• Archives of Aesthetic Plastic Surgery
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• v.23 no.3
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• pp.143-145
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• 2017

Medical leech therapy is a treatment for the venous congestion of tissue flaps, grafts, and replants. We report a case of methicillin-resistant Staphylococcus aureus (MRSA) following leech application at a congested flap after mastectomy. A 45-year-old woman had an invasive ductal carcinoma. Modified radical mastectomy was performed. The chest wall defect was reconstructed with a local rotation flap. On postoperative day (POD) 1, congestion and color change were observed, and 10 medical leeches were applied to the congested area. On POD 4, another 10 medical leeches were applied. On POD 12, wound necrosis progressed and a pus-like discharge appeared. A wound swab culture revealed MRSA. Debridement was carried out on POD 15. From POD 16, vancomycin and piperacillin/tazobactam were injected for 18 days. The wound culture on POD 18 also revealed MRSA. A split-thickness skin graft was performed on POD 28. MRSA has not been clearly identified in the literature as a leech enteric bacterium. Although MRSA may have come from another source, the present case raises the possibility of MRSA infections following leech application at congested flaps. When medical leeches are applied at the congestion site of a flap, an aseptic cradle will be helpful. Vancomycin irrigation may be needed if infection occurs.

• Archives of Plastic Surgery
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• v.48 no.2
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• pp.175-178
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• 2021

The umbilicus is an important aesthetic component of the abdomen; therefore, its absence is both cosmetically and psychologically distressing to the patient. However, loss of the umbilicus during abdominal surgical procedures is often unavoidable. Umbilical reconstruction is aimed at obtaining a natural, three-dimensional appearance. We propose a simple method for immediate umbilical reconstruction with good long-term results. This technique was used successfully on a patient who underwent tumor excision. A 49-year-old woman presented with a large mass, measuring 5.8×4.0 cm, on her umbilicus. The mass, an epidermal cyst, developed after laparoscopic uterine myomectomy 5 years earlier. Complete excision of the mass resulted in a large defect, and immediate umbilical reconstruction was planned. Our procedure involved apposing and anchoring two opposing flaps onto the abdominal wall, so that the umbilicus would retain its depth over a long period of time. Negative-pressure wound therapy was applied for 72 hours as a mild compressive dressing. No complications were encountered. The healing process was uneventful and the aesthetic outcome was pleasing; a natural-appearing navel was created. The patient was satisfied with the end result. This technique provides a permanent and sufficient depression for the umbilicus.

• Journal of Ocean Engineering and Technology
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• v.36 no.1
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• pp.11-20
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• 2022

Generally, tsunamis are generated by the rapid crustal movements of the ocean floor. Other factors of tsunami generation include landslides on coastal and ocean floor slopes, glacier collapses, and meteorite collisions. In this study, two numerical analyses were conducted to examine the formation, propagation, and deformation properties of landslide tsunamis. First, LS-DYNA was adopted to simulate the formation and propagation processes of tsunamis generated by dropping rigid bodies. The generated tsunamis had smaller wave heights and wider waveforms during their propagation, and their waveforms and flow velocities resembled those of theoretical solitary waves after a certain distance. Second, after the formation of the landslide tsunami, a tsunami based on the solitary wave approximation theory was generated in a numerical wave tank (NWT) with a computational domain that considered the stability/steady phase. The comparison of two numerical analysis results over a certain distance indicated that the waveform and flow velocity were approximately equal, and the maximum wave pressures acting on the upright wall also exhibited similar distributions. Therefore, an effective numerical model such as LS-DYNA was necessary to analyze the formation and initial deformations of the landslide tsunami, while an NWT with the wave generation method based on the solitary wave approximation theory was sufficient above a certain distance.

• Journal of the Korean Institute of Electrical and Electronic Material Engineers
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• v.20 no.10
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• pp.829-838
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• 2007

The stochiometric mix of evaporating materials for the $CdGa_2Se_4$ single crystal thin films was prepared from horizontal furnace. To obtain the single crystal thin films, $CdGa_2Se_4$ mixed crystal was deposited on thoroughly etched semi-insulating GaAs(100) substrate by the Hot Wall Epitaxy (HWE) system. The source and substrate temperature were $630^{\circ}C$ and $420^{\circ}C$, respectively. The crystalline structure of single crystal thin films was investigated by the photoluminescence and double crystal X-ray diffraction (DCXD).The carrier density and mobility of $CdGa_2Se_4$ single crystal thin films measured from Hall effect by van der Pauw method are $8.27{\times}10^{17}\;cm^{-3},\;345\;cm^2/V{\cdot}s$ at 293 K. respectively. The temperature dependence of the energy band gap of the $CdGa_2Se_4$ obtained from the absorption spectra was well described by the Varshni's relation, $Eg(T)\;=\;2.6400\;eV\;-\;(7.721{\times}10^{-4}\;eV/K)T^2/(T+399\;K)$. After the as-grown single crystal $CdGa_2Se_4$ thin films were annealed in Cd-, Se-, and Ga -atmospheres, the origin of point defects of single crystal $CdGa_2Se_4$ thin films has been investigated by PL at 10 K. The native defects of $V_{Cd}$, $V_{Se}$, $Cd_{int}$, and $Se_{int}$ obtained by PL measurements were classified as donors or accepters. We concluded that the heat-treatment in the Cd-atmosphere converted single crystal $CdGa_2Se_4$ thin films to an optical p-type. Also, we confirmed that Ga in $CdGa_2Se_4/GaAs$ did not form the native defects because Ga in single crystal $CdGa_2Se_4$ thin films existed in the form of stable bonds.

• Proceedings of the Korean Institute of Electrical and Electronic Material Engineers Conference
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• 2005.11a
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• pp.111-112
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• 2005

To obtain the single crystal thin films, $CuInSe_2$, mixed crystal was deposited on thoroughly etched semi-insulating GaAs(100) substrate by the hot wail epitaxy (HWE) system. The source and substrate temperatures were 620$^{\circ}C$ and 410$^{\circ}C$, respectively. The crystalline structure of the single crystal thin films was investigated by the photoluminescence and double crystal X-ray diffraction (DCXD). The carrier density and mobilily of $CuInSe_2$ single crystal thin films measured with Hall effect by van der Pauw method are $9.62\times10^{16}$ $cm^{-3}$ and $296cm^2/V{\cdot}s$ at 293 K, respectively. The temperature dependence of the energy band gap of the CulnSe$_2$ obtained from the absorption spectra was well described by the Varshni's relation E$_g$(T) = 1.1851 eV - ($8.99\times10^{-4}$ ev/K)T$_2$/(T + 153K). After the as-grown $CuInSe_2$ single crystal thin films was annealed in Cu-, Se-, and In-atmospheres the origin of point defects of $CuInSe_2$ single crystal thin films has been investigated by the photoluminescence(PL) at 10 K. The nat ive defects of V$_{Cu}$, $V_{Se}$, Cu$_{int}$, and $Se_{int}$ obtained by PL measurements were classified as a donors or accepters type. And we concluded that the heat-treatment in the Cu-atmosphere converted $CuInSe_2$ single crystal thin films to an optical n-type. Also, we confirmed that In in $CuInSe_2$/GaAs did not form the native defects because In in $CuInSe_2$ single crystal thin films existed in the form of stable bonds.

• Korean Journal of Materials Research
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• v.23 no.12
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• pp.714-721
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• 2013

A stoichiometric mixture of evaporating materials for $ZnAl_2Se_4$ single-crystal thin films was prepared in a horizontal electric furnace. These $ZnAl_2Se_4$ polycrystals had a defect chalcopyrite structure, and its lattice constants were $a_0=5.5563{\AA}$ and $c_0=10.8897{\AA}$.To obtain a single-crystal thin film, mixed $ZnAl_2Se_4$ crystal was deposited on the thoroughly etched semi-insulating GaAs(100) substrate by a hot wall epitaxy (HWE) system. The source and the substrate temperatures were $620^{\circ}C$ and $400^{\circ}C$, respectively. The crystalline structure of the single-crystal thin film was investigated by using a double crystal X-ray rocking curve and X-ray diffraction ${\omega}-2{\theta}$ scans. The carrier density and mobility of the $ZnAl_2Se_4$ single-crystal thin film were $8.23{\times}10^{16}cm^{-3}$ and $287m^2/vs$ at 293 K, respectively. To identify the band gap energy, the optical absorption spectra of the $ZnAl_2Se_4$ single-crystal thin film was investigated in the temperature region of 10-293 K. The temperature dependence of the direct optical energy gap is well presented by Varshni's relation: $E_g(T)=E_g(0)-({\alpha}T^2/T+{\beta})$. The constants of Varshni's equation had the values of $E_g(0)=3.5269eV$, ${\alpha}=2.03{\times}10^{-3}eV/K$ and ${\beta}=501.9K$ for the $ZnAl_2Se_4$ single-crystal thin film. The crystal field and the spin-orbit splitting energies for the valence band of the $ZnAl_2Se_4$ were estimated to be 109.5 meV and 124.6 meV, respectively, by means of the photocurrent spectra and the Hopfield quasicubic model. These results indicate that splitting of the ${\Delta}so$ definitely exists in the ${\Gamma}_5$ states of the valence band of the $ZnAl_2Se_4/GaAs$ epilayer. The three photocurrent peaks observed at 10 K are ascribed to the $A_1$-, $B_1$-exciton for n = 1 and $C_{21}$-exciton peaks for n = 21.

• Journal of Chest Surgery
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• v.29 no.5
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• pp.564-568
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• 1996

Pseudoaneurysm of the ascending aorta following cardiac surgery is very unusual and it is poten- tially fatal. We report here a fourteen year-old female patient with pseudoaneurysm of the ascending aorta following a repair of a congenital ventricular septal defect at other hospital 50 months ago. Although she had a mild superficial wound infection postoperatively, she enjoyed uneventful. life until she visited our hospital for a generalized weakness and exertional dyspnea which developed a month ago. Chest CT and echocardiogram showed partially calcified pseudoaneurysm of the ascending aorta. Two aortic defects were located on the anterolateral ascending aortic wall wkere it was suspected as a previous sites of aortic and cardioplegic cannulation. The internal wall of the pseudoaneurysm was covered with neoendothelium and intervened by septal tissue. Two defects on he aortic wall were oval in shape and about 1.5cm in the greatest diameter The defects were trimmed to make a one large de- fect and it was reconstructed with patch designed from 22mm collagen impregnated double velour Dacron graft. The postoperative course was uneventful.

• Nuclear Engineering and Technology
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• v.42 no.6
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• pp.662-669
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• 2010

To develop the manufacturing methods for the blanket first wall (FW) of the International Thermonuclear Experimental Reactor (ITER) and to verify the integrity of the joint, Be/Cu mockups were fabricated and tested at the KoHLT-1 (Korea Heat Load Test facility), a graphite heater facility located at the Korea Atomic Energy Research Institute (KAERI). Since Be and Cu joining is the focus of the present study, the fabricated mockups had a CuCrZr heat sink joined with three Be tiles as an armor material, unlike the original ITER blanket FW, which has a stainless steel structure and coolant tubes. Hot isostatic pressing (HIP) was carried out at $580^{\circ}C$ and 100 MPa for 2 hours as the method for Be/Cu joining. Three interlayers, namely, $1{\mu}mCr/10{\mu}mCu$, $1{\mu}mTi/0.5{\mu}mCr/10{\mu}mCu$, and $5{\mu}mTi/10{\mu}mCu$ were applied as a coating to the Be tiles by a physical vapor deposition (PVD) method. A shear test was performed with the specimens, which were fabricated by the same methods as those used to fabricate the mockups. The average values were 125 MPa to 180 MPa, and the samples with the $1{\mu}mCr/10{\mu}mCu$ interlayer showed the lowest value. No defect or delamination was found in the joints of the mockups by the developed ultrasonic test using a flat-type probe with a 10 MHz frequency and a 0.25 inch diameter. High heat flux (HHF) tests were performed at $1.0\;MW/m^2$ heat flux for each mockup using the given conditions, and the results were analyzed by ANSYS-CFX code. For the test criteria, an expected fatigue lifetime about 1,000 cycles was obtained by analysis with ANSYS-mechanical code. Mockups using the interlayers of $1{\mu}mTi/0.5{\mu}mCr/10{\mu}mCu$ and $5{\mu}mTi/10{\mu}mCu$ survived up to 1,100 cycles over the required number of cycles. However, one of the Be tiles in the other two mockups using the $1{\mu}mCr/10{\mu}mCu$ interlayer was detached during the screening test, and others were detached by discharge after 862 cycles. The integrity of the joints using the proposed interlayers was proven by the HHF test, but the other interlayer requires more study before it can be used for the joining of Be to Cu. Moreover, it was confirmed that the measured temperatures agreed well with the analysis temperatures, which were used to estimate the lifetime and that the developed facility showed its capability of the long time operation.

• The Korean Journal of Nuclear Medicine
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• v.38 no.3
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• pp.225-232
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• 2004

Purpose : Transient wall motion abnormality and contractile dysfunction of the left ventricle (LV) can be observed in patients with coronary artery disease due to post-stress myocardial stunning. To understand clinical characteristics of stress induced LV dysfunction, we have compared the findings of exercise stress test, myocardial perfusion SPECT and coronary angiography between subjects with and without post-stress LV dysfunction. Materials and Methods : Among subjects who underwent exercise stress test, myocardial perfusion SPECT and coronary angiography within a month of interval, we enrolled 36 patients with post-stress LV election fraction (LVEF) was $\geq5%$ lower than rest (stunning group) and 16 patients with difference of post-stress and rest LVEF was lesser than 1 %(non-stunning group) for this study. Treadmill exercise stress gated myocardial perfusion SPECT was performed with dual head SPECT camera using 740 MBq Tc-99m MIBI and coronary angiography was also performed by conventional Judkins method. Results : Stunning group had a significantly higher incidence of hypercholesterolemia than non-stunning group(45.5 vs. 7.1%, p=0.01). Stunning group also had higher incidence of diabetes mellitus and lower incidence of hypertension, but these were not statistically significant. Stunning group had larger and more severe perfusion defect in stress perfusion myocardial SPECT than non-stunning group(extent 18.2 vs. 9.2%, p=0.029; severity 13.5 vs. 6.9, p=0.040). Stunning group also had higher degree of reversibility of perfusion defect, higher incidence of positive exercise stress test and higher incidence of having severe stenosis ($80{\sim}99%$) in coronary angiography than non-stunning group, but these were not statistically significant. In stunning group, all of 4 patients without perfusion defect had significant coronary artery stenosis and had received revascularization treatment. Conclusion : Patients with post-stress LV dysfunction had larger and more severe perfusion defect and severe coronary artery stenosis than patients without post-stress LV dysfunction. All of the patients without perfusion defect in stunning group had significant coronary artery stenosis and needed revascularization. Therefore, we suggest that invasive diagnostic procedures and therapeutic interventions might be needed in patients with post-stress LV dysfunction.

• Radiation Oncology Journal
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• v.25 no.1
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• pp.26-33
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• 2007

[ $\underline{Purpose}$ ]: The aim of this study is to evaluate and compare the incidence and aspects of myocardial perfusion defects in patients who were subjected to either two-dimensional or three-dimensional simulation techniques for early left-sided breast cancer. The myocardial perfusion defects were determined from using single photon emitted computerized tomography (SPECT) myocardial perfusion images. $\underline{Materials\;and\;Methods}$: Between January 2002 and August 2003, 32 patients were enrolled in this study. The patients were diagnosed as having early (AJCC stage T1-T2N0M0) left-sided breast cancer and were treated with tangential irradiation after breast-conserving surgery and systemic chemotherapy. The patients were divided into two groups according to the type of simulation received: two-dimensional simulation using an X-ray fluoroscope simulator or three-dimensional simulation with a CT simulator. All patients underwent technetium-99m-sestamibi gated perfusion SPECT at least 3 years after radiotherapy. The incidence and area of myocardial perfusion defects were evaluated and were compared in the two groups, and at the same time left ventricular ejection fraction and cardiac wall motion were also analyzed. The cardiac volume included in the radiation fields was calculated and evaluated to check for a correlation between the amount of irradiated cardiac volume and aspects of myocardial perfusion defects. $\underline{Results}$: A myocardial perfusion defect was detected in 11 of 32 patients (34.4%). There were 7 (46.7%) perfusion defect cases in 15 patients who underwent the two-dimensional simulation technique and 4 (23.5%) patients with perfusion defects in the three-dimensional simulation group (p=0.0312). In 10 of 11 patients who had myocardial perfusion changes, the perfusion defects were observed in the cardiac apex. The left ventricular ejection fraction was within the normal range and cardiac wall motion was normal in all patients. The irradiated cardiac volume of patients in the three-dimensional simulation group was less than that of patients who received the two-dimensional simulation technique, but there was no statistical significance as compared to the incidence of perfusion defects. $\underline{Conclusion}$: Radiotherapy with a CT simulator (three-dimensional simulation technique) for early left-sided breast cancer may reduce the size of the irradiated cardiac volume and the incidence of myocardial perfusion defects. Further investigation and a longer follow-up duration are needed to analyze the relationship between myocardial perfusion defects and clinical ischemic heart disease.