• Archives of Plastic Surgery
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• v.45 no.5
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• pp.466-469
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• 2018

The highly contoured nature of the nose and the abundant free margin makes it especially difficult to reconstruct. In this report, we describe the use of a new helical rim free flap technique for the reconstruction of full-thickness nasal alar defects via supermicrosurgery. Briefly, after a wide excision with a margin of 0.7 cm, an alar defect with a size of $1{\times}1{\times}0.5cm$ was obtained, which included the full thickness of the skin, mucosa, and lower lateral cartilage. Vessel dissection was performed in a straightforward manner, starting from the incision margin for flap harvest, without any further dissection for reach the greater trunk of the superficial temporal artery. The flap was inset in order to match the contour of the contralateral ala. We closed the donor site via rotation and advancement. No donor site morbidity was observed, despite the presence of a small scar that could easily be covered with hair. The alar contour was satisfactory, and the patient was satisfied with the results. The supermicrosurgical technique did not require further dissection to identify the vessels for anastomosis, leading to better cosmetic outcomes and a reduced operating time.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.546-551
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• 2006

Purpose: The reconstruction of oropharyngeal defect after cancer surgery is very difficult because of their complicated structure and the functional importance to prevent velopharyngeal incompetence. In this article we investigated affecting factors of velopharyngeal function after reconstruction and a fundamental rule of reconstruction for saving their functions such as swallowing, speeching and breathing. Methods: We classified 18 patients into three group under Kimata's grouping. Type I defect(6 patients) was healed by primary closure or secondary intention. In Type II or III defect, two operation methods were used - the folded flap(8 patients) and modified Gehanno method(4 patients), which include a lateral-posterior pharyngeal rotation-advancement flap. We evaluated wound dehiscence between the flap and the soft palate, speech intelligibility using Hirose's method, regurgitation during oral feeding, and hypernasality. Results: Most of type I or II defects patients recovered satisfactory velopharyngeal function. But, in patients with type III defects we found wound dehiscence, worse speech function, and common velopharyngeal incompetence. Conclusion: The large defect size and presence of wound dehiscence are major factors of postoperative velopharyngeal function. We conclude that folded flap or modified Gehanno method is a good reconstructive operation method for broad contact between the flap and defect site, preventing wound problem.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.529-545
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• 1996

In order to find the distribution, causes and treatments of cleft lip and/or palate, I analyzed 113 patients of cleft lip and/or palate who were treated in the Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University, Iksan, Chunbuk, KOREA from September 1984 to August 1995. The obtained results were as follows. 1. In total 113 patients of cleft lip and/or palate, male patients were 63 cases (56%) and female patients were 50 cases (44%). 2. In distribution of cleft lip and/or palate, cleft lip patients were 30 cases (27%), cleft palate patient were 23 cases (20%) and cleft lip and palate patients were 60 cases (53%). 3. Unilateral cleft lip patients (78 cases: 87%) were larger than bilateral cleft lip. In unilateral cleft lip patients, lip side cleft lip patients (45 cases: 50%) were larger than right side cleft lip patients (33 cases: 37%). 4. Possible causes of cleft lip and/or palate were related with familial tendency, drug intoxication, malnutrition, old maternal age, stress and hypoxia during 4-8 weeks of pregnancy period. 5. The favorite treated method of cleft lip was Millard rotation-advancement method. Probably the most popular operated period was 3 months. 6. The useful operating technique of cleft palate was Wardill V-Y flap method. The most popular period has been 18 to 24 months. 7. In 11 patients with velopharyngeal insufficiency, hypernasality decreased by superior based pharyngeal flap pharyngoplasty. 8. Cleft alveolus was treated with autogenous and allogeneic bone graft. The most appropriate operation period was 9 to 11 years.

• Korean Journal of Cleft Lip And Palate
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• v.7 no.2
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• pp.93-106
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• 2004

본 연구의 목적은 편측성 구순구개열 (UCLP) 환자에서 술전 비치조 정형장치 (presurgical nasoalveolar molding appliance, PNAM) 와 구순 봉합수술의 치조골 정형효과를 3차원 (3-D) 분석을 통하여 평가하는 것이다. 연구대상은 16명의 UCLP 환자 (평균 파열부거리: 10.46mm) 이며 PNAM 장치에 의한 치료와 rotation-advancement법에 의한 구순 봉합수술을 받았다 처음 내원시 (평균연령: $37.0{\pm}27.89$ 일), PNAM 치료를 받고 난 후이며 구순봉합수술 1달 전 (평균연령: $119.25{\pm}40.18$ 일), 구순봉합수술 2달 후 (평균연령: $190.81{\pm}42.78$ 일)에 상악의 인상을 채득하였다. 그 후 laser scanning machine (Orapix, Dimennex, Seoul, Korea) 과 3-D view software (3Dxer, Dimennex) 를 사용하여 3-D모형을 제작하였다. 선, 각도, 정중선변이, 거리, 면적 항목을 3-D 모형상에서 계측하고, 각 시기별의 차이를 비교하기 위하여 Wilcoxon signed rank test를 사용하여 분석하였다. PNAM치료 동안과 구순 봉합수술 후에도 치조골 후방부는 안정된 구조물이었다. PNAM치료에 의한 파열부 거리의 감소는 대분절 (greater segment) 의 내측 굴곡 (bending) 에 의하여 발생하였다. 대분절 (greater segment)의 전방 성장은 PNAM치료에 의하여 억제되었으나, 구순 봉합수술 후에 회복되었다. 구순 봉합수술 후에 대분절과 소분절 사이의 전방부 각도의 증가는 구순 반흔 (lip scar) 의 압력에 의한 치조골 정형 효과 때문으로 생각된다. 정중선변이는 PNAM치료에 의하여 개선되었다. PNAM치료 동안과 구순 봉합수술 후에 구개부 (palatal segment) 의 면적은 계속 증가하였다. 치조골 면적과 거리 항목의 증가는 후방부에서 크게 나타났다. 이러한 결과는 PNAM치료에 의한 치조골 정형효과는 주로 전방부에서 발생하며, 치조골의 성장은 구순 봉합수술 후에 후방부에서 주로 발생한다는 것을 의미한다.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.720-726
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• 2009

Purpose: Fasciocutaneous flap with random pattern flap has limitation in mobility and length - width ratio. This characteristic is more pronounced in lower extremity which has relatively poor vascularity. Perforator based flap in lower extremity reconstruction has various advantages as a axial flap, allowing abundant blood supply and widening of mobility range. So if it is not a case of wide defect, free flap can be replaced by perforator based flap. Methods: From April 2007 to March 2009, 18 cases of perforator flap were performed. 8 had defect in upper 1/3 of calf, 6 in middle 1/3, and 4 in lower 1/3. In 10 cases island flap were used, 3 case had transposition flap, 2 cases used advancement flap, 2 case had propeller flap and 1 case had rotation flap. Results: 17 cases survived without flap necrosis. Partial flap necrosis occurred in 1 case, so secondary split thickness skin graft was done. Chronic wound with pseudomonas infection occurred in 1 case, but it was completely cured with conservative treatment. Conclusion: Perforator based flap is useful in lower extremity reconstruction because of relative freedom in changing the size and thickness of the flap depending on the recipient site, good mobility, and abundant vascularity. And donor site morbidity can be minimized. Lower extremity reconstruction using perforator based flap is a good method because it can minimize the complication and obtain effective result.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.465-468
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• 2010

Purpose: Soft tissue deformity and skin defect after tumor resection in the periorbital area can cause trouble in the function of eyelid as well as in the aspect of external appearance. Therefore, as cosidering reconstruction in periorbital area, detailed assessment of both functional and aesthetic property are required. thus, the purpose of this study is to examine an appropriate reconstruction through clinical cases. Methods: A 14-year-old girl with congenital giant hairy nevus on right periorbital area was selected. Her first visit to our plastic surgery outpatient clinic was on July 2006. Since then, she has undergone staged removal of lesions and reconstruction by various flap technique such as pedicled island flap, forehead galeal flap, paramedian forehead flap, cheek rotation & advancement flap. Results: In the case of this girl, most lesions were removed and replaced by normal skins. Although there was the difference of skin color after skin graft, such difference was not noticeable and section scar by skin flaps was slight. There was no obvious dysfunction in the eyelids and the girl and her parents were satisfied with results after the surgery. Conclusions: In the reconstruction of soft tissue defect or soft tissue deformity and contracture, it is required to choose appropriate reconstruction method, considering aesthetic and functional aspects depending on aesthetic unit sufficiently.

• Archives of Craniofacial Surgery
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• v.22 no.5
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• pp.268-275
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• 2021

Background: The study aimed to evaluate nasal reconstruction techniques customized for Asians. The currently available nasal reconstruction guidelines are based on Caucasian patients, and their applicability is limited in Asian patients due to differences in anatomical and structural features. Methods: A retrospective analysis was performed of the medical records of 76 patients who underwent nasal reconstruction at a single center between January 2010 and June 2020. A comprehensive evaluation was conducted of patients' baseline demographics and clinical characteristics, including age, sex, medical history, defect size and location, reconstructive procedure, pathological diagnosis, postoperative complications, and recurrence. Results: In 59 cases (77%), nasal defects resulted from tumor ablation, and the remaining 17 cases involved post-traumatic (20%) and infection-induced (3%) tissue damage. The most common defect location was the alae, followed by the sidewalls, tip, and dorsum. Forehead flaps were the most commonly used reconstructive technique, followed by nasolabial advancement flaps, rotation flaps, and skin grafts. Each procedure was applied considering aspects of structural anatomy and healing physiology specific to Asians. Complications included nasal deformity, hypertrophic scarring, secondary infection, and partial flap necrosis, but no cases required additional surgical procedures. Tumors recurred in two cases, but tumor recurrence did not significantly affect flap integrity. Conclusion: Nasal reconstruction techniques applied considering Asians' facial features resulted in fewer postoperative complications and higher patient satisfaction than the approaches that are currently in widespread use. Therefore, this study is expected to serve as an essential reference for establishing treatment guidelines for nasal reconstruction in Asians.

• The Journal of the Convergence on Culture Technology
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• v.8 no.3
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• pp.507-514
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• 2022

This study is to compare and analyze the evaluation of cleaning cleanliness and usability according to the muscle activity and cleaning method in the wrist rotation motion when using a bottle washer for women with childbirth experience. To this end, when using an automatic bottle washer and a manual bottle washer, the muscle activity and cleaning cleanliness of the forearm muscles were quantitatively evaluated using equipment, and the effects of variables were analyzed and the following conclusions were obtained. First, it was found that the muscle activity was lower than that of the automatic baby bottle cleaner when using a manual bottle cleaner. Second, the cleanliness was judged to be the best in automatic washing (forward + reverse direction), followed by automatic washing (forward direction) and manual washing. Third, the usability evaluation of the use of the baby bottle washing machine showed higher satisfaction than that of the automatic baby bottle washing machine. Through these conclusions, this study can be used as basic data for product advancement in the future by proving the effectiveness of using an automatic bottle washer.

• Computers and Concrete
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• v.33 no.5
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• pp.535-544
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• 2024

In the rapidly advancing landscape of computer vision (CV) technology, there is a burgeoning interest in its integration with the construction industry. Camera calibration is the process of deriving intrinsic and extrinsic parameters that affect when the coordinates of the 3D real world are projected onto the 2D plane, where the intrinsic parameters are internal factors of the camera, and extrinsic parameters are external factors such as the position and rotation of the camera. Camera pose estimation or extrinsic calibration, which estimates extrinsic parameters, is essential information for CV application at construction since it can be used for indoor navigation of construction robots and field monitoring by restoring depth information. Traditionally, camera pose estimation methods for cameras relied on target objects such as markers or patterns. However, these methods, which are marker- or pattern-based, are often time-consuming due to the requirement of installing a target object for estimation. As a solution to this challenge, this study introduces a novel framework that facilitates camera pose estimation using standardized materials found commonly in construction sites, such as concrete forms. The proposed framework obtains 3D real-world coordinates by referring to construction materials with certain specifications, extracts the 2D coordinates of the corresponding image plane through keypoint detection, and derives the camera's coordinate through the perspective-n-point (PnP) method which derives the extrinsic parameters by matching 3D and 2D coordinate pairs. This framework presents a substantial advancement as it streamlines the extrinsic calibration process, thereby potentially enhancing the efficiency of CV technology application and data collection at construction sites. This approach holds promise for expediting and optimizing various construction-related tasks by automating and simplifying the calibration procedure.

• Journal of Chest Surgery
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• v.34 no.11
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• pp.848-853
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• 2001

Background: Sternal infection or dehiscence after cardiac surgery through median sternotomy is rare. If suitable treatment is not performed for the complication, however, the mortality is high. For 12 patients with sternal dehiscence or infection, we performed wide excision of the infected and necrotic tissue and covered with muscle flap(s) to obliterate the mediastinal dead space. Material and method: Sternal infection or dehiscence occurred in 13 of patients who underwent cardiac surgery One patient, who died of cerebral infarction before the sternal complication was treated, was excluded in this study. The sternal wound complication occurred in 6 of patients with valve replacement and 6 of patients with coronary bypass surgery, respectively. Since 1991, 9 patients underwent definite surgical debridement and muscle transposition as soon as fever was controlled with closed irrigation and drainage. The necrotic tissue and bone was widely excised and the sternal dead space was eradicated with the single flap or the combined flaps of right pectoralis flap(turnover flap), left pectoralis flap(turnover flap or rotation-advancement flap), and right rectus muscle flap. Result : There was no mortality in 12 patients with coverage of muscle flap(s) for sternal infection or dehiscence The mean interval between the diagnosis of sternal complication and the myoplasty was 6.6$\pm$3.9 days. In 4 patients, one pectoralis muscle flap was used, and in 8 patients both pectoralis muscle flaps were used. For each 1 patient and 2 patients in each group, right rectus muscle flap was added. For the last 3 patients, a single pectoralis flap was used to eradicate the mediastinal dead space and the longer placement of the mediastinal drain catheter was needed. One patient, who had suffered from necrosis of left pectoralis flap(rotation-advancement flap) with subsequent chest wall abscess after coverage of both pectoralis flaps, was managed with reoperation using right rectum flap. Conclusion : Sternal dehiscence or infection after cardiac operation can be readily managed with wide excision of necrotic infected tissue(including bone) and muscle flap coverage after short-term irrigation of sternal wound. The sternal(mediastinal) dead space may be completely eradicated with right pectoralis major muscle flap alone.