259 KCTC 10197BP, was evaluated. Optimum time to reach 1st stage of dough fermentation decreased with increasing ${\beta}-glucan$ content, whereas mixing time increased. Addition of ${\beta}-glucan$ did not affect pH of dough. Hunter color L, a, and b values of dough added with up to 20% ${\beta}-glucan$ were not significantly different from those of control. Rheology properties such as cohesiveness and springiness of ${\beta}-glucan$ added dough increased, while hardness and gumminess decreased. Amylogram showed addition of ${\beta}-glucan$ to flour lowered setback and consistency, which are suggested to delay retrogradation.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4381-4389
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• 2016

Background: Surgery is the corner stone for the management of rectal cancer. The purpose of this study was to demonstrate the optimal time of surgical resection after the completion of neoadjuvant chemo-radiotherapy (CRT) in treatment of locally advanced rectal cancer. Materials and Methods: This study compared 2 groups of patients with locally advanced rectal cancer, treated with neoadjuvant CRT followed by surgical resection either 6-8 weeks or 9-14 weeks after the completion of chemo-radiotherapy. The impact of delaying surgery was tested in comparison to early surgical resection after completion of chemo-radiotherapy. Results: The total significant response rate that could result in functional preservation was estimated to be 3.85% in group I and 15.4% in group II. Some 9.62% of our patients had residual malignant cells at one cm surgical margin. All those patients with positive margins at one cm were in group I (19.23%). There was less operative time in group II, but the difference between both groups was statistically insignificant (P=0.845). The difference between both groups regarding operative blood loss and intra operative blood transfusion was significantly less in group II (P=0.044). There was no statistically significant difference between both groups regarding the intra operative complications (P=0.609). The current study showed significantly less post-operative hospital stay period, and less post-operative wound infection in group II (P=0.012 and 0.017). The current study showed more tumor regression and necrosis in group II with a highly significant main effect of time F=61.7 (P<0.001). Pathological TN stage indicated better pathological tumor response in group II (P=0.04). The current study showed recurrence free survival for all cases at 18 months of 84.2%. In group I, survival rate at the same duration was 73.8%, however none of group II cases had local recurrence (censored) (P=0.031). Disease free survival (DFS) during the same duration (18 months) was 69.4 % for patients in group I and 82.3% for group II (P=0.429). Conclusions: Surgical resection delay up to 9-14 weeks after chemo-radiation was associated with better outcome and better recurrence free survival.

• Journal of the Institute of Electronics Engineers of Korea TC
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• v.43 no.1 s.343
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• pp.111-120
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• 2006

In this paper, a node architecture of WDM metro network for connecting broadband access networks to converge wire/wireless networks. In consideration of the proposed node architecture and network requirements we proposed and evaluated medium access control protocols. We review WDM related technologies of sub-carrier multiplexing and optical components in order to resolve the bottleneck between optical backbone networks md access networks, and a access node architecture sharing common wavelength is introduced. Source-stripping (SS) MAC protocol Is evaluated under the proposed functional node architecture. DS+IS (Destination-Stripping and Source-Stripping) and DS+IS (Destination-Stripping and Intermediate-Stripping) MAC protocols are described to increase the slot-reuse factor which is low on SS MAC protocol. The key function of new MAC protocols regards the optical switch module of proposed node architecture and helps intermediate or source access nodes for dropping slots to destinations of different wavelength group. Thus, slot-reuse factor increases as the MAC protocols reduce the unnecessary ring-rotation of transferred slots. We use a numerical analysis to expect bandwidth efficiency and maximum throughput by slot-reuse factor Throughput network simulation, the verification of throughput, queuing delay, and transmission fairness are compared among MAC protocols.