Through Knee Amputation: Technique Modifications and Surgical Outcomes

Frank P Albino,Rachel Seidel,Benjamin J Brown,Charles G Crone,Christopher E Attinger 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.5

Background: Knee disarticulations (KD) are most commonly employed following trauma ortumor resection but represent less than 2% of all lower extremity amputations performed inthe United States annually. KDs provide enhanced proprioception, a long lever arm, preservationof adductor muscle insertion, decreased metabolic cost of ambulation, and an endweight-bearing stump. The role for KDs in the setting of arterial insufficiency or overwhelminginfection is less clear. The purpose of this study is to describe technique modifications andreport surgical outcomes following KDs at a high-volume Limb Salvage Center. Methods: A retrospective study of medical records for all patients who underwent a throughkneeamputation performed by the senior author (C.E.A.) between 2004 and 2012 wascompleted. Medical records were reviewed to collect demographic, operative, and postoperativeinformation for each of the patients identified. Results: Between 2004 and 2012, 46 through-knee amputations for 41 patients wereperformed. The mean patient age was 68 and indications for surgery included infection (56%),arterial thrombosis (35%), and trauma (9%). Postoperative complications included superficialcellulitis (13%), soft tissue infection (4%), and flap ischemia (4%) necessitating one case ofsurgical debridement (4%) and four trans-femoral amputations (9%). 9 (22%) patients wenton to ambulate. Postoperative ambulation was greatest in the traumatic cohort and forpatients less than 50 years of age, P<0.05. Alternatively, diabetes mellitus and infectionreduced the likelihood of postoperative ambulation, P<0.01. Conclusions: Knee disarticulations are a safe and effective alternative to other lower extremityamputations when clinically feasible. For patient unlikely to ambulate, a through-kneeamputation maximizes ease of transfers, promotes mobility by providing a counterbalance,and eliminates the potential for knee flexion contracture with subsequent skin breakdown.

Clinical Factors Associated with the Non- Operative Airway Management of Patients with Robin Sequence

Frank P. Albino,Benjamin C. Wood,Kevin D. Han,Sojung Yi,Mitchel Seruya,Gary F. Rogers,Albert K. Oh 대한성형외과학회 2016 Archives of Plastic Surgery Vol.43 No.6

Background The indications for surgical airway management in patients with Robin sequence (RS) and severe airway obstruction have not been well defined. While certain patients with RS clearly require surgical airway intervention and other patients just as clearly can be managed with conservative measures alone, a significant proportion of patients with RS present with a more confusing and ambiguous clinical course. The purpose of this study was to describe the clinical features and objective findings of patients with RS whose airways were successfully managed without surgical intervention. Methods The authors retrospectively reviewed the medical charts of infants with RS evaluated for potential surgical airway management between 1994 and 2014. Patients who were successfully managed without surgical intervention were included. Patient demographics, nutritional and respiratory status, laboratory values, and polysomnography (PSG) findings were recorded. Results Thirty-two infants met the inclusion criteria. The average hospital stay was 16.8 days (range, 5–70 days). Oxygen desaturation (<70% by pulse oximetry) occurred in the majority of patients and was managed with temporary oxygen supplementation by nasal cannula (59%) or endotracheal intubation (31%). Seventy-five percent of patients required a temporary nasogastric tube for nutritional support, and a gastrostomy tube placed was placed in 9%. All patients continued to gain weight following the implementation of these conservative measures. PSG data (n=26) demonstrated mild to moderate obstruction, a mean apneahypopnea index (AHI) of 19.2±5.3 events/hour, and an oxygen saturation level <90% during only 4% of the total sleep time. Conclusions Nonsurgical airway management was successful in patients who demonstrated consistent weight gain and mild to moderate obstruction on PSG, with a mean AHI of <20 events/hour.

Sustainability in Ultra precision and Micro machining: A Review

Frank Schneider,Jayanti Das,Benjamin Kirsch,Barbara Linke,Jan C. Aurich 한국정밀공학회 2019 International Journal of Precision Engineering and Vol.6 No.3

Ultra precision and micro machining processes become more and more important. This can be led back to the development of functionalized surfaces and parts and the mass production of smaller products e.g. lenses for personal devices. With increasing application and distribution, the importance of sustainability in these processes also increases. In this paper, an overview of ultra precision and micro machining in a system approach is given and the most decisive input parameters are elaborated. Included are general findings and current issues of process design with regard to the economic, environmental and social dimension of sustainability. Finally, it is discussed how the sustainability of ultra precision and micro machining can be increased and for which class of products certain strategies are recommended.

Correlation Between food Processing-Associated Stress Tolerance and Antimicrobial Resistance in Food Pathogens

Benjamin Kojo Woode,Frank Daliri,Eric Banan-Mwine Daliri 한국식품위생안전성학회 2020 한국식품위생안전성학회지 Vol.35 No.2

최근 최소한으로 가공된 안전한 식품에 대한 소비자의 수요가 기하급수적으로 증가하고 있다. 이러한 이유로 많은 식품가공 업체에서는 식품안전을 강화하고 유통기한을 연장하기 위한 최소한의 가공공정 중 허들기술(hurdle technology)을 적용하고 있다. 한편, 연구에 따르면 식품에 함유된 병원균을 비활성화하기 위한 공정 및 방법들은 식중독세균들의 스트레스 적응 메커니즘을 촉발시켜 심지어 후속 치료로부터 교차 보호를 준다. 또한, 항생 제와 제초제 사용과 같은 일상적인 농장 관행은 항생제 내성을 가진 병원균의 생성을 초래할 수 있다. 이러한 항생제 내성 박테리아는 식품 처리과정과 관련된 스트레스에 내성을 가질 수 있고 가공 식품에서 생존 할 수 있는 가능성을 높일 수 있다. 이 리뷰에서는 식품 가공과 관련된 스트레스와 항생제 내성의 상관관계에 대해 논의한다. 또한, 항균성 화합물 및 기타 식품 처리 관련 스트레스에 대한 교차 보호 수단으로서 시그마 인자 (sigma factors), SOS 반응 경로(SOS response pathways) 및 유출 펌프(efflux pumps)의 사용과 같은 분자유전학적 기작에 대해서도 논의한다. Recently, consumer demand for safe but minimally processed food has rapidly increased. For this reason, many food processing industries are applying hurdle technology to enhance food safety, extend shelf life, and make foods appear minimally processed. Meanwhile, studies have shown that a treatment (stress) meant to inactivate foodborne pathogens may trigger adaptation mechanisms and could even offer cross protection against subsequent treatments. Also, certain routine farm practices such as antibiotic and herbicide use could result in the development of antibiotic-resistant pathogens. Such bacteria may be tolerant to food processing-associated stress and be more likely to remain viable in processed foods. In this review, we discuss the correlation between food processing-associated stress and antibiotic resistance. We also discuss molecular mechanisms such as the use of sigma factors, SOS response pathways and efflux pumps as means of cross protection against antimicrobial compounds and other food processingassociated stresses.

Correlation Between food Processing-Associated Stress Tolerance and Antimicrobial Resistance in Food Pathogens

Woode, Benjamin Kojo,Daliri, Frank,Daliri, Eric Banan-Mwine The Korean Society of Food Hygiene and Safety 2020 한국식품위생안전성학회지 Vol.35 No.2

최근 최소한으로 가공된 안전한 식품에 대한 소비자의 수요가 기하급수적으로 증가하고 있다. 이러한 이유로 많은 식품가공 업체에서는 식품안전을 강화하고 유통기한을 연장하기 위한 최소한의 가공공정 중 허들기술(hurdle technology)을 적용하고 있다. 한편, 연구에 따르면 식품에 함유된 병원균을 비활성화하기 위한 공정 및 방법들은 식중독세균들의 스트레스 적응 메커니즘을 촉발시켜 심지어 후속 치료로 부터 교차 보호를 준다. 또한, 항생제와 제초제 사용과 같은 일상적인 농장 관행은 항생제 내성을 가진 병원균의 생성을 초래할 수 있다. 이러한 항생제 내성 박테리아는 식품 처리과정과 관련된 스트레스에 내성을 가질 수 있고 가공 식품에서 생존할 수 있는 가능성을 높일 수 있다. 이 리뷰에서는 식품가공과 관련된 스트레스와 항생제 내성의 상관관계에 대해 논의한다. 또한, 항균성 화합물 및 기타 식품 처리 관련 스트레스에 대한 교차 보호 수단으로서 시그마 인자(sigma factors), SOS 반응 경로(SOS response pathways) 및 유출 펌프(efflux pumps)의 사용과 같은 분자유전학적 기작에 대해서도 논의한다. Recently, consumer demand for safe but minimally processed food has rapidly increased. For this reason, many food processing industries are applying hurdle technology to enhance food safety, extend shelf life, and make foods appear minimally processed. Meanwhile, studies have shown that a treatment (stress) meant to inactivate foodborne pathogens may trigger adaptation mechanisms and could even offer cross protection against subsequent treatments. Also, certain routine farm practices such as antibiotic and herbicide use could result in the development of antibiotic-resistant pathogens. Such bacteria may be tolerant to food processing-associated stress and be more likely to remain viable in processed foods. In this review, we discuss the correlation between food processing-associated stress and antibiotic resistance. We also discuss molecular mechanisms such as the use of sigma factors, SOS response pathways and efflux pumps as means of cross protection against antimicrobial compounds and other food processing-associated stresses.

Interoperable Networking Applications for Emergency Services

Raphael Frank,Thomas Engel,Benjamin Hourte,Dan Jungels 보안공학연구지원센터 2009 International Journal of Multimedia and Ubiquitous Vol.4 No.1

Efficient communication is a major requirement in crisis situations. This research is motivated by the need to develop new communication tools to enhance the coordination and response time of first responders. In this paper we present an application which enables group calls among different rescue entities. Additionally, we present a video application that provides a real time access to surveillance cameras. The objective is to provide a powerful communication tool that can be used over different network technologies. As opposed to other existing systems, our application provides a complete communication platform that relies on open standards. A prototype has been implemented and tested during a demonstration held in July 2007 in Luxembourg. In this paper we provide technical details on how the applications were realized and evaluate the outcome of the demonstration. We also propose future improvements based on the outcome to enhance the system.

Clinical Factors Associated with the Non-Operative Airway Management of Patients with Robin Sequence

Albino, Frank P.,Wood, Benjamin C.,Han, Kevin D.,Yi, Sojung,Seruya, Mitchel,Rogers, Gary F.,Oh, Albert K. Korean Society of Plastic and Reconstructive Surge 2016 Archives of Plastic Surgery Vol.43 No.6

Background The indications for surgical airway management in patients with Robin sequence (RS) and severe airway obstruction have not been well defined. While certain patients with RS clearly require surgical airway intervention and other patients just as clearly can be managed with conservative measures alone, a significant proportion of patients with RS present with a more confusing and ambiguous clinical course. The purpose of this study was to describe the clinical features and objective findings of patients with RS whose airways were successfully managed without surgical intervention. Methods The authors retrospectively reviewed the medical charts of infants with RS evaluated for potential surgical airway management between 1994 and 2014. Patients who were successfully managed without surgical intervention were included. Patient demographics, nutritional and respiratory status, laboratory values, and polysomnography (PSG) findings were recorded. Results Thirty-two infants met the inclusion criteria. The average hospital stay was 16.8 days (range, 5-70 days). Oxygen desaturation (<70% by pulse oximetry) occurred in the majority of patients and was managed with temporary oxygen supplementation by nasal cannula (59%) or endotracheal intubation (31%). Seventy-five percent of patients required a temporary nasogastric tube for nutritional support, and a gastrostomy tube placed was placed in 9%. All patients continued to gain weight following the implementation of these conservative measures. PSG data (n=26) demonstrated mild to moderate obstruction, a mean apneahypopnea index (AHI) of $19.2{\pm}5.3events/hour$, and an oxygen saturation level <90% during only 4% of the total sleep time. Conclusions Nonsurgical airway management was successful in patients who demonstrated consistent weight gain and mild to moderate obstruction on PSG, with a mean AHI of <20 events/hour.

Through Knee Amputation: Technique Modifications and Surgical Outcomes

Albino, Frank P.,Seidel, Rachel,Brown, Benjamin J.,Crone, Charles G.,Attinger, Christopher E. Korean Society of Plastic and Reconstructive Surge 2014 Archives of Plastic Surgery Vol.41 No.5

Background Knee disarticulations (KD) are most commonly employed following trauma or tumor resection but represent less than 2% of all lower extremity amputations performed in the United States annually. KDs provide enhanced proprioception, a long lever arm, preservation of adductor muscle insertion, decreased metabolic cost of ambulation, and an end weight-bearing stump. The role for KDs in the setting of arterial insufficiency or overwhelming infection is less clear. The purpose of this study is to describe technique modifications and report surgical outcomes following KDs at a high-volume Limb Salvage Center. Methods A retrospective study of medical records for all patients who underwent a through-knee amputation performed by the senior author (C.E.A.) between 2004 and 2012 was completed. Medical records were reviewed to collect demographic, operative, and postoperative information for each of the patients identified. Results Between 2004 and 2012, 46 through-knee amputations for 41 patients were performed. The mean patient age was 68 and indications for surgery included infection (56%), arterial thrombosis (35%), and trauma (9%). Postoperative complications included superficial cellulitis (13%), soft tissue infection (4%), and flap ischemia (4%) necessitating one case of surgical debridement (4%) and four transfemoral amputations (9%). 9 (22%) patients went on to ambulate. Postoperative ambulation was greatest in the traumatic cohort and for patients less than 50 years of age, P<0.05. Alternatively, diabetes mellitus and infection reduced the likelihood of postoperative ambulation, P<0.01. Conclusions Knee disarticulations are a safe and effective alternative to other lower extremity amputations when clinically feasible. For patient unlikely to ambulate, a through-knee amputation maximizes ease of transfers, promotes mobility by providing a counterbalance, and eliminates the potential for knee flexion contracture with subsequent skin breakdown.

[4th Prize] Jörg Friedrich & Partner, Hamburg

Jorg Friedrich,Frank Bischoff,Nurcan Eren,Claudia Ganady,Michael Mogilowski,Jan Mollwitz,Gotz Schneider,Heidi Schweinfest,Susanne Wandel,Jean Pommee,Benjamin Poppe 현대건축사 2002 월간 CONCEPT Vol.- No.34

Decorrelation scales for Arctic Ocean hydrography - Part I: Amerasian Basin

Sumata, Hiroshi,Kauker, Frank,Karcher, Michael,Rabe, Benjamin,Timmermans, Mary-Louise,Behrendt, Axel,Gerdes, Rü,diger,Schauer, Ursula,Shimada, Koji,Cho, Kyoung-Ho,Kikuchi, Takashi Copernicus GmbH 2018 Ocean science Vol.14 No.1

<P><p><strong>Abstract.</strong> Any use of observational data for data assimilation requires adequate information of their representativeness in space and time. This is particularly important for sparse, non-synoptic data, which comprise the bulk of oceanic in situ observations in the Arctic. To quantify spatial and temporal scales of temperature and salinity variations, we estimate the autocorrelation function and associated decorrelation scales for the Amerasian Basin of the Arctic Ocean. For this purpose, we compile historical measurements from 1980 to 2015. Assuming spatial and temporal homogeneity of the decorrelation scale in the basin interior (abyssal plain area), we calculate autocorrelations as a function of spatial distance and temporal lag. The examination of the functional form of autocorrelation in each depth range reveals that the autocorrelation is well described by a Gaussian function in space and time. We derive decorrelation scales of 150-200<span class='thinspace'></span>km in space and 100-300 days in time. These scales are directly applicable to quantify the representation error, which is essential for use of ocean in situ measurements in data assimilation. We also describe how the estimated autocorrelation function and decorrelation scale should be applied for cost function calculation in a data assimilation system.</p> </P>