• 대한두개안면성형외과학회지
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• 제21권5호
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• pp.309-314
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• 2020

Reconstructions of extensive composite scalp and cranial defects are challenging due to high incidence of postoperative infection and reconstruction failure. In such cases, cranial reconstruction and vascularized soft tissue coverage are required. However, optimal reconstruction timing and material for cranioplasty are not yet determined. Herein, we present a large skull defect with a chronically infected wound that was not improved by repeated debridement and antibiotic treatment for 3 months. It was successfully treated with anterolateral thigh (ALT) free flap transfer for wound salvage and delayed cranioplasty with a patient-specific polyetheretherketone implant. To reduce infection risk, we performed the cranioplasty 1 year after the infection had resolved. In the meantime, depression of ALT flap at the skull defect site was observed, and the midline shift to the contralateral side was reported in a brain computed tomography (CT) scan, but no evidence of neurologic deterioration was found. After the surgery, sufficient cerebral expansion without noticeable dead-space was confirmed in a follow-up CT scan, and there was no complication over the 1-year follow-up period.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권1호
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• pp.104-109
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• 1991

외상이나 감염 또는 종양의 적출에 의해 발생한 하악골 결손부는 심미적, 기능적으로 많은 문제를 야기한다. Sykoff가 1900년에 자가골 이식으로 하악골 결손부를 수복한 이후 현재까지 많은 이식물과 이식 방법이 이용되어져 왔으며 특히 늑연골은 1920년에 Gillies에 의해서 TMJ 수복에 처음 사용된 이후 성장기 아동의 과두결손부 수복에 많이 이용되고 있다. 또한 자가장골은 안면부의 수복에 보편적으로 이용되고 있는 공급부위이며 특히 많은 양의 망상골이 필요한 경우에는 후방 접근법을 이용함으로서 충분한 양의 골을 얻을 수 있다. 수복의 시기는 환자마다 차이가 있어서 나이, 과거력, 초기질별의 상태, 성장발육정도 및 심미적, 정신적인 면을 고려하여야 하며 악성종양의 제거시에는 재발여부와 방사선 치료 등을 고려하여 적절한 시기를 선택하여야 하나, 일반적으로 술후 약 1-2년 후에 시행할 수 있다. 본원에서는 하악골 골육종으로 진단된 15세 남자 환자에서 과두를 포함하는 좌측 하악골 절단술후 임시로 레진수복물을 장착한뒤 약 20개월간의 주기적인 검진결과 재발의 기미가 없어 늑연골과 장골의 복합이식을 통하여 심미적, 기능적으로 양호한 결과를 얻었기에 그 증례를 보고하는 바이다.

• 대한골관절종양학회지
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• 제4권1호
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• pp.22-29
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• 1998

A limb-sparing operation has a definitive role in the treatment of osteosarcoma in the lower extremity of skeletally-immature patients. After a limb-sparing operation, leg length discrepancy remains as a major disability that should be corrected. This study was designed to suggest methods of tumor resection and proper timing of leg length equalization in skeletally immature osteosarcoma patients. From September 1990 to January 1998, we reviewed eight osteosarcoma patients in an immature skeletal age. There were 4 males and 4 females, and their mean duration of follow-up was 50.37 months (range : 25 to 88 months). Mean skeletal age was 8 years (range : 8 months to 11 years). The patients were classified according to the methods of tumor resection ; intercalary resection in 1 case, transepiphyseal resection in 1, intra-articular resection in 5, and extra-articular resection in 1. The results were as follows ; 1. The leg lengthening was begun when a patient's leg length discrepancy reached 4-5cm. 2. The age of final lengthening with permanent reconstruction was 14 years in males and 12 years in females (about 2 years before skeletal maturity). 3. When reconstruction was performed with a temporary spacer, the site of lengthening Was in the soft tissue, not in bone, and then a permanant reconstruction was done. 4. Reconstruction with a biologic spacer to preserve the joint function was a reasonable method for equalization of leg length. In conclusion, the appropriate choice of reconstructive method and the age at which to correct the leg length discrepancy in a skeletally-immature osteosarcoma patients are important factors for maintaining leg length at full maturity.

• 한국통신학회논문지
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• 제29권1C호
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• pp.102-110
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• 2004

본 논문에서는 이차원 이산 웨이블릿 변환을 이용한 실시간 영상 압축 및 복원 프로세서의 구조를 제안하고 ASIC(Application specific integrated circuit) 라이브러리를 이용하여 최소의 하드웨어로 구현하였다. 구현된 하드웨어에서 데이터 패스부는 웨이블릿 변환과 역변환을 수행하는 DWT 커널(Kernel)부, 양자화기 및 역양자화기, 허프만 엔코더 및 디코더, 웨이블릿 역변환 시 계수의 덧셈을 수행하는 덧셈기 및 버퍼, 그리고 입출력을 위한 인터페이스와 버퍼로 구성하였다. 제어부는 프로그래밍 레지스터와 명령어를 디코딩하여 제어 신호를 생성하는 주 제어부, 그리고 상태를 외부로 알리는 상태 레지스터로 구성된다. 프로그래밍 조건에 따라서 영상을 압축할 때의 출력은 웨이블릿 계수, 양자화 계수 혹은 양자화 인덱스, 그리고 허프만 코드 중에서 선택하여 발생할 수 있고 영상을 복원할 때의 출력은 허프만 디코딩 결과, 복원된 양자화 계수 그리고 복원된 웨이블릿 계수 중에서 선택하여 발생할 수 있다. 프로그래밍 레지스터는 총 16개로 구성되어 있는데 각각이 한번의 수직 혹은 수평 방향의 웨이블릿 변환을 수행할 수 있고 각각의 레지스터들이 차례대로 동작하기 때문에 4 레벨의 웨이브릿 변환을 한번의 프로그래밍으로 수행가능하다. 구현된 하드웨어는 Hynix 0.35m CMOS 공정의 합성 라이브러리를 가지고 Synopsys 합성툴을 이용하여 게이트 레벨의 네트리스트(Netlist)를 추출하였고 이 네트리스트로부터 Vela 툴을 이용하여 타이밍정보를 추출하였다. 추출된 네트리스트와 타이밍정보(sdf 파일)를 입력으로 하여 NC-Verilog를 이용하여 타이밍 시뮬레이션을 수행하여 구현된 회로를 검증하였다. 또한 Apollo 툴을 이용하여 PNR(Place and route) 및 레이아웃을 수행하였다. 구현된 회로는 약 5만 게이트의 적은 하드웨어 자원을 가지고 최대 80MHz에서 동작 가능하였다.

• 한국건설관리학회논문집
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• 제16권6호
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• pp.41-52
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• 2015

군 시설물은 80년대 이후 현대화 계획 및 군 복지의 향상 등으로 인해 그 수가 급격하게 증가하였다. 그러나 이렇게 증가한 시설물에 대해 체계적인 유지관리가 이루어지지 못하여 노후화되면서 이러한 노후시설의 성능향상이 필요하게 되었다. 노후 시설물의 성능향상 방안은 재건축과 리모델링으로 나눌 수 있다.그러나 표준 리모델링 범위 내에서는 리모델링이 더 경제적이라는 연구결과에도 불구하고 군 시설의 리모델링은 성능 향상의 수단으로써 재건축과 동등하게 고려되고 있지 않다. 따라서 본 연구에서는 건축물의 생애주기 동안의 성능 변화와 리모델링 필요 범위의 관계성에 착안하여 재건축보다 리모델링이 경제적인 특정시점(SPT)에 리모델링을 선택하는 방식의 리모델링 프로세스 모델(RPM)을 제안한다. 또한 군 시설물의 자료에 근거하여 이를 위해 필요한 현실성 있는 내용연수와 기능성 평가기준을 함께 제시한다. 이 RPM을 통해 기존프로세스에서 발생하는 안전성에는 문제가 없으나 기능성에 문제가 있는 시설물들이 적절한 리모델링 시기를 놓쳐 어쩔 수 없이 재건축을 하게 되는 사례를 방지할 수 있게 하였다. 또한 준공시기와 유형이 다른 시설물을 관리하는 입장에서의 재건축/리모델링 선택의 의사결정을 보다 간단하게 할 수 있는 가능성을 제시하였다. 이러한 리모델링에 보다 초점을 맞춘 프로세스를 통해 예산절감 효과뿐만 아니라 재건축으로 인한 사회적 낭비를 줄이는데 기여할 수 있을 것이라 판단된다.

• 대한정형외과학회지
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• 제55권4호
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• pp.294-304
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• 2020

전방십자인대 재건술은 수술의 시기, 수술 기법, 이식건의 선택 및 고정 방법, 재활 등 각각의 수술 과정을 성공적으로 수행해야하는 수술이다. 여러 과정들 중에서 이식건의 선택과 고정 방법은 아주 중요한 과정 중에 하나이지만 아직 술자들 간에 많은 논쟁의 여지가 있다. 이식건의 장단점에 관해 많은 연구들이 진행되고 있지만 여전히 이상적인 건에 대한 결론은 없다. 이와 유사하게 대퇴터널 및 경골터널 고정 방법에 대해서도 최근 많은 방법들이 개발되고 소개되고 있지만 그중에서 가장 좋은 방법을 찾지 못한 상태이다. 그래서 술자는 다양한 이식건과 고정 방법에 대하여 익숙해져야 하며 각각의 방법에 대한 장단점을 잘 알고 있어야 할 것이다. 따라서 본 종설은 전방십자인대 손상에서 이식건의 선택과 고정 방법에 대하여 지금까지 밝혀진 연구들을 분석하고 이에 관해 논의하고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권3호
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• pp.207-215
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• 2009

Purpose: The aim of the present study is to evaluate the long term bone healing after horizontal ridge augmentation using auto block bone graft for implant installation timing. Materials and Methods: Five Beagle dogs(which were 14 months old and weighted approximately 10kg). In surgery 1(extraction & bone defect), premolars(P2, P3,P4) were extracted and the buccal bone plate was removed to create a horizontally defected ridge. After three months healing, in surgery 2(ridge augmentation). Auto block bone grafts from the mandibular ramus were used in filling the bone defects were fixed with stabilizing screws. The following fluorochrome labels were given intravenously to the beagle dogs: oxytetracycline 1week after the surgery, alizarin red 4 weeks after the surgery, calcein blue 8 weeks after the surgery. The tissue samples were obtained from the sacrificed dogs of 1, 4, 8, 12, 16 weeks after the surgery. Non-decalcified sections were prepared by resin embedding and microsection to find thickness of $10{\mu}m$ for the histologic examination and analysis. Results: 1. We could achieve the successful reconstruction of the horizontal bone defect by auto block bone graft. The grafted bone block remained stable morohologically after 16 weeks of the surgery. 2. In the histologic view. We observed osteoid tissue from the sample $4^{th}$ week sample and active capillary reconstruction in the grafted bone from the $12^{th}$ week sample. Healing procedures of auto bone grafts were compared to that of the host bone. 3. Bone mineralization could be detected from the $8^{th}$ week sample. 4. Fluorochrome labeling showed active bony changes and formation at the interface of the host bone and the block graft mainly. Bony activation in the grafted bone could be seen from the $4^{th}$ week samples. Conclusions: Active bone formation and remodeling between the grafted bone and host bone can be seen through the revascularization. After the perfect adhesion to host bone, Timing of successful implant installation can be detected through the ideal ridge formation by horizontal ridge augmentation.

• Journal of Chest Surgery
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• 제21권2호
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• pp.254-269
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• 1988

52 cases of ventricular septal defect [VSD] associated with aortic insufficiency [Al] were found among 1271 patients with simple VSD operated during 27-year period [1959, August-1987, June] at Seoul National University Hospital. Their preoperative data, intraoperative findings and postoperative short-term and long-term follow-up data were evaluated to find the proper timing and method of surgical treatment. The result of this survey shows as follows: 1. To obtain the proper surgical indication, cardiac catheterization and angiography, especially root aortography, was essential. 2. Of all 52 patients, the VSD were type I in 40 patients [77%], type II in 8 [15%] and combination of type I and II in 4 [3%]. Patch closure of VSD were performed in 46 patients and direct suture closure of small VSD in 6. Most common pathologic findings of Al were prolapse of right coronary cusp [40 cases, 77%]. Aortic valve reconstruction were performed in 19 patients, aortic valve replacement in 6 and VSD closure alone in 27. 3. There were 3 surgical deaths [mortality 5.8%], and the long-term follow-up shows that VSD closure alone might have been sufficient to arrest progression of Al in younger patients [less than 10-year old], particularly in those with mild insufficiency. Valve reconstructions, when necessary, were more effective when done at an early age [less than 15-year old]. In a conclusion, we could recommend followings: 1. If patient at any age having VSD with Al is diagnosed, prompt operation is recommended. As for the surgical method, VSD closure only may be fit for mild degree of Al when patient is less than 10-year old, but the management of valve itself may be needed for moderate to severe degree of Al, especially when patient is over 10 year old. The management of valve itself may be variable, but valve reconstruction should be considered as a first choice in less than 15-year old patient. If patient is diagnosed less than 5-year old without evidence of Al, close follow-up observation is recommended. But if Al evidences of clinical findings and/or echocardiography during follow-up examination are notified, corrective operation should be accomplished while the Al is mild. If cusp prolapse and/or even type I VSD of significant size is demonstrated on aortogram, without Al, it should be corrected as early as possible before the patient is about 5 years old.

• 대한전기학회논문지:시스템및제어부문D
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• 제53권1호
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• pp.1-9
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• 2004

In this paper, we proposed a hardware(H/W) structure which can compress and recontruct the input image in real time operation and implemented it into a FPGA platform using VHDL(VHSIC Hardware Description Language). All the image processing element to process both compression and reconstruction in a FPGA were considered each of them was mapped into a H/W with the efficient structure for FPGA. We used the DWT(discrete wavelet transform) which transforms the data from spatial domain to the frequency domain, because use considered the motion JPEG2000 as the application. The implemented H/W is separated to both the data path part and the control part. The data path part consisted of the image processing blocks and the data processing blocks. The image processing blocks consisted of the DWT Kernel for the filtering by DWT, Quantizer/Huffman Encoder, Inverse Adder/Buffer for adding the low frequency coefficient to the high frequency one in the inverse DWT operation, and Huffman Decoder. Also there existed the interface blocks for communicating with the external application environments and the timing blocks for buffering between the internal blocks. The global operations of the designed H/W are the image compression and the reconstruction, and it is operated by the unit or a field synchronized with the A/D converter. The implemented H/W used the 54％(12943) LAB(Logic Array Block) and 9％(28352) ESB(Embedded System Block) in the APEX20KC EP20K600CB652-7 FPGA chip of ALTERA, and stably operated in the 70MHz clock frequency. So we verified the real time operation. that is. processing 60 fields/sec(30 frames/sec).

• 대한치과교정학회지
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• 제49권6호
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• pp.413-426
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• 2019

This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.