• Archives of Plastic Surgery
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• 제38권4호
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• pp.508-511
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• 2011

Purpose: Blue toe syndrome consists of blue or purplish toes in the absence of a history of obvious trauma, serious cold exposure, or disorders producing generalized cyanosis. It is a life-threatening and still underrecognized disease. It can be commonly occurred by vascular surgery, invasive cutaneous procedures or anticoagulant therapy. Our case is presented of blue toe syndrome related to atheromatous embolization that was presumably triggered by angio CT. Methods: A 69-year-old man presented with the suddenly developed pain, cyanosis and livedo reticularis of the toes in right foot. Dorsalis pedis pulses were palpable. He had been performed a diagnostic angio CT 1 month earlier. Angio CT revealed diffuse aortic atheromatous plaque in lower abdominal aorta and both common iliac artery. One month after angio CT, he visited our clinic. There was no visible distal first dorsal metatarsal artery and digital artery of right first toe in lower extremity arteriography. A diagnosis was established of blue toe syndrome. Because his symptom was aggravated, we performed the exploration of the right foot. After exposure of first dorsal metatarsal artery, microsurgical atheroembolectomy was done. Results: There were no postoperative complications. After three months the patient had no clinically demonstrable problems. Conclusion: Patient with blue toe syndrome is at high risk of limb loss and mortality despite treatment. Blue toe syndrome produces painful, cyanosed toes with preserved pedal pulses. It needs to be aware of blue toe syndrome. Careful history should reveal the diagnosis. Treatment is controversial, however, most believe that anticoagulation therapy should be avoided.

• Archives of Plastic Surgery
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• 제37권6호
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• pp.795-800
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• 2010

Purpose: According to various medical publications, it is believed that epinephrine should not be injected in fingers. However numerous articles show the successful use of local anesthetic with epinephrine in the digits. Epinephrine-mixed lidocaine solution enables to maintain a bloodless field for operation and provides long duration of local anesthesia when patient was wide awake. Methods: From May 2009 to December 2009, ten patients underwent flexor tendon reconstruction with local anesthesia using epinephrine. No tourniquet was necessary. Before operation, all patients were injected with local anesthetics using 1% lidocaine 20 mL and 0.1% epinephrine 0.1 mL. Results: There was no case of digital necrosis nor gangrene in the epinephrine injection. All 10 patients actively could move the finger through a full range of motion. All procedures were performed without sedation nor tourniquet and we could obtain a good vision of operative field and patients were comfortable. The patient make his or her fingers move through a full range of active motion before the skin is closed. Phentolamine was not required to reverse the vasoconstriction in any patients. Conclusion: The assertation that epinephrine should not be injected into the fingers is clearly no longer valid. The epinephrine injection allowed the authors to adjust flexor tendon surgery without risks associated with general anesthesia. It also enables to ensure longer anesthetic duration and bloodless operative field, and prevent post operative complications. In case of flexor tendon surgery, the use of epinephrine injection is recommended because of the advantages of local anesthesia.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.654-659
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• 2009

Purpose: A botulinum toxin type A (BoNT - A) injection has been used as a noninvasive management for lower face contouring since 2000. The aim of this study was to compare reduction rate of lower face width for a longtime according to repeated Botox$^{(R)}$ injections on masseter muscles for lower face contouring procedure. Methods: Forty - five patients were analyzed for single session of Botox$^{(R)}$ injection and 13 patients were evaluated for repeated Botox$^{(R)}$ injections for over two years. Single injection group was tracked regular intervals at 1, 3, 6, 10, 12 months after injection, and repeated injection group was measured at every injection time. Twenty - five to thirty units of Botox$^{(R)}$ was injected into each masseteric muscle at five to six points at the prominent portions of the mandibular angle. Standardized frontal view of digital photographs were analyzed by Adobe Photoshop$^{(R)}$ (version CS3) to measure an reduction rate of lower face width. Results: Reduction rate was 3.7%, 6.9%, 6.2%, 4%, 4% at 1, 3, 6, 10, 12 months post injection each other in single injection group. However, more than 8% reduction rate was found in repeated injection group persistently for more than two years. Conclusion: This study shows that effective duration of Botox$^{(R)}$ injection for lower face contouring is expected to continue over one year clinically. Moreover, repeated injections maintained lower reduction rate consistently for a long time. Therefore, repeated injections on masseter muscles at regular intervals are most effective procedure for lower face contouring.

• Archives of Plastic Surgery
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• 제45권1호
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• pp.58-61
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• 2018

Background Venous anastomosis is an important component of digital replantation, but is not always feasible, as some cases require external bleeding to treat venous congestion in the replanted tissue. In the present study, we evaluated the relationship between the number of vein anastomoses and the survival rate of Tamai zone I replantations. Methods A retrospective review was performed of all patients who underwent replantation of a fingertip amputation between 2014 and 2016. Patient charts were reviewed for demographic information, the mechanism of injury, the number of venous anastomoses, and the use of anticoagulation, external bleeding, and/or leeches. The cohort was divided into 3 groups depending on the number of venous anastomoses: no veins (group 1), a single vein (group 2), and 2 or more veins (group 3). Survival rates and external bleeding rates were analyzed across the groups. Results The review identified 143 fingertip replantations among 134 patients. The overall survival rate was 94% (135 of 143). Failures were due equally to venous complications (n=4, 50%) and to arterial complications (n=4, 50%). Our analysis did not identify any correlation between the number of veins anastomosed and the replant survival rate (P=0.689). However, a greater number of anastomoses was associated with a significantly lower frequency of external bleeding (P=0.017). Conclusions The number of venous anastomoses was not correlated with the survival rate. However, a greater number of venous anastomoses was associated with a decreased need for external bleeding, corresponding to a significant decrease in the need for postoperative monitoring and leech therapy.

• 한국문헌정보학회지
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• 제43권3호
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• pp.147-162
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• 2009

본 연구는 대학 내에서 생산하고 있는 이러닝 콘텐츠의 수집 및 보존을 위한 아카이빙 메타데이터 요소를 개발하고자 하였다. 이러닝 콘텐츠를 서비스하고 있는 국 내외의 현황을 살펴보고, 교육용 기반 메타데이터 표준을 검토하였다. KOCW에서 제공하고 있는 교육용 메타데이터인 KEM3.0에서는 아카이빙 관련 메타데이터 요소를 수용하고 있지 않아 아카이빙을 위한 메타데이터 범주를 확장하고 요소를 추가하였다. 확장된 KEM3.0+ 요소로 아카이빙을 위한 메타데이터를 적용해 본 결과, 이러닝 콘텐츠를 아카이빙할 수 있는 기초가 마련되었다.

• 보존과학회지
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• 제37권4호
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• pp.322-339
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• 2021

This paper focuses on the dating and provenance of two paintings, Climbing the hill and View from St. John's Fort by the prominent Singaporean artist Liu Kang (1911-2004). Climbing the hill, from the National Gallery Singapore collection, was believed to have been created in 1937, based on the date painted by the artist. However, a non-invasive examination unveiled evidence of an underlying paint scheme and a mysterious date, 1948 or 1949. These findings prompted a comprehensive technical study of the artwork in conjunction with comparative analyses of View from St. John's Fort (1948), from the Liu family collection. The latter artwork is considered to be depicting the same subject matter. The investigation was carried out with UVF, NIR, IRFC, XRR, digital microscopy, PLM and SEM-EDS to elucidate the materials and technique of both artworks and find characteristic patterns that could indicate a relationship between both paintings and assist in correctly dating Climbing the hill. The technical analyses were supplemented with the historical information derived from the Liu family archives. The results showed that Climbing the hill was created in 1948 or 1949 on top of an earlier composition painted in Shanghai between 1933 and 1937. As for the companion View from St. John's Fort from 1948, the artist reused an earlier painting created in France in 1931. The analytical methods suggested that Liu Kang used almost identical pigment mixtures for creating new artworks. However, their painting technique demonstrates some differences. Overall, this study contributes to the understanding of Liu Kang's painting materials and his working practice.

• 기록학연구
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• 제27호
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• pp.209-238
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• 2011

1968년 프랑스에서 출현하여 전 세계로 널리 확산된 생태박물관은 유물의 소장 전시보다 어떤 지역의 자연 문화유산 전체를 '본래의 장소에서' 보존 해석하여 그 지역의 장소적 의미를 찾고 주민의 참여와 지역 공동체의 발전을 도모하는 것을 목적으로 하는 새로운 유형의 박물관이다. 이 박물관이 갖는 의의는 사라져가는 지역의 집단 기억을 회복하여 주민의 문화적 정체성을 되찾고 낙후된 지역을 활성화하는 데 있다. 그런데 이 박물관은 분산형 야외박물관인 경우가 많기 때문에 흩어져있는 지역 유산 전반에 대한 원격 정보 제공과 종합적 해석이 가능하도록 유산을 디지털화하여 기록 보존 해석 활용하는 '웹 생태박물관'이 필요하다. 본고에서는 무등산이라는 지역을 예로 들어 웹 생태박물관의 가능성과 그 구성 내용 방법에 대해 고찰하였다. 특히 후자에 대해서는 지역 고유의 주제를 선정하여 관련 유산을 토대로 디지털 아카이브를 구축(기록 보존)하고, 웹 전시를 개최(해석)하고, 전자문화지도를 제작(활용)하는 방안을 제시하였다.

• Archives of Plastic Surgery
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• 제46권2호
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• pp.108-113
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• 2019

Background The aim of this study was to assess the safety of one-per-mil tumescent injections into viable skin flaps that had survived an ischemic insult, in order to assess the potential suitability of one-per-mil tumescent injections in future secondary reconstructive procedures such as flap revision and refinements after replantation. Methods Forty groin flaps harvested from 20 healthy Wistar rats weighing 220 to 270 g were subjected to acute ischemia by clamping the pedicle for 15 minutes. All flaps showing total survival on the 7th postoperative day were randomly divided into group A (one-per-mil tumescent infiltration; n=14), group B (normal saline infiltration; n=13), and group C (control, with no infiltration; n=13) before being re-elevated. Transcutaneous oxygen tension ($TcPO_2$) was measured before and after infiltration, and changes in $TcPO_2$ were statistically analyzed using analysis of variance, the paired t-test, and the independent t-test. The viability of flaps was also assessed using the Analyzing Digital Images software at 7 days after the second elevation. Results Thirty-nine flaps survived to the final assessment, with the sole exception of a flap from group A that did not survive the first elevation. $TcPO_2$ readings showed significant decreases (P<0.05) following both one-per-mil tumescent ($99.9{\pm}5.7mmHg$ vs. $37.2{\pm}6.3mmHg$) and normal saline ($103{\pm}8.5mmHg$ vs. $48.7{\pm}5.9mmHg$) infiltration. Moreover, all groin flaps survived with no signs of tissue necrosis. Conclusions One-per-mil tumescent infiltration into groin flap tissue that had survived ischemia did not result in tissue necrosis, although the flaps experienced a significant decrease of cutaneous oxygenation.

• Archives of Plastic Surgery
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• 제48권1호
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• pp.107-113
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• 2021

Background Applicants to integrated plastic and reconstructive surgery (PRS) residency in the United States spend exorbitant amounts of time and money throughout the interview process. Outside of first-hand experience through a visiting rotation, applicants utilize various resources in learning about a program. Today's applicants are "Millennials," the demographic cohort raised during the information age and proficient with digital technology. The authors evaluated whether programs have a presence on social media, and whether applicants are following these accounts. Methods An online survey was sent to applicants to a single integrated plastic surgery program evaluating basic demographics, social media utilization, and sources of information accessed throughout the residency application process. A manual search of popular social media platforms (Instagram, Facebook, and Twitter) was performed in October 2019. Accounts affiliated with integrated PRS programs were identified and analyzed. Results Eighty-four of 222 applicants (37.8%) completed the survey. Ninety-six percent of applicants were within the Millennial demographic. Ninety-six percent of applicants had some form of social media presence, with Facebook (90%) and Instagram (87%) being the most popular platforms. Seventy-three percent of applicants reported following a PRS residency social media account. As of October 2019, 59 integrated residency programs (73%) have active Instagram accounts. Conclusions Applicants still rely on the program website when researching potential residencies, but social media is being rapidly adopted by programs. Program social media accounts should be used as a dynamic form of communication to better inform applicants of program strengths and weaknesses.

• 융합정보논문지
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• 제11권2호
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• pp.1-9
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• 2021

OASIS는 온라인상의 디지털 정보자원을 체계적으로 수집·관리·보존하기 위해 2004년도부터 시작된 국립중앙도서관의 웹 아카이빙 프로젝트이다. 본 연구에서는 OASIS 웹 사이트의 접속 로그 분석과 이용자 설문조사를 실시하여 다음과 같은 문제점을 도출하였다. 첫째, OASIS 프로젝트에 대한 사람들의 인지도는 매우 낮았고, 웹 사이트의 첫 접속자가 많았다. 둘째, OASIS 이용률 제고를 위한 적극적인 홍보나 서비스 개편 등이 미흡했다. 연구에서는 이에 대한 개선점으로 자체적인 직접 홍보와 타 기관과 연계한 간접홍보를 강화할 것을 제안하였다. 또한 이용자 맞춤형 서비스를 통해 서비스를 고도화하고, 흥미와 재미를 유발하는 콘텐츠 강화할 것을 제안하였다.