Kim, Min-Sik;Sun, Dong-Il;Park, Hae-Sup;Cho, Seung-Ho;Jai, Hyeon-Soon
Korean Journal of Bronchoesophagology
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v.5
no.2
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pp.191-197
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1999
Background and Objective : Soft palate plays a great role in function of speech and swallowing. Ablation of tonsil cancer results in multi-demensional defect including soft palate in most cases and restoration of the postoperative oral cavity function is a continuing surgical challenge. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for these defect, which offers a thin, pliable, and relatively hairless skin, and a long vascular pedicle. The aim of the present study is to report the speech and swallowing function test results of our 5 consecutive radial forearm free flaps used for tonsil cancers. Materials and Methods : We reviewed the medical records of 5 patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for tonsil cancers, from Dec. 1997 to Oct. 1998, and analyzed the surgical methods, complications, and speech and swallowing function test results. We have examined with modified barium swallow to evaluate postoperative wallowing function and articulation and resonance test for speech. Results : The tumor sizes by TNM stage(AJCC, 1997) were T1(1), T2(2), and T4(3). The paddles of flaps were tailored in multilobed designs from oval shape to pentalobed design and in variable size from 24$cm^2$ to 108$cm^2$(average size = 78.4$cm^2$), according to the defect after ablation. This procedures resulted in satisfactory flap success and functional results all but 1 case of flap contracture in 2 postoperative week, achieved early oral diet until 16-57 postoperative day(average, 28 days) and social speech. The oropharyngeal defect including soft palate reconstruction with radial forearm free flap might be an excellent method for the maximal functional results, after ablative surgery of tonsil cancer that results in multidimensional defect.
Cho Kwang-Jae;Chun Byung-Jun;Sun Dong-Il;Cho Seung-Ho;Kim Mn-Sik
Korean Journal of Head & Neck Oncology
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v.19
no.1
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pp.41-46
/
2003
Background and Objectives: Surgical ablation of tumors in the oral cavity and the oropharynx results in a three dimensional defect because of the needs to resect the adjacent area for the surgical margin. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for this defect, which offers a thin, pliable, and relatively hairless skin and a long vascular pedicle. We report the clinical results of our 54 consecutive radial forearm free flaps used for oral cavity and oropharynx cancers. Materials and Methods: We reviewed the medical records of patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for oral cavity and oropharyngeal cancers from August 1994 to February 2003 and analyzed surgical methods, flap survival rate, complication, and functional results. Among these, 20 cases were examined with modified barium swallow to evaluate postoperative swallowing function and other 8 cases with articulation and resonance test for speech. We examined recovery of sensation with two-point discrimination test in 15 cases who were offered sensate flaps. Results: The primary sites were as follows : mobile tongue (18), tonsil (17), floor of mouth (4), base of tongue (2), soft palate (2), retromolar trigone (3), buccal mucosa (1), oro-hypopharynx (6), and lower lip (1). The paddles of flaps were tailored in multilobed designs from oval shape to tetralobed design and in variable size according to the defects after ablation. This procedures resulted in satisfactory flap success rate (96.3%) and showed good swallowing function and social speech. Eight of 15 cases (53.3%) who had offered sensate flap showed recovery of sensation between 1 and 6 postoperative months (average 2.6 month). Conclusion: The reconstruction with radial forearm free flap might be an excellent method for the maximal functional results after ablative surgery of oral cavity and oropharyngeal cancers that results in multidimensional defect.
KIPS Transactions on Software and Data Engineering
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v.11
no.8
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pp.315-324
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2022
In this paper, we propose KoEPT, a Transformer-based generative model for automatic math word problems solving. A math word problem written in human language which describes everyday situations in a mathematical form. Math word problem solving requires an artificial intelligence model to understand the implied logic within the problem. Therefore, it is being studied variously across the world to improve the language understanding ability of artificial intelligence. In the case of the Korean language, studies so far have mainly attempted to solve problems by classifying them into templates, but there is a limitation in that these techniques are difficult to apply to datasets with high classification difficulty. To solve this problem, this paper used the KoEPT model which uses 'expression' tokens and pointer networks. To measure the performance of this model, the classification difficulty scores of IL, CC, and ALG514, which are existing Korean mathematical sentence problem datasets, were measured, and then the performance of KoEPT was evaluated using 5-fold cross-validation. For the Korean datasets used for evaluation, KoEPT obtained the state-of-the-art(SOTA) performance with 99.1% in CC, which is comparable to the existing SOTA performance, and 89.3% and 80.5% in IL and ALG514, respectively. In addition, as a result of evaluation, KoEPT showed a relatively improved performance for datasets with high classification difficulty. Through an ablation study, we uncovered that the use of the 'expression' tokens and pointer networks contributed to KoEPT's state of being less affected by classification difficulty while obtaining good performance.
Gene-manipulated mice were discovered for the first time about a quarter century ago. Since then, numerous sophisticated technologies have been developed and applied to answer key questions about the fundamental roles of the genes of interest. Functional genomics can be characterized into gain-of-function and loss-of-function, which are called transgenic and knock-out studies, respectively. To make transgenic mice, the most widely used technique is the microinjection of transgene-containing vectors into the embryonic pronucleus. However, there are critical drawbacks: namely position effects, integration of unknown copies of a foreign gene, and instability of the foreign DNA within the host genome. To overcome these problems, the ROSA26 locus was used for the knock-in site of a transgene. Usage of this locus is discussed for the gain of function study as well as for several brilliant approaches such as conditional/inducible transgenic system, reproducible/inducible knockdown system, specific cell ablation by Cre-mediated expression of DTA, Cre-ERTM mice as a useful tool for temporal gene regulation, MORE mice as a germ line delete and site specific recombinase system. Techniques to make null mutant mice include complicated steps: vector design and construction, colony selection of embryonic stem (ES) cells, production of chimera mice, confirmation of germ line transmission, and so forth. It is tedious and labor intensive work and difficult to approach. Thus, it is not readily accessible by most researchers. In order to overcome such limitations, technical breakthroughs such as reporter knock-in and gene knock-out system, production of homozygous mutant ES cells from a single targeting vector, and production of mutant mice from tetraploid embryos are developed. With these upcoming progresses, it is important to consider how we could develop these systems further and expand to other animal models such as pigs and monkeys that have more physiological similarities to humans.
Chronic postsurgical pain (CPSP) is an unwanted adverse event in any operation. It leads to functional limitations and psychological trauma for patients, and leaves the operative team with feelings of failure and humiliation. Therefore, it is crucial that preventive strategies for CPSP are considered in high-risk operations. Various techniques have been implemented to reduce the risk with variable success. Identifying the risk factors for each patient and applying a timely preventive strategy may help patients avoid the distress of chronic pain. The preventive strategies include modification of the surgical technique, good pain control throughout the perioperative period, and preoperative psychological intervention focusing on the psychosocial and cognitive risk factors. Appropriate management of CPSP patients is also necessary to reduce their suffering. CPSP usually has a neuropathic pain component; therefore, the current recommendations are based on data on chronic neuropathic pain. Hence, voltage-dependent calcium channel antagonists, antidepressants, topical lidocaine and topical capsaicin are the main pharmacological treatments. Paracetamol, NSAIDs and weak opioids can be used according to symptom severity, but strong opioids should be used with great caution and are not recommended. Other drugs that may be helpful are ketamine, clonidine, and intravenous lidocaine infusion. For patients with failed pharmacological treatment, consideration should be given to pain interventions; examples include transcutaneous electrical nerve stimulation, botulinum toxin injections, pulsed radiofrequency, nerve blocks, nerve ablation, neuromodulation and surgical management. Physical therapy, cognitive behavioral therapy and lifestyle modifications are also useful for relieving the pain and distress experienced by CPSP patients.
Journal of the Microelectronics and Packaging Society
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v.27
no.3
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pp.73-76
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2020
Silver nanowires (AgNWs) intrinsically possess high conductivity, ductility, and network structure percolated in a low density, which have led to many advanced applications of transparent and flexible electronics. Most of these applications require patterning of AgNWs, for which photolithographic and printing-based techniques have been widely used. However, several drawbacks such as high cost and complexity of the process disturb its practical application with patterning AgNWs. Herein, we propose a novel method for the patterning of AgNWs by employing UV-curable adhesive tape with a structure of liner/adhesive layer/polyolefin (PO) film and UV irradiation to simplify the process. First, the UV-curable adhesive tape was attached to AgNWs/polyurethane (PU), and then selectively exposed to UV irradiation by using a photomask. Subsequently, the UV-curable adhesive tape was peeled off and consequently AgNWs were patterned on PU substrate. This facile method is expected to be applicable to the fabrication of a variety of low-cost, shape-deformable transparent and wearable devices.
Background Axillary osmidrosis is characterized by unpleasant odors originating from the axillary apocrine glands, resulting in psychosocial stress. The main treatment modality is apocrine gland removal. Until now, of the various surgical techniques have sometimes caused serious complications. We describe herein the favorable outcomes of a new method for ablating apocrine glands by minimal subdermal shaving using sclerotherapy with absolute ethanol. Methods A total of 12 patients underwent the procedure. The severity of osmidrosis was evaluated before surgery. Conventional subdermal shaving was performed on one side (control group) and ablation by means of minimal subdermal shaving and absolute ethanol on the other side (study group). Postoperative outcomes were compared between the study and control groups. Results The length of time to removal of the drain was 1 day shorter in the study group than in the control group. There were no serious complications, such as hematoma or seroma, in either group, but flap margin necrosis and flap desquamation occurred in the control group, and were successfully managed with conservative treatment. Six months after surgery, we and our patients were satisfied with the outcomes. Conclusions Sclerotherapy using absolute ethanol combined with minimal subdermal shaving may be useful for the treatment of axillary osmidrosis. It can reduce the incidence of seroma and hematoma and allow the skin flap to adhere to its recipient site. It can degrade and ablate the remaining apocrine glands and eliminate causative organisms. Furthermore, since this technique is relatively simple, it takes less time than the conventional method.
Purpose: A palatal defect following maxillectomy can cause multiple problems like the rhinolalia, leakage of foods into the nasal cavity, and hypernasality. Use of a prosthetic is the preferred method for obturating a palate defect, but for rehabilitating palatal function, prosthetics have many shortcomings. In a small defect, local flap is a useful method, however, the size of flap which can be elevated is limited. In 12 cases of palatomaxillary defect, we used various microvascular free flaps in reconstructing the palate and obtained good functional results. Method: Between 1990 and 2004, 12 patients underwent free flap operation after head and neck cancer ablation, and were reviewed retrospectively. Among the 12 free flaps, 6 were latissimus dorsi myocutaneous flaps, 3 rectus abdominis myocutaneous flaps, and 3 radial forearm flaps. Result: All microvascular flap surgery was successful. Mean follow up time was 8 months and after the follow up time all patients reported satisfactory speech and swallowing. Wound dehiscence was observed in 4 cases, ptosis was in 1 case and fistula was in 1 case, however, rhinolalia, leakage of food, or swallowing difficultly was not reported in the 12 cases. Conclusion: We used various microvascular flaps for palatomaxillary reconstruction. For 3-dimensional flap needs, we used the latissimus dorsi myocutaneous flap to obtain enough volume for filling the defect. Two-dimensional flaps were designed with latissimus dorsi myocutaneous flap, rectus abdominis flap and radial forearm flap. For cases with palatal defect only, we used the radial forearm flap. In palatomaxillary reconstruction, we can choose various free flap techniques according to the number of skin paddles and flap volume needed.
Hyperhidrosis of the palms, axillae, and the face has a strong negative impact on the quality of life for many people. Existing nonsurgical therapeutic options are far from ideal. A definitive cure can be obtained by upper thoracic sympathectomy. The traditional open surgical technique is a major procedure; few patients and doctors have found that risk-benefit considerations favor surgery. Endoscopic minimal invasive surgical techniques are now available. We investigated whether endoscopic ablation of upper thoracic sympathetic chain(T2-4) is an efficient and safe treatment of hyperhidrosis. We treated 40 patients with bilateral endoscopic transthoracic sympathectomy. There were no mortalities, life-threatening complication, no treatment failures occurred in 40 patients. After a short-term follow-up, 100% of the patients reported satisfactory results. Endoscopic transthoracic sympathectomy is an efficient, safe, and minimally invasive surgical method for the treatment of palmar, axillary hyperhidrosis.
Seo, Mi-Hyun;Park, Jung-Min;Kim, Soung-Min;Kang, Ji-Young;Myoung, Hoon;Lee, Jong-Ho
Maxillofacial Plastic and Reconstructive Surgery
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v.34
no.2
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pp.148-154
/
2012
Peripheral nerve injuries in the oral and maxillofacial regions require nerve repairs for the recovery of sensory and/or motor functions. Primary indications for the peripheral nerve grafts are injuries or continuity defects due to trauma, pathologic conditions, ablation surgery, or other diseases, that cannot regain normal functions without surgical interventions, including microneurosurgery. For the autogenous nerve graft, sural nerve and greater auricular nerve are the most common donor nerves in the oral and maxillofacial regions. The sural nerve has been widely used for this purpose, due to the ease of harvest, available nerve graft up to 30 to 40 cm in length, high fascicular density, a width of 1.5 to 3.0 mm, which is similar to that of the trigeminal nerve, and minimal branching and donor sity morbidity. Many different surgical techniques have been designed for the sural nerve harvesting, such as a single longitudinal incision, multiple stair-step incisions, use of nerve extractor or tendon stripper, and endoscopic approach. For a better understanding of the sural nerve graft and in avoiding of uneventful complications during these procedures as an oral and maxillofacial surgeon, the related surgical anatomies with their harvesting tips are summarized in this review article.
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