• Archives of Reconstructive Microsurgery
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• v.24 no.1
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• pp.28-31
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• 2015

A case report of a patient who developed radiation-induced sarcoma in the left chest wall is presented. The patient had partial mastectomy and adjuvant radiation therapy (total dose, 5,220 cGy) and chemotherapy. Five years later, she visited with rapidly growing mass with central ulceration in the irradiated chest wall. The mass was diagnosed as malignant fibrous histiocytoma. The chest wall mass resected en bloc ($23{\times}18cm$) including five consecutive ribs. After the defected thoracic cage was reinforced using a polytetrafluoroethylene patch, omental flap and split thickness skin graft was done for soft tissue coverage. We applied negative pressure wound closer system for effective suction of omeantal exudate. The wound healed without complications. The patient suffered no perioperative pulmonary complications. Pulmonary function tests showed no significant changes. Each of Gore-Tex, omental flap, negative pressure wound therapy and skin graft is widely used method. However, If these methods are used in combination, we can reconstruct the large defect of chest wall including multiple ribs without any repiratory function problems.

• Journal of Chest Surgery
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• v.37 no.5
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• pp.448-451
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• 2004

Report of right atrial thrombus complicating pulmonary embolism after cardiac surgery is rare. A 54-year-old woman operated on the atrial septal defect 10 months ago was admitted for left pleuritic pain and dyspnea. Multiple segmental perfusion defects were detected in lung perfusion scan. Transesophageal echocardiography showed a large mobile right atrial mass attached to the free wall of the right atrium with a stalk. Despite the intravenous heparinization for 13 days, follow-up echocardiography revealed the right atrial mass had not diminished in size. The mass which was confirmed as an organizing thrombus was excised under cardiopulmonary bypass. The patient recovered uneventfully and was discharged on warfarin therapy.

• Korean Journal of Head & Neck Oncology
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• v.39 no.1
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• pp.27-31
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• 2023

Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, is a rare immunological small vessel disease which usually affects respiratory tract and kidneys. However, salivary gland involvement in GPA is rare as a primary manifestation. We report a case of GPA with the primary presentation of submandibular gland involvement. A 48-year-old female patient presented submandibular swelling with a skin defect that lasted for 1 month. Although the biopsy result was chronic inflammation, the skin defect did not heal for a month. Further imaging study revealed multiple lung and renal masses. More clinical manifestations such as gingivitis, ischemic change of finger joint and nasal tip skin, and positive c-ANCA test was presented. Additional biopsy was made at the submandibular gland, lung, and finger skin. The patient was finally diagnosed with GPA and treated with steroid pulse therapy and cyclophosphamide. The patient showed improvement of prior clinical symptoms.

• Journal of Korea Multimedia Society
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• v.15 no.2
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• pp.204-214
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• 2012

This paper proposes an image segmentation for a vision-based automated defect inspection system on surface image of TFT-LCD(Thin Film Transistor Liquid Crystal Display) panels. TFT-LCD images have non-uniform brightness, which is hard to finding defective regions. Although there are several methods or proposed algorithms, it is difficult to divide the defect with high reliability because of non-uniform properties in the image. Kamel and Zhao disclosed a method which based on logical stage algorithm for segmentation of graphics and character. This method is a one of the local segmentation method that has a advantage. It is that characters and graphics are well segmented in an image which has non-uniform property. As TFT-LCD panel image has a same property, so this paper proposes new algorithm to segment regions of defects based on Kamel and Zhao's algorithm. Our algorithm has an advantage that there are a few ghost objects around the defects. We had experiments to prove performance in real TFT-LCD panel images, and comparing with the FFT(Fast Fourier Transform) method which is used a bandpass filter.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.620-629
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• 1989

A clinical analysis of 138 cases of ventricular septal defect operated on from 1983 to June 1988 at the department of Thoracic and Cardiovascular Surgery, School of Medicine, Chung-nam National University was done. The following results were obtained. 1. The VSD were 27.6 % and 41.0 % respectively of 500 open heart surgery cases and 334 congenital heart disease. 2. The range of age when the VSD was repaired was 3 months to 45 years, the mean age was 10.4 years and the 53.6 % of patients were under 7 years. The sex ratio was 6:4 in males favor. 3. The two common symptoms were frequent upper respiratory infection and dyspnea whose frequency was 62.5 % and 58.7% respectively. 4. 52% of the patients was below 25 percentile of the standard body weight. 5. The most common chest PA findings were cardiomegaly and increased pulmonary vascularity. 6. On anatomical classification, perimembranous type was most common [65.5%], subpulmonary arterial type was 27.6 %, perimembranous plus subpulmonary arterial type was 3.4 % multiple VSD was 0.8 % and LV-RA defect was 2.6 %. 7. Associated cardiac anomalies were founded in 39 cases [35.5 %] and PDA and aortic valve prolapse were most common associated anomalies and extracardiac anomalies were founded in 6.7 % of patients. 8. Mean extracorporeal circulation time was 68 min. and mean aortic cross-clamping time was 42 min. 9. The postoperative complications developed in 26 % of patients and the most common one was minor wound infection. 10. Right bundle branch block developed in 54.8% of the patients who had right ventriculotomy, 40.0% of the patients who had right atriotomy and 10.5% of the patients who had pulmonary arteriotomy. 11. The overall operative mortality was 5.1 % and the operative mortality of the patients who body weigh under 10 Kg was 23.8%.

• Archives of Reconstructive Microsurgery
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• v.15 no.2
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• pp.58-64
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• 2006

Purpose: Management of soft-tissue defect after open tibial fractures includes immediate and repeated debridement, skeletal stabilization, and early soft-tissue coverage with muscle flaps. The purpose of this study was to evaluate the outcome of the free rectus abdominis muscle flap (RA flap) for treatment of open fractures of the tibia and to discuss its advantages compared with the latissimus dorsi muscle flap (LD flap) in poly trauma patients. Materials and Methods: We performed a retrospective review of 5 patients who had a severe (Gustilo IIIb or IIIc) open fracture of the tibia treated with RA flap from May 2003 to March 2006. All were men, and the mean age was 46.6 years (range, $28{\sim}68$). Three patients had combined injuries such as pelvic bone fractures, multiple rib fractures with hemothorax, and contralateral tibial fracture. All patients received RA flap within 7 days after trauma except two with established chronic osteomyelitis. Results: All flaps survived, and there was no marginal flap necrosis. During the follow-up period, there was no evidence of persistent or recurrent osteomyelitis. The size of RA flap ranged from $8{\sim}20\;cm$ in length and $6{\sim}10\;cm$ in width. The average time required for RA flap elevation was 32 minutes, which is shorter than LD flap. Flap elevation could be done in supine position which is essential in poly trauma patients. Conclusion: Although a wide variety of options are available, RA flap is regarded as an optimal method for coverage of soft-tissue defect of the open tibial fracture in poly trauma patients. LD flap is reserved for large sized soft-tissue defect which cannot be covered by RA flap.

• Archives of Plastic Surgery
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• v.45 no.6
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• pp.588-592
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• 2018

Harvesting grafts from the anterior iliac bone has been associated with various complications. A 50-year-old woman presented to our department with a chief complaint of right inguinal swelling and pain. Autologous bone grafts had been harvested on two previous occasions from the right anterior iliac crest for use in the reconstruction of multiple facial fractures. Computed tomography and magnetic resonance imaging revealed a full-thickness bone defect in the right anterior iliac crest. A mass was noted in the right gluteus minimus, while a multilocular cystic mass extended from the right iliac crest defect to the right inguinal region. Both the inguinal mass and gluteal mass were removed under general anesthesia. Following histopathological analysis, the gluteal mass was diagnosed as a venous malformation (VM). Based on the patient's clinical course, iliac bone graft harvesting and trauma to the gluteal region triggered hemorrhaging from the VM. Blood components leaked out from the fragile portion of the iliac bone defect, forming a cystic lesion that developed into the inguinal mass. In this case, a coincidental VM resulted in a rare complication of iliac bone graft harvesting. These sequelae could have been avoided by planning for more appropriate ways to collect the grafts.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.531-535
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• 2006

Purpose: To report our experience of retro-angular flap for reconstruction of the midface defect. The midface, including nose, lower eyelid, and intercanthal area, is the very prominent area of face. Also midface is more vulnerable to trauma and skin cancer and defect of mid face of highly perceptible. Reconstruction of mid face is difficult because of complexity of anatomy and functions. Following factors should be considered in reconstructive prcedure of midface. First, multiple procedure may need for complete the reconstruction of mid face defect. Second, secondary reconstructive surgeries such as flap rotation or skin graft may need for donor site morbidity. Third, the color, texture and thickness of the skin used are not always complacency. Methods: 8 cases of the midface defects (3 cases of lower eyelid, 1 case of intercanthal area, and 4 cases of nose) from skin cancer were reconstructed with retroangular flap from March 2004 to August 2005. Results: Satisfactory result were obtained in color, texture and donor site scar. There was no major complication such as wound disruption, hematoma, and atrophy of flap. But partial necrosis of flap and bulkiness were observed one case in each. Retroangular flap is simple procedure that can be preceded in one stage under local anesthesia closing primary wound closure. It will leave less visible donor scar, acceptable color, texture and thickness of the skin. Conclusions: The retro-angular flap could be suggested as a safe and effective method for midface reconstruction.

• Clinical and Experimental Pediatrics
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• v.59 no.1
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• pp.16-23
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• 2016

Purpose: The 1p36 deletion syndrome is a microdeletion syndrome characterized by developmental delays/intellectual disability, craniofacial dysmorphism, and other congenital anomalies. To date, many cases of this syndrome have been reported worldwide. However, cases with this syndrome have not been reported in Korean populations anywhere. This study was performed to report the clinical and molecular characteristics of five Korean patients with the 1p36 deletion syndrome. Methods: The clinical characteristics of the 5 patients were reviewed. Karyotyping and multiplex ligation-dependent probe amplification (MLPA) analyses were performed for genetic diagnoses. Results: All 5 patients had typical dysmorphic features including frontal bossing, flat right parietal bone, low-set ears, straight eyebrows, down-slanting palpebral fissure, hypotelorism, flat nasal roots, midface hypoplasia, pointed chins, small lips, and variable degrees of developmental delay. Each patient had multiple and variable anomalies such as a congenital heart defect including ventricular septal defect, atrial septal defect, and patent duct arteriosus, ventriculomegaly, cryptorchism, or hearing loss. Karyotyping revealed the 1p36 deletion in only 1 patient, although it was confirmed in all 5 patients by MLPA analyses. Conclusion: All the patients had the typical features of 1p36 deletion. These hallmarks can be used to identify other patients with this condition in their early years in order to provide more appropriate care.

• Journal of Periodontal and Implant Science
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• v.53 no.4
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• pp.295-305
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• 2023

Purpose: Various methods have been proposed to achieve the nearly complete decontamination of the surface of implants affected by peri-implantitis. We investigated the in vitro debridement efficiency of multiple decontamination methods (Gracey curettes [GC], glycine air-polishing [G-Air], erythritol air-polishing [E-Air] and titanium brushes [TiB]) using a novel spectrophotometric ink-model in 3 different bone defect settings (30°, 60°, and 90°). Methods: Forty-five dental implants were stained with indelible ink and mounted in resin models, which simulated standardised peri-implantitis defects with different bone defect angulations (30°, 60°, and 90°). After each run of instrumentation, the implants were removed from the resin model, and the ink was dissolved in ethanol (97%). A spectrophotometric analysis was performed to detect colour remnants in order to measure the cumulative uncleaned surface area of the implants. Scanning electron microscopy images were taken to assess micromorphological surface changes. Results: Generally, the 60° bone defects were the easiest to debride, and the 30° defects were the most difficult (ink absorption peak: 0.26±0.04 for 60° defects; 0.32±0.06 for 30° defects; 0.27±0.04 for 90° defects). The most effective debridement method was TiB, independently of the bone defect type (TiB vs. GC: P<0.0001; TiB vs. G-Air: P=0.0017; TiB vs. GE-Air: P=0.0007). GE-Air appeared to be the least efficient method for biofilm debridement. Conclusions: T-brushes seem to be a promising decontamination method compared to the other techniques, whereas G-Air was less aggressive on the implant surface. The use of a spectrophotometric model was shown to be a novel but promising assessment method for in vitro ink studies.