• Archives of Plastic Surgery
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• v.35 no.6
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• pp.663-668
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• 2008

Purpose: Pedicled transverse rectus abdominis myocutaneous(TRAM) flap has been a gold standard for breast reconstruction and one of surgical techniques preferred by many surgeons. The authors examined the course of deep epigastric artery focusing on distance from margins of rectus abdominis to pedicle and location of choke vessels to get minimal muscles during pedicled TRAM flap operation. Methods: Eleven rectus abdominis muscle from nine cadavers were used in this study. Rectus abdominis was separated from the cadavers, deep inferior and superior epigastric artery were isolated and then 8 anatomical landmarks in medial and lateral margins of rectus abdominis were designated. Distance to a pedicle meeting first horizontally was measured and vertical location from umbilicus to choke vessel was determined. In addition, 32 rectus abdominis images of 16 women(average age: 37.2 years old) from 64 channel abdomen dynamic computerized tomography were also examined with the same anatomical landmarks with those of cadavers. Results: Average distance from four landmarks on lateral margin of rectus abdominis to pedicle was 1.9 - 3.4cm and 1.8 - 3.8 cm on medial margin. Choke vessel was located between middle and inferior tendinous intersection in all cases and average distance between two tendinous intersection was 6.7 - 7.0 cm on medial margin and 6.2 cm on lateral margin. Location of inferior tendinous intersection was on umbilicus or superior of it in all cases and its average distance from umbilicus was 1.8 - 5.6 cm on medial margin and 2.7 - 6.2 cm on lateral margin. Conclusion: Distance from medial and lateral margins of rectus abdominis muscle to pedicle was the shortest in inferior tendinous intersection and that was averagely 1.8 cm on medial margin and 1.9 cm in average on lateral margin. All choke vessels were located between middle and inferior tendinous intersection.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.1
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• pp.69-74
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• 1997

The authors compared 20 cases of preoperative and postoperative results in patients with hypernasality who were treated at Yongdong Severance hospital from January 1994 to August 1996. According to the severity of the hypernasality, types of operations such as superior based pharyngeal flap surgery or posterior pharyngeal wall augmentation was selected. The preoperative and postoperative results wert analyzed by 2 otorhinolaryngologists and 1 speech therapist through an endoscopic examination and voice evaluation. follow up period was 1 month to 17 months and mean was 5.6 months. Types of the velopharyngeal closure according to the mobility of soft palate and pharyngeal wall could be divided into 3 types : coronal type(2 cases), sagittal type(4 cases), and circular types(14 cases), The results indicated that sagittal type showed the best result. In surgical treatment for hypernasality, the mobility of the pharyngeal lateral wall and making suitable size of lateral per during surgery were the most important factors affecting the patient's satisfaction.

• The Korean Journal of Pain
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• v.29 no.1
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• pp.57-61
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• 2016

Foraminal or extraforaminal Far Lateral Disc Herniations (FLDH) extending into or beyond the foraminal zone have been recognized as between 7-12% of all lumbosacral disc herniations. Conventional posterior laminectomy may not provide good access to a herniation that lies far lateral to the lateral margin of the pedicle. Use of the endoscopic technique through a percutaneous approach to treat such FLDH patients can decrease the surgical morbidity while achieving better outcomes. We made an effort to utilize the advantages of percutaneous endoscopic lumbar discectomy (PELD) and to determine the appropriate approach for FLDH at the level between the 5th Lumbar and first Sacral vertebrae(L5-S1). The authors present a case of an endoscopically resected lumbar extruded disc of the left extraforaminal zone with superior foraminal migration at the level of L5-S1, which had led to foot drop, while placing the endoscope in the anterior epidural space without facetectomy.

• Journal of the Korean Institute of Electrical and Electronic Material Engineers
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• v.17 no.1
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• pp.27-30
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• 2004

In this paper, a new small size Lateral Trench Electrode Power MOSFET is proposed. This new structure, called "LTEMOSFET"(Lateral Trench Electrode Power MOSFET), is based on the conventional MOSFET. The entire electrode of LTEMOSFET is placed in trench oxide. The forward blocking voltage of the proposed LTEMOSFET is improved by 1.6 times with that of the conventional MOSFET. The forward blocking voltage of LTEMOSFET is 250V. At the same size, a increase of the forward blocking voltage of about 1.6 times relative to the conventional MOSFET is observed by using TMA-MEDICI which is used for analyzing device characteristics. Because the electrodes of the proposed device are formed in trench oxide, the electric field in the device are crowded to trench oxide. We observed that the characteristics of the proposed device was improved by using TMA-MEDICI and that the fabrication of the proposed device is possible by using TMA-TSUPREM4.

• Journal of Information Technology Services
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• v.6 no.2
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• pp.19-33
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• 2007

The current advance of IT and the e-commerce triggers the wide practice of dynamic pricing in all industries although the price discrimination has been very cautiously applied in the limited areas in the past. The price discrimination which offers different prices for each customer depending on their preference and buying behaviors has recently gained attention as it could provide superior benefits to sellers. The wide adoption of price discrimination, on the other hand, is reported to face buyer resistances and complaints. Our limited understanding on the perception of price fairness, which we think is key concept in the price discrimination on the Internet-enabled transactions, motives us to investigate factors that affect the perception of price fairness. This study focuses on illusion of control and lateral customer relationship to investigate their effects on price fairness in online auction and group purchase context. By conducting laboratory experiments, our study demonstrates that customers' perception on illusion of control in price determination and advantageous lateral customer relationship significantly affect price fairness perception in both online auction and group purchase environment. The findings are expected to provide researchers and managers with useful insights to develop better pricing strategies and design effective dynamic pricing mechanisms.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.553-559
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• 2008

Purpose: The lateral orbital wall fractures have been previously classified by some authors. As there are some limitations in applying in their own classifications, we hope to present a refined classification system of the lateral orbital wall fracture and to identify the correlation between the specific type of the fracture and clinical diagnosis. Methods: The facial bone CT scans and medical records of 78 patients with the lateral orbital wall fractures were reviewed in a retrospective manner. The classification is based on the CT scan. In type I, the fracture and its segments are away from the lateral rectus muscle and in type II, they are next to or slightly pushing the muscle in axial CT scan. In type III, the fracture segments compress and displace the longitudinal axis of the muscle or the optic nerve in axial view of CT scan. Type IV fracture includes multiple fractures found around the orbital apex or optic canal in coronal view of CT scans of the type I and type II fractures. Results: The most common fracture pattern was type I(43.6%), followed by type IV(29.5%), type II(20.5%), and type III(6.4%). As diplopia and restriction of extraocular muscles were found in type I and II fractures, severe ophthalmic complications such as superior orbital fissure syndrome, orbital apex syndrome, and traumatic optic neuropathy were found in type III and IV fractures almost exclusively. Conclusion: We propose an easy classification system of the lateral orbital wall fracture which correlates closely with ophthalmic complications and may help to make further treatment plan. In Type III and IV fractures, severe ophthalmic complications may ensue in higher rates, so early diagnosis and treatment should be performed.

• Journal of Korean Neurosurgical Society
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• v.54 no.1
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• pp.25-29
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• 2013

Objective : To clarify the landmark for deciding the entry point for C1 lateral mass screws via the posterior arch by using 3-dimensional (3D) computed images. Methods : Resnick insisted that the C1 posterior arch could be divided into pure posterior and lateral lamina (C1 pedicle). Authors studied where this transition point (TP) is located between the posterior lamina and the C1 pedicle and how it can be recognized. The 3D computed images of 86 cadaver C1s (M : F=45 : 41) were used in this study. Results : The superior ridge of the C1 posterior arch had 2 types of orientation. One was in the vertical direction in the C1 posterior lamina and the other was in the horizontal direction in the C1 pedicle. The TP was located at the border between the 2 areas, the same site as the posterior end of the groove of the vertebral artery. On posterior-anterior projection, the posterior arch was sharpened abruptly at TP. We were unable to identify the TP in 6.4% of specimens due to complete or partial osseous bridges. A total of 93.8% of the TP were located between the most enlarged point of the spinal canal and the medial wall of the vertebral artery. Conclusion : The anatomic entry zone of C1 lateral laminar screws was clarified and identified based on the TP by using preoperative 3D computed images.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.546-551
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• 2006

Purpose: The reconstruction of oropharyngeal defect after cancer surgery is very difficult because of their complicated structure and the functional importance to prevent velopharyngeal incompetence. In this article we investigated affecting factors of velopharyngeal function after reconstruction and a fundamental rule of reconstruction for saving their functions such as swallowing, speeching and breathing. Methods: We classified 18 patients into three group under Kimata's grouping. Type I defect(6 patients) was healed by primary closure or secondary intention. In Type II or III defect, two operation methods were used - the folded flap(8 patients) and modified Gehanno method(4 patients), which include a lateral-posterior pharyngeal rotation-advancement flap. We evaluated wound dehiscence between the flap and the soft palate, speech intelligibility using Hirose's method, regurgitation during oral feeding, and hypernasality. Results: Most of type I or II defects patients recovered satisfactory velopharyngeal function. But, in patients with type III defects we found wound dehiscence, worse speech function, and common velopharyngeal incompetence. Conclusion: The large defect size and presence of wound dehiscence are major factors of postoperative velopharyngeal function. We conclude that folded flap or modified Gehanno method is a good reconstructive operation method for broad contact between the flap and defect site, preventing wound problem.

• Journal of Oral Medicine and Pain
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• v.17 no.2
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• pp.63-73
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• 1992

This study was performed for the purpose of investigating the relation between width of temporomandibular joint space and craniofacial morphology in patients with CMDs. The subjects utilized here were aged from 16 to 63 years old and 19 male and 46 female. For the study, each patient was taken radiographs by Transcranial and Lateral Cephalographic projection and the films were traced with routine method. The measured items were anterior, superior, posterior joint space and relative condylar position to the deepest part of glenoid fossa in Transcranial film and items related vertical and/or horizontal growth in Cephalogram. The data were processed with SPSS/PC+ package for statistical analysis. The obtained results were as follows : 1. Anterior joint space in affected side were wider than that of unaffected side, but for superior and posterior joint space, the value of unaffected side were more than those of affected side. 2. Superior or posterior joint space of affected side were significantly correlated with items related vertical growth, such as ramus height, Jarabak ratio, FMA. From this, the following cold be proposed, the wider the joint space of superior or posterior aspect of affected side was, the more the patient showed growth pattern of counter clockwise. 3. Superior or posterior joint space of affected side were significantly correlated with items related horizontal growth, such as SNPo, NAPo, APDI and ANB. From this the following could be proposed, the wider the joint space of superior or posterior aspect of affected side was, the more the patient showed anterior displacement of mandible. 4. It would be proposed that the diagnositic value of superior and posterior joint space of affected side in transcranial radiograph was excellent.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.595-599
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• 2010

Purpose: Trochanteric pressure sores management has been improved through the development of musculocutaneous flaps. But it has many drawbacks such as donor site morbidity and functional muscle sacrifice. With the introduction of perforator flap, it is possible to use in every location where musculocutaneous perforators are present. We have reconstructed trochanteric pressure sores using perforator-based flaps from the ascending branch of lateral circumflex femoral artery. Methods: Between May of 2006 and April of 2008, we performed six cases of perforator-based flap from the ascending branch of lateral circumflex femoral artery for the coverage of trochanteric pressure sores. For identifying perforators, a line was drawn from the anterior superior iliac spine to the superolateral border of the patella as the vertical axis, from the pubis to the trochanteric prominence as the horizontal axis. In the lateral aspect of the intersection of these two axes, various flap were designed according to its defects. The flap was raised in the subcutaneous plane above the fascia and the pedicle was traced by doppler and identified. The pedicle was meticulously dissected not to injure the periadventitial tissues and transposed to the defect. The donor site was closed primarily. Results: The mean age of patients was 56.2 years. Four male and two female patients were studied. Five patients were paraplegic. The mean defect size was $6{\times}4\;cm$. The largest flap dimension was $14{\times}7\;cm$. Donor sites were closed primarily without any complications. All flaps survived completely without necrosis, hematoma or infection. There were no recurrence during the follow-up period. Conclusion: Trochanteric pressure sores using perforator-based flap from the ascending branch of lateral circumflex femoral artery can be performed safely and it would be a reliable option for coverage of trochanteric pressure sores with minimal donor site morbidity.