• 대한두경부종양학회지
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• 제33권2호
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• pp.89-93
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• 2017

Background. Ever since the first report of deltopectoral flap in pharyngo-esophageal reconstruction in 1965, various methods of flap reconstruction have been introduced, allowing surgical eradication of tumors that were once thought to be inoperable. Despite these advancement, many literatures emphasize distant metastasis and second primary malignancies as the most important factors that contribute to the low 5-year survival rate of the patients. Specific consensus about defining second primary cancer is still debatable, due to small number of reports regarding second primary tumors arising in flaps used for reconstruction of defects in the head and neck region. Case. We report a case of a 72-year-old male patient who, under the diagnosis of hypopharyngeal cancer, underwent total laryngectomy with partial pharyngectomy, extended right radical neck dissection with extended left lateral neck dissection, right hemithyroidectomy and radial forearm free flap reconstruction on June 16, 2003. After 37 cycles of radiation therapy, the patient exhibited no sign of recurrence. The patient revisited our department on June 14, 2016 with chief complaint of dysphagia that started two months before the visit. Radiologic studies and histology revealed squamous cell carcinoma in neopharynx, one that had been reconstructed with forearm free flap. Conclusion. Until now, only a handful of reports regarding patients with second primary cancer in reconstructed flaps have been described. Despite its rarity, diagnostic criteria for second primary cancer should always kept in consideration for patients with recurred tumor.

• 대한두개안면성형외과학회지
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• 제21권5호
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• pp.269-275
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• 2020

Background: The advance in microsurgical technique has facilitated a proper approach for reconstruction of extensive head and neck defects. For the success of free tissue reconstruction, selection of the recipient vessel is one of the most important factors. However, the vascular anatomy of this region is very complex, and a clear guideline about this subject is still lacking. In this study, we present our 30 years of experiences of free tissue reconstruction for head and neck defects. Methods: In this retrospective study, we analyzed a total of 138 flaps in 127 patients who underwent head and neck reconstruction using free tissue transfer following tumor resection between October 1986 to August 2019. Patients who underwent facial palsy reconstruction were excluded. Medical records including patient's demographics, detailed operation notes, follow-up records, and photographs were collected and analyzed. Results: Among a total of 127 patients, 10 patients underwent a secondary operation due to cancer recurrence. The most commonly used type of flap was radial forearm flap (n=107), followed by the anterolateral thigh flap (n=18) and fibula flap (n=10). With regard to recipient vessels, superior thyroid artery was most commonly used in arterial anastomosis (58.7%), and internal jugular vein (51.3%) was the first choice for venous anastomosis. The flap survival rate was 100%. Four cases of venous thrombosis were resolved with thrombectomy and re-anastomosis. Conclusion: Superior thyroid artery and internal jugular vein were reliable choices as recipient vessels. Proper recipient vessel selection could improve the result of head and neck reconstruction.

• 정보처리학회논문지B
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• 제14B권4호
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• pp.311-320
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• 2007

본 논문에서는 강건한 얼굴 포즈 추정과 실시간 표정제어가 가능한 비전 기반 3차원 얼굴 모델의 자동 표정 생성 방법 및 시스템을 제안한다. 기존의 비전 기반 3차원 얼굴 애니메이션에 관한 연구는 얼굴의 움직임을 나타내는 모션 추정을 반영하지 못하고 얼굴 표정 생성에 초점을 맞추고 있다. 그러나, 얼굴 포즈를 정확히 추정하여 반영하는 작업은 현실감 있는 얼굴 애니메이션을 위해서 중요한 이슈로 인식되고 있다. 본 연구 에서는 얼굴 포즈추정과 얼굴 표정제어가 동시에 가능한 통합 애니메이션 시스템을 제안 하였다. 제안된 얼굴 모델의 표정 생성 시스템은 크게 얼굴 검출, 얼굴 모션 추정, 표정 제어로 구성되어 있다. 얼굴 검출은 비모수적 HT 컬러 모델과 템플릿 매칭을 통해 수행된다. 검출된 얼굴 영역으로부터 얼굴 모션 추정과 얼굴 표정 제어를 수행한다. 얼굴 모션 추정을 위하여 3차원 실린더 모델을 검출된 얼굴 영역에 투영하고 광류(optical flow) 알고리즘을 이용하여 얼굴의 모션을 추정하며 추정된 결과를 3차원 얼굴 모델에 적용한다. 얼굴 모델의 표정을 생성하기 위해 특징점 기반의 얼굴 모델 표정 생성 방법을 적용한다. 얼굴의 구조적 정보와 템플릿 매칭을 이용하여 주요 얼굴 특징점을 검출하며 광류 알고리즘에 의하여 특징점을 추적한다. 추적된 특징점의 위치는 얼굴의 모션 정보와 표정 정보의 조합으로 이루어져있기 때문에 기하학적 변환을 이용하여 얼굴의 방향이 정면이었을 경우의 특징점의 변위인 애니메이션 매개변수(parameters)를 계산한다. 결국 얼굴 표정 복제는 두 개의 정합과정을 통해 수행된다. 애니메이션 매개변수 3차원 얼굴 모델의 주요 특징점(제어점)의 이동은 획득된 애니메이션 매개변수를 적용하여 수행하며, 정점 주위의 부가적 정점의 위치는 RBF(Radial Basis Function) 보간법을 통해 변형한다. 실험결과 본 논문에서 제안된 비전기반 애니메이션 시스템은 비디오 영상으로부터 강건한 얼굴 포즈 추정과 얼굴의 표정변화를 잘 반영하여 현실감 있는 애니메이션을 생성함을 입증할 수 있었다.

• Journal of Trauma and Injury
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• 제27권2호
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• pp.13-19
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• 2014

Purpose: In general, X-ray examinations are not recommended for radial head subluxation (pulled elbow) patients. The purpose of this study was to determine the frequency of X-ray examinations and to investigate the factors associated with the decision to perform an X-ray examination on a patient with a pulled elbow. Methods: Patients who visited the pediatric emergency department (ED) of one tertiary hospital from January 1, 2011, to December 31, 2012, with a diagnosis of radial head subluxation at discharge were enrolled in this study. Through retrospective chart reviews, factors that could have influenced the decision to perform an X-ray examination and their statistical relevance were analyzed. Results: A total 308 patients were enrolled, and 101 patients (32.8%) underwent X-ray examinations. Among the 252 patients with a typical pulled elbow, 65 underwent X-ray examination. This result showed statistical significance compared to atypical pull-elbow group (25.8% vs. 64.3%, p<0.001). Factors associated with the decision to perform an X-ray examination were analyzed using the Chi-square test and the Fisher's exact test. The mechanism of injury and consultation with an orthopedic surgeon (p=0.001) showed statistical significance. In the multivariable logistic regression, the odds ratio (OR) for the injury mechanism was 4.7 (95% CI: 1.8~8.8, p<0.001) and that for consultation with an orthopedic surgeon was 8.0 (95% CI: 1.6~40.7, p=0.004). Conclusion: One third of patients with a pulled elbow underwent X-ray examination, and patients with an atypical mechanism of injury underwent more frequent X-ray examinations than did patients with a typical mechanism of injury. The factors that could have influenced the decision to perform an X-ray examination were mechanism of injury and consultation with an orthopedic surgeon.

• 대한두개안면성형외과학회지
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• 제11권1호
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• pp.53-57
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• 2010

연부조직만으로 경구개를 재건하는데 있어서는 환자군을 적절히 선택하는 것이 중요하며 골재건이 필요하지 않은 Okay 분류 Ia와 Ib가 주요한 적응증이 된다. 하악이나 구강저부 결손을 재건하는 것과는 다르게 경구개 결손은 구강과 비강 점막층을 동시에 수복할 수 있는 피판이 이상적이다. 이중 저자들은 전완유리피판에 전상판화 방법을 좀 더 안정적으로 시행, 경구개 전층을 성공적으로 재건하였으며, 특히 저작과 연하 등 기능적 측면뿐 아니라 경구개 및 비강의 점막을 함께 복원할 수 있는 해부학적인 장점이 있는 피판임을 확인하여 문헌고찰과 함께 보고하는 바이다.

• Investigative Magnetic Resonance Imaging
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• 제18권2호
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• pp.87-106
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• 2014

Purpose : To describe how a robust implementation of a radial 3D gradient-echo sequence with stack-of-stars sampling can be achieved, to review the imaging properties of radial acquisitions, and to share the experience from more than 5000 clinical patient scans. Materials and Methods: A radial stack-of-stars sequence was implemented and installed on 9 clinical MR systems operating at 1.5 and 3 Tesla. Protocols were designed for various applications in which motion artifacts frequently pose a problem with conventional Cartesian techniques. Radial scans were added to routine examinations without selection of specific patient cohorts. Results: Radial acquisitions show significantly lower sensitivity to motion and allow examinations during free breathing. Elimination of breath-holding reduces failure rates for non-compliant patients and enables imaging at higher resolution. Residual artifacts appear as streaks, which are easy to identify and rarely obscure diagnostic information. The improved robustness comes at the expense of longer scan durations, the requirement for fat suppression, and the nonexistence of a time-to-center value. Care needs to be taken during the configuration of receive coils. Conclusion: Routine clinical use of radial stack-of-stars sequences is feasible with current MR systems and may serve as substitute for conventional fat-suppressed T1-weighted protocols in applications where motion is likely to degrade the image quality.

• 대한자기공명의과학회:학술대회논문집
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• 대한자기공명의과학회 1999년도 제4차 추계학술대회 초록집
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• pp.114-114
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• 1999

• International Journal of Automotive Technology
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• 제6권5호
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• pp.513-517
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• 2005

A full-bead of multi-layer-steel engine head gasket, taking charge of the dynamic sealing of combustion chamber, is susceptible to fatigue failure. The fatigue durability of full-bead was assessed with the finite element analysis results and the high-cycle multi-axial fatigue theory. The assessment aimed to reveal the effects of the forming parameters and dimensions of full-bead. The results show that the selection of embossing parameters producing less deformation of bead plate is beneficial for the improvement of durability while the flatting has marginal influence. The fatigue durability also improves with the increase in the width of full-bead and the radial length of bore-side flat region. However, the dimensional effects are limited due to the occurrence of snap-through.

• Archives of Reconstructive Microsurgery
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• 제21권2호
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• pp.81-85
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• 2012

Purpose: Saturday night palsy is a transient form of nerve palsy that occurs after a prolonged period of direct pressure on the course of radial nerve by one's own or spouse's head. Although commonly encountered, there have been only few studies concerning its convalescence. The purpose of this study is to predict the prognosis of Saturday night palsy based on the causes, time to recovery and degree of recovery. Materials and Methods: Retrospective study of 20 patients who were diagnosed compression radial nerve palsy was performed. The average age was 36.7 years old and the mean follow-up period was 19.6 months. We investigated sleeping hours as an indirect measure of nerve compression time, recovery of wrist and finger extension, DASH score on the monthly based follow up. Results: The mean sleeping hours was 5.8 hours and all patients showed full recovery of wrist and fingers extension with the mean duration of symptom for 3.2 months. DASH score was an average 1.53 at the last follow up and we found no statistical significance between the time to recovery and the sleeping hours. Conclusion: Complete natural recovery can be expected in compression radial nerve palsy in this study without correlation with sleeping time. Accurate diagnosis is important in order to avoid unnecessary therapeutic intervention and further study should be accomplished for clarifying the related prognostic factors in larger scale of the cases.

• Archives of Plastic Surgery
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• 제50권3호
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• pp.264-273
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• 2023

The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap, and yet is less commonly utilized than other free flaps in microvascular reconstructions of the head and neck. The aim is to conduct a high-quality Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)- and Assessment of Multiple Systematic Reviews 2 (AMSTAR 2)-compliant systematic review comparing the use of the MSAP flap to other microvascular free flaps in the head and neck. Medline, Embase, and Web of Science databases were searched to identify all original comparative studies comparing patients undergoing head and neck reconstruction with an MSAP flap to the radial forearm free flap (RFFF) or anterolateral thigh (ALT) flap from inception to February 2021. Outcome studied were the recipient-site and donor-site morbidities as well as speech and swallow function. A total of 473 articles were identified from title and abstract review. Four studies met the inclusion criteria. Compared with the RFFF and the ALT flaps, the MSAP flap had more recipient-site complications (6.0 vs 10.4%) but less donor-site complications (20.2 vs 7.8%). The MSAP flap demonstrated better overall donor-site appearance and function than the RFFF and ALT flaps (p = 0.0006) but no statistical difference in speech and swallowing function following reconstruction (p = 0.28). Although higher quality studies reviewing the use of the MSAP flap to other free flaps are needed, the MSAP flap provides a viable and effective reconstructive option and should be strongly considered for reconstruction of head and neck defects.