• 대한두경부종양학회지
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• 제39권1호
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• pp.27-31
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• 2023

Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, is a rare immunological small vessel disease which usually affects respiratory tract and kidneys. However, salivary gland involvement in GPA is rare as a primary manifestation. We report a case of GPA with the primary presentation of submandibular gland involvement. A 48-year-old female patient presented submandibular swelling with a skin defect that lasted for 1 month. Although the biopsy result was chronic inflammation, the skin defect did not heal for a month. Further imaging study revealed multiple lung and renal masses. More clinical manifestations such as gingivitis, ischemic change of finger joint and nasal tip skin, and positive c-ANCA test was presented. Additional biopsy was made at the submandibular gland, lung, and finger skin. The patient was finally diagnosed with GPA and treated with steroid pulse therapy and cyclophosphamide. The patient showed improvement of prior clinical symptoms.

• Archives of Reconstructive Microsurgery
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• 제19권2호
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• pp.88-92
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• 2010

The forefoot reconstruction is a challenging field for plastic surgeons. Weight bearing tolerability and stability are important factor of choosing reconstruction methods, but cosmetic aspect has to be considered. 51 year old man visited our clinic with extensive degloving injury on right forefoot by roller. The soft tissue defect started from metatarsal area to the toe tip including nails. We harvested the anterolateral thigh flap and transferred it to the forefoot defect area with nerve coaptation. The flap was successful without skin necrosis or other complications. Secondary flap debulking surgery was performed after ten months from initial operation. Patient was satisfied with functional and cosmetic outcomes. The patient was able to wear shoes and walk with adequate sensory recovery. As there is few report about reconstruction of forefoot soft tissue defects, we report a unique case of the anterolateral thigh innervated free flap reconstruction in degloving injury.

• Journal of Chest Surgery
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• 제6권1호
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• pp.63-68
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• 1973

Two patients operated upon for tricuspid atresia by Glenn operation are presented. They were five years old and four years old females who were cyanotic shortly after birth, and remained cyanotic. On physical examination, cyanosis on digits and lips, clubbing of fingers, thrill and grade III systolic murmur on 4th I.C.S. along left sternal border were noted. In the first case, chest roentgenograms showed normal pulmonary markings, and the electrocardiogram was interpreted as showing left ventricular hypertrophy with left axis deviation and peaked P-wave in lead IL Right heart catheterization showed high pressure in right atrium and the catheter tip was easily inserted into the left atrium through septal defect. In the second case, chest roentgenograms showed cardiomegaly with sparse pulmonary vascular markings and narrowed vascular pedicle, and the electrocardiogram showed left ventricular hypertrophy with some element of right atrial hypertrophy. Angiocardiogram showed changes characteristic of tricuspid atresia, including "right ventricular window" The findings of right heart catheterization were similar to those of first case. On the basis of these observations, they were diagnosed as tricuspid atresia, and Glenn operation was performed. Normal position of great vessels combined with ventricular septal defect and pulmonary stenosis were noted on the first case, and on second case, transposition of great vessels was additional finding. Postoperative course was uneventful and favorable outcome was obtained.

• 대한용접접합학회:학술대회논문집
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• 대한용접접합학회 1996년도 특별강연 및 추계학술발표 개요집
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• pp.139-141
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• 1996

Among various welding parameters, the welding current which is inversely proportional to the tip-to-workpiece distance in GMAW is an essential parameter to monitor the GMAW process of horizontal fillet joints. For the case of weld defect such as overlap in horizontal fillet welding, therefore, the signal processing for process monitoring or automatic seam tracking should be modified by considering the weld pool surface geometry including the corresponding weld defect. In other words, the adequate signal processing algorithm is indispensible to improve the performance of the arc sensor. However, arc sensor algorithm already developed usually focus on weld seam tracing but do not considering the weld qualities. In this paper, various experiments were carried out to investigate the tendencies of the weld defects when weaving motion is added, and the experimental method based on 2$^n$ factorial design was proposed for deriving the mathematical model between the leg length and the various welding conditions. Moreover, a signal processing method based on the artificial neural network(Adaptive Resonance Theory) was proposed far discriminating the current signal of sound weld beads from that of weld beads with overlap. Finally, the algorithm for weld seam tracking combined with the mathematical modeling and the signal processing method was carried out to track the weld line in conjunction with the improvement of the weld qualities. The reliability of the proposed algorithms were evaluated through various experiments, which showed that the proposed algorithms could be effectively used for arc welding automation.

• 한국가스학회지
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• 제25권6호
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• pp.14-21
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• 2021

-162℃ 초저온 상태의 LNG를 저장하는 저장탱크의 내조는 균열과 같은 결함에 대한 구조 건전성 평가가 필요하다. 전통적인 파괴역학 관점에서는 응력확대계수 K, J-적분 그리고 CTOD를 이용한 단일 매개변수 평가가 주로 수행되어왔다. 그러나 실제 구조에서 발생되는 균열선단은 구조물의 크기, 시편형상 그리고 인장과 굽힘과 같은 하중의 형태에 따라 구속효과의 차이로 인한 영향이 발생하게 된다. 단일 매개변수 파괴역학을 보완하기 위해 다양한 시도가 있었고, 대표적으로 Q-응력법이 있다. 본 논문에서는 비선형 탄성영역의 균열선단 응력장 평가에 적합한 J적분에 Q응력을 유도하여 2 매개변수 접근법을 사용하고자 한다. SENB 시편의 균열비 0.1~0.7 그리고 광폭시편 균열비 0.2~0.6에 시편 균열선단의 응력을 J-Q 평가법을 이용하여 구속효과를 정량적으로 평가 하였다.

• Archives of Reconstructive Microsurgery
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• 제18권1호
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• pp.35-39
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• 2009

Purpose: Various techniques have been attempted for design of the flaps. However, there are some disadvantages. They have thin, pliable, and two dimensional methods. The aim of this study is to report usefulness of polyurethane foam dressing materials for three dimensional design of the digital island flap. Methods: From June of 2007 to september of 2008, 10 patients received digital island flap surgery for soft tissue defect of the finger. After minimal debridement of the wound, size and shape of the defect were measured using polyurethane foam. We used Medifoam-$5^{(R)}$ And then, designed this inset the wound. The flap was designed on the donor site with a arterial pedicle as the central axis according to size and shape. A full thickness skin graft from the groin is applied on the flap donor defect and secured with a tieover bolster dressing. Results: Reviewing sizes of the flaps, the length and width of flaps ranged from 1.5 to 3.3 cm and 1.0 to 2.5 cm. The PACS(Picture Archiving Communication System) program allows identification of the donor depth of finger. The distance for the soft tissue ranged from 4.3 mm to 6.7 mm. Mean depth of donor site was 5.3${\pm}$0.6 mm. Also, the thickness of Medifoam-$5^{(R)}$ ranged nearly 5 mm. On flap insetting, full-thickness skin graft was necessary. We did not experience any problems in the recipient site size either, regardless of the extended flaps. Conclusion: Polyurethane foam has many advantages over the more conventional templates. Refinements in flap design and surgical technique resulted in favorable functional and cosmetic results. Especially, for beginner, Polyurethane foam dressing material is a simple and safe tool and therefore is an excellent choice for design of the island flap.

• Archives of Plastic Surgery
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• 제32권4호
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• pp.539-542
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• 2005

Reconstructions of soft tissue defect of the posterior ankle including Achilles the tendon should take into account not only coverage but functional outcome. Various methods of tendon transfer and tendon graft have been reported as a single-stage procedure. With advances and refinements in microsurgical techniques, several free composite flaps including tendon, fascia, or nerve have been used in single-stage reconstructions of large defects in this area minimizing further damage to the traumatized leg. However, when free flap is not feasible for some reasons, this cannot be accomplished successfully. Here we present a patient with Achilles tendon and circumferential large soft tissue defect. Because of circulatory compromise of the lower extremity, free flap reconstruction could not be applied. Instead, cross-leg composite flap of the dorsalis pedis flap including the extensor hallucis brevis musle and tendon, and tendon strips of the Second, third and fourth extensor digitorum logus were employed, Functional reconstruction of the tendon and resurfacing were obtained at the same time. The flap was detached 3 weeks postoperatively, and the transplanted flap has survived without any complications. By 3 months after surgery, full weight bearing, tip-toe standing and even walking without crutch assistance was possible. When functional reconstruction with the free flap is unattainable in the large defect of the posterior ankle including the Achilles tendon, cross-leg composite island flap of dorsalis pedis flap and tendon strips of the extensor digitorum longus tendon is a viable alternative.

• 대한치과보철학회지
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• 제37권5호
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• pp.607-619
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• 1999

Cortical support is an important factor, as the engagement of the fixture in strong compact bone offers an increased load-carrying capacity and initial stability. Because of the poor bone quality in the posterior mandible and other anatomic considerations, it has been suggested that implant fixtures be placed in these locations with apical engagement of the lingual cortical plate for so-called bicortication. The purpose of this investigation was to determine the effect of cortical engagements and in addition polyoxymethylene(POM) intramobile connector(IMC) of IMZ implant on implant load transfer in edentulous posterior segment of mandible, using three-dimensional (3D) finite element analysis models composed of cortical and trabecular bone involving single implant. Variables such as (1) the crestal peri-implant defect, (2) the apical engagement of lingual cortical plate, (3) the occlusal contact position (a vertical load at central fossa or buccal cusp tip), and (4) POM IMC were investigated. Stress patterns were compared and interfacial stresses along the bone-implant interface were monitored specially. Within the scope of this study, the following observations were made. 1) Offset load and angulation of fixture led to increase the local interfacial stresses. 2) Stresses were concentrated toward the cortical bones, but the crestal peri-implant defect increased the interfacial stresses in trabecular bone. 3) For the model with bicortication, it was noticed that the crestal cortical bone provided more resistance to the bending moment and the lingual cortical plate provided more support for the vertical load. But Angulation problem of the fixture from the lingual cortical engagement caused the local interfacial stress concentrations. 4) It was not clear that POM IMC had the effect on stress distribution under the present experimental conditions, especially for the cases of crestal peri-implant defect.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권4호
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• pp.428-434
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• 2008

Introduction: Piezosurgery device is one of the most commonly used instrument on the intraoral surgery such as maxillary sinus lift and autogeneous bone graft. Piezosurgery instrument also contains the tips that are manufactured especially for the convenient bone graft, which now many surgeons apply them for collecting bone graft materials in the curettage method for the restoration of skull defects. However, objective data has not been shown concerning the effects about bone graft with using Piezosurgery. Therefore we investigated the effects of Piezosurgery on the rabbit-skull defect healing. Materials & Methods: To investigate the regeneration of the bony defect with various bone graft, 10 adult New Zealand white rabbits (average weight : $2.8{\pm}0.3kg$, about 12weeks) were used. The four circular bony defects measuring 6mm in diameter were made with Piezosurgery device on each rabbit cranial bone. The harvested bone tissues during defect formation were also used for autogeneous bone graft. They were grafted into the defects in a various type; block type (Group 1), particulated type by the bone mill (Group 2), chopped type by curette shaped Piezosurgery tip (Group 3), the defect without any graft was served as control (control group). The animals were sacrificed after 6 weeks and bone regeneration capacity was evaluated histomorphometrically. Result & Conclusion: Autogeneous bone graft harvested using a Piezosurgery instrument showed satisfactory bone regeneration. There was no conspicuous difference bone prepared among by bone mill or Piezosurgery and block bone graft. Therefore, the bone harvested from the intraoral site near the operation field using the piezosurgery device can be a feasible and reliable graft for intraoral bony defects.

• Journal of Medicine and Life Science
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• 제15권2호
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• pp.105-107
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• 2018

The reconstruction method of nasal area can be used differently depending on the location, size, age. In this elderly female patient case, without using the forehead medial flap, good results can be obtained by using an advancement flap considering the nasal aesthetic unit.