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      • KCI등재

        Mucormycosis Management in COVID-19 Era: Is Immediate Surgical Debridement and Reconstruction the Answer?

        Samarth Gupta,Pradeep Goil,Arbab Mohammad,Joseph M. Escandón 대한성형외과학회 2022 Archives of Plastic Surgery Vol.49 No.3

        Background Excessive use of corticosteroids therapy along with gross immunocompromised conditions in the novel coronavirus disease 2019 (COVID-19) pandemic has raised the risks of contracting opportunistic fungal infections. Here, we describe our experience with the implementation of a surgical protocol to treat and reconstruct rhino-orbital-cerebral mucormycosis. Methods A retrospective review of our prospectively maintained database was conducted on consecutive patients diagnosed with mucormycosis undergoing immediate reconstruction utilizing our “Mucormycosis Management Protocol.” All patients included in this study underwent reconstruction after recovering fromCOVID-19. Wide local excision was performed in all cases removing all suspected and edematous tissue. Reconstruction was done primarily after clear margins were achieved on clinical assessment under a cover of injectable liposomal amphotericin B. Results Fourteen patients were included. The average age was 43.6 years and followup was 24.3 days. Thirteen patients had been admitted for inpatient care of COVID-19. Steroid therapy was implemented for 2 weeks in 11 patients and for 3 weeks in 3 patients. Eight patients (57.1%) had a maxillectomy and mucosal lining resection with/without skin excision, and six patients (42.8%) underwent maxillectomy and wide tissue excision (maxillectomy and partial zygomatic resection, orbital exenteration, orbital floor resection, nose debridement, or skull base debridement). Anterolateral thigh (ALT) flapswere used to cover defects in all patients. All flaps survived. No major or minor complications occurred. No recurrence of mucormycosis was noted. Conclusion The approach presented in this study indicates that immediate reconstruction is safe and reliable in cases when appropriate tissue resection is accomplished. Further studies are required to verify the external validity of these findings.

      • KCI등재

        Definitive Closure of the Tracheoesophageal Puncture Site after Oncologic Laryngectomy: A Systematic Review and Meta-Analysis

        Joseph M. Escandón,Arbab Mohammad,Saumya Mathews,Valeria P. Bustos,Eric Santamaría,Pedro Ciudad,Hung-Chi Chen,Howard N. Langstein,Oscar J. Manrique 대한성형외과학회 2022 Archives of Plastic Surgery Vol.49 No.5

        Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservativemeasures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure. A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure.We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed. Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1–13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI<1–43%), 7% (95% CI<1–34%) for dermal graft interposition,<1% (95%CI<1–37%) for radial forearm free flap,<1% (95% CI<1–52%) for ligation of the fistula, 17% (95% CI<1–64%) for interposition of a deltopectoral flap, 9% (95% CI<1– 28%) for primary closure, and 2% (95% CI<1–20%) for interposition of a sternocleidomastoid muscle flap. Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit fromfistula excision and tracheal and esophagealmultilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.

      • KCI등재

        Application of high frequency ultrasound in different irradiation systems for photosynthesis pigment extraction from Chlorella microalgae

        Masoud Rahimi,Elham Mohamadian,Soheil Dadari,Mohammad Moein Arbab,Naser Karimi 한국화학공학회 2017 Korean Journal of Chemical Engineering Vol.34 No.4

        Microalgae are considered the biological drug factories of the future. To benefit from these microfactories, the intracellular metabolite of algae should be extracted. One of the most economically competitive methods is the ultrasound technique. This study was concerned with ultrasound-assisted extractions of useful substances from microalgae by comparing direct and indirect irradiation methods with respect to the extraction rate and yields. It is most likely that the direct and indirect irradiations had different irradiation powers. The systems were exposed to ultrasound wave (1.7 MHz) for 240min. For each system, the changes of optical density, concentration and biovolume of Chlorella were estimated. In addition, the concentration of extracted chlorophylls (a, b and a+b), carotenoid and lipid were measured. The factors were studied after 30, 60, 120, 180 and 240 min of exposure to ultrasound irradiation. Both direct and indirect irradiation systems produced cavitation in the cell membrane, and they reduced the concentration and biovolume of the Chlorella cells. The amount of lipids and chlorophylls was greater in the direct irradiation as compared to the indirect one, and it caused more cell disruption. However, the extraction of the carotenoid was less effective because direct irradiation produced more transmitted power of ultrasound, resulting in degradation of carotenoid. The results and analysis presented in this research showed that selection of the best method of irradiation is an important step, and it depends on the biomaterials to be extracted.

      • KCI등재

        Influence of tungsten doping concentration on the electronic and optical properties of anatase TiO2

        Matiullah Khan,Wenbin Cao,Ning Chen,Zahid Usman,Dil Faraz Khan,Arbab Mohammad Toufiq,Murad Ali Khaskheli 한국물리학회 2013 Current Applied Physics Vol.13 No.7

        The structural, electronic and optical properties of tungsten-doped TiO2 have been investigated using density functional theory with plane wave basis sets and ultrasoft pseuodopotential. Substitutional W doping at Ti sites create W 5d states just below the conduction band minimum while interstitial W doping gives isolatedW5d states in the middle of forbidden region. Averaged bond lengths show that W doping at Ti sites produce minimum structural distortion as compared to the interstitial W-doped TiO2. Substitutional W-doped TiO2 has better visible light absorption compared to interstitial W-doped TiO2and has stable configuration which provide reasonable explanation for the experimental findings. Tungsten doping in TiO2 with different doping concentrations is investigated as an enabling concept for enhancing the visible light absorption. Optical properties show that optimal W doping concentration would improve the visible light absorption. 2.08% W doping concentration gives strong visible and ultraviolet light absorption among all doped models found consistent with experiments.

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