• Journal of Korean Neurosurgical Society
• /
• 제55권4호
• /
• pp.208-211
• /
• 2014

Recently, the increasing rates of facial nerve preservation after vestibular schwannoma (VS) surgery have been achieved. However, the management of a partially or completely damaged facial nerve remains an important issue. The authors report a patient who was had a good recovery after a facial nerve reconstruction using fibrin glue-coated collagen fleece for a totally transected facial nerve during VS surgery. And, we verifed the anatomical preservation and functional outcome of the facial nerve with postoperative diffusion tensor (DT) imaging facial nerve tractography, electroneurography (ENoG) and House-Brackmann (HB) grade. DT imaging tractography at the 3rd postoperative day revealed preservation of facial nerve. And facial nerve degeneration ratio was 94.1% at 7th postoperative day ENoG. At postoperative 3 months and 1 year follow-up examination with DT imaging facial nerve tractography and ENoG, good results for facial nerve function were observed.

• Korean Journal of Radiology
• /
• 제24권11호
• /
• pp.1114-1130
• /
• 2023

Magnetic resonance neurography (MRN) is increasingly used to visualize peripheral nerves in vivo. However, the implementation and interpretation of MRN in the brachial and lumbosacral plexi are challenging because of the anatomical complexity and technical limitations. The purpose of this article was to review the clinical context of MRN, describe advanced magnetic resonance (MR) techniques for plexus imaging, and list the general categories of utility of MRN with pertinent imaging examples. The selection and optimization of MR sequences are centered on the homogeneous suppression of fat and blood vessels while enhancing the visibility of the plexus and its branches. Standard 2D fast spin-echo sequences are essential to assess morphology and signal intensity of nerves. Moreover, nerve-selective 3D isotropic images allow improved visualization of nerves and multiplanar reconstruction along their course. Diffusion-weighted and diffusion-tensor images offer microscopic and functional insights into peripheral nerves. The interpretation of MRN in the brachial and lumbosacral plexi should be based on a thorough understanding of their anatomy and pathophysiology. Anatomical landmarks assist in identifying brachial and lumbosacral plexus components of interest. Thus, understanding the varying patterns of nerve abnormalities facilitates the interpretation of aberrant findings.

• Journal of Korean Neurosurgical Society
• /
• 제50권6호
• /
• pp.503-506
• /
• 2011

Objective : The aim of this study was to assess the safety and efficacy of radiation-sterilized allografts of iliac bone and fascia lata from cadaver specimens to repair skull base defects after transsphenoidal surgery. Methods : Between May 2009 and January 2010, 31 consecutive patients underwent endonasal transsphenoidal surgery and all patients received sellar reconstruction using allografts following tumor removal. The allografts were obtained from the local tissue bank and harvested from cadaver donors. The specimens used in our approach were tensor fascia lata and the flat area of iliac bone. For preparation, allografts were treated with gamma irradiation after routine screening by culture, and then stored at $-70^{\circ}C$. Results : The mean follow-up period after surgery was 12.6 months (range, 7.4-16 months). Overall, postoperative cerebrospinal fluid (CSF) leaks occurred in three patients (9.7%) and postoperative meningitis in one patient (3.2%). There was no definitive evidence of wound infection at the routine postoperative follow-up examination or during re-do surgery in three patients. Postoperative meningitis in one patient was improved with the use of antibiotics and prolonged CSF diversion. Conclusion : We suggest that allograft materials can be a feasible alternative to autologous tissue grafts for sellar reconstruction following transsphenoidal surgery under selected circumstances such as no or little intraoperative CSF leaks.

• Journal of information and communication convergence engineering
• /
• 제14권1호
• /
• pp.57-63
• /
• 2016

In generally, the resolution of reconstructed three-dimensional images can be seriously degraded by undesired occlusions in the integral imaging system, because the undesired information of the occlusion overlap the three-dimensional images to be reconstructed. To solve the problem of the undesired occlusion, we present an exemplar-based image restoration method in integral imaging system. In the proposed method, a minimum spanning tree-based stereo matching method is used to remove the region of undesired occlusions in each elemental image. After that, the removed occlusion region of each elemental images are re-established by using the exemplar-based image restoration method. For further improve the performance of the image restoration, the structure tensor is used to solve the filling error cause by discontinuous structures. Finally, the resolution enhanced three-dimensional images are reconstructed by using the restored elemental images. The preliminary experiments are presented to demonstrate the feasibility of the proposed method.

• Archives of Reconstructive Microsurgery
• /
• 제6권1호
• /
• pp.47-55
• /
• 1997

One hundred and thirty-seven patients had reconstructive surgery of injured feet with microsurgical technique in the Department of Orthopaedic Surgery at Yonsei University College of Medicine from 1983 to 1997. The results were as follows: 1. There were 89 cases in men and 48 cases in women, who together had a mean age of 21.3 years. 2. The causes of injuries were 97 cases from traffic accidents, 15 cases from burns, 11 cases from machinery injury, 5 cases from infection, 2 cases from falling, 2 cases from glass injury, 2 cases from snake bite, 2 cases from explosive injury, and 1 case from ulceration. 3. There were 47 cases with inguinal flaps, 36 cases with scapular flaps, 36 cases with parascapular flaps, 7 cases with deltoid flaps, 4 cases with lateral thigh flaps, 3 cases with latissimus dorsi flaps, 2 cases with tensor fascia lata flaps, and 2 cases with dorsalis pedis flaps. 4. One hundred and twenty-seven(92.7%) cases were successful in reconstructive surgery with microsurgical technique. 5. Functionally, the thick skin flap or sensory flap has less ulceration and good protective sensation. We considered that the function and cosmetic appearance were excellent after reconstructive surgery of the injured feet with microsurgical reconstructive technique and that the thick skin flap or sensory flap has less ulceration and good protective sensation.

• Archives of Reconstructive Microsurgery
• /
• 제24권1호
• /
• pp.32-36
• /
• 2015

The reconstruction of recurrent pressure sores is challenging due to a limited set of treatment options and a high risk of flap loss. Successful treatment requires scrupulous surgical planning and a multidisciplinary approach. Although the tensor fascia lata flap is regarded as the standard treatment of choice-it provides sufficient tissue bulk for a deep trochanteric sore defect-plastic surgeons must always consider the potential of recurrence and accordingly save the second-best tissues. With the various applications of anterolateral thigh (ALT) flaps in the reconstructive field, we report two cases wherein an alternative technique was applied, whereby pedicled ALT fasciocutaneous island flaps were used to cover recurrent trochanteric pressure sores. The postoperative course was uneventful without any complications. The flap provided a sound aesthetic result without causing a dog-ear formation or damaging the lower-leg contour. This flap was used as an alternative to myocutaneous flaps, as it can cover a large trochanteric defect, recurrence is minimized, and the local musculature and lower-leg contour are preserved.

• 대한자기공명의과학회:학술대회논문집
• /
• 대한자기공명의과학회 2002년도 제7차 학술대회 초록집
• /
• pp.84-84
• /
• 2002

목적： 야간성 전두협 발작 (Nocturnal frontal lobe epilepsy NFLE)은 임상적으로 특징적인 야간성 운동성 발작으로 잘 알려져 있지만 일반적인 MR 영상에서는 대부분에서는 특이한 소견을 보이지 않아 확산 텐서 영상 (DTI)에서의 이상 소견 발현 유무를 알아보고자 한다. 대상 및 방법： 임상적 소견과, EEG 소견으로 진단된 NFLE 환자 6명을 대상으로 DTI 영상을 촬영하였다. 남자 2명, 여자 4명으로 평균연령은 32세 이었다. DTI영상은 single shot spin echo EPI 펄스 열을 사용하였고 사용한 영상 변수는 b value는 0, 1000 s/$\textrm{mm}^2$, TR 10000 msec, TE 71.8/72.3 msec, matrix 128$\times$128 (256 reconstruction), FOV 23cm, 5mm thickness, 2mm interstice gap, NEX 1. 19 slices, time은 4min 21sec (25방향) 이었다. 대조군으로 정상 성인 10명 (평균연령 31세)에서 동일한 방법으로 DTI 영상을 시행하여 분할 비등방도 (fractional anisotropy) 영상을 얻고 전두엽 백질에서 분할 비등방도 값을 측정하여 NFLE 환자군과 비교하였다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제35권4호
• /
• pp.265-275
• /
• 2013

The anterolateral thigh flap (ALTF) is a versatile fasciocutaneous or myocutaneous flap, which can be harvested incorporating several skin islands and muscle components. The perforator of the ALTF is usually derived from the descending or transverse branch of the lateral circumflex femoral artery, and these vessels are based mainly on musculocutaneous perforators traversing the vastus lateralis muscle, and also based on the septocutaneous vessels running in between the rectus femoris and vastus lateralis muscle. Despite its usefulness for the oral cavity reconstruction, anatomic variations of these nutrient vessels, such as three main branches of ALTF and its relations with sartorius, vastus lateralis, tensor fasciae latae and rectus femoris muscle, have been reconstructive surgeons to be hesitated for the selection of ALTF. For the better understanding of ALTF as a routine reconstructive procedure in oral and maxillofacial surgery, various anatomical findings must be learned and memorized by young doctors in the course of the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article will discuss the vascular anatomy and relavant anatomical variations of ALTF with Korean language.

• 한국지진공학회논문집
• /
• 제2권4호
• /
• pp.41-52
• /
• 1998

한반도 동남부에 위치하고 있는 동래단층은 단일 불연속면 단층이 아니라 수많은 소단층을 포함하는 단층대의 형태를 보여준다. 동래단층의 고응력을 해석하기 위하여 부산시 금정구에서 울산시에 이르는 단층 주변의 노두에서 329개의 소단층 자료를 측정하였다 먼저 수집된 솬층 자료의 기하학적인 특징을 살펴보면 주향은 NE계열(N10E, N30E, N70E) 이 우세하며 경사의 경우는 65。 이상의 곡각의 단층이 우세하게 분포한다. 그리고 선주각의 경우는 30。이하가 전체의 절반 이상을 차지한다. 동래단층의 고응력을 해석하기 위해서 수집된 자료를 Angelier의 집적연산 방법과 Choi의 방법을 병행하여 실시하였다 그 결과 동래단측 지역에서 확인된 지구조 사건은 (1) NNE-SSW 압축응력 및 ESE-WNW 인장응력 (사건 1) (2) NNE-SSW 인장응력 (사건II)(3) ESE-WNW 인장응력 (사건III) (4) ENE-WSW 압축응력 및 NNW-SSE 인자응력(사건V) 이다. 이들 지구조 사건에 따른 동래단층 운동을 살펴보면 먼저 사건 I에 의해서 동래단층 지역에 우수감가의 NS주향 좌수 감각의 ENE-WSW 가지는 주향이동성 단층들이 형성되었고 이후 사건 II, III에의해서 정단층성 단층들이 발달되고 사건 IV에 의해서 NNE 주향의 동래단층이 우수 주향이동운동으로 길게 연장 발달한 것으로 추정된다.

• Archives of Reconstructive Microsurgery
• /
• 제5권1호
• /
• pp.70-79
• /
• 1996

From January 1980 to May 1995, ninety-six patients had been treated by free-flap transfer for the soft tissue defects of the extremities. Ninety-eight cases of free-tissue transfer were reviewed to evaluate the clinical reliability in terms of survival and quality of long-time function after reconstructive surgery. Among these 98 cases(27 cases in latissimus dorsi myocutaneous flap, 25 in dorsalis pedis flap, 20 in forearm fasciocutaneous flap, 9 in groin flap, 7 in gracilis myocutaneous flap, 6 in 1st web space flap of foot and 4 cases in tensor fascia lata flap), 92 cases of then were survived. 7 cases were performed with vein grafts. We ananalyzed the reconstruction of the extremities on 98 cases with the soft tissue defects which had been reconstructed free-flap transfer and followed for minimum 1 year period at Korea University Hospital. 1. 92 cases(93.9%) of the total 98 cases were successful and can be obtained the excellent results in soft tissue free-flap transfer. 2. While there were no clinically significant differences in survival rate of flaps transferred from different potential flap donor sites,3 cases of 9 groin flaps were showed higher failure rate due to the complications such as arterial thrombosis, infection and anatomical variation of vessels. 3. Postoperative thrombectomy was performed in 30 cases to be occured in the arterial and venous thrombosis. The revision was failed in 2 cases due to persistent arterial thrombosis and infection, then treated with skin graft. 4. Vein graft was frequently required in severely compromised-soft tissue defects resulted from high-energy trauma. The vein graft was not stitistically significant on the frequency of flap failure rate(P<0.04). 5. Meticulous monitoring, careful planning, early revision and technical considerations will provide for a high clinical success of the free-flap transfer.