• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.3
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• pp.227-232
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• 2007

The radial forearm fasciocutaneous flap(RFFF) is a well-known flap for the reconstruction of oral and maxillofacial defects. It was first described by Yang et al. in 1981 and Soutar et al. developed it for the reconstruction of intraoral defect. RFFF provides a reliable, thin, and pliable soft tissue/skin paddle that is amenable to sensate reconstruction. It also has a long vascular pedicle that can be anastomosed to any vessel in either the ipsilateral or contralateral neck. However, split thickness skin graft(STSG) is most commonly used to cover the donor site, and a variety of donor site complications have been reported, including delayed healing, swelling of the hand, persistent wrist stiffness, reduced hand strength, and partial loss of the graft with exposure of the forearm flexor tendon. Various methods for donor site repair in addition to STSG have been developed and practiced to minimize both functional and esthetic morbidity, such as direct closure, V-Y closure, full thickness skin graft, tissue expansion, acellular dermal graft. We got a good result of using artificial dermis($Terudermis^{(R)}$) and secondary STSG for the repair of RFFF donor site defect esthetically and report with a review of literature.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.589-594
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• 2010

Purpose: Full thickness skin grafts are useful in the reconstruction of facial skin defects when primary closure is not feasible. Although the supraclavicular area has been considered as the choice of donor site for large facial skin defect, many patients are reluctant to get a neck scar and some patients do not have enough skin to cover the defect owing to the same insult occurred to the neck such as burn accident. We present several cases of reconstruction of facial skin defects by freehand full-thickness skin graft from anterolateral chest wall resulting aesthetically acceptable outcome with lesser donor site morbidity. Methods: Retrospective review was performed from March, 2007 to September, 2009. 15 patients were treated by this method. Mean age was 31.5 years. The ethiology was congenital melanocytic nevus in 7 cases, capillary malformation in 5 cases and burn scar contracture in 3 cases. Mean area of lesion was measured to 67.3 cm2 preoperatively. The lesion was removed beneath the subcutaneous fatty tissue layer. The graft was not trimmed to be thin except defatting procedure. For the larger size of defect, two pieces of grafts were harvested from both anterolateral chest wall in separation and combined by suture. Results: The mean follow up period was 9.7 months. All the grafts survived without any problem except small necrotic areas in 4 cases, which healed spontaneously under conventional dressings in 6 weeks postoperatively. Color match was relatively excellent. There were 2 cases of hyperpigmentation immediately, but all of them disappeared in a few months. Conclusion: In cases of large facial skin defects, the anterolateral chest wall may be a good alternative choice of full-thickness skin graft.

• Annals of Clinical Neurophysiology
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• v.11 no.2
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• pp.54-58
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• 2009

Background: Obstructive sleep apnea (OSA) is associated with several cardiovascular diseases. However, the mechanisms are not completely understood. The measure of common carotid artery intima-media thickness (IMT) has been extensively used as an early marker of atherosclerosis. The aim of this study was to test the hypothesis that early signs of atherosclerosis are present in patients with OSA and correlate with OSA severity Methods: Eleven male patients with OSA were studied by using full standard overnight polysomnography and high-definition echo-tracking device to measure intima-media thickness and carotid artery diameter. Eight healthy volunteers matched for age and sex were studied by portable respiratory monitoring device. All participants were free of hypertension, diabetes, and were not on any medications. Patients with OSA were naive to treatment. Results: All patients and normal controls were male. There was no significant difference of age between patients and controls ($48.4{\pm}8.85$ and $48.0{\pm}9.77$). Significant differences existed between control subjects and patients with mild to moderate and severe OSA (apnea-hypopnea index, $1.51{\pm}1.15$ and $38.51{\pm}19.13$ respectively) in intima-media thickness ($0.59{\pm}0.064$ and $0.93{\pm}0.16$; P=0.0023), and carotid diameter ($5.79{\pm}0.44$ and $6.47{\pm}0.51$; P=0.0227). Multivariate analyses showed that the apnea-hypopnea index correlated independently with intima-media thickness and carotid diameter (r=0.79, P=0.0008, and r=0.47, P=0.0482). Conclusions: Middle-aged patients with OSA who are free of overt cardiovascular diseases have early signs of atherosclerosis, which further supports the hypothesis that OSA plays an independent role in atherosclerosis progression.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.4
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• pp.363-368
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• 2000

The purposes of the study was to examine changes in thickness and strength of the rat femur after administration of sodium fluoride in the drinking water. 48 female Sprague-Dawley rats were randomly divided into 4 groups, and they were supplied with 0(control), 1, 5 and 50 ppm of fluoride in the drinking water ad libitum for 6 weeks. Rats were killed and both sides of femur were dissected. Bone strength was measured as the stress of failure of femur at the middle point and femoral neck with Instron. Histologic slides were prepared from the femur shaft with routine processing of fixing, demineralizing, embedding and HE staining. Thickness and area of cortical bone and medullary cavity were measured by using Camera Lucida and Image Analyzer. All the collected data were analyzed with one-way ANOVA, Duncan's multiple range test for post-hoc tests and ANCOVA using the SAS 6.12 package at the level of 0.05. Bone strength increased significantly in the animals given 1 and 5 ppm of fluoride in the water, as compared to the control group. There were significant decreases of stress at fracture in 50 ppmF group compared to the 1 and 5 ppmF groups. The similar trends of bone strength at the femoral neck fracture test, but there were no statistical significances. Cortical bone thickness and area of the femur increased in the 1 and 5 ppmF groups compared to the control. However, the thickness of 50 ppmF group also decreased significantly as compared to 1 and 5 ppmF groups. On the other hand, medullary thickness and area increased in all fluoride groups than control group. All of the findings presented support the conclusion that, low fluoride dosage used in water fluoridation could increase the bone strength and might have preventive effect on femur fracture.

• Journal of Fashion Business
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• v.13 no.5
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• pp.37-44
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• 2009

As the modern society has become highly industrialized and functionalized, the entry of women in public affairs has become brisk and extensive, and the studies of jackets which can satisfy the functions and designs for various activities have become important. Especially in the tailored collar which is the typical collar for female jackets, the studies such as scientific original form design, and design evaluation through analyzing functionality and sensitivity and others must be systematically carried out. In this study, therefore, the objective was placed in examining the actual state of the production of the tailored collar in the field of production first, and inquiring the general theories on the constituent elements of tailored-collar and production methods by analyzing it and comparing it with the educational tailored-collar production methods. First, in regard to the relation between the collar and the length of the backside neck of the bodice, in most cases, they were employing the method to enlarge the length of the backside neck of the bodice by shortening the length of the neck-base girth. That is, they were processing in order that the self collar band inside of the roll line and the fall of the collar can make a soft curved line. Second, when producing tailored-collar patterns, it is desirable to very the inclination according to the breath of the collar or thickness of the fabric because the stability of the inclination of the collar differs depending on the condition the collar is set, the girth of the collar edge. the broader the breath of the collar becomes, the thicker the fabric becomes, and the more the cloth is against the cold, it is necessary to make the inclination larger. Third, in the size relation between the upper collar and under collar, when sewing collars, it becomes thick and stabilized as it goes from the part in which extra pieces were put to the part in which extra pieces are not put. So you must make the upper collar larger by putting in extra pieces. The amount to be put in differs depending on characteristics of the materials.

• Korean Journal of Head & Neck Oncology
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• v.27 no.1
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• pp.27-31
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• 2011

Purpose : Anterolateral thigh and radial forearm flap is the most important fasciocutaneous flap widely used for reconstruction of tongue. One important purpose of flap is replacing the volume of tongue but still there is no data about the surface area and volume to be reconstructed after glossectomy. In this paper, surface area and volume is estimated from the 3-dimensionally reconstructed MRI images to see which flap is more ideal and to give the reference value for reconstruction. Materials and Methods : With coronal MRI image, tongue including only the intrinsic muscle is delineated in every section and reconstructed 3-dimensionally and calculated the volume and surface area to be reconstructed according to the degree of glossectomy. This volume and surface area was compared with the volume of anterolateral thigh and radial forearm flap. Results : The volume and surface area to be reconstructed in hemiglossectomy was $39.0{\pm}4.0cm^3$ and $31.8{\pm}2.7cm^2$ respectively. The average thickness of anterolateral thigh flap is $9.4{\pm}2.8mm$ and that of radial forearm is $3.8{\pm}1.0mm$. Comparing the curve of tongue surface area and volume with the volume of flap, the anterolateral thigh flap has more ideal volume to replace the defect. Conclusions : The surface area and volume requested for reconstruction could be suggested and the anterolateral thigh flap has more ideal volume for reconstruction of glossectomy defect.

• Archives of Craniofacial Surgery
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• v.22 no.4
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• pp.183-192
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• 2021

Background: The purse-string suture (PSS) is a simple and rapid wound closure method that results in minimal scarring. It has been used to treat circular or oval skin defects caused by tumor excision or trauma. However, due to obscurity, it is not widely used, especially for the head and neck. This study aimed to modify the PSS to obtain predictable and acceptable results. Methods: A total of 45 sites in 39 patients with various types of skin and soft tissue defects in the head and neck were treated with PSS. We used PDS II (2-0 to 5-0), which is an absorbable suture. Minimal dissection of the subcutaneous layer was performed. The suture knot was hidden by placing it in the dissection layer. Depending on the characteristics of the skin and soft tissue defects, additional surgical interventions such as side-to-side advancement sutures, double PSS, or split-thickness skin graft were applied. Results: All wounds healed completely without any serious complications. Large defects up to 45 mm in diameter were successfully reconstructed using only PSS. Postoperative radiating folds were almost flattened after approximately 1-2 months. Conclusion: PSS is simple, rapid, and relatively free from surgical design. Owing to the circumferential advancement of the surrounding tissue, PSS always results in a smaller scar than the initial lesion and less distortion of the body structures around the wound in the completely healed defect. If the operator can predict the process of healing and immediate radiating folds, PSS could be a favorable option for round skin defects in the head and neck.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2009.10a
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• pp.191-192
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• 2009

• The Journal of Korean Society for Radiation Therapy
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• v.9 no.1
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• pp.87-93
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• 1997

The using of compensator is required to adjust the irregular dose distribution due to irregular thickness of the body in Total Body Irradiation. Aluminuim, copper or lead is generally used as compensator. In our study, we would like to introduce a result of the attenuation and compensation effect of radiation use compensator made by duralumin and its clinical use. The thickness of compensator was calculated by the attenustion of radiation, which was measured by polystyrene phantom and ionization chamber(farmer). The compensation effect of radiation was measured by diode detector. All of conditions were set as in real treatment, and the distanc from source to detector was 446 cm. We also made fixation of device to easily attach the compensator to LINAC. Beam spoiler was menufactured and placed on the patient to irradiate sufficient dose to the skin. diode detector were placed on head, neck, chest, umbilicus. pelvis and knee with each their entranced exit points, and datas of dose distribution were evaluated and compared in each points for eleven patients(Feb. 96-Feb. 97). The attenuation rate of irradiation by duralumin compensator was measured as $1.4\%$ in 2mm thickness. The mean attenuation rate was $1.3\%$ per 2mm as increasing the thickness gradually to 50 mm. By using duralunim compensator, dose distribution in each points of body was measured with ${\pm}2.8\%$ by diode detectior. We could easily calculate the thickness of compensator by measuring the attenuation rate of radiation, remarkably reduce the irragularity of dose distribution duo to the thickness of body and magnify the effect of radiation therapy.

• Physical Therapy Rehabilitation Science
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• v.9 no.3
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• pp.191-196
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• 2020

Objective: Congenital muscular torticollis (CMT) is a disease with abnormal head and neck posture in infants. It affects the child's movement and development and can lead to complications. Therefore, this study aims to find out what factors influence the rehabilitation treatment duration of infants with CMT. Design: Cross-sectional study. Methods: The subjects were 63 infants under 90 days of age who were diagnosed with CMT. Age, thickness of the sternocleidomastoid muscle (SCM) on the affected and non-affected side, head tilt angle, and head rotation angle of the affected head in infants were collected. The ratio of muscle thickness was calculated from the thickness of the affected SCM and the thickness of the non-affected SCM (A/N ratio). All subjects underwent conservative physical therapy twice a week for 30 minutes, and the end of the treatment was when the angle of head tilt was normal or less than 5 degrees, and the treatment duration was calculated. Results: Age, thickness of affected SCM, and head tilt were significantly correlated with treatment duration (p<0.05). The thickness of the non-affected SCM, A/N ratio, and head rotation angle did not show any correlation with treatment duration. The factors affecting the treatment duration were head tilt and age, showing 21% explanatory power of adjusted R². Conclusions: The main factors affecting the treatment duration of infants with CMT are head tilt and age. Therefore, more attention should be directed to the infant's head tilt and age for effective physical therapy of infants with CMT.