• Archives of Plastic Surgery
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• v.37 no.4
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• pp.396-399
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• 2010

Purpose: In hand injury, pedicle is usually damaged by avulsion injury or crushing injury. Because of postoperative pedicle obliteration, it is often hard to save the injured hand and fingers, even after successful replantation. The author introduces three cases of extensive hand injury, and successful results after applicatoin of multiple venous grafts to these patients. Methods: In all cases there was no circulation in any finger. In the first case, some vessels were extracted, so venous graft was applied to two sites of severely damaged venous sites. In the second case, venous grafts were applied to all four digital arteries of all fingers except thumb which got severely crushed, and two sites of dorsal veins. In the third case, venous graft was applied to all four digital arteries of all five fingers, and two sites of dorsal veins and palmar veins each. Results: In all cases, survival of hands and fingers was successful. In the second case, however, amputation in thumb and little finger at DIP joint level was inevitable, because of its severe damage, and the large dorsal defect on index finger was filled with DIEP free flap. Thumb was reconstructed with toe-to-thumb free flap, and additional debulking procedures and contracture release is furtherly needed. In the first case, additional surgery was done, as FDP tendon got re-ruptured, but in long term follow-up, satisfactory range of motion was attained. In the third case, FTSG on dorsal skin region was planned. as flap on dorsal area got partial necrosis. Conclusion: In hand injury, there are many structures to be repaired, but sometimes venous graft is avoided for its long operating time. Even though the length of damaged vessel is enough for anastomosis, the endothelium is often damaged (zone of injury). In extensive hand injury, successful reconstruction would be possible with active venous graft to all vessels suspicious for damage.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.578-582
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• 2009

Purpose: In extensive deep burn of the lower limb, due to less amount of soft tissue, bone is easily exposed. When it happens, natural healing or reconstruction with skin graft only is not easy. Local flap is difficult to success, because adjacent skins are burnt or skin grafted tissues. Muscle flap or free flap are also limited and has high failure rate due to deep tissue damage. The authors acquired good outcome by performing one - stage operation on bone exposed soft tissue defect with AlloDerm$^{(R)}$(LifeCell, USA), an acellular dermal matrix producted from cadaveric skin. Methods: We studied 14 bone exposed soft tissue defect patients from March 2002 to March 2009. Average age, sex, cause of burn, location of wound, duration of admission period, and postoperative complications were studied. We removed bony cortex with burring, until conforming pinpoint bone bleeding. Then rehydrated AlloDerm$^{(R)}$(25 / 1000 inches, meshed type) was applicated on wound, and thin split thickness(6 ~ 8 / 1000 inches) skin graft was done at the immediately same operative time. Results: Average age of patients was 53.6 years(25 years ~ 80 years, SD = 16.8), and 13 patients were male(male : female = 13 : 1). Flame burn was the largest number. (Flame burn 6, electric burn 3, contact burn 4, and scalding burn 1). Tibia(8) was the most affected site. (tibia 8, toe 4, malleolus 1, and metatarsal bone 1). Thin STSC with AlloDerm$^{(R)}$ took without additional surgery in 12 of 14 patients. Partial graft loss was shown on four cases. Two cases were small in size under $1{\times}1cm$, easily healed with simple dressing, and other two cases needed additional surgery. But in case of additional surgery, granulation tissue has easily formed, and simple patch graft on AlloDerm$^{(R)}$ was enough. Average duration of admission period of patients without additional surgery was 15 days(13 ~ 19 days). Conclusion: AlloDerm$^{(R)}$ and thin split thickness skin graft give us an advantage in short surgery time and less limitations in donor site than flap surgery. Postoperative scar is less than in conventional skin graft because of more firm restoration of dermal structure with AlloDerm$^{(R)}$. We propose that AlloDerm$^{(R)}$ and thin split thickness skin graft could be a solution to bone exposured soft tissue defects in extensive deep burned patients on lower extremities, especially when adjacent tissue cannot be used for flap due to extensive burn.

• Journal of Chest Surgery
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• v.40 no.2 s.271
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• pp.136-139
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• 2007

Bilateral popliteal artery entrapment syndrome is a rare vascular disease, which leads to ischemic claudication as a result of disturbance to the blood flow from the abnormal relationship of the popliteal artery to the gastrocnemius muscle, a fibrous band or the popliteus muscle in the young male population. A 58-years-old male patient, complaining of ischemic claudication, coldness and 3rd toe gangrene of left leg of 1 month's duration was admitted to our institution. His left ankle-brachial index was decreased; therefore, a femoral artery angiography was peformed, which revealed a total occlusion below the distal superficial femoral artery of the left leg. An EKG revealed atrial fibrillation, suggestive of a thromboembolism of the popliteal artery due to atrial fibrillation; therefore, Urokinase thrombolysis was attempted. After the Urokinase thrombolysis, popliteal artery entrapment syndrome was diagnosed, with MRI then performed for an anatomical diagnosis. The popliteal artery entrapment was type 1, where the popliteal artery was displaced medial to the Gastrocnemius head. After complete removal of the popliteal artery aneurysm, interposition was performed with a contra lateral greater saphenous vein graft. A mild right popliteal artery aneurysm still remained, but surgery was not performed. Currently, the patent is surviving, without complications. Herein, the good results obtained for the surgical treatment of a severely affected leg, and the conservative treatment of a mildly affected leg, are reported.

• Journal of the Korean Geotechnical Society
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• v.36 no.5
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• pp.25-34
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• 2020

Studies on nondestructive evaluation methods using electromagnetic waves have been commonly conducted to evaluate necking defects in bored piles. However, the propagation of electromagnetic waves are affected by water contents of surrounding materials. This study aims to investigate a suitability of electromagnetic waves for evaluating necking defects in bored piles embedded in sandy soils through laboratory experiments. Laboratory experiments are performed with a model pile having a necking defect. The diameter and length of model pile are 600 mm and 1 m, respectively, and the model pile is embedded in sandy soils with different water contents of 10%, 20%, and 30%. For the propagation of electromagnetic waves, a transmission line is configured in reinforcement cage using an electrical wire. The generation and detection of electromagnetic waves are conducted using a time domain reflectometer. Experimental results show that the peak amplitude of electromagnetic waves reflected at the necking defect decreases with an increase in the water content in sandy soils. In addition, the velocity of electromagnetic waves reflected from the toe of the model pile decreases win an increase in the water content. However, estimated locations of the necking defects are almost the same to that of the actual location of the necking defect. This study demonstrates that electromagnetic waves may be an effective method for evaluating necking defects in bored piles embedded in sandy soils

• Journal of Yeungnam Medical Science
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• v.7 no.1
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• pp.39-50
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• 1990

The one event on signalling mechanism is the cleavage by adenyl cyclase of ATP into second messenger, cyclic AMP. The other transfer system of inositol metabolism. it is widely recognized that hydrolysis of the minor membrane lipid phosphoinositide bisphosphate($PIP_2$) initiated by occupation of certain receptors and catalyzed by phospholipase C, lead to toe generation of the two intracellular messengers, inositol triphosphate($IP_3$) and diacylglycerol(DG). $IP_3$ is converted to inositol tetrakisphosphate($IP_4$) by $IP_3$ kinase. In the present study, it is that purification of calmodulin is used by phenyl-Sepharose CL-4B chromatography. it's molecular weigh, 17.000 in SDS-polyacrylamide gel electrophoresis. In order to observe the affinity between calmodulin (CaM)-Affigel 15 and $IP_3$ kinase, and isolated $IP_3$ kinase, was applied in CaM-Affigel with $Ca^{2+}$ equilibirum buffer and EGTA equilibirum buffer. We compared with binding and elution effect of $IP_3$ kinase in several condition of buffer. In affinity of binding. $Ca^{2+}$ equilibrium buffer was in the most proper condition. and elution, CaM/$Ca^{2+}$ buffer(CE1 10.36, CE2 12. 76pM/min/mg of protein) was effected much more than EGTA buffer(E2 1.48, E3 2.43pM/min/mg of protein), but CaM/$Ca^{2+}$ stimulate the activity of $IP_3$ kinase. And then, several detergents such as sodium deoxycholate, tween 20. cholic acid, polyethylene glycol, chaps were applied. The 0.2% chaps buffer(E2 23.19, E3 8.05pM/min/mg of protein) was the most effective in elution of $IP_3$ kinase.

• Structural Engineering and Mechanics
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• v.57 no.1
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• pp.1-20
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• 2016

On the basis of the geological conditions of high and steep mountainous slope on which an exit portal of an express railway tunnel with a bridge-tunnel combination is to be built, the composite structure of the exit portal with a bridge abutment of the bridge-tunnel combination is presented and the stability of the slope on which the express railway portal is to be built is analyzed using three dimensional (3D) numerical simulation in the paper. Comparison of the practicability for the reinforcement of slope with in-situ bored piles and diaphragm walls are performed so as to enhance the stability of the high and steep slope. The safety factor of the slope due to rockmass excavation both inside the exit portal and beneath the bridge abutment of the bridge-tunnel combination has been also derived using strength reduction technique. The obtained results show that post tunnel portal is a preferred structure to fit high and steep slope, and the surrounding rock around the exit portal of the tunnel on the high and steep mountainous slope remains stable when rockmass is excavated both from the inside of the exit portal and underneath the bridge abutment after the slope is reinforced with both bored piles and diaphragm walls. The stability of the high and steep slope is principally dominated by the shear stress state of the rockmass at the toe of the slope; the procedure of excavating rockmass in the foundation pit of the bridge abutment does not obviously affect the slope stability. In-situ bored piles are more effective in controlling the deformation of the abutment foundation pit in comparison with diaphragm walls and are used as a preferred retaining structure to uphold the stability of slope in respect of the lesser time, easier procedure and lower cost in the construction of the exit portal with bridge-tunnel combination on the high and steep mountainous slope. The results obtained from the numerical analysis in the paper can be used to guide the structural design and construction of express railway tunnel portal with bridge-tunnel combination on high and abrupt mountainous slope under similar situations.

• Journal of Climate Change Research
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• v.5 no.2
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• pp.153-163
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• 2014

This study analyzed directions of the energy product efficiency improvement and Carbon Tax for the domestic building sector. In order to analyze GHG reduction potential and total cost, the cost optimization model MESSAGE was used. In the case of the "efficiency improvement scenario," the cumulative potential GHG reduction amount - with respect to the "Reference scenario" - from 2010 to 2030 is forecast to be $104MtCO_2eq$, with a total projected cost of 2.706 trillion KRW. In the "carbon tax scenario," a reduction effect of $74MtCO_2eq$ in cumulative potential GHG reduction occurred, with a total projected cost of 2.776 trillion KRW. The range of per-ton GHG reduction cost for each scenario was seen to be approximately $-475{\sim}272won/tCO_2eq$, and the "efficiency improvement scenario" showed as the highest in the order of priority, in terms of the GHG reduction policy direction. Regarding policies to reduce GHG emissions in the building sector, the energy efficiency improvement is deemed to deployed first in the future.

• Journal of Korean Foot and Ankle Society
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• v.23 no.2
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• pp.58-66
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• 2019

Purpose: To evaluate the efficacy of antibiotic-loaded cement spacers (ALCSs) for the treatment of diabetic foot infections with osteomyelitis as a salvage procedure and to analyze the risk factors of treatment failure. Materials and Methods: This study reviewed retrospectively 39 cases of diabetic foot infections with osteomyelitis who underwent surgical treatment from 2009 to 2017. The mean age and follow-up period were $62{\pm}13years$ and $19.2{\pm}23.3months$, respectively. Wounds were graded using the Wagner and Strauss classification. X-ray, magnetic resonance imaging (or bone scan) and deep tissue cultures were taken preoperatively to diagnose osteomyelitis. The ankle-brachial index, toe-brachial index (TBI), and current perception threshold were checked. Lower extremity angiography was performed and if necessary, percutaneous transluminal angioplasty was conducted preoperatively. As a surgical treatment, meticulous debridement, bone curettage, and ALCS placement were employed in all cases. Between six and eight weeks after surgery, ALCS removal and autogenous iliac bone graft were performed. The treatment was considered successful if the wounds had healed completely within three months without signs of infection and no additional amputation within six months. Results: The treatment success rate was 82.1% (n=32); 12.8% (n=5) required additional amputation and 5.1% (n=2) showed delayed wound healing. Bacterial growth was confirmed in 82.1% (n=32) with methicillin-resistant Staphylococcus aureus being the most commonly identified strain (23.1%, n=9). The lesions were divided anatomically into four groups; the largest number was the toes: (1) toes (41.0%, n=16), (2) metatarsals (35.9%, n=14), (3) midfoot (5.1%, n=2), and (4) hindfoot (17.9%, n=7). A significant difference in the Strauss wound score and TBI was observed between the treatment success group and failure group. Conclusion: The insertion of ALCSs can be a useful treatment option in diabetic foot infections with osteomyelitis. Low scores in the Strauss classification and low TBI are risk factors of treatment failure.

• Journal of Korean Society of Coastal and Ocean Engineers
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• v.33 no.4
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• pp.168-178
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• 2021

Numerical simulations were implemented to look into the modified seabed topography due to the presence of breakwaters of varying reflection characteristics. The numerical model was composed of OlaFlow, an OpenFoam-based tool box, and a physics-based morphology model [Seoul Foam]. In doing so, the interaction between the seabed, which undergoes deformation due to siltation and scouring, and the incoming waves was described using Dynamic Mesh. The rubble-mound, vertical, and curved slit caisson breakwaters with varying reflection characteristics resulted in standing waves that differ from each other, shown to have a significant influence on the seabed topography. These results are in line with Nielsen's study (1993) that sands saltated under the surface nodes of standing waves, where the near-bed velocities are most substantial, convected toward the surface antinodes by boundary-layer drift. Moreover, the crest of sand waves was formed under the surface antinodes of standing waves, and the trough of sand waves was formed under the surface antinodes. In addition, sand wave amplitude reaches its peak in the curved slit caisson with a significant reflection coefficient, and the saltation of many grains of sand would cause this phenomenon due to the increased near-bed velocity under the nodes when the reflection coefficient is getting large.

• Journal of the Korean GEO-environmental Society
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• v.23 no.2
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• pp.25-36
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• 2022

In this study, seepage control effect of relief well was evaluated quantitatively on embankment of small fill dam and levee. Seepage analysis of dam and levee were carried out according to the permeability of fill material and foundation and to analyze behaviour characteristics of seepage. The up-lift pressure at toe of embankment was analyzed which is generated by seepage according to relief well installation condition. The relief well could reduce pore water pressure which is to cause piping or up-lift pressure at foundation ground of embankment and it does not be influenced on geometric condition such as dam height and slope incline. In case of relative low permeable ground, the pore water pressure reduction effect of relief well was decreased compare with high permeable ground but it shows pore water pressure reduction effect compare with no relief well condition. The reduction effect of relief well shows relative gap according to diameter and penetration length of relief well and the installation length of relief well is the most effective factor for seepage control.