• Archives of Plastic Surgery
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• v.35 no.4
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• pp.439-445
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• 2008

Purpose: Malignant fibrous histiocytoma(MFH) is the most common soft tissue sarcoma in adult. As to this date, tissue development, treatment and prognosis of the tumor has not been definitely clarified, however, it has been reported that wide surgical resection of the tumor along with the radiotheraphy and chemotheraphy is needed for treatment. In MFH with high recurrence rate, the reconstruction method and points to be considered for reconstruction in recurrent case were studied in 10 patients who were treated in our hospital. Methods: From August of 1991 to August 2007, location of tumor, initial mass size, 1st recurred period, lymph node metastasis, recurrence rate, treatment modality, complication, reconstruction in recurrent defect, and follow up period was studied in 10 patients who underwent reconstruction at our Plastic surgery department following wide excision. Results: The average age was 62.8(46 - 73) years old, average follow up period was 7.7(1 - 17) years. Various reconstructions has been performed for recurrent cases and postoperative chemotheraphy and radiotheraphy was done. As for reconstruction in recurrent cases, After wide excision, local flap was performed in 6 cases, and free flap in 2 cases. After radiotherapy, osteoradionecrosis was occurred in 4 cases. Recurrence rate was 1 - 5(2.6) times and reconstruction due to recurrence was 7 out of 10 cases(70%). Conclusion: The treatment modality of MFH is not yet defined. Due to it's high recurrence rate, radiotherapy and chemotherapy is commonly combined with surgery. Even still, additional excision and reconstruction may be required. Therefore, possibility of re-operation must be considered when performing every excision and reconstruction; in case a recurrence or osteoradionecrosis occurs. Free flap coverage should be left as the last resort, according to the principle of reconstruction. Nevertheless, if the defect is large or osteoradionecrosis is present, it will benefit greatly to the patient's quality of life.

• Archives of Plastic Surgery
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• v.44 no.6
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• pp.482-489
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• 2017

Background Polydeoxyribonucleotide (PDRN) is known to have anti-inflammatory and angiogenic effects and to accelerate wound healing. The aim of this study was to investigate whether PDRN could improve peripheral tissue oxygenation and angiogenesis in diabetic foot ulcers. Methods This was a prospective randomized controlled clinical trial. Twenty patients with a non-healing diabetic foot ulcer were randomly distributed into a control group (n=10) and a PDRN group (n=10). Initial surgical debridement and secondary surgical procedures such as a split-thickness skin graft, primary closure, or local flap were performed. Between the initial surgical debridement and secondary surgical procedures, 0.9% normal saline (3 mL) or PDRN was injected for 2 weeks by the intramuscular (1 ampule, 3 mL, 5.625 mg, 5 days per week) and perilesional routes (1 ampule, 3 mL, 5.625 mg, 2 days per week). Transcutaneous oxygen tension ($TcPO_2$) was evaluated using the Periflux System 5000 with $TcPO_2/CO_2$ unit 5040 before the injections and on days 1, 3, 7, 14, and 28 after the start of the injections. A pathologic review (hematoxylin and eosin stain) of the debrided specimens was conducted by a pathologist, and vessel density (average number of vessels per visual field) was calculated. Results Compared with the control group, the PDRN-treated group showed improvements in peripheral tissue oxygenation on day 7 (P<0.01), day 14 (P<0.001), and day 28 (P<0.001). The pathologic review of the specimens from the PDRN group showed increased angiogenesis and improved inflammation compared with the control group. No statistically significant difference was found between the control group and the PDRN group in terms of vessel density (P=0.094). Complete healing was achieved in every patient. Conclusions In this study, PDRN improved peripheral tissue oxygenation. Moreover, PDRN is thought to be effective in improving inflammation and angiogenesis in diabetic foot ulcers.

• Archives of Reconstructive Microsurgery
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• v.8 no.2
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• pp.154-162
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• 1999

The laryngopharyngectomy for tumor ablation is the most common indication for pharyngoesophageal reconstruction in our country. Most of these cases are advanced laryngeal cancer that has spread beyond the larynx, pharynx and cervical esophagus. Such patients are obviously unable to breathe, swallow, or speak in the normal manner. The ideal reconstruction would restore normal anatomy, permitting patients to breathe and swallow without aspiration, and would not require a permanent tracheostomy. Reconstruction of the pharyngoesophageal defect traditionally been carried out with tubed local random flap, deltopectoral or musculocutaneous flap. Another approach is the pedicled enteric flap. But microsurgical reconstruction of the pharyngoesophagus, using either the free jejunal or the tubed radial forearm flap, have now become the preferred technique. Among them, we used jejunal free flap in 39 cases, tubed radial forearm free flap in 5 cases, patched radial forearm free flap in 2 cases and pectoralis major myocutaneous island flap in 2 cases from December 1990 to Febrary 1999. In this paper we illustrated that both forearm and jejunal free flap is a usful alternative in reconstruction of hypopharynx and cervical esophagus.

• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.68-71
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• 2012

Purpose: Eczema herpeticum, caused by herpes simplex virus, is an infectious disease involving skin and internal organs. Varieties of physiologic, psychosocial, or environmental stress reactivate reservoir virus which exists in the trigeminal nerve ganglia. Authors report rare cases of nasal eczema herpeticum following corrective rhinoplasty. Methods: First case, 22-year-old female underwent corrective rhioplasty through an external approach in a local clinic. She developed progressive and painful erythema, nodules and vesicles on nose on the 9th day postoperatively. This unfamiliar lesion lead to a misdiagnosis as a bacterial infection, and had accelerated its progress to the trigeminal innervation of the nasal unit. Second case, a 23-year-old female underwent corrective rhinoplasty by external lateral osteotomy. Ten days after the surgery, disruption occurred on the external osteotomy site, and the ulceration gradually worsened. The surgeon misdiagnosed it as secondary bacterial infection and only an antibacterial agent was applied. Results: Both cases were healed effectively without any complication with proper wound dressing and antiviral therapy, and show no sequelae during an 8-month follow-up period. Conclusion: Eczema herpeticum is rare in the field of plastic surgery, but it should be kept in mind that secondary bacterial infections may lead to serious complications such as full-thickness skin loss. Thus, acknowledgement of the patient's past history regarding perioral or intraoral lesion may provide the surgeon with the possible expectancy of eczema herpeticum. Thus, if anyone develops eczema herpeticum, following facial plastic surgery, early diagnosis and immediate proper antiviral therapy will allow fast recovery without serious complications.

• Archives of Craniofacial Surgery
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• v.17 no.2
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• pp.56-62
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• 2016

Background: The two most common skin cancers are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The purpose of this study was to describe the detailed clinical behavior of BCC and SCC in the head and neck region over 19 years at a single institution. Methods: A retrospective analysis was performed for all patients with non-melanoma skin cancer who had undergone surgical resection over an 18-year period. Patient charts were reviewed for demographic information, tumor size, onset-to-diagnosis, anatomic location, clinical subtype, histologic differentiation, method of surgical treatment, and recurrence. Results: The review identified 265 cases of either BCC or SCC in 226 patients. Of the 226 patients, 80 (35.4%) were men and 146 (64.6%) were women. BCC (n=138, 55.9%) was more frequent than SCC (109, 44.1%). The most frequent age group was 70-to-79 year olds (45 patients, 35.2%) for BCC and 80-to-89 year olds (41 patients, 41.8%) for SCC. By aesthetic units of the face, the most common location was the nasal unit (44 cases, 31.9%) for BCC and the buccal unit (23 cases, 21.1%) for SCC. The most common clinical subtype of BCC was the nodular type (80 cases, 58.0%). Local flaps were most commonly used to cover surgical defects (136 cases, 55.1%). Recurrent rates were 2.2% for BCC and 5.5% for SCC. Conclusion: In our study, many characteristics of BCC and SCC were compared to previously published reports were generally similar, except the ratio of BCC to SCC. Further study can help to establish the characteristics of BCC and SCC.

• Archives of design research
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• v.17 no.4
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• pp.201-210
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• 2004

This study is to analyze the present situation of Incheon design and to research Incheon industrial design with the special character of the city. Next, the final purpose is to apply this study for the Incheon International Design Competition event that will be held first time sponsored by Incheon Metropolitan. Incheon is Metropolitan which has 2.6 million people and the entrance of seoul Metropolitan which is the center of export industry and one of the greatest industrial city. It is growing the hub of International trade city of the twenty-first centry due to the opening of Incheon International Airport and the new development of Song-do city. The industrial structure of Incheon is mostly consist of small industry centered which has a lack of design development capacity, and it has a little insufficient design-related institutes which can educate the design personnel. It has only two universities and six junior colleges. Especially, design-related academics and exhibitions are rare nearby Seoul area. I will contribute the study which makes the industrial character and the necessity of design that can be possible through the Incheon International Design Exhibition, and it will promote the backward design industry and economy of Incheon that compared to other regions of Korea. And, I am going to utilize as basic data bases for exercising advanced Incheon Industrial Design Competition. Furthermore, I would like to contribute the image improvement of new International Incheon Metropolitan through the training of excellent design experts and finding design-related personnels which can be accomplished the cooperation among local autonomy, industries and schools.

• Archives of design research
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• v.19 no.2 s.64
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• pp.109-120
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• 2006

Part of public arts, environmental builforms not only enhance the beauty of a building, but also serve to stabilize the citizen's psychology and as a landmark having intimate values with the city environment and symbolic meanings. Thus they do have sociocultural values as an original formative artwork. The purpose of this study was to suggest evaluation and review methods and an evaluation framework for environmental builtforms, which had legal binding under the building decoration system, to a local government to improve the quality level of urban environment. It will be such a distant goal of creating a desirable urban environment as long as environmental builtforms are merely regarded as an object to follow a vogue and a mandatory passage procedure. It's important to take a perspective of an expert to set up and suggest an evaluation system in the public aspects. In the study a consideration was made of the current systems and review criteria of environmental builtforms, which was followed by the development of a theoretical research model and of a framework for statistical evaluation by a group of experts. The questionnaire designed based on the theoretical research model was tested for validity and reliability. Its pilot test results were then analyzed to verify the hypotheses. The questionnaire collected twice were statistically analyzed in exploratory and confirmatory factor analysis with the SPSSWIN 11 program. All the analysis results were used to come up with a final evaluation framework.

• Archives of design research
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• v.17 no.3
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• pp.231-244
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• 2004

The curriculum in the vocational training shall be planed and operated on a basis what is the occupational category that the students can be employed after their graduation and the ability necessary to the engagement in their occupations. Accordingly, the course selecting the quality of education in the curriculum plan for the vocational training shall be developed continuously and gradually through the maintenance of dose relation by the participation of the persons in the industries related to the major field. If the curriculum in the vocational training is for the preparation of employment, the focus of curriculum shall be adjusted to the employment. It needs to collect and analyze the related data between the universities and industries, particularly regional industries synthetically in order to develop the curriculum in the vocational training. The curriculum shall be planned on a basis of the data. As for the data related to the local community, it needs to develop new programs considering the prospect of demand of manpower by the industry, necessary knowledge, technology and attitudes, particularly considering the occupational category available in the employment with a bright prospect hereafter. Also, the contents to improve in the existing curriculum(a change of technology, a form of facilities for experimentㆍpractice, and a type of continuing & further education) shall be investigated and analyzed objectively. Accordingly, this study is to develop the curriculum more systematically in order to foster the character designer specially who to engage in the character industry that increases its role and expectation all the more with the development of animation industries and the extension of markets now. The purpose of this study is to decrease the estrangement between the school education that has been problems and the practical affairs in the field, to foster the special manpower that can satisfy the industries demand.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.477-484
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• 2011

Purpose: Retro-orbicularis oculi fat (ROOF) and preseptal fat pad (PSF) are deep fat structures of frontal and supraorbital area, that encounter galeal fat pad (GFP). If galeal wall is weakened by aging process, GFP loses its anchoring structure, moved downward pushing ROOF and PSF. This especially occur in lateral brow area. As a result of drooping, eyebrow affects the eyelid covering PSF as a sac descended to a lateral hooding and ptotic eyelid simultaneously. Consequently, in the case of lateral hooding and brow ptosis, besides the skin, deep fat structures (ROOF and PSF) should be corrected as well. Methods: ROOF-PSF repositioning technique in subbrow resection were performed. 21 cases of patients from April, 2007 to January, 2008. Before surgery, all patients were examined carefully to evaluate the degrees of dermatochalasia, drooping of the eyebrow, marginal reflex distance 1 (MRD1), eyelid crease height. Surgery was performed under local anesthesia, then excised the drooped eyelid skin by lateral subbrow resection, removed proper amount of ROOF, repositioned ROOF-PSF at the supraorbital rim, and fix it on periosteum. During follow up periods, the patients were surveyed of the satisfaction of surgery, and postoperative MRD1 was evaluated. Results: One patient had a hematoma on left eyebrow, and another one patient had a numbness on left forehead for two months. Except for these two patients, all patients had good results without any significant complications. The mean follow up period was about 5 months, and the position of lateral eyebrow maintained above the supraorbital rim in all cases. Postoperatively, MRD1 increased by 0.8 mm in 5-months mean follow up period. Conclusion: In patient with lateral brow ptosis and lateral hooding, the ROOF-PSF repositioning technique in sub-brow resection could be a good operative option.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.383-390
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• 2011

Purpose: To correct the upper lip depression after the correction of unilateral cleft lip, autologous grafts such as bone, dermal, fascial grafts and fat injections or alloplastic implants are used. Transplanted bones, dermis and fascia have a tendency to be absorbed and have donor morbidity. Fat injections are absorbed inconsistently and alloplastic implants have problems such as foreign body reactions, protrusions and infections. Authors corrected the upper lip depression using conchal cartilage graft in unilateral cleft lip deformity and the results was analysed with photos. Methods: 26-unilateral cleft lip and 2-microform cleft lip cases, totally 28 cases were performed. Their mean age was 21.89 years. The male and female cases were 12 and 16, respectively. Under anesthesia (general: 18 cases and local: 10 cases), cavum conchae (n=8), cymba conchae (n=16) and whole conchae (n=4) were harvested. Transversely cut the margin of the obtained cartilage, we cut out the most bent portion and put a partial-thickness incision on concave surface in cases of excessive convexity. Then, we performed the onlay graft of the conchal cartilage via scar revision site in unilateral cleft lip and via the reconstruction site of the cupid bow in microform cleft lip. The augmentation of the upper lip was evaluated with photos. Adapting the baseline connecting between the both cheilions as a horizontal standard line, we measured the highest point among the tangents between the upper lip and nose (point a), the lowest point (point c), the middle point between a and c (point b) and the vertical line from the alare (point d) to the horizontal standard line. To assess the postoperative symmetry, we compared cleft side upper lip contour index (%) A,B,C,D=(a,b,c,d)-ch ${\times}$ 100/(ch-ch) and non-cleft side upper lip contour index (%) A',B',C',D'= (a',b',c',d')-ch ${\times}$ 100 / (ch-ch).h) Results: After the surgery, no complication was found except in one case which double layers graft performed in the cleft lip deformity, the lateral portion was protruded. The upper lip contour index, the difference of A and A' were-0.83%, and thus the mild depression was persisted. Difference of B and B', C and C', D and D' were 0.83%, 1.07%, 0.90%. There were statistically significant difference, and thus the depression of upper lip were improved generally. Conclusion: Authors performed the onlay graft of the conchal cartilage in unilateral cleft lip deformity and found that the depression of the upper lip was well corrected except the uppermost part when photogrammetrically analyzed.