• Journal of Korean Neurosurgical Society
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• v.55 no.4
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• pp.200-204
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• 2014

Objective : To evaluate the incidence of postsurgical sensory complications in patients with scalp masses and classify the locations of them from a surgical standpoint according to anatomical considerations. Methods : A total of 121 patients who underwent surgery for scalp mass were included in this study. The authors reviewed medical records and preoperative radiologic images. We investigated the complications related to sensory changes after procedure. Enrolled patients have been divided into three groups. Group A included patients with tumors above the superior nuchal line (SNL), Group B with tumors within the trapezius muscle area and patients who had tumors on the lateral trapezius muscle area were assigned to Group C. We compared the incidence related to postoperative sensory complications and summarized their additional treatments for these with clinical outcome. Results : There were 12 patients (10%) with sensory complications related on the mass excision site (Group A : 1 patient, Group B : 2 patients, Group C : 9 patients). Six patients were affected with lesser occipital nerve (LON), 2 patients on greater occipital nerve (GON) and 4 patients on GON and LON. Over 6 months after surgery, two of the twelve patients with sensory complications did not have complete recovered pain in spite of proper medications and local chemical neurolysis with 1.0% lidocaine and dexamethasone. Conclusion : Occipital neuropathy should be considered as a complication related excision of scalp mass. The sensory complications are more frequent in Group C because of the anatomical characteristics of the occipital nerves and there were no statistical difference for other variables.

• Archives of Plastic Surgery
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• v.46 no.4
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• pp.324-329
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• 2019

Background Multiple approaches for nipple reconstruction exist, and none is considered superior to all others. The star flap is one of the most popular methods for nipple reconstruction, but gradual height loss is a major concern. We present a new modification of the star flap that incorporates a de-epithelialized dermal flap, along with the associated surgical results. Methods We reviewed the medical records of patients who underwent nipple reconstruction using the modified star flap method. The design was different from the conventional star flap in that the lateral wings were changed into a trapezoidal shape and de-epithelialized dermal flaps were added. The patients were followed up at 2, 4, 6, and 12 months postoperatively, and nipple height was measured. The postoperative nipple height achieved using the modified method was compared with that obtained using the traditional method. Results From February 2013 to June 2017, 32 patients received surgery using the modified star flap, and 18 patients who underwent nipple reconstruction before 2013 comprised the conventional method group. All patients had undergone breast reconstruction with an abdominal tissue-based flap. The mean follow-up period was 14.4 months in the modified method group and 17.3 months in the conventional method group. The mean maintenance of projection at 12 months postoperatively was $56.28%{\pm}18.58%$ in the modified method group, and $44.23%{\pm}14.15%$ in the conventional method group. This difference was statistically significant (P<0.05). Conclusions The modified method using a de-epithelialized dermal flap provides reliable maintenance of projection in patients who have undergone abdominal tissue-based breast reconstruction.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.2
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• pp.236-250
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• 2019

Objectives: The purpose of this study was to investigate the effect of intensive rehabilitation programs on pain, range of motion (ROM), lumbar muscle strength, core muscle endurance, disability, and depression in patients with traumatic low back injuries and to compare the efficacy of this therapy with that of conventional rehabilitation therapy. Methods: The study was performed with a retrospective medical chart review of patients with traumatic low back injury referred to the rehabilitation center at the Daegu Hospital of the Korean Workers Compensation and Welfare Service. Forty-four patients were allocated to either the conventional rehabilitation group (CRG; n = 22) or the intensive rehabilitation group (IRG; n = 22). The CRG group patients, who received 30-min therapist-supervised physical therapy and modality therapy five times per week for four weeks, were compared with the IRG group patients, who received 60-min therapist-supervised physical therapy, 30-min therapist-patient 1:1 matching rehabilitation therapy, and modality therapy five times per week for four weeks. Outcome measures were a numerical rating scale, ROM, lumbar muscle strength, lumbar core muscle endurance, thickness of lumbar deep focal core muscle (transverse abdominis and lumbar multifidus), Oswestry disability index (ODI), and depression (Korean version patient health questionnaire-9). Results: There were statistically significant improvements after treatment in all outcome measures in both groups (p < 0.05). In the intergroup comparison, NRS scores on the activity and thickness of lumbar deep focal core muscles increased significantly more in the IRG than in the CRG (p < 0.05). There were no statistically significant intergroup differences in NRS scores on resting, ROM except left lateral bending, lumbar muscle strength, core muscle endurance, ODI, and depression. Conclusions: We could confirm the superior effectiveness of an intensive rehabilitation program compared to conventional rehabilitation therapy in patients with traumatic low back injuries.

• Earthquakes and Structures
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• v.16 no.4
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• pp.469-485
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• 2019

A numerical investigation regarding local (${\mu}_L$) and story (${\mu}_S$) ductility demand evaluation of steel buildings with perimeter moment resisting frames (PMRF) and interior gravity frames (IGF), is conducted in this study. The interior connections are modeled, firstly as perfectly pinned (PP), and then as semi-rigid (SR). Three models used in the SAC steel project, representing steel buildings of low-, mid-, and high-rise, are considered. The story ductility reduction factor ($R_{{\mu}S}$) as well as the ratio ($Q_{GL}$) of $R_{{\mu}S}$ to ${\mu}_L$ are calculated. ${\mu}_L$ and ${\mu}_S$, and consequently structural damage, at the PMRF are significant reduced when the usually neglected effect of SR connections is considered; average reductions larger than 40% are observed implying that the behavior of the models with SR connections is superior and that the ductility detailing of the PMRF doesn't need to be so stringent when SR connections are considered. $R_{{\mu}S}$ is approximately constant through height for low-rise buildings, but for the others it tends to increase with the story number contradicting the same proportion reduction assumed in the Equivalent Static Lateral Method (ESLM). It is implicitly assumed in IBC Code that the overall ductility reduction factor for ductile moment resisting frames is about 4; the results of this study show that this value is non-conservative for low-rise buildings but conservative for mid- and high-rise buildings implying that the ESLM fails evaluating the inelastic interstory demands. If local ductility capacity is stated as the basis for design, a value of 0.4 for $Q_{GL}$ seems to be reasonable for low- and medium-rise buildings.

• Journal of Gynecologic Oncology
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• v.29 no.6
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• pp.87.1-87.4
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• 2018

Objective: Upper paraaortic lymph node dissection (UPALD) to the infrarenal level is one of the most challenging robotic procedures. Because robotic system has the limitation in robotic arm mobility. This surgical video introduces a novel robotic approach, lower pelvic port placement (LP3), to perform optimally and simultaneously both UPALD and pelvic procedures in gynecologic cancer patients using da Vinci Xi system. Methods: The patient presented with high-grade endometrial cancer. She underwent robotic surgical staging operation. For the setup of the LP3, a line was drown between both anterior superior iliac spines. At 3 cm below this line, another line was drown and four robotic ports were placed on this line. Results: After paraaortic lymph node dissection (PALD) was completed, the boom of robotic system was rotated $180^{\circ}$ to retarget for the pelvic lateral displacement. Robotic ports were placed and docked again. The operation was completed robotically without any complication. Conclusion: The LP3 was feasible for performing simultaneously optimal PALD as well as procedures in pelvic cavity in gynecologic cancer patients. The advantage of LP3 technique is the robotic port placement that affords for multi-quadrant surgery, abdominal and pelvic dissection. The LP3 is facilitated by utilizing advanced technology of Xi system, including the patient clearance function, the rotating boom, and 'port hopping' that allows using every ports for a camera. The LP3 will enable surgeons to extend the surgical indication of robotic surgical system in the gynecologic oncologic field.

• Architectural research
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• v.25 no.1
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• pp.1-9
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• 2023

Structural ageing influences the structural performance in a negative way by reducing the seismic resilience of the structure which makes it a major concern around the world. Retrofitting is considered to be a pragmatic and feasible solution to address this issue. Numerous retrofitting techniques are devised by researchers over the years. The viability of using steel bracings as retrofitting component is evaluated on a G+30 storied building model designed according to ACI318-14 and ASCE 7-16. Four different types of steel bracing arrangements (V, Inverted V/ Chevron, Cross/ X, Diagonal) are assessed in the model developed in commercial nu-merical analysis software while considering both material and geometric nonlinearities. Reducing displacement and cost in the structures indicates that the design is safe and economical. Therefore, the purpose of this article is to find the best bracing system that causes minimum displacement, which indicates maximum lateral stiffness. To evaluate the seismic vulnerability of each system, incremental dynamic analysis was conducted to develop fragility curves, followed by the formation of collapse margin ratio (CMR) as stipulated in FEMA P695 and finally, a cost estimation was made for each system. The outcomes revealed that the effects of ge-ometric nonlinearity tend to evoke hazardous consequences if not considered in the structural design. Probabilistic seismic and economic probes indicated the superior performance of V braced frame system and its competency to be a germane technique for retrofitting.

• Korean Journal of Radiology
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• v.2 no.1
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• pp.8-13
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• 2001

Objective: To determine the incidence and etiologies of celiac axis stenosis in asymptomatic individuals. Materials and Methods: This prospective study involved 400 consecutive patients (male: 319, female: 81) referred to us for celiac arteriography between April and July 1999. When celiac axis branches were opacified by collateral circulation during superior mesenteric arteriography, the presence of celiac axis stenosis was suspected; lateral projection celiac arteriography was performed and the pressure gradient was measured. The indicators used to determine whether or not celiac axis stenosis was significant were luminal narrowing of more than 50% and a resultant pressure gradient of at least 10 mmHg. Its etiology was determined on the basis of angiographic appearances and CT findings. Results: Twenty-nine patients (7.3%) had celiac axis stenosis. The etiology of the condition was extrinsic compression due to the median arcuate ligament in 16 patients (55%) and atherosclerosis in three (10%), while in ten (35%) it was not determined. The incidence of celiac axis stenosis did not vary significantly according to sex, age and the presence of calcified aortic plaque representing atherosclerosis. Conclusion: The incidence of hemodynamically significant celiac axis stenosis in this asymptomatic Korean population was 7.3% and the most important etiology was extrinsic compression by the median arcuate ligament of the diaphragm. Atherosclerosis was only a minor cause of the condition.

• Journal of Veterinary Science
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• v.25 no.2
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• pp.22.1-22.15
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• 2024

Background: Achilles tendon is composed of dense connective tissue and is one of the largest tendons in the body. In veterinary medicine, acute ruptures are associated with impact injury or sharp trauma. Healing of the ruptured tendon is challenging because of poor blood and nerve supply as well as the residual cell population. Platelet-rich plasma (PRP) contains numerous bioactive agents and growth factors and has been utilized to promote healing in bone, soft tissue, and tendons. Objective: The purpose of this study was to evaluate the healing effect of PRP injected into the surrounding fascia of the Achilles tendon after allograft in rabbits. Methods: Donor rabbits (n = 8) were anesthetized and 16 lateral gastrocnemius tendons were fully transected bilaterally. Transected tendons were decellularized and stored at -80℃ prior to allograft. The allograft was placed on the partially transected medial gastrocnemius tendon in the left hindlimb of 16 rabbits. The allograft PRP group (n = 8) had 0.3 mL of PRP administered in the tendon and the allograft control group (n = 8) did not receive any treatment. After 8 weeks, rabbits were euthanatized and allograft tendons were transected for macroscopic, biomechanical, and histological assessment. Results: The allograft PRP group exhibited superior macroscopic assessment scores, greater tensile strength, and a histologically enhanced healing process compared to those in the allograft control group. Conclusions: Our results suggest administration of PRP on an allograft tendon has a positive effect on the healing process in a ruptured Achilles tendon.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.397-405
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• 2023

Background: A precontoured plate rarely fits properly within the patient's clavicle and must be bent intraoperatively. This study aimed to determine whether anatomical reduction could be achieved using a plate bent before surgery. Methods: This study included 87 consecutive patients with displaced mid-shaft clavicle fractures who underwent plate fixation and were followed-up for a minimum of 1 year. After exclusions, 39 consecutive patients underwent fixation with a precontoured plate bent intraoperatively (intraoperative bending group), and 28 underwent fixation with the plate bent preoperatively (preoperative bending group). Using free software and a three-dimensional (3D) printer, ipsilateral clavicle 3D-printed models were constructed. Using plain radiographs, the distance between the edge of the lateral inferior cortex and the medial inferior cortex was measured. The angle between the line connecting the inferior cortex edge and the line passing through the flat portion of the superior cortex of the distal clavicle was measured. Results: Mean length differences between the ipsilateral and contralateral clavicle were smaller on both anteroposterior (AP; P=0.032) and axial images (P=0.029) in the preoperative bending group. The mean angular differences on both AP (P=0.045) and axial images (P=0.008) were smaller in the preoperative bending group. No significant differences were observed between the two groups in functional scores at the last follow-up. Conclusions: Smaller differences in length and angle between the ipsilateral and contralateral clavicle, indicative of reduction, were observed in the preoperative bending group. Using the precontoured technique with low expense, the operation was performed more effectively as reflected by a shorter operation time. Level of evidence: III.

• Archives of Craniofacial Surgery
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• v.25 no.2
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• pp.77-84
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• 2024

Background: The facial artery is an important blood vessel responsible for supplying the anterior face. Understanding the branching patterns of the facial artery plays a crucial role in various medical specialties such as plastic surgery, dermatology, and oncology. This knowledge contributes to improving the success rate of facial reconstruction and aesthetic procedures. However, debate continues regarding the classification of facial artery branching patterns in the existing literature. Methods: We conducted a comprehensive anatomical study, in which we dissected 102 facial arteries from 52 embalmed and formaldehyde-fixed Vietnamese cadavers at the Anatomy Department, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam. Results: Our investigation revealed eight distinct termination points and identified 35 combinations of branching patterns, including seven arterial branching patterns. These termination points included the inferior labial artery, superior labial artery, inferior alar artery, lateral nasal artery, angular artery typical, angular artery running along the lower border of the orbicularis oculi muscle, forehead branch, duplex, and short course (hypoplastic). Notably, the branching patterns of the facial artery displayed marked asymmetry between the left and right sides within the same cadaver. Conclusion: The considerable variation observed in the branching pattern and termination points of the facial artery makes it challenging to establish a definitive classification system for this vessel. Therefore, it is imperative to develop an anatomical map summarizing the major measurements and geometric features of the facial artery. Surgeons and medical professionals involved in facial surgery and procedures must consider the detailed anatomy and relative positioning of the facial artery to minimize the risk of unexpected complications.