• Archives of Plastic Surgery
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• v.49 no.2
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• pp.174-183
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• 2022

Management of traumatic skull base fractures and associated complications pose a unique reconstructive challenge. The goals of skull base reconstruction include structural support for the brain and orbit, separation of the central nervous system from the aerodigestive tract, volume to decrease dead space, and restoration of the three-dimensional appearance of the face and cranium with bone and soft tissues. An open bicoronal approach is the most commonly used technique for craniofacial disassembly of the bifrontal region, with evacuation of intracranial hemorrhage and dural repair performed prior to reconstruction. Depending on the defect size and underlying patient and operative factors, reconstruction may involve bony reconstruction using autografts, allografts, or prosthetics in addition to soft tissue reconstruction using vascularized local or distant tissues. The vast majority of traumatic anterior cranial fossa (ACF) injuries resulting in smaller defects of the cranial base itself can be successfully reconstructed using local pedicled pericranial or galeal flaps. Compared with historical nonvascularized ACF reconstructive options, vascularized reconstruction using pericranial and/or galeal flaps has decreased the rate of cerebrospinal fluid (CSF) leak from 25 to 6.5%. We review the existing literature on this uncommon entity and present our case series of n = 6 patients undergoing traumatic reconstruction of the ACF at an urban Level 1 trauma center from 2016 to 2018. There were no postoperative CSF leaks, mucoceles, episodes of meningitis, or deaths during the study follow-up period. In conclusion, use of pericranial, galeal, and free flaps, as indicated, can provide reliable and durable reconstruction of a wide variety of injuries.

• Journal of Korean Society of Coastal and Ocean Engineers
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• v.33 no.3
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• pp.93-100
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• 2021

Since the IB (Immersed Boundary) method, which can perform coupling analysis with objects and fluids having an impermeable boundary of arbitrary shape on a fixed grid system, has been developed, the IB method in various CFD models is increasing. The representative IB methods are the directing-forcing method and the ghost cell method. The directing-forcing type method numerically satisfies the boundary condition from the fluid force calculated at the boundary surface of the structure, and the ghost-cell type method is a computational method that satisfies the boundary condition through interpolation by placing a virtual cell inside the obstacle. These IB methods have a disadvantage in that the computational algorithm is complex. In this study, the simplified immersed boundary (SIB) method enables the analysis of temporary structures on a fixed grid system and is easy to expand to three proposed dimensions. The SIB method proposed in this study is based on a one-field model for immiscible two-phase fluid that assumes that the density function of each phase moves with the center of local mass. In addition, the volume-weighted average method using the density function of the solid was applied to handle moving solid structures, and the CIP method was applied to the advection calculation to prevent numerical diffusion. To examine the analysis performance of the proposed SIB method, a numerical simulation was performed on an object falling to the free water surface. The numerical analysis result reproduced the object falling to the free water surface well.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.2
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• pp.1109-1117
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• 2014

We study free vibration analysis of sigmoid functionally graded materials(S-FGM) nano-scale plates, using a nonlocal elasticity theory of Eringen in this paper. This theory has ability to capture the both small scale effects and sigmoid function in terms of the volume fraction of the constituents for material properties through the plate thickness. Numerical solutions of S-FGM nano-scale plate are presented using this theory to illustrate the effect of nonlocal theory on natural frequency of the S-FGM nano-scale plates. The relations between nonlocal and local theories are discussed by numerical results. Further, effects of (i) power law index (ii) nonlocal parameters, (iii) elastic modulus ratio and (iv) thickness and aspect ratios on nondimensional frequencies are investigated. In order to validate the present solutions, the reference solutions are compared and discussed. The results of S-FGM nano-scale plates using the nonlocal theory may be the benchmark test for the free vibration analysis.

• Radiation Oncology Journal
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• v.36 no.2
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• pp.129-138
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• 2018

Purpose: This study was conducted to compare clinical outcomes and treatment-related toxicities after stereotactic body radiation therapy (SBRT) with two different dose regimens for small hepatocellular carcinomas (HCC) ${\leq}3cm$ in size. Materials and Methods: We retrospectively reviewed 44 patients with liver-confined HCC treated between 2009 and 2014 with SBRT. Total doses of 45 Gy (n = 10) or 60 Gy (n = 34) in 3 fractions were prescribed to the 95% isodose line covering 95% of the planning target volume. Rates of local control (LC), intrahepatic failure-free survival (IHFFS), distant metastasis-free survival (DMFS), and overall survival (OS) were calculated using the Kaplan-Meier method. Results: Median follow-up was 29 months (range, 8 to 64 months). Rates at 1 and 3 years were 97.7% and 95.0% for LC, 97.7% and 80.7% for OS, 76% and 40.5% for IHFFS, and 87.3% and 79.5% for DMFS. Five patients (11.4%) experienced degradation of albumin-bilirubin grade, 2 (4.5%) degradation of Child-Pugh score, and 4 (9.1%) grade 3 or greater laboratory abnormalities within 3 months after SBRT. No significant difference was seen in any oncological outcomes or treatment-related toxicities between the two dose regimens. Conclusions: SBRT was highly effective for local control without severe toxicities in patients with HCC smaller than 3 cm. The regimen of a total dose of 45 Gy in 3 fractions was comparable to 60 Gy in efficacy and safety of SBRT for small HCC.

• Journal of Korea Water Resources Association
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• v.52 no.10
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• pp.743-752
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• 2019

The flow in the meandering channel is characterized by the spiral motion of secondary currents that typically cause the erosion along the outer bank. Hydraulic structures, such as spur dike and groyne, are commonly installed on the channel bottom near the outer bank to mitigate the strength of secondary currents. This study is to investigate the effects of submerged vanes installed in a $90^{\circ}$ meandering channel on the development of secondary currents through three-dimensional numerical modeling using the hybrid RANS/LES method for turbulence and the volume of fluid method, based on OpenFOAM open source toolbox, for capturing the free surface at the Froude number of 0.43. We employ the second-order-accurate finite volume methods in the space and time for the numerical modeling and compare numerical results with experimental measurements for evaluating the numerical predictions. Numerical results show that the present simulations well reproduce the experimental measurements, in terms of the time-averaged streamwise velocity and secondary velocity vector fields in the bend with submerged vanes. The computed flow fields reveal that the streamwise velocity near the bed along the outer bank at the end section of bend dramatically decrease by one third of mean velocity after the installation of vanes, which support that submerged vanes mitigate the strength of primary secondary flow and are helpful for the channel stability along the outer bank. The flow between the top of vanes and the free surface accelerates and the maximum velocity of free surface flow near the flow impingement along the outer bank increases about 20% due to the installation of submerged vanes. Numerical solutions show the formations of the horseshoe vortices at the front of vanes and the lee wakes behind the vanes, which are responsible for strong local scour around vanes. Additional study on the shapes and arrangement of vanes is required for mitigate the local scour.

• Korean Journal of Head & Neck Oncology
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• v.16 no.2
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• pp.167-171
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• 2000

Objectives: To compare the outcomes of treatment with a focus on the effectiveness of the two primary techniques of radiation used for treating parotid gland malignancies. Materials and Methods: A retrospective analysis of 70 patients with parotid gland cancer treated between 1981-1997. Radiation was delivered through an ipsilateral field of high energy electron and photon in 37 patients(52.9%). Two wedge paired photon was used to treat in 33 patients(47.1%). The median dose was 60 Gy, typically delivered at 1.8-2.0Gy per fraction. The median follow-up times for surviving patients was 60 months. Results: The overall and disease free 5 year survival rates were 71.6% and 69.5%, respectively. Wedge paired photon and photon-electron treatment disease tree 5 year survival rates were 61.1% and 80.5%, respectively. Overall local failure rate was 18.6%. Local failure rate of wedge paired photon technique was higher than that of mixed beam technique. Late complication rate was 37.1%, but most of them were mild grade. Conclusion: Techniques of radiation were associated with local control. The technique of using an ipsilateral field encompassing the parotid bed and treated with high energy electrons often mixed photons was effective with minimal severe late toxicity. To irradiate deep sited tumors, we consider 3-D conformal treatment plan for well encompassing the target volume.

• The Journal of the Korean bone and joint tumor society
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• v.19 no.1
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• pp.9-13
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• 2013

Purpose: We evaluated oncologic outcomes of chondrosarcomas and analyzed the disease-free survival rate of chondrosarcomas according to the various factors. Materials and Methods: We performed a retrospective study for the disease-free survival rate of 48 chondrosarcomas, 44 of which underwent surgical treatment and followed up more than 18 months since 1993, and in the remaining 4 cases, the patients died before 18 months after surgery. The vsariables were location, tumor volume, histologic grade, stage, age at presentation and treatment performed. The mean follow up period was 43.8 months (1-196 months). Results: The overall disease-free survival rate was 77.1% at mean 43.8 month follow up. The 5 year- and 10 year disease-free survival rates were 64% and 58% respectively. The histologic grade, stage, age at presentation revealed statistical significance on disease-free survival. All 9 patients treated with extended curettage for grade 1 central chondrosarcomas revealed disease-free survival with excellent functional outcome. Conclusion: The disease-free survival rate of chondrosarcomas mainly depended on histologic grade, stage and age at presentation. Local recurrence and distant metastasis also revealed statistically significant differences of disease-free survival rate. Comparing to wide resection, extended curettage for low-grade central chondrosarcomas in extremities were efficient methods with similar survival rate and less functional losses and complications.

• Journal of Korean Tunnelling and Underground Space Association
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• v.14 no.4
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• pp.375-395
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• 2012

According to the local highway tunnel ventilation guideline, ventilation capacity calculation should be performed at the speed ranging from 10 km/h to 80 km/h. This is so reasonable method considering uncongested and congested traffic conditions in urban tunnels. But recently due to low traffic volume and very low congestion frequency in rural highway tunnels, it seems to be an inadequate way to apply the guideline. Therefore the calculation should be performed separately for the free flow and congested traffic cases classified by the appropriate decision model. This paper aims at determining unnecessary running speed range for reasonable tunnel ventilation design, considering free flow and congested traffic conditions. Firstly, traffic volumes in highway tunnels were collected and if any, the causes of congestion were investigated. And with concept of 'margin speed'($u-u_m$), the decision model on traffic congestion was developed. Applicability of the decision model was also analyzed with case study. According to the results, when design speed is 100 km/h, with V/C less than 0.1, then the range of unnecessary speed in tunnel ventilation design is less than 40 km/h; for $V/C{\leqq}0.35$, $V/C{\leqq}0.6$ and $V/C{\leqq}0.75$, the unnecessary speed ranges are found to be ${\leqq}30$, ${\leqq}20$ and ${\leqq}10km/h$, respectively.

• Radiation Oncology Journal
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• v.29 no.4
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• pp.260-268
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• 2011

Purpose: To evaluate the treatment outcome and prognostic factor after postoperative radiotherapy in retroperitoneal sarcoma. Materials and Methods: Forty patients were treated with surgical resection and postoperative radiotherapy for retroperitoneal sarcoma from August 1990 to August 2008. Treatment volume was judged by the location of initial tumor and surgical field, and 45-50 Gy of radiation was basically delivered and additional dose was considered to the high-risk area. Results: The median follow-up period was 41.4 months (range, 3.9 to 140.6 months). The 5-year overall survival (OS) was 51.8% and disease free survival was 31.5%. The 5-year locoregional recurrence free survival was 61.9% and distant metastasis free survival was 50.6%. In univariate analysis, histologic type (p = 0.006) was the strongest prognostic factor for the OS and histologic grade (p = 0.044) or resection margin (p = 0.032) had also effect on the OS. Histologic type (p = 0.004) was unique significant prognostic factor for the actuarial local control. Conclusion: Retroperitoneal sarcoma still remains as a poor prognostic disease despite the combined modality treatment including surgery and postoperative radiotherapy. Selective dose-escalation of radiotherapy or combination of effective chemotherapeutic agent must be considered to improve the treatment result especially for the histopathologic type showing poor prognosls.

• Radiation Oncology Journal
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• v.15 no.1
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• pp.1-10
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• 1997

Purpose : To evaluate the role of radiotherapy in the management of incompletely resected supratentorial low grade astrocytoma with the analysis of the survival, the Pattern of failure, and the prognostic variables affecting survival. Material and methods : Between January 1990 and December 1995, fifty-one patients with supratentorial low grade astrocytoma received radiotherapy after subtotal resection(16 patients) or stereotactic biopsy(35 patients) at Asan Medical Center, External radiotherapy was done by conventional fractionation with the total dose of 4820cGy to 6000cGy(median 5580cGy) and partial brain volume. The follow-up was done from 6 to 79 months(median 48 months) Result : Overall actuarial survival rate at 2 and 5 years were $83.4\%\;and\;54.8\%$, respectively. Progression free survival at 2 and 5 years were $67.4\%\;and\;48.7\%$, respectively The significant prognostic factors affecting overall survival rate were the performance status, 1 stage, histologic subtype, radiation field and radiation response. The major pattern of failure was local failure, such as Progressive disease and primary site recurrence in 23 patients $(45.1\%)$. Progression free survivors excluding 2 patients were physically and intellectually intact without major neurologic deficit. Conclusion : Although the follow-up period of this study was relatively short, overall actuarial and progression free survival rate were encouraging. Patients with good performance status, lower T stage, pilocytic subtype, patients treated with small radiation field and radiation responder showed better survival. As the local failure was the major pattern of failure, the various efforts to decrease the local failure is necessary.