• 디지털융복합연구
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• 제13권4호
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• pp.303-310
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• 2015

최근 게임 기술은 모의 수술 시뮬레이션이나 사이버 모델하우스 구축 등의 여러 응용 분야에까지 적용되어지고 있다. 이러한 응용 분야에서 꼭 필요하고 중요한 기술 중 하나는 3D 모델을 실시간으로 절단하는 것이다. 실시간 모의 절단 기술은 자동차나 건축물의 실시간 해체 시뮬레이션 구축에 꼭 필요하며, 다양한 융복합 산업 분야에서 응용이 가능하다. 기존의 BSP-Tree를 이용한 절단 기법에서는 무한 평면을 기준으로 3D 모델을 두 부분으로 절단시키기 때문에 일반적인 절단 작업에 유용하게 사용하기 어렵다. 본 논문에서는 이러한 문제점을 해결하기 위해 유한한 영역 내에서 3D 모델을 절단하는 기법을 제안하였다. 구체적으로 절단 경로면을 유한하게 정의할 수 있도록 하였으며, 절단 범위 이내에서만 3D 모델을 분열시키도록 하여, 다양한 산업 분야에서 유용하게 사용할 수 있도록 하였다. 본 연구에서 제안한 부분 절단 기법의 유용성을 보이기 위해 원자로 3D 모델의 해체 작업 과정을 모의 시뮬레이션 하는 과정에 적용해 보았다.

• Archives of Plastic Surgery
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• 제46권5호
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• pp.462-469
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• 2019

Background Incisional hernia is a common complication following visceral organ transplantation. Transplant patients are at increased risk of primary and recurrent hernias due to chronic immune suppression and large incisions. We conducted a retrospective review of patients with a history of liver or kidney transplantation who underwent hernia repair to analyze outcomes and hernia recurrence. Methods This is a single center, retrospective review of 19 patients who received kidney and/or liver transplantation prior to presenting with an incisional hernia from 2011 to 2017. All hernias were repaired with open component separation technique (CST) with biologic mesh underlay. Results The mean age of patients was $61.0{\pm}8.3years\;old$, with a mean body mass index of $28.4{\pm}4.8kg/m^2$, 15 males (78.9%), and four females (21.1%). There were seven kidney, 11 liver, and one combined liver and kidney transplant patients. The most common comorbidities were hypertension (16 patients, 84.2%), diabetes (9 patients, 47.4%), and tobacco use (8 patients, 42.1%). Complications occurred in six patients (31.6%) including hematoma (1/19), abscess (1/19), seroma (2/19), and hernia recurrence (3/19) at mean follow-up of $28.7{\pm}22.8months$. With the exception of two patients with incomplete follow-up, all patients healed at a median time of 27 days. Conclusions This small, retrospective series of complex open CST in transplant patients shows acceptable rates of long-term hernia recurrence and healing. By using a multidisciplinary approach for abdominal wall reconstruction, we believe that modified open CST with biologic mesh is a safe and effective technique in the transplant population with complex abdominal hernias.

• Archives of Reconstructive Microsurgery
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• 제9권2호
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• pp.127-133
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• 2000

Free TRAM flap is now increasingly suggested to patients requiring breast reconstruction after the mastectomy. This study is to introduce the experiences of bilateral free TRAM flaps for reconstruction of bilateral breasts and to suggest the way of getting the more satisfactory results. A total of 6 breasts were reconstructed in 3 patients using bilateral free TRAM flaps immediately following the mastectomy. Average operative time for bilateral breast reconstruction was 8 hours comparing to 6.5 hours for unilateral breast reconstruction. Partial or total flap loss did not occur in 6 flaps. Abdomen was repaired directly with muscle and fascia sparing technique without necessity of mesh graft. There was no complication in donor site like abdominal hernia. Bilateral breast reconstruction can achieve exceptionally good aesthetic result with low complication if it is performed with skillful technique and experience. The reason for this is that fairly good symmetry usually is obtained in the initial surgery and in most cases only minimal additional surgery is required to achieve a satisfactory aesthetic result. The one disadvantage of bilateral reconstruction with autologous tissue is the length of the surgical procedure. Although the initial bilateral breast reconstruction can be a long, tedious procedure if free flaps are used, it must be a valuable treatment option for bilaterally mastectomized patients.

• 대한두개안면성형외과학회지
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• 제21권1호
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• pp.45-48
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• 2020

In neurosurgical cases, problems related to wound healing can vary from simple wound dehiscence to multilayer defects. This study demonstrates an effective method to prevent persistent cerebrospinal fluid (CSF) leakage using reinforcing acellular dermal matrix in neurosurgical patients with wound dehiscence. A 52-year-old woman was admitted for management of recurrent glioblastoma. After tumor removal surgery, the patient experienced sustained CSF leakage from the wound despite reparative attempts. The plastic surgery team performed wound repair procedure after remnant tumor removal by the neurosurgery team. Acellular dermal matrix was applied over the mesh plate to prevent CSF leakage and the postoperative status of the patient was evaluated. No sign of CSF leakage was found in the immediate postoperative period. After 3 years, there were no complications including CSF leakage, wound dehiscence, and infection. We hereby propose this method as a feasible therapeutic alternative for preventing CSF leakage in patients experiencing wound problem after neurosurgical procedures.

• KSBB Journal
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• 제19권3호
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• pp.210-214
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• 2004

본 연구에서는 생분해성 고분자 담체인 PGA 담체에 부착된 간세포의 이식을 통해서 이식된 간세포가 괴사하지 않고 남아 있으며 간 조직 구조의 일종인 담세관 유사구조를 확인하였다. 조직공학적인 간세포 이식 방법의 개발은 간 질환에 새로운 치료방법 개발의 가능성을 열어줄 수 있다.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.226-228
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• 2013

Elderly patients with acute subdural hematomas have higher mortality and lower functional recovery rates compared with those of other head-injured patients. Early and widely surgical decompression and active intensive care represent the best way to assist these patients. However, abrupt decompression of the hematoma can lead to brain disruption and secondary ischemia in the brain surrounding the craniectomy site. Acute brain swelling and brain extrusion, which take place shortly after decompression, can lead to a catastrophic situation during the operation due to the impossibility of appropriate closure of the dura and scalp. To avoid the deleterious consequences of disruption of brain tissue, we have adopted multiple fenestrations of the dura in a mesh-like fashion and gradual release of subdural clots through the small dural openings that are left open. This is especially important in cases in which there are massive amount of subdural hematomas with small parenchymal lesion and severe midline shifts in elderly patients. Further clinical experiences should be conducted in a more selected series patients to estimate the impact of this technique on morbidity and mortality rates.

• The Korean Journal of Physiology
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• 제11권2호
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• pp.67-71
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• 1977

This study was undertaken to investigate the effect of cingulate cortical ablation upon gastric secretion and its components in rats. 23 male rats were divided into the cingulate(N=9) and the operated control(N= 14) groups. Cingulate cortex was ablated through a slit-shaped opening(1 mm in width, 5 mm in length) which was made symmetrically on both sides of, and parallel to, the sagittal suture by removing a bone flap from frontal bone on each side. In the operated control group, the surgical procedure was ended by the removal of the bone flap. Under light ether anesthesia, experimental animals were placed in a restraining jacket of fine mesh wire and gastric juice was collected for 5 hours via a canula which had been inserted through the anterior abdominal wall into the antral portion of the lumen of the stomach. Volume of the gastric juice was measured, and total acid output and free acid output were titrated with 0.04 N NaOH solution by using phenolphthalein and Topfer's reagent at indicator, and chloride ion output was estimated by means of chloridometer. Results obtained were that volume, total acid output, free acid output and chloride ion output of the gastric juice were higher significantly in the cingulate group than in the operated control group. It is inferred from the above results that the cingulate cortex exerts a fascilitatory influence upon gastric secretion and acid output in rats.

• 한국의류학회지
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• 제45권4호
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• pp.598-611
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• 2021

The purpose of this study was to investigate the necessary functions and areas of improvement in bras worn by patients during the initial three-month recovery period after a breast augmentation procedure, and a functional bra that fits properly was designed. In order to analyze the necessary functions, a bra was designed after relevant discussions with medical staff and patients who underwent breast augmentation surgeries and considering the advice from bra designers and clothing and textile experts. This bra was designed to protect the surgical scars and minimize the compression by inserting a nonwoven fabric into the shoulder and front parts. In addition, it was designed in a way that could fit the individual breast volume by using a mesh material partially on the upper side of the molded cups. Underwires that could support the breasts were inserted, and a detachable wire was used to suit the patient's needs and the diagnosis by the medical staff. As the bra designed in this study received excellent scores during the evaluation by research subjects and experts, it can be used for designing the prototype of a functional bra.

• 대한두개안면성형외과학회지
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• 제21권4호
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• pp.229-236
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• 2020

Background: Oncologic resection of the scalp confers several obstacles to the reconstructive surgeon dependent upon patient-specific and wound-specific factors. We aim to describe our experiences with various reconstructive methods, and delineate risk factors for coverage failure and complications in the setting of scalp reconstruction. Methods: A retrospective chart review was conducted, examining patients who underwent resection of fungating scalp tumors with subsequent soft-tissue reconstruction from 2003 to 2019. Patient demographics, wound and oncologic characteristics, treatment modalities, and outcomes were recorded and analyzed. Results: A total of 189 patients were appropriate for inclusion, undergoing a range of reconstructive methods from skin grafting to free flaps. Thirty-three patients (17.5%) underwent preoperative radiation. In all, 48 patients (25.4%) suffered wound site complications, 25 (13.2%) underwent reoperation, and 47 (24.9%) suffered from mortality. Preoperative radiation therapy was an independent risk factor for wound complications (odds ratio [OR], 2.85; 95% confidence interval [CI], 1.1-7.3; p=0.028) and reoperations (OR, 4.45; 95% CI, 1.5-13.2; p=0.007). Similarly, the presence of an underlying titanium mesh was an independent predictor of wound complications (OR, 2.49; 95% CI, 1.1-5.6; p=0.029) and reoperations (OR, 3.40; 95% CI, 1.2-9.7; p=0.020). Both immunosuppressed status (OR, 2.88; 95% CI, 1.2-7.1; p=0.021) and preoperative radiation therapy (OR, 3.34; 95% CI, 1.2-9.7; p=0.022) were risk factors for mortality. Conclusion: Both preoperative radiation and the presence of underlying titanium mesh are independent risk factors for wound site complications and increased reoperation rates following oncologic resection and reconstruction of the scalp. Additionally, preoperative radiation, along with an immunosuppressed state, may predict patient mortality following scalp resection and reconstruction.

• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.55-60
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• 2001

Objective : The purpose of the present study was to examine neurologic changes, fusion rate and degree of kyphosis from the surgical results of those patients who underwent multi-level anterior interbody fusion and internal fixation. Methods : Among 63 cases of the patients who received multi-level anterior interbody fusion and internal fixation in 5 years between 1995 to 1999 at the neurosurgery department, we performed a retrospective study in 52 cases that could be followed up with dynamic view imaging ; the results were compared and analyzed. The analysis was based on the results of history taking, physical findings and radiologic findings, and Odom criteria were used to classify those cases with neurologic changes. Results : Among those 52 cases in whom the follow-up was possible for at least a year and dynamic view imaging was possible, bone fusion was seen in 93% of the trauma cases and 95% in the non-trauma cases and overall bone fusion was observed in 94% of the cases. Bone fusion was seen in 93% of the autobone cases, 95% of the allobone cases, and 94% of the Mesh cases. Radiologic changes were observed by comparing the lateral view after surgery ; kyphosis was seen in 53% of the autobone cases, in 70% of the allobone cases, and in 35% of Mesh cases ; in 45% and 60% of the non-trauma cases and trauma cases, respectively ; and in 55% of the 2 level fusion cases and 46% of the 3 level fusion cases. Neurologic changes classified according to Odom criteria showed excellent result in 48% of all the cases, good in 23%, fair in 4%, and poor in 25%. Conclusion : Even those cases with multi-level fusion, a high fusion rate could be obtained by performing anterior interbody fusion and internal fixation ; those cases with kyphosis were related more with the presence or absence of posterior compartment injury rather than the fusion level ; and those trauma cases showed not much difference in the fusion rate compared with non-trauma cases but had a high possibility of kyphosis.