• 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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• 제10권1호
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• pp.40-43
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• 2009

Purpose: Extensive midface defect following total maxillectomy with orbital exenteration and cheek skin resection should be three dimensionally reconstructed with a large flap that have a sufficient volume of tissue and multiple skin islands. We describe our transverse rectus abdominis myocutaneous(TRAM) free flap with three skin islands which was successfully used in this situation. Methods: A 58-year-old man was performed enbloc total maxillectomy including orbital contents and wide cheek skin because of invasive maxillary squamous cell carcinoma. He was immediately reconstructed with TRAM flap that was designed not vertical but transverse fashion for providing sufficient skin area. Also, deepithelialization procedure making for multiple skin islands was done in flap insetting period when appropriate modification according to the intraoperative situation was possible. Dead space was completely obliterated by bulky muscular tissue, and three skin islands were used for lining of lateral nasal wall, palatal surface, and cheek skin restoration. Results: Postoperative course was satisfying. Maintaining of proper ipsilateral nasal airway, loss of rhinolalia and oronasal regurgitation of food particles, and restoration of cheek contour were successfully obtained. Conclusion: We report clinical experience of threedimensional reconstruction using free TRAM flap after total maxillectomy with orbital exenteration.

• 한국철도학회:학술대회논문집
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• 한국철도학회 2007년도 추계학술대회 논문집
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• pp.283-290
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• 2007

A bi-modal tram has been developed to offer an advanced transportation service compared with existing vehicles. The All-Wheel-Steering system is applied to the bi-modal tram to satisfy the required steering performance because the bi-modal tram has extended length and articulated mechanism. An ECU for the steering system is essential to steer wheels on 2nd and 3rd axles by the specific AWS algorithm with the prescribed driving condition. The Hardware-In-the-Loop Simulation(HILS) system is planned for the purpose of evaluating the steering system of the bi-modal tram. There are kinematic links with the hydraulic actuator to steer wheels on each 2nd and 3rd axles and also same steering mechanism as the actual vehicle is in the HILS system. Controlling the movement of hydraulic actuator which reflects the lateral steering reaction force on each wheel is the key to realize the HILS system, but the reaction force is continuously changed according to various driving conditions. Therefore, the simulation through the multi-body dynamics model is used to obtain the required forces.

• Archives of Plastic Surgery
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• 제36권1호
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• pp.29-32
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• 2009

Purpose: Introduction of the mammary implant through the abdominal route has been well known since late 1960s, but the use of transabdominal route for contralateral breast augmentation in transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction patients has not been reported in Korean literature. The authors report their experience with technical points as well as the selection of the appropriate patients. Methods: Simultaneous contralateral augmentation mammaplasty through transabdominal route was performed in 11 patients who underwent TRAM breast reconstruction from August 2003 to May 2008 with a mean follow up of 27 months. The pocket was created under direct vision: 3 subglandular, 7 subpectoral, and 1 dual plane was dissected. Eight saline and 3 silicone gel implants were used with an average volume of 165 cc. Results: There were no complications such as infection, hematoma, implant displacement, and capsular contracture. The result was well maintained throughout the follow up period. Conclusion: Transabdominal route could be recommended in selected patients for contralateral augmentation in TRAM breast reconstruction.

• Archives of Plastic Surgery
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• 제32권1호
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• pp.71-75
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• 2005

The purpose of this study is to assess abdominal sensation after free TRAM flap for breast reconstruction. 74 patients underwent breast reconstruction with free TRAM flap by authors and were followed up to check the sensation on abdomen following the surgery at the out patient clinic. They are compared with 20 female volunteer controls. Abdomens were divided into 13 zones, and assessed for superficial touch, superficial pain, temperature, two-point discrimination, and vibration. For all five sensory modalities, subjects were found to have decreased sensation in the umbilical and infraumbilical regions. This was statistically significant compared with controls. Division following pedicle dissection showed more reduction of sensation than non-dissection side. Both Inguinal areas below the donor site closure also showed markedly decreased sensation. Sensation on most area of abdomen recovered in postoperative 1 year, however, there were remained hypoesthesia in umbilical and infraumbilical area after post operative 1 year. This study clearly demonstrates that there is a significant and persistent reduction in abdominal sensibility following free TRAM flap surgery.

• 한국철도학회:학술대회논문집
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• 한국철도학회 2009년도 춘계학술대회 논문집
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• pp.1805-1816
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• 2009

현재 국내에서 개발 중인 바이모달트램은 철도의 정시성과 버스의 접근성 등의 장점을 합친 신교통수단으로서 국내 도입에 따른 대중교통체계의 변화가 예상된다. 본 연구에서는 바이모달트램의 국내 도입 전략에 대하여 도시규모별 교통수요 및 노선의 특성을 고려한 도입전략에 대하여 검토하였다. 지자체별로 다양한 교통 및 대중교통체계가 존재하고 재정적 여건 등 도입여건이 다양함으로 바이모오달트램을 일반적으로 적용할 수 있는 정책적 방안을 제시하였다. 본 연구의 결과는 지하철/정전칠을 도입하려는 지자체의 재정적 부담을 덜고 경전철에 준하는 수송력과 친환경성을 갖춘 바이모달트램의 도입을 검토하는데 효과적일 것으로 판단된다.

• 한국철도학회:학술대회논문집
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• 한국철도학회 2009년도 춘계학술대회 논문집
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• pp.229-238
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• 2009

In this paper, AWS ECU test method, which is considering behavior of a Bi-modal tram, is described. In order to evaluate the performance of an electronic automotive ECU, the method which combines HILS (Hardware In the Loop Simulation) and RBT (Requirement Based Testing) is introduced. HILS is the method to predict the behavior of a vehicle adopting an ECU. The behavior of a Bi-modal tram can be analyzed by using the vehicle dynamic model. Requirement Based Testing compare the outputs of a real system with a virtual electronic unit (oracle) which created by the requirements. Rear axles of the Bi-modal tram are independently controlled by two AWS ECU. Especially, swing out can happen when an articulated vehicle is operated in the curved road. Therefore dynamic behaviour of a Bi-modal tram is considered at this situation. Through this study, the reliability of ECU can be verified economically and safely using the proposed test method before conducting the track test.

• 한국철도학회:학술대회논문집
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• 한국철도학회 2008년도 춘계학술대회 논문집
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• pp.143-146
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• 2008

With unexpected torrential rainfall, flash flooding is occurring frequently and its impacts are tremendous. Thus proper natural disaster management plans are required. The disaster management system of the Bimodal tram utilizes the SWMM as a core engine to simulate runoff and urban sewer networks for flooding simulation. To develop the efficient Bimodal tram disaster management system, very detailed subcatchment boundaries and flow networks have to be developed in a GIS data format. Thus the objective of this study is to develop ArcView GIS based module (AV2SWMM) for easy preparation of model input for the tram disaster management system. With the AV2SWMM module, very detailed subcatchment boundaries and flow networks can be developed for accurate simulation of flash flooding at the study site, which were not/hardly possible with SWMM 5.0 interface. The AV2SWMM can be used in developing accurate model input for other regions where the Bimodal tram system is expected to be introduced.

• 한국철도학회:학술대회논문집
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• 한국철도학회 2008년도 춘계학술대회 논문집
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• pp.118-121
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• 2008

Bimodal tram is a transit with no-step floor for wheel-chaired persons, with docking to the station precisely and moving on schedule like train. Because of the automatic traveling of bimodal tram to search and follow the magnet embedded in roadway, bimodal tram should be careful about rainfall, snow and wind like a car driving on roadway in respect to natural disasters. Though response procedures in emergency are different according to the passengers' boarding, emergency mobilization is needed if any emergency situation happens. Emergency mobilization is the act of preparing for major catastrophic events, which may affect public transportation systems or their service areas, by assembling and organizing resources, including people, equipment, facilities, communications systems, expert technical support, and public information systems and protocols. Mobilization is the process that ensures that the right people will deploy appropriate resources at the correct time. Effective mobilization requires a partnership of local and state agencies. Public transportation operators and systems play vital roles in response to and recovery from emergencies and other unexpected catastrophic events. These systems, and their capabilities to mobilize resources, are profoundly affected by the decisions and directives of others during these activities. In this study, we focused on the emergency management for bimodal tram and reviewed the considerations about infrastructures under natural disasters, especially heavy rainfall.

• 한국기계가공학회지
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• 제13권4호
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• pp.91-98
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• 2014

In this study, the first and second electronically controlled cooling systems for a bimodal tram were developed. The performance characteristics of the cooling systems were assessed experimentally with actual and identical conditions, and a simulation was run using ANSYS Fluent. The results of the experimental and FEA method were standardized. In order to confirm the reliability of the experimental method, the experiment was carried out by a testing institution. The low-volume flow-rate condition was found to be better, but the cooling system performed in a minimal condition. Therefore, it is important to find the optimum performance levels. The cooling system equipment was revised to determine the optimized design parameters, after which the cooling performance levels increased at the radiation area. Specifically, with a greater fan diameter. Through this study, the newly developed cooling system will be reevaluated after being mounted on an actual bimodal tram. This will lead to a completely domestically produced bi-modal tram cooling system.