Search

BACKGROUND Nontuberculous mycobacteria are commonly found pathogens; however, skin and soft tissue infections due to nontuberculous mycobacteria are often associated with surgical procedures, particularly after lipoplasty. Although nontuberculous mycobacteria are resistant to some chemical disinfectants, glutaraldehyde, peracetic acid, povidone iodine, alcohol, and chlorine are still used for the sterilization of medical instruments. This study investigated the efficacy of various disinfectants in a fatty environment with adipose and a bloody environment without adipose. In addition, this study was also used to identify the most effective disinfectant against nontuberculous mycobacteria. METHODS Three nontuberculous mycobacteria (Mycobacterium avium, M. abscessus, and M. fortuitum), pathogens frequently found in skin and soft tissue infections, were used. Seven chemical disinfectants were tested in both fatty and bloody environments. The disinfectants used were considered to have a sterilization effect when the log10 reduction factor exceeded 5. RESULTS Most disinfectants had some sterilizing effects against nontuberculous mycobacteria; however, glutaraldehyde was the most effective against all 3. Chlorhexidine and povidone iodine also displayed sterilizing effects. Of the disinfectants tested, only alkyldiaminoethylglycine hydrochloride showed a diminished effect with statistical significance, specifically against M. fortuitum in a fatty environment, whereas it had effective results in a bloody environment. CONCLUSIONS Glutaraldehyde showed the greatest sterilizing effect on nontuberculous mycobacteria with a log10 reduction factor >5 in both fatty and bloody environments. However, some chemical disinfectants did not show sufficient sterilizing effects in a fatty environment and, therefore, should be used with caution for the sterilization of nontuberculous mycobacteria. LEVEL OF EVIDENCE Level II.

AimTo validate six previously known primary open-angle glaucoma (POAG)-related loci in a Korean population.MethodsRepresentative POAG-related single-nucleotide polymorphisms (SNPs) from six loci (cyclin-dependent kinase 4 inhibitor B antisense RNA 1 (CDKN2B)-AS1, sineoculis homeobox homolog 1/sineoculis homeobox homolog 6(SIX1/SIX6), atonal BHLH transcription factor 7 (ATOH7), cell division cycle 7-transforming growth factor beta receptor 3, CAV1, transmembrane and coiled-coil domain family 1 (TMCO1) were selected and genotyped from discovery (POAG=309, heathy=5400) and replication cohorts (POAG=310, healthy=5612 and POAG=221, healthy=6244, respectively). Data were analysed using logistic regression to calculate the OR for POAG risk associated with SNP.ResultsFrom the discovery cohort, rs1900004 in ATOH7 (OR=1.29, p=0.0024); rs1063192 (OR=0.69, p=0.0006), rs2157719 (OR=0.63, p=0.0007) and rs7865618 (OR=0.63, p=0.0006) in CDKN2B-AS1, and rs10483727 in SIX1/SIX6 (OR=0.68, p=7.9E–05) were nominally associated with the risk of POAG. The replication cohorts revealed nominal associations with rs2157719 (OR=0.72, p=0.0135), rs1063192 (OR=0.63, p=0.0007) and rs7865618 (OR=0.52, p=0.0004) in CDKN2B-AS1. A mega-analysis from the entire Korean population revealed significance with rs1063192 (OR=0.77, p=6.0E–05), rs2157719 (OR=0.63, p=0.0007) and rs7865618 (OR=0.58, p=1.9E–06) in CDKN2B-AS1 and with rs10483727 in SIX1/SIX6 (OR=0.79, p=9.4E–05), with the same direction of effect between the discovery association and the replication sample.ConclusionsVariants near CDKN2B-AS1 and SIX1/SIX6 may require further investigation to obtain more genetic information on POAG development in a Korean population.

Purpose: Intraoperative indocyanine green (ICG) lymphography is an effective tool to obtain real-time video images of functioning lymph vessels in edematous limbs. However, it is difficult to identify the course of lymph vessels in obese patients or patients with large dermal backflow. Without the image, surgeons have to rely on their experience when performing the skin incision to locate the lymphatic vessels. This study focused on elucidating lymphatic vessel flow patterns in healthy lower extremities in an Asian population to refer these findings for lymphedema treatment.Methods: ICG fluorescence lymphography was performed by injecting 0.2 mL of ICG into the first web space of the foot. After 4 hours, fluorescence images of lymphatic vessels were obtained and the lymphatic vessels were marked. Three landmarks were designated; the medial malleolus, the medial patellar border, and the groin femoral artery. Straight lines connecting the points were drawn, and the distance between the connected lines and the marked lymphatic vessels was measured in eight points. Results: Fifteen subjects with healthy lower extremities (15 right and 15 left) were included. The average course of the main lymph vessels passed 26.2±18.0 mm dorsally to the medial malleolus, 53.7±35.7 mm medially to the medial patellar border, and 25.5±19.2 mm medially to the three-quarters point of the upper landmark line.Conclusion: The main functioning lymphatic vessel largely follows the great saphenous vein course, passes in front of the medial malleolus, runs over the posterior border of the medial epicondyle at the knee level, and travels anteriorly toward the inguinal lymph nodes.

Purpose: COVID-19 guidelines for persons with disabilities published globally during the early phase of the pandemic by non-governmental organizations and federal agencies were reviewed and analyzed by trends of information provided under various settings. Method: The Google search engine was used by applying the following search terms: COVID-19, Coronavirus 2019, Disability, and Guidelines. Search efforts yielded 514 records from 1 December 2019 to 16 May 2020. The selected 26 guidelines were classified for analysis by organizations (NGOs, non-profit, and governmental institutions), information provided (risks, prevention, and countermeasures), target group (people with disability, service and support providers, and family members), and environmental setting (hospital, community, and home). Results: Government agencies from eight countries published results. Eight of the 26 guidelines were presented by non-governmental organizations, and 18 were not. There were 15 guidelines for individuals with disabilities, seven for service providers, staff, and families providing care, and four addressing both the individuals with a disability and care providers. In terms of appropriate environment and scope, there were 19 guidelines produced for community, government, home, and hospital. The information predominantly presented regarded the prevention of COVID-19 with 22 sources, followed by general information containing risks and response strategies. Conclusion: The majority of the published guidelines focused primarily on the risks and prevention of COVID-19 for people with disabilities. Future procedures should include specific methods in guiding COVID-19 response strategies for the disabled and caregivers who provide essential health services with access to online resources in multiple languages and dialects.

Bone morphogenetic protein-2 (BMP-2) is commonly used to enhance bone regeneration. The potential of BMP-2 for bone regeneration varies according to the concentration and release kinetics on the implanted site. Therefore, it is important to determine appropriate carriers of BMP-2. However, no optimal delivery vehicles have been identified. In the present study, we used alginate microbeads as a delivery vehicle for BMP-2. Alginate microbeads can be implanted onto the disease site through surgery or injection. The objective of this study was to evaluate that the osteoinductive properties of BMP-2 are effective in alginate microbeads as a carrier. In this study, the release kinetics of BMP-2 in alginate microbeads was evaluated using an enzyme-linked immunosorbent assay. BMP-2 released from alginate microbeads induced high alkaline phosphatase activity in canine adipose tissue-derived mesenchymal stem cells. Injection of alginate microbeads with BMP-2 into mouse subcutaneous tissue, as well as surgical implantation into the 5-mm circular calvarial defects in rats, was conducted and the results showed extensive new bone formation. In conclusion, alginate microbeads can be utilized as an effective BMP-2 delivery vehicle for use in orthopedic surgery and as an injectable vehicle for a minimally invasive therapy. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 107B: 286-294, 2019.

Abdominal tissue transfer has become the most commonly used tool for breast reconstruction. However, a secondary operator is often responsible for donor closure, which leaves dissatisfaction to patients due to inconsistent donor scars. Now, an absorbable dermal stapler is popularized worldwide and currently used for wound closure in many surgical fields. In this study, we aim to evaluate the abdominal donor site scar in using an absorbable dermal staple compared to a conventional suture.This is a prospective, randomized controlled and double-blinded study. Between January 2018 and April 2019, a total of 30 patients who underwent breast reconstruction using abdominal flap were included. Donor sites were divided into equal halves, and the each dermal layer was sutured with either dermal staples or traditional suturing, respectively. At 1, 3 and 6 months after operation, the scar was evaluated by two blinded plastic surgeons by using the modified Manchester scar scale (MSS).An averaged sum of modified MSS was lower for the side sutured with a dermal stapler at the first month (11.76 ± 2.12 vs. 12.28 ± 2.03, p = 0.097), third month (12.17 ± 1.86 vs. 12.62 ± 2.31, p = 0.301) and sixth month (11.28 ± 2.63 vs. 12.14 ± 2.76, p = 0.051). Also, the dermal stapler side scored significantly higher for patient satisfaction than did the suture side (4.03 ± 0.98 vs 3.66 ± 0.97, p 0.05).The objective outcome of the scar closed by an absorbable dermal stapler was not statistically superior to conventional suturing. (p 0.05) In the subjective outcome, however, it showed a significantly higher patients' satisfaction (p 0.05).This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A virtual power plant (VPP) technology is a cluster of distributed generation installations. VPP system is that integrates several types of distributed generation sources, so as to give a reliable overall power supply. Virtual power plant systems play a key role in the smart grids concept and the move towards alternative sources of energy. They ensure improved integration of the renewable energy generation into the grids and the electricity market. VPPs not only deal with the supply side, but also help manage demand and ensure reliability of grid functions through demand response (DR) and other load shifting approaches in real time. In this paper, utilizing a variety of distributed generation resources(such as emergency generator, commercial generator, energy storage device), activation scheme of the virtual power plant technology. In addition, through the analysis of the domestic electricity market, it describes a scheme that can be a virtual power plant to participate in electricity market. It attempts to derive the policy support recommendation in order to obtain the basics to the prepared in position of power generation companies for the commercialization of virtual power plant.

Recently, proportion of the induction motor load is gradually increased. When a contingency in the power systems, it has been discovered phenomenon that the voltage is delayed recover caused mechanical characteristics of the induction motor load. It can be a serious impact on the voltage stability of the power system considering induction motor load. The scheme to mitigate this phenomenon tripping off the motors to prevent voltage drop and delayed voltage recovery on the load demand side. Fault induced delayed voltage recovery phenomenon is caused by stalling of small induction motor load in transmission level contingencies. In this paper, fault induced delayed voltage recovery phenomenon mitigation method implementation under voltage load shedding on the korean power system considering induction motor load.

Bone morphogenetic protein-2 (BMP-2) is commonly used to enhance bone regeneration. The potential of BMP-2 for bone regeneration varies according to the concentration and release kinetics on the implanted site. Therefore, it is important to determine appropriate carriers of BMP-2. However, no optimal delivery vehicles have been identified. In the present study, we used alginate microbeads as a delivery vehicle for BMP-2. Alginate microbeads can be implanted onto the disease site through surgery or injection. The objective of this study was to evaluate that the osteoinductive properties of BMP-2 are effective in alginate microbeads as a carrier. In this study, the release kinetics of BMP-2 in alginate microbeads was evaluated using an enzyme-linked immunosorbent assay. BMP-2 released from alginate microbeads induced high alkaline phosphatase activity in canine adipose tissue-derived mesenchymal stem cells. Injection of alginate microbeads with BMP-2 into mouse subcutaneous tissue, as well as surgical implantation into the 5-mm circular calvarial defects in rats, was conducted and the results showed extensive new bone formation. In conclusion, alginate microbeads can be utilized as an effective BMP-2 delivery vehicle for use in orthopedic surgery and as an injectable vehicle for a minimally invasive therapy. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 107B: 286-294, 2019.

An electric power system sometimes fails because of disturbances that occur unexpectedly, such as the uncontrolled loss of load that developed from cascading blackout. Which make stability through a little of under voltage load shedding should work. The development of phasor measurement unit(PMU) makes network supervision possible. The information obtained from PMU is synchronized by global positioning system(GPS). There are many real-time algorithms which are monitoring the voltage stability. This paper presents the study on the VILS(Voltage Instability Load Shedding) using PMU data. This algorithm computes Voltage Stability Margin Index(VSMI) continuously to track the voltage stability margin at local bus level. The VSMI is expressed as active and reactive power. The VSMI is used as an criterion for load shedding. In order to examine the algorithm is effective, applied to KEPCO system. Key Words : PMU, Under voltage load shedding, Voltage instability load shedding(VILS), Voltage stability margin †교신저자, 정회원 : 고려대학교 전기전자공학과 박사E-mail : yunan2@korea.ac.kr 접수일자 : 2013년 11월 15일수정일자 : 2013년 12월 11일 최종완료 : 2014년 1월 22일

Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer`s side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors` perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

This work has been conducted to investigate the behavior of pesticides in ginseng(Panax ginseng C. A. Meyer) cultivation environment, with a fungicide procymidone as a model pesticide. Procymidone adsorption on ginseng cultivating soil was studied and persistency of procymidone in soil was monitored in indoor incubation experiments at 25 and 10. The soil adsorption coefficients() of procymidone were in the range of 513743 suggesting the mobility of procymidone in soil is relatively low. Procymidone showed higher persistency in soil under indoor incubation condition than outdoor field condition. The half lives estimated from the first order reaction kinetics were 248 days and 330 days at 25 and 10, respectively.