• 디자인학연구
• /
• 제17권2호
• /
• pp.479-486
• /
• 2004

20세기에는 물질과 분석적 디자인의 중시로 환경문제가 크게 대두되었다. 이제 21세기를 맞아 의미와 전체와의 조화의 개념이 중시되는 전일적 디자인방법이 필요하다. 따라서 본 연구의 목적은 동양의 전일적 사고에 바탕한 21세기의 새로운 디자인패러다임과 디자인방법을 제시하는데 있다. 구체적인 연구의 내용으로는 '유ㆍ불ㆍ도교 등의 동양사상에서 나타나는 전일적 개념이 파악되고(4장)', '통일성, 조화성, 변화성을 중심으로 한 전일적사고의 주요가치들이 분석되었으며(5장)', 이를 바탕으로 새로운 디자인방법의 대안으로서 '첫째-대상관찰, 둘째-대상평가, 셋째-대상개선의 3단계로 구성된 전일적인 디자인프로세스가 제시되었다(6장)' 그리고 결론으로서 각 단계의 중심적 디자인가치가 아래와 같이 규명되었다. 대상관찰 단계-대상을 바라봄에 있어 분리보다는 '전일적 관점'을 중시한다. 대상평가-가치를 판단함에 있어 차별과 대립보다는 '화합과 조화를 중시' 한다. 대상개선-창조의 개념은 변증법적 발전(creation)보다는 '순환과 변용과정의 개선적 변화(process of transformation)'를 중시한다.

• Restorative Dentistry and Endodontics
• /
• 제45권1호
• /
• pp.1.1-1.9
• /
• 2020

Objectives: The purpose of this study was to determine the incidence of radix molaris (RM) (entomolaris and paramolaris) in the mandibular first permanent molars of a sample Saudi Arabian subpopulation using cone-beam computed tomography (CBCT). Materials and Methods: A total of 884 CBCT images of 427 male and 457 female Saudi citizens (age 16 to 70 years) were collected from the radiology department archives of 4 dental centers. A total of 450 CBCT images of 741 mature mandibular first molars that met the inclusion criteria were reviewed. The images were viewed at high resolution by 3 examiners and were analyzed with Planmeca Romexis software (version 5.2). Results: Thirty-three (4.5%) mandibular first permanent molars had RM, mostly on the distal side. The incidence of radix entomolaris (EM) was 4.3%, while that of radix paramolaris was 0.3%. The RM roots had one canal and occurred more unilaterally. No significant difference in root configuration was found between males and females (p > 0.05). Types I and III EM root canal configurations were most common, while type B was the only RP configuration observed. Conclusions: The incidence of RM in the mandibular first molars of this Saudi subpopulation was 4.5%. Identification of the supernumerary root can avoid missing the canal associated with the root during root canal treatment.

• Archives of Plastic Surgery
• /
• 제34권3호
• /
• pp.346-351
• /
• 2007

Purpose: As a rare congenital anomaly, Poland's syndrome has been known to show hypoplasia in breast and nipple, absence of pectoralis major muscle, and aplasia or deformity of rib or costal cartilage which has been reported to be more common in male. However, most patients who are seeking operation are female patients having one-side deformity. In the field of plastic surgery, the major surgical indications could be asymmetric chest wall depression in man or breast hypoplasia in woman. There are many reconstruction options according to the degree of patient's deformity: a prosthetic implant, breast implant with or without tissue expander, latissimus dorsi musculocutaneous pedicled flap with or without implant and/or tissue expander, and free tissue transfer with or without tissue expander. Methods: The authors have treated 4 patients(2 male, 2 female) who had a diagnosis of Poland's syndrome. According to the degree of patient's deformity, all patients underwent correction of breast asymmetry and unilateral anterior thoracic hypoplasia with one-staged or two-staged reconstruction. Results: All patents were satisfied with the results and there occurred no specific complications. Conclusion: The authors propose the treatment plan for patient with Poland's syndrome, according to the degree of patient's deformity. In case of male patient with mild deformity, the prosthetic implant or latissimus dorsi musculocutaneous pedicled flap will simulate the missing pectoralis and improve the contour deformity. In case of female patient with moderate to severe breast asymmetry and upward displaced nipple areolar complex (NAC), NAC can be lowered with tissue expander, breast can be enlarged with autologous free flaps or latissimus dorsi musculocutaneous pedicled flap with implant.

• Archives of Plastic Surgery
• /
• 제40권1호
• /
• pp.44-50
• /
• 2013

Background The aim of this investigation was to systematically review the current literature to provide the best data for indications, outcomes, survival, and complication rates of pedicled propeller perforator flaps for upper body defects. Methods A comprehensive literature review for articles published from January 1991 to December 2011 was performed using the PubMed, Medline, and Cochrane Databases. Articles without available full-text, single case reports or papers with excessive missing data were excluded. Papers reporting pedicle-perforator (propeller) flaps used for lower extremity reconstruction were excluded from meta-analysis. Results From the initial 1,736 studies our search yielded, 343 studies qualified for the second stage of selection. Of 117 full-text reports screened, 41 studies, met the definitive inclusion and exclusion criteria. Of the selected 41 articles, 26 were case series, original papers or retrospective reviews and were included, whereas 15 were case report papers and therefore were excluded. Two hundred ninety-five propeller flaps were reported to have been used in a total of 283 patients. Indications include repair of trauma-induced injuries, post-trauma revision surgery, cancer resection, chronic infection, pressure sores, and chronic ulcers with a major complication rate (3.3%) comparable to that of free flaps. No specific exclusion criteria for the procedure were presented in the studies reviewed. Conclusions Pedicled propeller flaps are a versatile and safe reconstructive option that are easy and quick to raise and that provide unlimited clinical solutions because of the theoretical possibility of harvesting them based on any perforator chosen among those classified in the body.

• Archives of Plastic Surgery
• /
• 제39권4호
• /
• pp.354-359
• /
• 2012

Background During the planning of a thoracodorsal artery perforator (TDAP) free flap, preoperative multidetector-row computed tomographic (MDCT) angiography is valuable for predicting the locations of perforators. However, CT-based perforator mapping of the thoracodorsal artery is not easy because of its small diameter. Thus, we evaluated 1-mm-thick MDCT images in multiple planes to search for reliable perforators accurately. Methods Between July 2010 and October 2011, 19 consecutive patients (13 males, 6 females) who underwent MDCT prior to TDAP free flap operations were enrolled in this study. Patients ranged in age from 10 to 75 years (mean, 39.3 years). MDCT images were acquired at a thickness of 1 mm in the axial, coronal, and sagittal planes. Results The thoracodorsal artery perforators were detected in all 19 cases. The reliable perforators originating from the descending branch were found in 14 cases, of which 6 had transverse branches. The former were well identified in the coronal view, and the latter in the axial view. The location of the most reliable perforators on MDCT images corresponded well with the surgical findings. Conclusions Though MDCT has been widely used in performing the abdominal perforator free flap for detecting reliable perforating vessels, it is not popular in the TDAP free flap. The results of this study suggest that multiple planes of MDCT may increase the probability of detecting the most reliable perforators, along with decreasing the probability of missing available vessels.

• Archives of Plastic Surgery
• /
• 제39권1호
• /
• pp.55-58
• /
• 2012

We experienced satisfactory outcomes by synchronously transplanting an artery and vein using an anterolateral thigh flap pedicle between the vascular pedicle and recipient vessel of a flap for scalp reconstruction. A 45-year-old man developed a subdural hemorrhage due to a fall injury. In this patient, the right temporal cranium was missing and the patient had $4{\times}3cm$ and $6{\times}5cm$ scalp defects. We planned a scalp reconstruction using a latissimus dorsi free flap. Intraoperatively, there was a severe injury to the right superficial temporal vessel because of previous neurosurgical operations. A 15 cm long pedicle defect was needed to reach the recipient facial vessels. For the vascular graft, the descending branch of the lateral circumflex femoral artery and two venae comitantes were harvested. The flap survived well and the skin graft was successful with no notable complications. When an interposition graft is needed in the reconstruction of the head and neck region for which mobility is mandatory to a greater extent, a sufficient length of graft from an anterolateral flap pedicle could easily be harvested. Thus, this could contribute to not only resolving the disadvantages of a venous graft but also to successfully performing a vascular anastomosis.

• Archives of Reconstructive Microsurgery
• /
• 제19권2호
• /
• pp.108-111
• /
• 2010

Purpose: In reconstructing a defect on the dorsum of the hand, there are many cases of extensor tendons exposed or even missing. The repaired or reconstructed tendons need relevant gliding environment for good functional recovery. The anterolateral thigh flap offers a vascular fascial component with large amounts that can be used for covering exposed tendons and we report a unique case of single-stage hand dorsum and gliding surface reconstruction. Methods: A 35-year-old man had severe post-traumatic scarring in his left dorsal hand and coverage of the flap with split-thickness skin graft has been done before. After scarred skin excision and extensor tendon graft for missed part, a free anterolateral thigh adipofascial flap was used to resurface the hand dorsum and to reconstruct a two-layer gliding surface of the extensor tendons. The extensor tendons were wrapped in the fascial component with the fat layer inside. Results: He had an uneventful postoperative course without infection, dehiscence and flap necrosis. Good overall functional recovery and tendon excursion were observed. He was also satisfied with postoperative appearance. Conclusion: A free anterolateral thigh adipofascial flap was used successfully for reconstruction of a two-layer tendon gliding surface to treat a patient with severe scarring in the dorsal hand.

• Archives of Plastic Surgery
• /
• 제48권6호
• /
• pp.703-713
• /
• 2021

The field of vascularized composite allografts (VCAs) has undergone significant advancement in recent decades, and VCAs are increasingly common and accepted in the clinical setting, bringing hope of functional recovery to patients with debilitating injuries. A major obstacle facing the widespread application of VCAs is the side effect profile associated with the current immunosuppressive regimen, which can cause a wide array of complications such as infection, malignancy, and even death. Significant concerns remain regarding whether the treatment outweighs the risk. The potential solution to this dilemma would be achieving VCA tolerance, which would allow recipients to receive allografts without significant immunosuppression and its sequelae. Promising tolerance protocols are being studied in kidney transplantation; four major trials have attempted to withdraw immunosuppressive treatment with various successes. The common theme in all four trials is the use of radiation treatment and donor cell transplantation. The knowledge gained from these trials can provide valuable insight into the development of a VCA tolerance protocol. Despite similarities, VCAs present additional barriers compared to kidney allografts regarding tolerance induction. VCA donors are likely to be deceased, which limits the time for significant pre-conditioning. VCA donors are also more likely to be human leukocyte antigen-mismatched, which means that tolerance must be induced across major immunological barriers. This review also explores adjunct therapies studied in large animal models that could be the missing element in establishing a safe and stable tolerance induction method.

• 대한두개안면성형외과학회지
• /
• 제24권1호
• /
• pp.37-40
• /
• 2023

Penetrating wounds to the face are cosmetically devastating and can be life-threatening. If the foreign body causing the penetrating wound is a piece of wood, small remnants might be left behind after the initial treatment. A 33-year-old male patient presented to the emergency center after a piece of lumber pierced his face as a passenger in a traffic accident. The patient's vital signs were stable, and emergency surgery was performed to remove the foreign body and repair the soft tissue. No noteworthy complications were seen after open reduction and internal fixation of the facial bone fractures. Seven months after the accident, the patient underwent scar revision along with full-thickness skin grafting for post-traumatic scars. After the surgery, pus-like discharge which was not previously present was observed, and the graft did not take well. A residual foreign body, which was the cause of graft failure, was found on computed tomography and the remaining foreign body was removed through revision surgery. The patient is receiving outpatient follow-up without any complications 6 months after surgery. This case demonstrates the importance of performing a careful evaluation to avoid missing a residual foreign body, especially if it is of wooden nature.

• 대한지리학회지
• /
• 제49권1호
• /
• pp.45-56
• /
• 2014

지표의 식생활력도를 간접적으로 반영하는 위성 기반의 식생지수 자료를 연속적으로 확보하기 위해 자료합성법이 통상적으로 적용된다. 이는 자료합성을 통해 누락 자료나 신호 오류의 영향을 최소화함으로써 장기적인 식생지수 자료 구축이 가능해지기 때문이다. 또, 합성주기에 따라 두 개 이상의 위성 센서로부터 같은 시점에 생성된 식생지수 자료를 상호교호적으로 사용할 경우, 식생지수 자료 축적의 연속성과 안정성을 보다 더 강화할 수 있다. 본 연구는 식물생장 연구에 있어 위성시스템 간 자료 호환 가능성뿐만 아니라 MODIS 자료 취득 조건, 즉 태양과 센서의 천정각이 미치는 영향을 센서 geometry 측면에서 파악하여 장기적인 식생모니터링을 위한 자료 구축 개선에 기여하고자 한다. 연구 기간 중 센서천정각의 변화는 일정한 패턴을 보이지 않았고, 연도별로 불규칙한 등락을 나타냈다. 또, 동일 계절별로 분석한 결과에서도 계절에 따른 특징적 경년변화 패턴은 나타나지 않았다. 두 가지 분석 대상 자료인 NDVI와 EVI를 비교했을 때, EVI가 NDVI에 비해 더 안정된 결과를 보여주었고, 전반적으로 중위도 지역 식물생장의 계절적 특성을 전형적으로 보여주었다. 식생피복에 따른 NDVI-EVI 간 상관관계는 모두 유효한 결과를 얻었으나, 식생피복별로 상관도 차이를 보였고 상호간에 선형 관계가 아닌 상단부에서 수렴되는 곡선 관계를 보여주었다. Terra와 Aqua 위성에 의해 오전과 오후에 각각 관측된 식생지수를 비교한 결과, 상관계수 범위는 NDVI의 경우 0.641-0.880로, EVI의 경우 0.747-0.963으로 나타나, NDVI자료에 비해 EVI자료의 호환성이 높은 것으로 조사되었다. 두 센서 기반의 식생지수간 호환성 개선을 위해서는 두 자료 간의 회귀선으로부터 벗어나 있는 예외치에 대한 정밀한 분석이 과제로 남는다.