• Archives of Plastic Surgery
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• 제32권2호
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• pp.183-188
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• 2005

Defect on the temporal area caused by, surgical ablation of a tumor or an infection should be reconstructed immediately to prevent potentially life-threatening complications such as meningitis and cerebrospinal fluid leakage. The defect on the temporal area usually presents as a typical 'cone-shape'. Successful reconstruction requires sufficient volume of well-vascularized soft tissue to cover the exposed bone and dura. From 1994 through 2003, the authors applied rectus abdominis free flap for the reconstruction of the temporal defect from 1994 through 2003. There were 10 patients with a mean age of 52.1 years. Of these 10 patients, external auditory canal cancer was present in four patients, temporal bone cancer in two, parotid gland cancer in one and three patients were reconstructed after debridement of infection(destructive chronic otitis media). All the free flaps survived, and flap-related complications did not occur. Compared to a local flap, the rectus abdominis free flap can provide sufficient volume of well-vascularized tissue to cover the large defect and can be well-tolerated during an adjuvant radiation therapy. The long and flat muscle can be easily molded to fit in to the 'cone-shape' temporal defect without dead space. It is also preferred because of the low donor site morbidity, a large skin island and an excellent vascular pedicle. Two-team approach without position change is possible. In conclusion, the authors think that rectus abdominis free flap should be considered as one of the most useful method for the reconstruction of a cone-shaped temporal defect.

• Journal of Chest Surgery
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• 제54권1호
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• pp.9-16
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• 2021

Background: The deposition of monomeric C-reactive protein (mCRP) in the myocardium aggravates ischemia-reperfusion injury (IRI) and myocardial infarction. Ischemic preconditioning (IPC) is known to protect the myocardium against IRI. Methods: We evaluated the effects of IPC on myocardium upon which mCRP had been deposited due to IRI in a rat model. Myocardial IRI was induced via ligation of the coronary artery. Direct IPC was applied prior to IRI using multiple short direct occlusions of the coronary artery. CRP was infused intravenously after IRI. The study included sham (n=3), IRI-only (n=5), IRI+CRP (n=9), and IPC+IRI+CRP (n=6) groups. The infarcted area and the area at risk were assessed using Evans blue and 2,3,5-triphenyltetrazolium staining. Additionally, mCRP immunostaining and interleukin-6 (IL-6) mRNA reverse transcription-polymerase chain reaction were performed. Results: In the IRI+CRP group, the infarcted area and the area of mCRP deposition were greater, and the level of IL-6 mRNA expression was higher, than in the IRI-only group. However, in the IPC+IRI+CRP group relative to the IRI+CRP group, the relative areas of infarction (20% vs. 34%, respectively; p=0.079) and mCRP myocardial deposition (21% vs. 44%, respectively; p=0.026) were lower and IL-6 mRNA expression was higher (fold change: 407 vs. 326, respectively; p=0.376), although the difference in IL-6 mRNA expression was not statistically significant. Conclusion: IPC was associated with significantly decreased deposition of mCRP and with increased expression of IL-6 in myocardium damaged by IRI. The net cardioprotective effect of decreased mCRP deposition and increased IL-6 levels should be clarified in a further study.

• Journal of Gastric Cancer
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• 제22권2호
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• pp.145-155
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• 2022

Purpose: Weight loss and deterioration in body composition are observed in patients with gastric cancer (GC) following gastrectomy. This study aimed to investigate the impact of residual stomach volume (RSV) on the nutritional status and body composition of patients with GC treated with distal gastrectomy. Materials and Methods: In total, 227 patients who underwent minimally invasive distal gastrectomy with Billroth 1 anastomosis for stage I GC between February 2015 and May 2018 were enrolled. Clinicodemographic and laboratory data were collected from the GC registry. The RSV, abdominal muscle area, and subcutaneous/visceral fat areas were measured using computed tomography data. Results: A larger RSV was associated with a lower decrease in the nutritional risk index (P=0.004) and hemoglobin level (P=0.003) during the first 3 months after surgery, and better recovery at 12 months. A larger RSV demonstrated an advantage in the preservation of abdominal muscle area (P=0.02) and visceral fat (P=0.04) after surgery, as well as less reduction in weight (P=0.02) and body mass index (P=0.03). Conclusions: Larger RSV was associated with improved nutritional status and better preservation of muscle and fat after distal gastrectomy.

• 환경위생공학
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• 제23권1호
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• pp.33-48
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• 2008

The purpose of this study was to characterize background mass concentration of $PM_{10},\;PM_{2.5}$ and metallic composition from June 2004 to June 2005 in comparison with Seoul and Asan city. The results were as follows: 1. Annual mean of $PM_{10}$ concentrations in Seoul and Asan were $56.95({\pm}25.63){\mu}g/m^3,\;57.02({\pm}27.22){\mu}g/m^3$ respectly. 2. Annual mean of $PM_{2.5}$ concentrations in Seoul and Asan were $46.97({\pm}40.36){\mu}g/m^3,\;42.16({\pm}21.79){\mu}g/m^3$ respectly. 3. The average $PM_{2.5}/PM_{10}$ ratio was 0.82 in Seoul and 0.74 in Asan city. 4. The concentration of $PM_{10},\;PM_{2.5}$ were the highest in spring and the lowest in summer. Asan was higher than Seoul in spring and summer. 5. The results showed that average $PM_{10}$ composition order as Si>Fe>Pb>Zn>Mn in Seoul and Si>Fe>Zn>Pb>Mn in Asan. The concentration of metals in $PM_{10}$ of Seoul that Cr, Cu, Fe, Mn were high in spring and Zn was low in Fall. Fe, Mn were high in spring of Asan. 6. The results showed that average $PM_{2.5}$ composition order as Si>Pb>Fe>Zn>Mn in Seoul and Si>Fe>Pb>Zn>Cr in Asan. The concentration of metals in $PM_{2.5}$ of Seoul that Cr was high in spring. 7. The result showed that relation between Cr and Cu, Cu and Fe, Fe and Mn, Mn and Zn, Zn and Si in Seoul, Cr and Zn, Cu and Pb, Zn and Pb, Pb and Mn in Asan. The result showed that $PM_{10}$ concentration exceeding $50{\mu}g/m^3$(US-EPA Standard) and $PM_{2.5}$ concentration exceeding $15{\mu}g/m^3$(US-EPA Standard). In urban area, the monitoring of $PM_{2.5}$ permits the anthropogenic sources and the interference of natural sources with respect to $PM_{10}$ measurements.

• 대한공업교육학회지
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• 제39권1호
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• pp.1-22
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• 2014

이 연구는 중학교 학생 및 학부모, 산업체 인사 담당자의 요구를 조사 및 분석하여 아산지역 특성화고 설치에 필요한 시사점을 제안하는 것을 목적으로 한다. 이를 위해서 아산시 중학교 학생 및 학부모, 산업체 인사 담당자가 인식하는 아산시 특성화고 설치에 필요한 수요, 희망학과 및 지역 등의 요구를 설문 조사 및 분석하였다. 설문 조사 대상은 아산시 전체 중학교에서 학교별 3학년 1학급에서 표집된 학생과 학부모를 선정하였다. 또한, 산업체 인사 담당자는 종사자수 10명 이상의 산업체를 무선 표집하여 선정하였으며, 분석 대상 수는 학생 484, 학무모 458, 산업체 81이다. 연구의 결과는 다음과 같다. 첫째, 중학교 3학년 학생중에서 직업교육고등학교 진학을 희망하는 학생은 18.5%이고, 아산시에 특성화고 설치된다면 72.6%가 진학 가능성 있다고 응답하였다. 이중에서 8.8%는 반드시 진학하겠다고 응답하였다. 둘째, 학부모 중에서 직업교육고등학교 진학을 희망하는 학부모는 30.8%이고, 아산시에 특성화고 설치된다면 76.9%가 진학 가능성 있다고 응답하였다. 이중에서 8.4%는 반드시 진학하겠다고 응답하였다. 셋째, 산업체 인사 담당자는 아산지역 특성화고 졸업생 중에서 98.8%를 채용 및 채용 가능성 있다고 응답하였다. 이중에서 17.3%는 반드시 채용하겠다고 응답하였다. 채용 시기에 대한 응답은 '1년 이내'가 49.4%, '1~5년 이내'가 30.9%였으며, 근무할 직종은 '기계조작 및 조립종사자'가 60.8%, '기능원 및 기능종사자'가 31.6%였다. 넷째, 아산시 특성화고 설치시 가장 선호하는 학과에 대하여 중학생은 가정가사, 학부모는 전기전자, 산업체는 자동차기계로 응답하였다. 계열별로는 응답자의 절반이상이 공업계열을 희망하였다. 다섯째, 아산시 특성화고 설치시 희망 지역에 대하여 중학생과 학부모는 온양동, 산업체는 둔포면으로 응답하였고, 대체로 희망하는 지역과 주거지가 일치하였다.

• Korean Journal of Radiology
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• 제21권1호
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• pp.88-100
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• 2020

Objective: We aimed to develop and validate a deep learning system for fully automated segmentation of abdominal muscle and fat areas on computed tomography (CT) images. Materials and Methods: A fully convolutional network-based segmentation system was developed using a training dataset of 883 CT scans from 467 subjects. Axial CT images obtained at the inferior endplate level of the 3rd lumbar vertebra were used for the analysis. Manually drawn segmentation maps of the skeletal muscle, visceral fat, and subcutaneous fat were created to serve as ground truth data. The performance of the fully convolutional network-based segmentation system was evaluated using the Dice similarity coefficient and cross-sectional area error, for both a separate internal validation dataset (426 CT scans from 308 subjects) and an external validation dataset (171 CT scans from 171 subjects from two outside hospitals). Results: The mean Dice similarity coefficients for muscle, subcutaneous fat, and visceral fat were high for both the internal (0.96, 0.97, and 0.97, respectively) and external (0.97, 0.97, and 0.97, respectively) validation datasets, while the mean cross-sectional area errors for muscle, subcutaneous fat, and visceral fat were low for both internal (2.1%, 3.8%, and 1.8%, respectively) and external (2.7%, 4.6%, and 2.3%, respectively) validation datasets. Conclusion: The fully convolutional network-based segmentation system exhibited high performance and accuracy in the automatic segmentation of abdominal muscle and fat on CT images.

• 한국간담췌외과학회지
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• 제26권4호
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• pp.308-312
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• 2022

Backgrounds/Aims: Although body surface area (BSA)-based standard liver volume (SLV) formulae have been used for living donor liver transplantation and hepatic resection, hemi-liver volume (HLV) is needed more frequently. HLV can be assessed using right or left portal vein diameter (RPVD or LPVD). The aim of this study was to validate the reliability of using portal vein diameter ratio (PVDR) for assessing HLV in living liver donors. Methods: This study included 92 living liver donors (59 males and 33 females) who underwent surgery between January 2020 and December 2020. Computed tomography (CT) images were used for measurements. Results: Mean age of donors was 35.5 ± 7.2 years. CT volumetry-measured total liver volume (TLV), right HLV, left HLV, and percentage of right HLV in TLV were 1,442.9 ± 314.2 mL, 931.5 ± 206.4 mL, 551.4 ± 126.5 mL, and 64.6% ± 3.6%, respectively. RPVD, LPVD, and main portal vein diameter were 12.2 ± 1.5 mm, 10.0 ± 1.3 mm, and 15.3 ± 1.7 mm, respectively (corresponding square values: 149.9 ± 36.9 mm², 101.5 ± 25.2 mm², and 237.2 ± 52.2 mm², respectively). The sum of RPVD2 and LPVD2 was 251.1 ± 56.9 mm². BSA-based SLV was 1,279.5 ± 188.7 mL (error rate: 9.1% ± 14.4%). SLV formula- and PVDR-based right HLV was 760.0 ± 130.7 mL (error rate: 16.2% ± 13.3%). Conclusions: Combining BSA-based SLV and PVDR appears to be a simple method to predict right or left HLV in living donors or split liver transplantation.

• Radiation Oncology Journal
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• 제29권4호
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• pp.260-268
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• 2011

Purpose: To evaluate the treatment outcome and prognostic factor after postoperative radiotherapy in retroperitoneal sarcoma. Materials and Methods: Forty patients were treated with surgical resection and postoperative radiotherapy for retroperitoneal sarcoma from August 1990 to August 2008. Treatment volume was judged by the location of initial tumor and surgical field, and 45-50 Gy of radiation was basically delivered and additional dose was considered to the high-risk area. Results: The median follow-up period was 41.4 months (range, 3.9 to 140.6 months). The 5-year overall survival (OS) was 51.8% and disease free survival was 31.5%. The 5-year locoregional recurrence free survival was 61.9% and distant metastasis free survival was 50.6%. In univariate analysis, histologic type (p = 0.006) was the strongest prognostic factor for the OS and histologic grade (p = 0.044) or resection margin (p = 0.032) had also effect on the OS. Histologic type (p = 0.004) was unique significant prognostic factor for the actuarial local control. Conclusion: Retroperitoneal sarcoma still remains as a poor prognostic disease despite the combined modality treatment including surgery and postoperative radiotherapy. Selective dose-escalation of radiotherapy or combination of effective chemotherapeutic agent must be considered to improve the treatment result especially for the histopathologic type showing poor prognosls.

• Journal of Korean Neurosurgical Society
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• 제58권1호
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• pp.72-75
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• 2015

Dumbbell-shaped spinal extradural cavernous hemangioma is rare. The differential diagnosis of dumbbell-shaped spinal tumors based on magnetic resonance imaging includes schwannoma and lymphoma. Here, we report a dumbbell-shaped spinal extradural cavernous hemangioma with intrathoracic growth on T2-3 in a 64-year-old man complaining of right side infrascapular area back pain with no neurologic deficit. The cavernous hemangioma was resected through combined video-assisted thoracoscopy and laminectomy without a fusion procedure. The patient had tolerable operative wound pain with no neurologic deficit after surgery. Based on magnetic resonance imaging findings and a review of the literature, we discuss cavernous hemangioma among the differential diagnosis of paravertebral dumbbell-shaped spinal tumors and the importance of complete resection.

• Journal of Korean Neurosurgical Society
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• 제42권2호
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• pp.129-131
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• 2007

Intracranial epithelioid hemangioendothelioma is extremely rare. We report a case of intracranial epithelioid hemangioendothelioma which developed in a 55-year-old man who presented with dysarthria for two weeks. The brain computed tomography scan and magnetic resonance image showed masses which had fat component at the left frontal convexity and at left posterior parietal area. Excisional biopsy at the left frontal convexity confirmed epithelioid hemangioendothelioma which is immunopositive for CD31, supporting endothelial differentiation, and negative for CD68, SMA and HMB-45.