• Archives of Plastic Surgery
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• 제32권4호
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• pp.447-453
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• 2005

The coverage of soft tissue defects around the knee joint or upper one third of lower leg presents a difficult challenge to the reconstructive surgeon. Various reconstructive choices are available depending on the location, size and depth of the defect. The authors present their clinical application of a medial sural artery perforator island flap as a useful alternative method for upper one third of lower leg and knee reconstruction. From 2002 to 2004, we operated total 4 patients (total 4 flaps) using the medial sural artey perforator island flap for coverage of the defect on upper one third of lower leg and knee, of 4 patients, 3 patients was men and one was woman. Average patient age was 54.6 years. The largest flap obtained was 10x8cm2. Postoperative follow up of the patients ranged from two to 33 months. In two cases, defects was located on upper one third of lower leg and in other two cases, defects were on the knee. All four cases had bone exposure open wound. In angiography, 2 cases had injured in the anterior tibial artery, 1 case had injured in the posterior tibial artery. There were no diabetes or other vascular disease. All 4 flaps were survived completely, without minor complications such as venous congestion and hematoma. Donor morbidity was restricted substantially to the donor linear scar. There were no functional impairment. As the main advantages of the medial sural perforator island flap, it ensures constant location and reliable blood supply without sacrificing any main source artery or damaging underlying muscle. This procedure is valuable extension of local flap for defect coverage with minimal functional deficit donor site and good aesthetic result on the defect. We consider it as one of the useful methods of the upper one third of lower leg and knee reconstruction.

• Archives of Plastic Surgery
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• 제32권2호
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• pp.199-204
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• 2005

The nose is the most prominent area of the face, therefore susceptible to trauma and skin cancer. When small sized defect is in nasal tip, it results in disturbance of the facial harmony even if replantation, composite graft, skin graft or median forehead flap has been used for the reconstruction. So it is needed that the best method reconstruction is performed according to the degree of defect or deformity. And at the same time the physiology and anatomy of nose were clarified and its aesthetic subunits were employed. How can we cover the about 3 cm sized nasal defect in nasal tip with cartilage exposure? At first, we can think forehead island flap is most appropriate. We performed 7 cases of the forehead island flap for reconstruction of the defect in nasal tip(4 cases: cancer, 3 cases: trauma) from March, 2001 to August, 2004. This result was satisfactory in the point of texture, color, donor scar, and there were no complication such as wound disruption, infection, flap atrophy, and hematoma. The advantages of forehead island flap are: 1) No injury of deep vessel and nerve, 2) control of shape and volume, 3) Short operation time, 4) primary closure of donor site, 5) one stage operation. Also, forehead island flap can cover the defect in nose where skin graft and local flap can not cover. But, operator always must take care for flap congestion and donor site scar. We thought forehead island flap is one of the best option of reconstruction of nasal tip defect.

• Archives of Plastic Surgery
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• 제32권4호
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• pp.485-490
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• 2005

Fingertip is the end of tactile organ and the part of hand most frequently injured. Fingertip injuries should be evaluated on an individual basis considering patient's overall physical condition, medical history, etiology, time of injury, and anticipated future hand use, and accordingly one of various methods of reconstruction should be selected. Complications after the reconstruction of fingertip injuries have been reported as pain, hypersensitivity, numbness, distal paresthesia, cold intolerance, and atrophy. From January to December 2002, dermofat grafts were performed on 15 patients to correct painful fingertips after injury. The thickness of the soft tissue of fingertip was measured both preoperatively and postoperatively with simple X-ray. To evaluate the improvement of pain, visual analogue scale(VAS) was used through the direct interview with patients. The average of postoperative follow-up period was 10.9 months. The average of increased soft tissue thickness ratio was 88.4%(2.3mm to 3.8mm). The average of preoperative VAS was 7.6, and postoperative VAS was 3. Dermofat graft on fingertip needs a further long-term follow-up study for the absorption ratio of dermofat, however, this procedure is simple and could be done under local anesthesia, and would be a useful alternative procedure to correct painful fingertips with the soft tissue atrophy after injury.

• Archives of Plastic Surgery
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• 제32권2호
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• pp.183-188
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• 2005

Defect on the temporal area caused by, surgical ablation of a tumor or an infection should be reconstructed immediately to prevent potentially life-threatening complications such as meningitis and cerebrospinal fluid leakage. The defect on the temporal area usually presents as a typical 'cone-shape'. Successful reconstruction requires sufficient volume of well-vascularized soft tissue to cover the exposed bone and dura. From 1994 through 2003, the authors applied rectus abdominis free flap for the reconstruction of the temporal defect from 1994 through 2003. There were 10 patients with a mean age of 52.1 years. Of these 10 patients, external auditory canal cancer was present in four patients, temporal bone cancer in two, parotid gland cancer in one and three patients were reconstructed after debridement of infection(destructive chronic otitis media). All the free flaps survived, and flap-related complications did not occur. Compared to a local flap, the rectus abdominis free flap can provide sufficient volume of well-vascularized tissue to cover the large defect and can be well-tolerated during an adjuvant radiation therapy. The long and flat muscle can be easily molded to fit in to the 'cone-shape' temporal defect without dead space. It is also preferred because of the low donor site morbidity, a large skin island and an excellent vascular pedicle. Two-team approach without position change is possible. In conclusion, the authors think that rectus abdominis free flap should be considered as one of the most useful method for the reconstruction of a cone-shaped temporal defect.

• Archives of Plastic Surgery
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• 제32권2호
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• pp.175-182
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• 2005

Skull base tumors have been determined inoperable because it is difficult to accurately diagnose the extent of the involvement and to approach and excise the tumor safely. However, recently, the advent of sophisticated diagnostic tools such as computed tomography and magnetic resonance imaging as well as the craniofacial and neurosurgical advanced techniques enabled an accurate determination of operative plans and safe approach for tumor excision. Resection of these tumors may sometimes result in massive and complex extirpation defects that are not amenable to local tissue closure. The purpose of this study is to analyze experiences of skull base reconstruction and to evaluate long term survival rate and complications. All cranial base reconstructions performed from July 1993 to September 2000 at Department of Plastic and Reconstructive Surgery of the Seoul National University Hospital were observed. The medical records were reviewed and analysed to assess the location of defects, reconstruction method, existence of the dural repair, history of preoperative radiotherapy and chemotherapy, complications and causes of death of the expired patients. There were 12 cases in region II, 8 cases in region I and 1 case in region III according to the Irish classification of skull base. Cranioplasty was performed in 4 patients with a bone graft and microvascular free tissue transfer was selected in 17 patients to reconstruct the cranial base and/or mid-facial defects. Among them, 11 cases were reconstructed with a rectus abdominis musculocutaneous free flap, 2 with a latissimus dorsi muscluocutaneous free flap, 1 with a fibular osteocutaneous free flap, 2 with a scapular osteocutaneous free flap, and 1 with a forearm fasciocutaneous free flap, respectively. During over 3 years follow-up, 5 patients were expired and 8 lesions were relapsed. Infection(3 cases) and partial flap loss(2 cases) were the main complications and multiorgan failure(3 cases) by cancer metastasis and sepsis(2 cases) were causes of death. Statistically 4-years survival rate was 68%. A large complex defects were successfully reconstructed by one-stage operation and, the functional results were also satisfactory with acceptable survival rates.

• Archives of Plastic Surgery
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• 제39권2호
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• pp.106-112
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• 2012

Background : Complicated diabetic patients show impaired, delayed wound healing caused by multiple factors. A study on wound healing showed that platelet-rich plasma (PRP) was effective in normal tissue regeneration. Nonetheless, there is no evidence that when platelet-rich plasma is applied to diabetic wounds, it normalizes the diabetic wound healing process. In this study, we have analyzed matrix metalloproteinase (MMP)-2, MMP-9 expression to investigate the effect of PRP on diabetic wounds. Methods : Twenty-four-week-old male Otsuka Long-Evans Tokushima Fatty rats were provided by the Tokushima Research Institute. At 50 weeks, wounds were arranged in two sites on the lateral paraspinal areas. Each wound was treated with PRP gel and physiologic saline gauze. To determine the expression of MMP-2, MMP-9, which was chosen as a marker of wound healing, reverse transcription polymerase chain reaction (RT-PCR) was performed and local distribution and expression of MMP-2, MMP-9 was also observed throughout the immunohistochemical staining. Results : RT-PCR and the immunohistochemical study showed that the levels of MMP-2, MMP-9 mRNA expression in PRP applied tissues were higher than MMP-2, MMP-9 mRNA expression in saline-applied tissues. MMP-9 mRNA expression in wounds of diabetic rats decreased after healing began to occur. But no statistical differences were detected on the basis of body weight or fasting blood glucose levels. Conclusions : This study could indicate the extracellular matrix-regulating effect observed with PRP. Our results of the acceleration of wound healing events by PRP under hyperglycemic conditions might be a useful clue for future clinical treatment for diabetic wounds.

• 디자인학연구
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• 제18권1호
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• pp.253-262
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• 2005

급변하는 멀티미디어시대에 백화점은 지역 소비자들의 문화적 욕구를 충족시키는 장소역할 뿐 아니라 새로운 라이프스타일의 추구와 소비패턴의 연출장소로도 활용되고 있어 소비자들의 구매 욕구를 불러일으키기 위한 비주얼머천다이징의 중요성은 더욱 더 커지고 있다. 본 논문은 백화점 화장품매장에서 여성고객이 화장품을 구매할 때 비주얼머천다이징 전략이 어떠한 영향력이 있는지 그 선호도를 설문조사하여 분석하였는데 그 결과를 보면 다음과 같다. 매장디자인 연출구성에 있어서 색채와 P.P(Point of Sale Presentation)의 선호도가 일반요인인 상품의 품질, 가격, 직원서비스 다음으로 중요한 것으로 나타남에 따라 화장품기업들은 비주얼머천다이징전략을 시행할 때 제품의 판매촉진을 위해 각 브랜드의 차별화 된 트레이드컬러의 제시와 P.P 즉, 분류된 상품의 판매 포인트를 상품정보와 함께 표현, 연출하는 것이 무엇보다 중요하다고 할 수 있다.

• 디자인학연구
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• 제20권
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• pp.1-10
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• 1997

90년대 들어서 국내 패션시장은 소비자들의 생활수준향상, 라이프 스타일의 변화와 함께 해외 라이센스 브랜드 도입의 증가와 대기업은 물론 중소기업들의 신규참여 또한 증가하는 추세에 있다. 이러한 급변하는 시장환경 속에서 오랜 전통과 기술력을 가지고 있는 선발 패션업체로서 주식회사 세정의 인디안 브랜드는 90년대 현 상황에서 타 브랜드들과의 경쟁에서 상대적 우위를 선점 하고 미래의 소비자들을 충족시킬 수 있는 새로운 이미지 정립이 절실히 필요한 상황이다. 이러한 시점에서 (주)세정의 인디안 브랜드 이미지 제고를 위하여 경영환경의 입체적 마아케팅 조사를 실시, B.I. 컨셉을 설정한 후 시각적 이미지 표현작업에 착수하였다. 그 후 설문조사를 통해 Logo mark를 결정한 후 인디안 B.I의 주요 디자인 항목인 기본 요소와 응용요소를 전개, 전체 디자인 시스템을 완성하였다. 그리고 브랜드 이미지 통일의 효과를 극대화하기 위해 보완되어져야 할 요소로는 디자인 조형상의 원칙준수와 철저한 관리, 브랜드 관련 전체 구성원들의 사고와 행동의 일치, B.I의식 실천을 위한 지속적인 교육프로그램의 실시 등이 요구된다.

• 디자인학연구
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• 제20권1호
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• pp.33-44
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• 2007

1957년에 미국의 지원 하에, 미국인에 의해서 한국에 설립되어 3년간 운영되었던, 우리나라 최초의 디자인 진흥기관인 '한국공예시범소'의 행적을 살펴본다. 1장에서는 미국 Smith, Scherr & McDermott Industrial design, Arkon Office의 한국지원 활동내용을 연대기순으로 개괄하고, 2장에서는 한국내 KHDC의 설립, 과정과 구성, 기능을 살펴본다. 3장은 KHDC의 활동내용을 살펴본다. 수공예 프로젝트와 경공업 프로젝트, 전시, 현지답사 연구와 현지산업 지원활동, 교육 프로그램, 언론의 보도내용 등을 살펴봄으로써 실제로 한국 내에서 행했던 활동들을 구체적으로 다뤘다. 4장에서는 공예시범소의 활동성과를 살펴본다. 수공예 프로젝트와 경공업 프로젝트를 통하여 이뤄낸 성과들과 개발된 상품들, 그리고 대외적인 활동의 성과를 살펴보고, 5장에서는 제 활동들의 성과를 살펴보고 종합적인 평가를 한다.

• 디자인학연구
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• 제20권1호
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• pp.111-120
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• 2007

본 연구는 우리의 현대 건축이 극복해야할 과제인 지역적, 역사적 문제점의 해결방안으로써 맥락적 공간 표현을 하나의 가능성으로 제시하고 있다. 모더니즘 건축이 역사적, 장소적 맥락의 특수성을 거부하고 익명적인 공공성만을 지향하였다면, 이후의 포스트모던 건축, 지역주의건축 등은 다양한 역사적, 환경적 요소를 적극적으로 이용하여 단절되었던 맥락의 의미를 되살리고자 노력하였다. 그러나 이러한 시도들은 맥락을 피상적으로만 이해하여 건축의 소재로만 차용하였을 뿐, 끊임없이 변화하는 맥락을 수용해내지 못했다. 이러한 현대의 변화하는 맥락성에 대응 할 수 있는 공간 계획을 설명할 수 있는 건축가로 장 누벨을 선정하여 그의 건축공간에서 맥락적 표현 특성을 파악하고 작품을 사례로 분석하고자 하였다. 우선 맥락주의의 이론적 고찰을 바탕으로 건축적 맥락의 특징을 장 누벨의 맥락적 공간 표현과 비교하여 그 관계성을 찾았고, 위상기하학적 조작, 표피의 물질성, 투명성을 통하여 장 누벨이 단지 건축과 공간 내부에만 머물지 않고 자신을 둘러싼 세계를 이해하고 독창적인 해석과 표현방식을 통해 맥락성을 표현하고자 하였다. 그래서 본 연구를 통해 맥락성이란 임의적으로 추출되어 공간화 및 고정화된 것이 아니라, 과거에서부터 지금까지 그리고 앞으로도 지속적으로 흐르고 변화하는 유동적인 개념으로 받아들여야 할 것임을 시사해주고 있다.