• Journal of Korean Foot and Ankle Society
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• v.15 no.2
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• pp.51-57
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• 2011

Pilon fractures involving distal tibia remain one of the most difficult therapeutic challenges that confront the orthopedic surgeons because of associated soft tissue injury is common. To introduce and describe the diagnosis, current treatment, results and complications of the pilon fractures. In initial assessment, the correct evaluation of the fracture type through radiographic checkup and examination of the soft tissue envelope is needed to decide appropriate treatment planning of pilon fractures. Even though Ruedi and Allgower reported 74% good and excellent results with primary open reduction and internal fixation, recently the second staged treatment of pilon fractures is preferred to orthopedic traumatologist because of the soft tissue problem is common after primary open reduction and internal fixation. The components of the first stage are focused primarily on stabilization of the soft tissue envelope. If fibula is fractured, fibular open reduction and internal fixation is integral part of initial management for reducing the majority of tibial deformities. Ankle-spanning temporary external fixator is used to restore limb alignment and displaced intraarticular fragments through ligamentotaxis and distraction. And the second stage, definitive open reduction and internal fixation of the tibial component, is undertaken when the soft tissue injury has resolved and no infection sign is seen on pin site of external fixator. The goals of definitive internal fixation should include absolute stability and interfragmentary compression of reduced articular segments, stable fixation of the articular segment to the tibial diaphysis, and restoration of coronal, transverse, and sagittal plane alignments. The location, rigidity, and kinds of the implants are based on each individual fractures. The conventional plate fixation has more advantages in anatomical reduction of intraarticular fractures than locking compression plate. But it has more complications as infection, delayed union and nonunion. The locking compression plate fixation provides greater stability and lesser wound problem than conventional implants. But the locking compression plate remains poorly defined for intraarticular fractures of the distal tibia. Active, active assisted, passive range of motion of the ankle is recommended when postoperative rehabilitation is started. Splinting with the foot in neutral is continued until suture is removed at the 2~3 weeks and weight bearing is delayed for approximately 12 weeks. The recognition of the soft tissue injury has evolved as a critical component of the management of pilon fractures. At this point, the second staged treatment of pilon fractures is good treatment option because of it is designed to promote recovery of the soft tissue envelope in first stage operation and get a good result in definitive reduction and stabilization of the articular surface and axial alignment in second stage operation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.4
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• pp.1576-1581
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• 2013

In the present study, the performance of a PF heat exchanger for heat pump dryer was investigated. Capacity and dehumidification amount of the PF heat exchangers(PF1, PF2, PF3) by different inclination angles($0^{\circ}$, $30^{\circ}$, $60^{\circ}$) were studied. Experimental conditions were an air velocity crossing to the heat exchanger(0.5m/s), an air dry-bulb temperature($60^{\circ}C$) and relative humidity(70%). The experimental results have shown that the performance of the inclined PF heat exchangers was better than that of the vertically installed one. PF3 showed better performance compared to PF1 and PF2 due to the large pin pitch which are leading to more draining for dehumidified water. But, capacity and dehumidification amount of the PF heat exchanger at the inclination angles of $60^{\circ}$ was decreased due to pressure drop. Also, to predict the experimental data of the PF heat exchanger, the performance program was developed for the inclination angles of $0^{\circ}$. PF heat exchanger performance between experiment data and calculation data was satisfied within the maximum 2% for capacity and 3% for dehumidification amount.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.2
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• pp.133-139
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• 2012

This is a review regarding Mulliken's Modification using the Millard rotation-advancement principle for the repair of unilateral complete cleft lip and nasal deformity. All patients underwent prior labionasal adhesion and dentofacial orthopedics with a pin-retained (Latham) appliance used for infants with a cleft of the lip and palate. Technical variations concerning the operation are described. A high rotation and releasing incision in the columella lengthens the medial labial element and produces a symmetric prolabium with minimal transgression of the upper philtral column through the advancement flap. The orbicularis oris muscle is everted, from caudad to cephalad, to form the philtral ridge. A minor variation of unilimb Z-plasty is used to level the cleft side of Cupid's bow handle, and cutaneous closure proceeds superiorly from this junction. The dislocated alar cartilage is visualized though a nostril rim incision and suspended to the ipsilateral upper lateral cartilage. Symmetry of the alar base is addressed in three dimensions, including maneuvers to position the deviated anterior-caudal septum, configure the sill, and efface the lateral vestibular web. The authors believe the technical refinements described herein contribute favorably to the outcome of repair regarding unilateral cleft lip and nasal distortion.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.432-435
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• 2007

Purpose: The jejunal free flap has the shorter ischemic time than other flap and requires a laparotomy to harvest it. As the evaluation of the perfusion the buried flap is very important, the perfusion of the buried jejunal free flap requires monitoring for its salvage. We tried to improve the monitoring flap method in the jejunal free flap and examined its usefulness. Methods: From March 2002 to March 2006, the monitoring flap method was applied to 4 cases in 8 jejunal free flaps for the pharyngeal and cervical esophageal reconstructions. The distal part of the jejunal flap was exposed without suture fixation through cervical wound for monitoring its perfusion. The status of perfusion was judged by the color change of jejunal mucosa and mesentery. If necessary, pin prick test was performed. Doppler sonography was applied to mesenteric pedicle of the monitoring flap in case of suspicious abnormal circulation. Results: The monitoring flap shows no change in 3 cases, but the congestion happened in one case at the 12 hours after the operation. This congestion was caused by the twisting or kinking of the mesenteric pedicle of the monitoring flap. So, we fixed up the monitoring flap close to adjacent cervical skin for prevention of rotation. Finally, the main part of transferred jejunal flap was intact. Conclusion: The success of a jejunal free flap depends on close postoperative monitoring and early detection of vascular compromise. So, various monitoring methods have been tried, for instance, direct visualization using a fiberoptic pharyngoscope, through a Silastic window placed in the neck flap, or external surface monitoring with an Doppler sonography, use of a buried monitoring probe. But, all of the above have their own shortcomings of simplicity, non-invasiveness, reliability and etc. In our experience, monitoring flap can be a accurate and reliable method.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.7
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• pp.4842-4848
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• 2015

This paper presents a comparison of communication performance between the reconfigurable beam-steering antenna and the omni-directional (loop) antenna during standstill and walking motion. Both omni-directional and reconfigurable antennas were manufactured on the same fabric (${\varepsilon}_r=1.35$, $tqn{\delta}=0.02$) substrate and operated around 5 GHz band. The reconfigurable antenna was designed to steer the beam directions. To implement the beam-steering capability, the antenna used two PIN diodes. The measured peak gains were 5.9-6.6 dBi and the overall half power beam width (HPBW) was $102^{\circ}$. In order to compare the communication efficiency, both the bit error rate (BER) and the signal-to-noise ratio (SNR) were measured using a GNU Radio Companion software tool and user software radio peripheral (USRP) devices. The measurement were performed when both antennas were standstill and walking motion in an antenna chamber as well as in a smart home environment. From these results, the performances of the reconfigurable beam steering antenna outperformed that of the loop antenna. In addition, in terms of communication efficiencies, in an antenna chamber was better than in a smart home environment. In terms of movement of antennas, standstill state has better results than walking motion state.

• Journal of Veterinary Clinics
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• v.23 no.3
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• pp.291-299
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• 2006

During long bone lengthening, there are many disadvantages including axial deviation, malalignment and re-fracture which are commonly encountered inspite of its proven abilities. To study the effects of intramedullary K-wire application on the lengthening of long bone, ten skeletally mature mongrel dogs were separated into two groups(Group I, II). Right femurs of group I(5 dogs) were fixed with only monolateral external fixator after subperiosteal osteotomy. Right femurs of group II(5 dogs) were fixed with mono lateral external fixator and intramedullary K-wire after subperiosteal osteotomy. Lengthening was started at 7 days after the surgery with the rate of 0.5 mm per day for 5 weeks and the dogs were sacrificed after 15 weeks postoperatively to examine histologic differences and evaluate bone mineral density. Radiographic examination at an interval of two weeks was done to evaluate the type of callus formed and to analyze complications including instability of external skeletal fixation and axial deviation. Bone mineral density at the lengthened area and contralateral nonlengthened area were measured using quantitative computerized tomography. Histological examination of regenerated bone was performed using Masson's trichrome stain method. The radiographs demonstrated poor callus formation, higher incidence of axial deviation and screw loosening in the group I compared to the group II. The bone mineral density at the lengthened area in the group II was higher than that of the group I(P<0.05). Histological examination showed that the new bone trabeculae in the group II were greater than that of the group I. In conclusion, the combination of monolateral external fixator and intramedullary K-wire can prevent pin loosening, axial deviation and reduce healing period in dogs.

• Archives of Plastic Surgery
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• v.45 no.5
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• pp.449-457
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• 2018

Background Although previous studies have focused on determining prognostic and causative variables associated with fistula-related complications after head and neck reconstructive surgery, only a few studies have addressed preventive measures. Noting that pooled saliva complicates wound healing and precipitates fistula-related complications, we devised a continuous suction system to remove saliva during early postoperative recovery. Methods A continuous suction system was implemented in 20 patients after head and neck reconstructive surgery between January 2012 and October 2017. This group was compared to a control group of 16 patients at the same institution. The system was placed orally when the lesion was on the anterior side of the retromolar trigone area, and when glossectomy or resection of the mouth floor was performed. When the orohypopharynx and/or larynx were eradicated, the irrigation system was placed in the pharyngeal area. Results The mean follow-up period was $9.2{\pm}2.4$ months. The Hemovac system was applied for an average of 7.5 days. On average, 6.5 days were needed for the net drain output to fall below 10 mL. Complications were analyzed according to their causes and rates. A fistula occurred in two cases in the suction group. Compared to the control group, a significant difference was noted in the surgical site infection rate (P<0.031). Conclusions Clinical observations showed reduced saliva pooling and a reduction in the infection rate. This resulted in improved wound healing through the application of a continuous suction system.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.746-757
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• 1996

Bony defects may be found as a result of congenital anomalies, traumatic injury, automobile collisions and industrial accidents in the maxillofacial area. Such conditions are often associated with severs functional and esthetic problem. Various surgical procedure has been utilized in attempts to repair and reconstruct bony defects. Bone is a complex, living, constantly changing tissue. The architecture and composition of cancellous and cortical bone allow the skeleton to perform its essential mechanical functions. Periosteum covers the external surface of bone and consists of two layers : an outer fibrous layer and an inner more cellular and vascular layer. The inner osteogenic layer or cambium layer can form new bone while the outer layer firms part of the insertions of tendons, ligaments and muscles. This study was under taken to evaluate bone healing process on partial defect of calvarial bone with or without periosteum in rat. We made calvarial defects of different size(4mm, 6mm, 8mm) with periosteum or without periosteum in rat to study the effect of defect size on healing process. Control and experimental groups sacrified at 1, 2, 4, 6, 8 weeks, postoperatively. We examed the specimens by gloss findings, light microscophy, and fluorescent microscophy. The results were as follows. 1. Gloss findings: Control groups are larger bony defects than experimental groups after 2 weeks, and than control groups advanced healing of defected bone but experimental groups are lesser after 4, 6 weeks. After 8 weeks, bone defect has not been identified in control and experimental groups. 2. Light microscope: All defects of control groups are larger bony defects than experimental groups after 2 weeks. And than control groups show smaller defect after 4 weeks. After 8 weeks, the control group reveal pin-point sized, hardly identifiable defect space and the experimental group reveal small, but definite defect space. 3. Fluorescent microscope : Each week, new bone formation of control group is very similar to the experimental group. In this study, Osteogenesis of calvarial bone defects with periosteum or without periosteum was examined for 8 weeks in rats. The replaced periosteum had batter new bone formation than the removed periosteum.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.679-700
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• 1996

Inferior alveolar nerve dysfunction may be the result of trauma, disease, or iatrogenic injury. Inferior alveolar nerve injury is inherent risk in endodontic therapy, orthognathic surgery of the mandible, and extraction of mandibular teeth, particularly the third molars. The sensory disturbances of inferior alveolar nerve associated with such injury have been well documented clinical problem that is commonly evaluated by several clinical sensory test including Tinels sign, Von Frey test(static light touch detection), directional discrimination, two-point discrimination, pin pressure nociceptive discrimination, and thermal test. These methods used to detect and assess inferior alveolar nerve injury have been subjective in nature, relying on the cooperation of the patients. In addition, many of these techniques are sensitive to differences in the examiners experience and skill with the particular technique. Data obtained at different times or by different examiners are therefore difficult to compare. Prior experimental studies have used electro diagnostic methods(sensory evoked potential) to objectively evaluate inferior alveolar nerve after nerve injury. This study was designed with inferior alveolar nerve of rabbit. Several types of injury including mind, moderate, severe compression and perforation with 19 gauze, 21 gauze needle and 6mm, 10mm traction were applied for taking the sesory evoked ppterntial. Latency and amplitude of injury rabbit inferior alveolar nerve were investigated with sensory evoked potential using unpaired t-test. The results were as follows : 1. Intensity of threshold (T1) was $128{\pm}16{\mu}A$ : latency, $0.87{\pm}0.07$ microsecond : amplitude, $0.4{\pm}0.1{\mu}V$ : conduction velocity, 23.3 m/s in sensory evoked potential of uninjured rabbit inferior alveolar nerve. 2. Rabbit inferior alveolar nerve consists of type II and III sensory nerve fiber. 3. Latency was increased and amplitude was decreased in compression injury. The more injured, the more changed in latency and amplitude. 4. Findings in perforation injury was similar to compression injury. Waveform for sensory evoked potential improved by increasing postinjured time. 5. Increasing latency was prominent in traction injury rabbit inferior alveolar nerve. 6. In microscopic histopathological findings, significant degeneration and disorganization of the internal architecture were seen in nerve facicle of severe compression and 10mm traction group. From the above findings, electrophysiological assessment(sensory evoked potential) of rabbit injured inferior alveolar nerve is reliable technique in diagnosis and prognosis of nerve injury.

• Journal of Bio-Environment Control
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• v.12 no.3
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• pp.107-113
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• 2003

This study was carried out to improve the performance of pre-developed heat recovery devices attached to exhaust-gas flue connected to combustion chamber of greenhouse heating system. Four different units were compared in the aspect of heat recovery performance; A-, B-, and C-types are exactly the same with the old ones reported in previous studies. D-type newly developed in this experiment is mainly different with the old ones in its heat exchange area and tube thickness. But airflow direction(U-turn) and pipe arrangement are similar with previous three types. The results are summarized as follows; 1. System performances in the aspect of heat recovery efficiency were estimated as 42.2% for A-type, 40.6% for B-type, 54.4% for C-type, and 69.2% for D-type. 2. There was not significant improvement of heat recovering efficiency between two different airflow directions inside the heat exchange system. But considering current technical conditions, straight air flow pattern has more advantage than hair-pin How pattern (U-turn f1ow). 3. The main factors influencing on heat recovery efficiency were presumably verified to be the total area of heat exchange surface, the thickness of ail-flow pipes, and the convective heat transfer coefficient influenced by airflow velocity under the conditions of allowable pipe durability and safety. 4. Desirable blower capacity for each type of heat recovery units were significantly different to each other. Therefore, the optimum airflow capacity should be determined by considering in economic aspect of electricity required together with the optimum heat recovery performance of given heat recovery systems.