• Archives of Plastic Surgery
• /
• v.35 no.1
• /
• pp.36-41
• /
• 2008

Purpose: For facial reconstruction, skin color match is crucial to achieve great aesthetic result. Forehead flap and full thickness skin graft have been used for many years to reconstruct facial defect. Their results are aesthetically valuable with remarkable resemblance and harmony of the skin color between donor and recipient sites. The purpose of this study is to evaluate and compare the aesthetic outcome of the two methods as the analysis of skin color match. Methods: From January 1995 to December 2005, ten forehead flaps and ten full thickness skin grafts were performed. The reconstructed areas of forehead flaps were five noses and five eyelids. Recipient sites of full thickness skin grafts were seven eyelids, two noses and one forehead. In order to obtain the objective validity, the skin color of flap(or graft) and the recipient sites were measured by chromameter. The skin colors were quantified according to a three-dimensional coordinate system used in chromameter, L*(brightness), a*(redness), and b*(yellowness).Results: There was no significant color difference between forehead flap site and adjacent skin in all color values. On the other hand, the L* and b* values of graft sites were significantly lower than those of the adjacent skins. The a* values of graft sites were higher than those of the adjacent skins. Conclusion: This study reveals that skin color match of forehead flap is greater than that of full thickness skin graft. As forehead flap has adequate volume and great color match, it can be useful to reconstruct deep facial defect such as nasal defect. On the other hand, full thickness skin graft can be used for superficial defect like partial eyelid defect.

• Archives of Reconstructive Microsurgery
• /
• v.18 no.2
• /
• pp.62-66
• /
• 2009

Purpose: Despite the free tissue transfer using microsurgical technique being the current trend of soft tissue reconstruction of the hand, the pedicled groin flap has the advantage to provide coverage for the mangled hand without necessitating the use of a damaged arterial system and also providing the benefit of saving the arterial system for later free tissue transfer. This report presents the author's experience using pedicled groin flap in four cases of mangled hands with massive bone and soft tissue defects requiring later thumb reconstruction with the free wrap around flap. Materials and methods: The patients' age ranged from 30 to 51 years; three patients were male and one was female. The causes of mangled hand included two machinery crush injuries, one laboratory explosion and one motor vehicle accident. While evaluating the post-operative results, factors like flap survival, complications, stability in opposition, pinch power and 2 point discrimination were taken into account. Results: All massive soft tissue defects of the hands were completely covered with pedicled groin flap successfully. The reconstructed thumb using free wrap around flap did not have any limitation in opposition. There was no occurrence of post-operative infection and all the flaps survived completely. The average pinch power was 70% of the contralateral intact thumb and average 2 point discrimination was 10 mm. Conclusion: The pedicled groin flap for the reconstruction of the massive soft tissue defects of the hand with subsequent reconstruction of the thumb with a wrap around flap is a very useful procedure. The combined use of pedicled groin flap and wrap around flap allows adequate coverage of sizable soft tissue defects and functional thumb opposition in cases of reconstruction of the mangled hands.

• Archives of Plastic Surgery
• /
• v.34 no.1
• /
• pp.77-80
• /
• 2007

Purpose: Purpura fulminans is a rare but rapidly progressive, serious, often life-threatening disorder in childhood, which is complicated with septic shock or disseminated intravascular coagulopathy during acute infection. It occurs first as acute-onset petechial rash, and spreads rapidly into full thickness skin and soft tissue necrosis. In the past, it had high mortality rate, up to 80%, but recently, survival rate has increased due to early diagnosis, and rapid advancement of critical care and antibiotics. From our experiences of PF management, we would like to review the pathophysiology and suggest the surgical treatment guideline about meningococcal induced purpura fulminans. Methods: Two cases of purpura fulminans over the last 3 years were reviewed retrospectively about reconstructive management. After they were treated resuscitative management initially by the critical intensive care, reconstructive surgery was performed by plastic surgeon as soon as the patients were vitally and mentally stable. Results: There were 6 procedures in case 1, and 3 procedures in case 2. The mean delayed period from admission with sepsis to the first surgical debridement was 24 days and 42 days, respectively. Total hospitalization period was 103 days and 69 days, respectively. All of them were treated with debridement and split thickness skin graft, but delayed debridement was superior to early one in the point of preserving much more tissues. Conclusion: From our experience, we suggest that conservative therapy to the wounds appears to be the best tool in the initial vitally unstable period in order to preserve as much tissues and functions as possible if no active inflammation and compartment syndrome are detective.

• Archives of Plastic Surgery
• /
• v.34 no.2
• /
• pp.191-196
• /
• 2007

Purpose: Gluteal perforator is easily identified in the gluteal region and gluteal perforator flap is a very versatile flap in sacral sore reconstruction. We obtained satisfying results using the gluteal perforator flap, so we report this clinical experiences with a review of the literature. Methods: Between November of 2003 and April 2006, the authors used 16 gluteal perforator flaps in 16 consecutive patients for coverage of sacral pressure sores. The mean age of the patients was 47.4 years (range, 14 to 78 years), and there were 9 male and 7 female patients. All flaps in the series were supplied by musculocutaneous arteries and its venae comitantes penetrating the gluteus maximus muscle and reaching the intrafascial and suprafascial planes, and the overlying skin forming a rich vascular plexus arising from gluteal muscles. Patients were followed up for a mean period of 11.5 months. Results: All flaps survived except one that had undergone total necrosis by patient's negligence. Wound dehiscence was observed in three patients and treated by secondary closure. There was no recurrence during the follow-up period. Conclusion: Gluteal perforator flaps allow safe and reliable options for coverage of sacral pressure sores with minimal donor site morbidity, and do not sacrifice the gluteus maximus muscle and rarely lead to post-operative complications. Freedom in flap design and easy-to perform make gluteal perforator flap an excellent choice for selected patients.

• Archives of Plastic Surgery
• /
• v.37 no.4
• /
• pp.427-432
• /
• 2010

Purpose: The purpose of this study is to estimate muscle defect by ultrasonography in the patients with secondary deformities of the lip. We investigated the association between the muscle defect in the repaired cleft lip and the philtral appearance not only at resting state but also maximal puckering. Methods: From December 2006 to November 2007, 52 children were evaluated after primary or secondary cheiloplasty. Digital photographs were taken both from the front and both three quarter views in repose and at maximal pucker. Video clips were also taken in repose and at maximal pucker. A panel of four, scored the philtral ridge and dimple seen on these photographs and videos by using two visual analog scales. Eminence of the philtral ridge was scored by a 5 point grading scale, from "conspicuous groove" to "normal philtral ridge" and the philtral dimple was scored by 3 point grading scale, from "no dimple" to "prominent dimple". Ultrasound images of the upper lip were made using a linear array transducer at the resting position of the lip and evaluated by a single radiologist. Results: The philtral ridge eminence scored $2.79{\pm}0.54$ and $1.40{\pm}0.53$ at resting and maximal pucker, correlating with "flat" and "conspicous groove". The philtral dimpling scored $1.44{\pm}0.53$ and $2.27{\pm}0.66$ at resting and maximal pucker, correlating with "no dimple" and "slight dimple". Ultrasound imaging showed the average muscle dehiscence to be $3.78{\pm}2.14$ mm at resting position. Correlation between the muscle defect in ultrasound imaging and philtral ridge eminence at rest was statistically significant (p<0.050), but was not significant (p=0.756) at maximal pucker using Spearman's rank correlation. Correlation between the muscle defect in ultrasound imaging and philtral dimpling was not statistically significant both at rest (p=0.920) and at maximal pucker (p=0.815) using Spearman's rank correlation. Conclusion: Quantitative assessment of the muscle defect using ultrasonography correlates with the static philtral appearance, but does not correlate with the dynamic appearance. Also, the size of the muscle defect does not show any correlation with the philtral dimpling. Our findings reveal that ultrasound imaging partially reflect static appearance of philtrum but cannot reflect dynamic appearance and suggest the need for further research to evaluate dynamic appearance.

• Archives of Pharmacal Research
• /
• v.29 no.7
• /
• pp.591-597
• /
• 2006

Aerial parts of Artemisia asiatica (Compositae) have been traditionally used as an oriental medicine for the treatment of inflammatory and ulcerogenic diseases. In the present study, artemisolide was isolated as a nuclear factor $(NF)-{\kappa}B$ inhibitor from A. asiatica by activity-guided fractionation. Artemisolide inhibited $NF-{\kappa}B$ transcriptional activity in lipopolysaccharide (LPS)-stimulated macrophages RAW 264.7 with an $IC_{50}$ value of $5.8\;{\mu}M$. The compound was also effective in blocking $NF-{\kappa}B$ transcriptional activities elicited by the expression vector encoding the $NF-{\kappa}B$ p65 or p50 subunits bypassing the inhibitory kB degradation signaling $NF-{\kappa}B$ activation. The macrophages markedly increased their $PGE_2$ and NO production upon exposure to LPS alone. Artemisolide inhibited LPS-induced $PGE_2$ and NO production with $IC_{50}$ values of $8.7\;{\mu}M$ and $6.4\;{\mu}M$, respectively, but also suppressed LPS-induced synthesis of cyclooxygenase (COX)-2 or inducible NO synthase (iNOS). Taken together, artemisolide is a $NF-{\kappa}B$ inhibitor that attenuates LPS-induced production of $PGE_2$ or NO via down-regulation of COX-2 or iNOS expression in macrophages RAW 264.7. Therefore, artemisolide could represent and provide the anti-inflammatory principle associated with the traditional medicine, A. asiatica.

• The Korean Journal of Archival Studies
• /
• no.26
• /
• pp.33-62
• /
• 2010

Buddhism was introduced in the Korea Peninsula 1600 years ago, and now there are over 10 million believers in Korea. The systematic Management of Temple Records has a spiritual and cultural value in a rapidly changing modern society. This study proposes a better management system of Buddhist temple records for the Jogye Order of Korean Buddhism. this system Not only supports transparency of religious affairs, but presents a way for a more effective management. in this study, I conducted a study on the national legislation for the preservation of buddhist temples and the local rules of religious affairs from the Jogye Order. Through this, I analyzed the problems of Buddhist records management. in the long term, to improve these problems, I purpose the establishment of temple archives be maintained by parish head offices. This study presents a retention schedule for this systematic establishment system. I present charts for the standard Buddhist records management that manage the total process systematically from the production of records to its discard. Also I present a general plan to prevent random defamation of Buddhist temple documents and impose a duty for preservation. I intend for this plan to be subject to discussion and tailored to the particular needs of temple reads. In creating these charts standard of Buddhist temple records management, I analyzed operating examples of foreign religious institutions and examined their retention periods. I also examined the retention periods and classification system from the Jogye Order. Then I presented ways for this management system to operate through computer programs. There is a need to establish a large scale management system to arrange the records of buddhist documents. We must enforce the duty of conserving records through the proposed management system. We need the system to manage even the local parish temple records through the proposed management system and the operation of the proposed archive system. This study presents research to from the basic of the preservation and the passing of traditional records to future generations. I also discovered the historical cultural and social value that these records contain. Systematically confirmed Buddhist temple records management will pave the way that these tangible and intangible cultural records handed down from history can be the cultural heritages. establishing a temple records management system will pave the way for these cultural records to be handed down to future generations as cultural heritages.

• The Korean Journal of Archival Studies
• /
• no.23
• /
• pp.3-43
• /
• 2010

Finding aids are tools which facilitate to locate and understand archives and records. Traditionally there are two types of archival finding aids: vertical and horizontal. Vertical finding aids such as inventories have multi-level descriptions based on provenance, while horizontal ones such as catalogs and index are tools to guide to the vertical finding aids based on the subject. In the web environment, traditional finding aids are evolving into more dynamic forms. Respecting the principles of provenance and original order, vertical finding aids are changing to multi-entity structures with development of ISAD(G), ISAAR(CPF) and ISDF as standards for describing each entity. However, vertical finding aids can be too difficult, complicated, and boring for many users, who are accustomed to the easy and exciting searching tools in the internet world. Complementing them, new types of finding aids are appearing to provide easy, interesting, and extensive access channels. This study investigates the development and limitation of vertical finding aids, and the recent trend of evolving new finding aids complementing the vertical ones. The study finds three new trends of finding aid development. They are (i) mixture, (ii) integration, and (iii) openness. In recent days, certain finding aids are mixed with stories and others provide integrated searches for the collections of various heritage institutions. There are cases for experimenting user participation in the development of finding aids using Web 2.0 applications. These new types of finding aids can also cause some problems such as decontextualised description and prejudices, especially in the case of mixed finding aids and quality control of user contributed annotations and comments. To solve these problems, the present paper suggests to strengthen the infrastructure of vertical finding aids and to connect them with various new ones and to facilitate interactions with users of finding aids. It is hoped that the present paper will provide impetus for archives including the National Archives of Korea to set up and evaluate the development strategies for archival finding aids.

• The Korean Journal of Archival Studies
• /
• no.33
• /
• pp.113-153
• /
• 2012

Since the government of Republic of Korea was established in 1948, a period that made the biggest difference on National Records Management System was from 1999 when was enacted. Especially, it was the period of President Roh's five-year tenure called Participation Government (2003-2008). This paper illustrates distinct phenomena of Records Management System Policy during Participation Government. Three major agents of the system are President Roh, the Presidential Secretariat, and Archives Management Bureau at the National Archives of Korea. They sometimes competed with themselves for initiatives of policy, but they used to cooperate with each other and have brought about innovations on records management. The first distinctive characteristic of Participation Government (below PG)'s records management is that it implemented governance actively. That is, it tried to listen carefully to all opinions of interest organizations related to records management and enacted laws based on those. The PG not only listened to civic groups, but also created two professional groups called Records Management Innovation Expert Committee and Innovation Decentralization Assessment Committee. Those two groups enacted . Another remarkable feature is a nomination of records management specialists at public institutions. In 2005, PG created Archival Research Positions among research public officials and appointed experts in the field of Archival Research History at central department. With the process, the government tried to provide public records management system and to improve specialty of records management. Since then, records management specialists were employed not only at local governments but also at private archival institutions. It has allowed of entering a new phase in employing records management professionals. The Participation Government also legislated (completely revised) . It led to a beginning of developing records management in Republic of Korea. was revised thoroughly for the e-Government period and was established as a foundation for managing presidential records. An establishing process of a country's records management system describes the degree of democratic development of society. Following governments should supplement PG's shortcomings and carry out 'New Governance Records Management System'. Principal subjects of records management system should include not only a government but also civic groups, local governments, small businesses, and academic professionals. The object of records management also needs to be democratic by recording not only the plans and enforcements of a task but also influences and results of a task. The way of archiving ought to be discussed by all related principals.

• Archives of Plastic Surgery
• /
• v.35 no.5
• /
• pp.533-538
• /
• 2008

Purpose: Sensory changes in the upper limb are complications of a mastectomy with immediate breast reconstruction with the treatment of breast cancer. The purpose of this study is to clarify whether immediate breast reconstruction worsens the sensory changes. Methods: From March 2004 to December 2005, 20 patients who had a mastectomy with immediate breast reconstruction(reconstruction group) were compared with 23 patients who had a mastectomy alone(control group). All patients had stage I or II breast cancer. The sensory changes were assessed in a blind manner by one examiner that used light touch sensation, static two-point discrimination, pain, vibration, hot and cold temperature perception. The sensory changes were identified along the sensory dermatome for diagnosing the damaged nerves. The following factors and their relationship with the sensory changes were analyzed : age, complications, and the mastectomy method. Results: There was no statistical difference in the static two-point discrimination, pain, vibration, hot and cold temperature perception between the two groups. However, the ability to recognize light touch was significantly better(p=0.045) in the reconstruction group than in the control group. The main site of sensory change was the proximal and medial portion of the upper limb in both groups. At these sites, the mean value of Semmes-Weinstein monofilament was $1.01g/mm^2$(reconstruction group 0.82, control group 1.17) and 2-point discrimination was 51.74(converted to perfect score of 100; reconstruction group 42.50, control group 59.78). The total rate of early complications was found to be significantly lower(p=0.006) in the reconstruction group than in the control group. Conclusion: These findings suggest that an immediate breast reconstructive procedure following a mastectomy is as safe as or safer than a mastectomy alone with respect to postoperative sensory changes of the ipsilateral upper limb.