• Archives of Plastic Surgery
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• 제40권6호
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• pp.748-753
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• 2013

Background Nasal reconstruction is one of the most difficult challenges for the head and neck surgeon, especially in the case of complex full thickness defects following malignant skin tumor resection. Full-thickness defects require demanding multi-step reconstruction. Methods Seven patients underwent surgical reconstruction of full-thickness nasal defects with a bi-pedicled forehead flap shaped appropriately to the defect. Patients were aged between 58 and 86 years, with a mean age of 63.4 years. All of the tumors were excised using traditional surgery, and in 4 of the patients, reconstruction was performed simultaneously following negativity of fresh frozen sections of the margins under general anesthesia. Results Nasal reconstruction was well accepted by all of the patients suffering non-melanoma skin tumors with acceptable cosmetic outcomes. The heart-shaped forehead flap was harvested in cases of subtotal involvement of the nasal pyramid, while smaller defects were reconstructed with a wing-shaped flap. No cartilaginous or osseous support was necessary. Conclusions This bi-pedicled forehead flap was a valid, versatile, and easy-to-implement alternative to microsurgery or multi-step reconstruction. The flap is the best indication for full-thickness nasal defects but can also be indicated for other complex facial defects in the orbital (exenteratio orbitae), zygomatic, and cheek area, for which the availability of a flap equipped with two thick and hairless lobes can be a valuable resource.

• Archives of Plastic Surgery
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• 제44권5호
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• pp.420-427
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• 2017

Background It can be difficult to select an appropriate flap for various defects on the hand. Although defects of the hand usually must be covered with a skin flap, some defects require a flap with rich blood supply and adequate additive soft tissue volume. The authors present their experience with the anconeus muscle free flap in the reconstruction of various defects and the release of scar contractures of the hand. Methods Ten patients underwent reconstruction of the finger or release of the first web space using the anconeus muscle free flap from May 1998 to October 2013. Adequate bed preparations with thorough debridement or contracture release were performed. The entire anconeus muscle, located at the elbow superficially, was harvested, with the posterior recurrent interosseous artery as a pedicle. The defects were covered with a uniformly trimmed anconeus muscle free flap. Additional debulking of the flap and skin coverage using a split-thickness skin graft were performed 3 weeks after the first operation. Results The average flap size was $18.7cm^2$ (range, $13.5-30cm^2$). All flaps survived without significant complications. Vein grafts for overcoming a short pedicle were necessary in 4 cases. Conclusions The anconeus muscle free flap can be considered a reliable reconstructive option for small defects on the hand or contracture release of the web space, because it has relatively consistent anatomy, provides robust blood supply within the same operative field, and leads to no functional loss at the donor site.

• 한국결정성장학회지
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• 제15권2호
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• pp.45-50
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• 2005

규소 표면의 기계적 손상은 산화 공정 중에 규소 표면에 여러 가지 형태의 결함들을 발생 시킨다. 규소 표면에 손상을 주는 마모 입자가 커짐에 따라 OISF보다는 etch pit의 형상이 동굴형인 선 결함(line defects)들이 많이 발생된다. 이들 결함들은 실리콘 결정을 성장시키는 단계에서 형성되는 결함들과는 상호 관련이 없다. 방향성 응고법으로 성장된 규소 결정속에 존재하는 결함들은 주로 twin과 stacking fault들이며 응고과정에서 발생이 예상되는 응력에 의한 전위는 거의 발견되지 않았다. 따라서 Czochralski 법으로 성장된 단 결정 규소뿐 아니라 방향성 응고법으로 성장된 다 결정 규소 기판도 표면의 결함들을 이용하여 extrinsic gettering을 통한 규소 결정 내부의 불순물 제거의 가능성이 높다.

• 대한두개안면성형외과학회지
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• 제20권6호
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• pp.382-387
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• 2019

Background: Defects of the nasal ala and tip have a complex three-dimensional structure that makes them challenging to reconstruct. Many reconstructive options have been described for nasal ala and tip defects, ranging from primary closure to local flaps and skin grafts. However, it is difficult to determine which method will yield the best cosmetic results in each individual case. Thus, the purpose of this study was to determine which surgical procedures for reconstructing defects of the nasal ala and tip have better cosmetic results. Methods: From 2008 to 2018, 111 patients underwent surgery to reconstruct skin defects after resection of skin cancer in the nasal ala or tip. Their charts were reviewed to obtain data on age, sex, surgical location, size of the defect, surgical method, and cosmetic results using a visual analog scale (VAS). Results: For nasal ala reconstruction, the most commonly used surgical technique was the nasolabial flap (n= 42). This method also had the highest VAS score (7/10). The most commonly selected surgical method for nasal tip reconstruction was the bilobed flap (n= 13), and bilobed flaps and primary closure had the highest VAS score (7/10). Conclusion: Nasolabial flaps showed excellent cosmetic results for the reconstruction of nasal ala defects, while primary closure and bilobed flaps yielded excellent cosmetic results for the reconstruction of nasal tip defects.

• 치과방사선
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• 제10권1호
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• pp.63-68
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• 1980

The purpose of this article is to re-examine the roentgenographic appearance of alveolar osseous in an effort to determine the value of the orthopantomogram in the diagnosis of periodontal disease. A total of 158 osseous lesions from 13 human dry skulls were studied. 14 Ultra-speed periapical films, 2 bitewing films and Kodak panoramic film are used to obtain radiographs of all defects. The bisecting technic was used, with a target-film distance of. 8 inches and exposure factors of 70 kVp, 10MA and 0.4 sec. at anterior teeth, 0.6 see at posterior teeth in exposure time. For orthopantomogram, Panoura Eight-C was used with a exposure factors of 90kVp, 10MA. and 15sec. exposure time. All films were developed in a light. tight darkroom at 68°F for 4½ minutes. Comparison of orthopantomogram and intraoral films on the view-box was carefully studied in relation to the types of osseous defect visually evident; Proximal intraosseous defects, Interproximal craters, Interproximal hemisepta, Furcal defects on multirooted teeth, and Facial or Lingual one-walled defects. The results obtained were as follows; 1. Proximal osseous defects throughout the dental arches and furcal defects on facial and lingual surfaces of multirooted teeth can be identified with a high degree of accuracy from their orthopantomographic appearances. 2. Lesions on facial or lingual surface of the alveolar arches are rather difficult to locate or recognize on the dental radiographs. 3. In determining whether the proximal and furcal lesions are located facially or lingually, Orthopantomogram is superior to the conventional film Orthopantomogram obtained with standardization of head in proper position revealed the complete visualization of alveolar bone without showing occlusal surface of molars and proximal superimposition of teeth. Thus, on the standardized orthopantomograms, The roentgenographic characteristics of each defect were determined.

• Archives of Plastic Surgery
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• 제42권5호
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• pp.619-625
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• 2015

Background The reconstruction of ankle and heel defects remains a significant problem for plastic surgeons. The following options exist for reconstructing such defects: local random flaps, reverse flow island flaps, and free flaps. However, each of these methods has certain drawbacks. Peroneal artery perforators have many advantages; in particular, they are predictable and reliable for ankle and heel reconstructions. In this study, we report our clinical experience with peroneal artery perforator-based pedicled flaps in ankle and heel reconstructions. Methods From July 2005 to October 2012, 12 patients underwent the reconstruction of soft tissue defects in the ankle and heel using a peroneal artery perforator-based pedicled flap. These 12 cases were classified according to the anatomical area involved. The cause of the wound, comorbidities, flap size, operative results, and complications were analyzed through retrospective chart review. Results The mean age of the patients was 52.4 years. The size of the flaps ranged from $5{\times}4$ to $20{\times}8cm^2$. The defects were classified into two groups based on whether they occurred in the Achilles tendon (n=9) or heel pad (n=3). In all 12 patients, complete flap survival was achieved without significant complications; however, two patients experienced minor wound dehiscence. Nevertheless, these wounds healed in response to subsequent debridement and conservative management. No patient had any functional deficits of the lower extremities. Conclusions Peroneal artery perforator-based pedicled flaps were found to be a useful option for the reconstruction of soft tissue defects of the ankle and heel.

• Archives of Plastic Surgery
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• 제40권3호
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• pp.226-231
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• 2013

Background The reconstruction of volar surface defects is difficult because of the special histologic nature of the tissue involved. The plantar surface is the most homologous in shape and function and could be considered the most ideal of reconstructive options in select cases of volar surface defects. In this paper, we evaluate a single institutional case series of volar tissue defects managed with second toe plantar free flaps. Methods A single-institution retrospective review was performed on 12 cases of reconstruction using a second toe plantar free flap. The mean age was 33 years (range, 9 to 54 years) with a male-to-female ratio of 5-to-1. The predominant mechanism was crush injury (8 cases) followed by amputations (3 cases) and a single case of burn injury. Half of the indications (6 cases) were for soft-tissue defects with the other half for scar contracture. Results All of the flaps survived through the follow-up period. Sensory recovery was related to the time interval between injury and reconstruction-with delayed operations portending worse outcomes. There were no postoperative complications in this series. Conclusions Flexion contracture is the key functional deficit of volar tissue defects. The second toe plantar free flap is the singular flap whose histology most closely matches those of the original volar tissue. In our experience, this flap is the superior reconstructive option within the specific indications dictated by the defect size and location.

• Archives of Plastic Surgery
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• 제44권4호
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• pp.319-323
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• 2017

Background Free-flap surgery and skin grafting can be used to reconstruct large facial defects that may result after skin cancer removal by Mohs micrographic surgery (MMS). However, these two methods may produce low postsurgical patient satisfaction with aesthetics, and free-flap surgery may produce an undue burden for the majority of skin cancer patients, who are of advanced age. Hence, the authors examined outcomes of large facial defect reconstruction using multiple flaps. Methods Among patients undergoing MMS for skin cancer at Pusan National University Hospital between January 2013 and December 2015, we evaluated 7 patients (2 males, 5 females; average age, 73.14 years) treated for large facial defects from basal cell carcinoma. Based on operative and follow-up records, we investigated the number and type of flaps used, postsurgical complications, and patients' post-surgical satisfaction. Results Two and 3 types of flaps were used for 5 and 2 patients, respectively. Most frequently used were nasolabial flaps (7 times in 6 patients) and forehead flaps (once in each of 4 patients). The average follow-up period was 14 months, with no complications-including necrosis, hematoma, or wound dehiscence-observed. Post-surgical satisfaction averaged 4.4 out of a maximum of 5 points. Conclusions Reconstruction using two or more flaps for large facial defects after skin cancer removal using MMS produced satisfactory outcomes while preventing aesthetic problems. Practitioners should consider using multiple flaps when choosing a reconstruction method for large facial defects following skin cancer removal.

• 대한기계학회논문집A
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• 제36권12호
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• pp.1599-1604
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• 2012

주조공정에서 발생하는 수축공과 같은 내부 결함은 일반적으로 응력집중을 발생시키며 균열의 시작점이 되므로 충격과 같은 기계적 거동에 있어 결함의 영향을 이해하는 것이 중요하다. 본 연구는 주조 알루미늄 합금의 충격 거동에 대한 내부 수축 결함의 영향을 실험적 방법과 전산 해석을 이용하여 비교 및 평가하였다. 시편의 내부 결함은 주조 후 산업용 CT 장비를 통해 검출하였으며 추출된 결함은 형상단순화법에 의해 타원체로 단순화하고 충격 해석을 위한 전산 해석을 수행하였다. 그 결과 본 연구에서 제안한 방법으로 내부 결함을 포함한 주조품의 충격 거동을 실험과 유사하게 예측함을 확인할 수 있었다.

• 인터넷정보학회논문지
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• 제8권2호
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• pp.15-22
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• 2007

결함을 초기 단계에 발견하여 제거함으로써 품질이 좋은 소프트웨어를 만들 수 있다 이를 위해 결함을 효과적으로 추적하고 관리하는 결함 추적 시스템(Defect Trucking System)의 도입이 필요하다. 기존의 결함 추적 시스템은 한꺼번에 많은 종류의 데이터를 모음으로써 이를 도입한 조직에서 수많은 데이터를 왜 모아야 하는지에 대해 인식이 부족하고 결함 관리프로세스 없이 도구만 적용함으로써 결함 추적 시스템 도입에 어려움을 겪고 있다. 또한 CMMI 성숙도 수준 2, 3에서는 결함 관리 활동을 수행하는 프로세스 영역이 없기 때문에 CMMI 성숙도 수준 2, 3에 해당하는 조직이 결함 추적 시스템을 도입하는데 문제가 되고 있다. 이에 본 논문에서는 CMMI 기반의 조직이 기존의 결함 추적 시스템을 도입하였을 때 생기는 문제점을 해결하고 CMMI 각 성숙도마다 어떤 결함 데이터를 모아야 하는지, 어떻게 결함 관리를 해야 하는지에 대한 가이드라인을 제공하고자 한다. 그리고 검토 및 테스팅을 통해 도출된 결함 데이터에 대하여 각 담당자 별로 업무를 할당, 추적할 수 있게 하며, 결함에 관한 각종 상태정보와 통계 정보 등을 제공하는 결함 분석 및 통제 시스템을 개발하고자 한다.