• Archives of Plastic Surgery
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• v.32 no.2
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• pp.219-226
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• 2005

Muller's muscle-levator aponeurosis advancement procedure was performed to correct mild to moderate congenital blepharoptosis with moderate to good levator function and to correct severe aquired blepharoptosis with poor levator function. Through the blepharoplasty incision, the upper half of the tarsal plate was exposed and the orbital septum was opened to show the levator aponeurosis. The Muller's muscle was dissected from the superior margin of the tarsal plate and from the posteriorly located conjunctiva with sharp scissors. The Muller's muscle and levator aponeurosis were advanced on the anterior surface of the tarsal plate as a composite flap and fixed approximately 3 to 4 mm inferior to the upper edge of the tarsal plate with three horizontal 6-0 nylon mattress sutures. The amount of advancement of the composite flap was controlled by the location of the upper eyelid margin 2 mm below the upper limbus in primary gaze after the first suture in the middle portion of the flap. The excess flap was trimmed off with scissors, but trimming was usually not necessary in cases of mild to moderate ptosis. Nine cases underwent this Muller's muscle-levator aponeurosis advancement procedure from September 2003 to September 2004. Five cases were congenital blepharoptosis with 2-4 mm ptosis and more than 5 mm of levator function, but three of the four acquired ptosis cases had more than 4 mm ptosis with poor levator function. The age of the patients ranged from 7 to 81 years. In operative results, all patients except one traumatic case were within 1 mm of the desired eyelid height in primary gaze. This procedure can provide not only tightening of the Muller's muscle but also advancement and firm fixation of the levator aponeurosis to the tarsal plate, yielding predictable results.

• Archives of Plastic Surgery
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• v.39 no.3
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• pp.216-221
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• 2012

Background : Nipple-sparing mastectomy (NSM) is gaining popularity due to its superior aesthetic results. When reconstructing the breast with free abdominal tissue transfer, we must readdress the recipient vessel, because NSM can cause difficulty in access to the chest vessel. Methods : Between June 2006 and March 2011, a total of 92 women underwent NSM with free abdominal tissue transfer. A lateral oblique incision was used for the nipple-sparing mastectomy. For recipient vessels, the internal mammary vessels were chosen if the mastectomy flap did not block access to the vessels. If it did, the thoracodorsal vessels were used. Age, degree of breast ptosis, weight of the mastectomy specimen, and related complications of the internal mammary vessel group and the thoracodorsal vessel group were compared. Results : Thoracodorsal vessels were used as recipient vessels in 59 cases, and internal mammary vessels in 33 cases including 4 cases with perforators of the internal mammary vessels. Breast reconstruction was successful in all cases except one case involving a total flap failure, which was replaced by a silicone gel implant. The internal mammary group and the thoracodorsal group were similar in terms of age, height, breast weight, and degree of ptosis. The flap related complications such as flap loss and take-back operation rates were not significantly different between the two groups. The rate of nipple necrosis was higher in the internal mammary group. Conclusions : The thoracodorsal vessels could produce comparable outcomes in breast reconstruction after nipple-sparing mastectomies. If access to internal mammary vessels is difficult, the thoracodorsal vessel can be a better choice.

• Journal of the Korean Society of Propulsion Engineers
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• v.17 no.2
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• pp.94-104
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• 2013

A numerical analysis has been conducted to determine the pitch thrust vectoring characteristics of a two-dimensional convergent divergent exhaust nozzle for supersonic aircraft application. The numerical analysis was done by using Fluent and verified by the experimental test results. Analysis was performed with pitch angle of $0^{\circ}$ and $20^{\circ}$ each at the ambient temperature condition. To see the effect of a ratio of pitch flap length and pitch flap height, the ratio was varied from 0.5 to 2.5. The numerical analysis shows that pitch thrust is changed greatly with pitch flap length. The big difference of the pitch thrust with pitch flap length is due to the shock interactions in the nozzle.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.2
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• pp.143-149
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• 2005

Objects : With the advancement of tissue engineering techniques, the effort to develop bioartificial mucosa have been actively delivered. The problem we met with this technique is the lack of mechanical strength between kerationocyte layer and dermal layer, where in the normal skin and mucosa, they are tightly bound with rete ridge structure. The purpose of this study is to understand the 2D and 3D structure of rete ridge of mucosa and skin paddle for rendering more biomimetic structure to the artificial mucosa. Materials and Methods : Oral mucosa and skin from the patients who received the oral surgery and maxillofacial reconstruction were harvested. The epidermis was separated from the dermis after treating with dispase for 12-16 hours. H&E staining was performed for 2D(dimensional) structure study and confocal LASER and SEM study were performed for 3D structure. Mean height(Sc) and arithmetic mean deviation(Sa) of all surface height were calculated. Results : The average height of rete ridge of skin flap was between $67.14{\mu}m$ and $194.55{\mu}m$. That of oral mucosa was between $146.26{\mu}m$ and $167.51{\mu}m$. Pressure bearing area and attached gingiva of oral mucosa showed deeper rete ridges. Conclusion : To obtain the adequate strength of artificially cultured keratinocyte skin and mucosa flap, it is necessary to imitate the original skin and mucosa structure, especially rete ridge. Through this study, 2D and 3D rete ridge structure of normal mucosa and skin was obtained. These results can be used as basis for substrate morphology for keratinocytes culture.

• 한국전산유체공학회:학술대회논문집
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• 2011.05a
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• pp.494-499
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• 2011

One of the devices to prevent separated flow over a wing or a flap at high angle of attack is a vortex generator. In the present work, we numerically study the flow around a low-profile or micro vortex generator whose height is less than local boundary layer thickness which can delay separation with a minimum drag penalty owing to its very small wetted surface area. As a first step toward a parametric study to efficiently design this MVG flow control system, we simulate the flow around a single MVG on a flat plate. For the simulation, we employ OpenFOAM with Launder-Sharma ${\kappa}$-epsilon model. The analysis results are validated by comparing with experimental results of a rectangular MVG at an angle of attack of 10 degrees whose height is 20% of local boundary layer. Important results and aspects of this numerical study are discussed. We also simulate the flow around rectangular, triangular and trapezoidal MVGs and the results are compared

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.20.1-20.7
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• 2015

Background: The objectives of the present study were to investigate the reliability and outcomes of computer-assisted techniques in mandibular reconstruction with a fibula flap and verify whether the surgical navigation system was feasible in mandible reconstructive surgery. Methods: Eight cases were enrolled in the computer assisted surgery (CAS) group and 14 cases in the traditional group. The shaping and fixation of the fibula grafts were guided by computer assisted techniques, which could be monitored with the BrainLAB surgical navigation system. The variation of mandible configuration was evaluated by CT measurement in the Mimics software, including the variation of length, width, height and gonial angle of the mandible. The 3D facial soft tissue alteration was also analyzed in 3D chromatogram by Geomagic software. Results: All 22 fibula flaps survived. The mandibular configurations and facial contours had a better clinic result in the CAS group. The length, width, height and gonial angle of the reconstructive mandible were more similar to the original one. The Wilcoxon rank sum test analysis suggested significant differences in the measurements. The chromatographic analysis also visually showed superiority over the traditional group. Conclusions: The computer assisted surgical navigation method used in mandibular reconstruction is feasible and precise for clinical application. The contour of the reconstructed mandible and facial symmetry are improved with computer techniques.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.637-641
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• 2009

Purpose: Most unilateral secondary cleft lip nose deformities have depressed nostril base and sill on the cleft side. To obtain a symmetric nose, correction of the recession on nostril is critical. The authors have worked out effective methods to elevate the nostril of the cleft side according to the extent of the depression. Methods: A total of 115 unilateral secondary cleft lip nose deformity patients with nostril depression were evaluated. Data were acquired from patients' charts and photography with special reference to the height difference of the nostrils between the cleft side and the non - cleft side. Patients were divided into three groups based on the difference and operated with various techniques : (1) mild degree(< 1 mm) with graft, (2) moderate degree(1 ~ 3 mm) with C - flap or suspension suture of septal cartilage (3) severe degree(> 3 mm) with graft, C - flap and suspension suture. Follow - up period averaged 21.3 months. Results: Forty - six patients(40 percent) were in mild group, and forty - two(37 percent) were in moderate. In twenty - seven patients(23 percent), nostril recession was more than 3 mm. The elevated nostril base and sill were maintained without height alteration during follow - up. Conclusion: The symmetry of the nostril base, especially projection of nostril sill influences successful correction of unilateral cleft lip nose deformity. Our tolerable techniques can be applied to most deformities with nostril depression and can present a new guideline.

• Journal of Korean Society of Coastal and Ocean Engineers
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• v.26 no.3
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• pp.140-148
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• 2014

A storm surge barrier is a specific type of floodgate, designed to prevent a storm surge or spring tide from flooding the protected area behind the barrier. A surge barrier is almost always part of a larger flood protection system consisting of floodwalls, dikes, and other constructions. Surge barriers allow water to pass under normal circumstances but, when a (storm) surge is expected, the barrier can be closed. Among the various means of closing, buoyant flap typed storm surge barrier which was indicated by MOSE project in Italy is chosen for Masan bay protection, and the motion of the surge barrier under the action of storm surge and wave is examined using FLOW-3D, a computational fluid dynamics software analyzing various physical flow processes. Numerical result shows that storm surge barrier is successfully operated under wave height 3 m, and tidal range 2 m.

• Korean Journal of Cleft Lip And Palate
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• v.10 no.2
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• pp.67-74
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• 2007

After Tennison introduced a triangular flap method which, for the first time, preserved the Cupid's bow, Randall gave this method a sound mathematical basis. This method is also called as an inferior triangular cheiloplasty which is characterized by making a small triangular flap from the lateral border of cleft destined to be fitted into an incision on the medial side of cleft. He postulated that the height obtained was equal to the sum of the median of the two triangles used in the cheiloplasty. Using this technique, a 22 month-old male patient with incomplete unilateral cleft lip was corrected primarily. The deviation of the columella and flattening of the nostril on the cleft side were minimal. The operation was done under general anesthesia and patient was healed uneventfully. We tried to improve the symmetry and esthetic feature of philtrum, nostril sill, alar-facial groove, preventing the notch formation on the nostril floor, and to reconstruct the muscle sling in the upper part of lip. The shape of Cupid's bow was restored, and the symmetry of columella was regained as a result. In summary, the inferior triangular cheiloplasty is effective to correct the primary unilateral cleft lip, results in the restoration of favorable anatomy and function.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.740-746
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• 2011

Purpose: In the treatment of the unilateral cleft lip nasal deformities, the correction of the low-nostril height and short-columella are very difficult problems. We report the treatment outcomes of web uni-limb Z-plasty used for correction of unilateral cleft lip nasal deformities by using photographic analysis. Methods: A total of 36 patients with unilateral cleft lip nasal deformities were enrolled in this study, who underwent web uni-limb Z-plasty and were followed up for at least 6 months. First, a triangular flap was made on the medial side of alar-columella web. The nostril apex of cleft side was corrected to a higher point compared to noncleft side by 2 mm. The flap was transposed into the defect of the vestibule. To reduce the bulging of the flap, horizontal cinching sutures were added. Postoperative outcomes were evaluated by using photographic analysis. 2 indices and 1 angle were measured on their photographs taken before and after the surgery. Symmetry was also evaluated by means of the noncleft side to cleft side index. For anthropologic assessment, observers described postoperative outcomes, using Ordinary Scale Method. Results: The postoperative values obtained in photographic analysis improved compared to preoperative ones. More improving anthropologic assessment was shown in post-than pre-operative. Conclusion: Although, further long term follow up is needed, we found this technique to be an effective procedure to the symmetry of nostril apex level and the lengthening of columella in the unilateral cleft lip nasal deformities.