• Archives of Plastic Surgery
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• 제37권5호
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• pp.607-612
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• 2010

Purpose: Maxillectomy for malignant tumor resection often leads to functional and aesthetic sequalae. Reconstruction following maxillectomy has been a challenging problem in the field of head and neck cancer surgery. In this article, we described three dimensional midface reconstructions using free flaps and their functional and aesthetic outcomes. Methods: We reconstructed 35 cases of maxillectomy defects using 9 radial forearm free flaps, 7 lattisimus dorsi musculocutaneous free flaps, 6 rectus abdominis musculocutaneous free flaps, 4 fibular osteocutaneous free flaps, and 9 anterolateral thigh free flaps, respectively. We classified post-maxillectomy defects by Brown's classification. 1 Articulation clarity was measured with picture consonant articulation test. Swallowing function was evaluated with the University of Washington quality-of-life Head and Neck questionnaire by 4 steps.2 Aesthetic outcomes were checked to compare preoperative with postoperative full face photographs by 5 medical doctors who did not involve in our operation. Results: The average articulation clarity was 92.4% (100-41.9%). 27 (81.9%) patients were able to eat an unrestricted diet. Aesthetic results were considered excellent in 18 patients (51.4%). Functional results were best in the group reconstructed with fibular osteocutaneous free flap. Considering the range of wide excision, aesthetic results is best in the group reconstructed with anterolateral thigh free flap. Conclusion: The free flap is a useful technique for the reconstruction of the midface leading to good results, both functionally and aesthetically. Especially, because osteocutaneous flap such as fibular osteocutaneous free flap offered bone source for osteointegrated implant, It produces the best functional results. And perforator flap like as anterolateral thigh free flap reliably provides the best aesthetic results, because it provides sufficient volume and has no postoperative volume diminution.

• Archives of Plastic Surgery
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• 제32권2호
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• pp.183-188
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• 2005

Defect on the temporal area caused by, surgical ablation of a tumor or an infection should be reconstructed immediately to prevent potentially life-threatening complications such as meningitis and cerebrospinal fluid leakage. The defect on the temporal area usually presents as a typical 'cone-shape'. Successful reconstruction requires sufficient volume of well-vascularized soft tissue to cover the exposed bone and dura. From 1994 through 2003, the authors applied rectus abdominis free flap for the reconstruction of the temporal defect from 1994 through 2003. There were 10 patients with a mean age of 52.1 years. Of these 10 patients, external auditory canal cancer was present in four patients, temporal bone cancer in two, parotid gland cancer in one and three patients were reconstructed after debridement of infection(destructive chronic otitis media). All the free flaps survived, and flap-related complications did not occur. Compared to a local flap, the rectus abdominis free flap can provide sufficient volume of well-vascularized tissue to cover the large defect and can be well-tolerated during an adjuvant radiation therapy. The long and flat muscle can be easily molded to fit in to the 'cone-shape' temporal defect without dead space. It is also preferred because of the low donor site morbidity, a large skin island and an excellent vascular pedicle. Two-team approach without position change is possible. In conclusion, the authors think that rectus abdominis free flap should be considered as one of the most useful method for the reconstruction of a cone-shaped temporal defect.

• 암석학회지
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• 제23권2호
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• pp.139-144
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• 2014

저어콘 음극선발광영상의 입체적 연구를 위해, 단계적 연마를 사용한 연쇄단층촬영과 영상 후처리작업으로 저어콘 내부 누대구조의 3차원 복원을 최초로 시도하였다. 연구에 사용된 시료는 경상분지 북동부 영덕화강암체에서 분리한 고생대말 시기의 저어콘으로 평면 음극선발광영상에서는 전형적인 진동누대구조가 관찰된다. 시료의 연쇄단층촬영을 위해 에폭시마운트 제작 후 $3{\mu}m$과 $1{\mu}m$ 연마액을 이용한 연마와 후방산란전자영상과 음극선발광영상 촬영을 시료가 소진될 때까지 반복하였다. 단계별 두께의 차이는 약 $3{\mu}m$이며, 약 80여개의 저어콘 중 7개를 선정하여 같은 면적 영상파일로 저장한 후 영상편집 소프트웨어인 Image J와 Volume Viewer를 이용하여 3차원 내부구조를 복원하여, 저어콘의 진동누대 및 덧성장구조를 입체적으로 재현하는데 성공하였다. 3차원적 내부구조 영상은 2차원적으로 관찰하는 단면영상의 내부구조와 달리 특정방향에 따른 단면관찰이 가능하고 다양한 변화양상을 재현할 수 있다. 이 방법은 고분해능 이차이온질량분석기 연대결과가 복잡하게 나오는 저어콘이나 미세구조 파악이 필요한 다른 지질시료의 입체적인 성장 및 재결정작용의 내부 구조연구에 응용될 수 있다.

• Archives of Plastic Surgery
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• 제39권5호
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• pp.504-508
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• 2012

Background The most common complication of latissimus dorsi myocutaneous flap in breast reconstruction is seroma formation in the back. Many clinical studies have shown that fibrin sealant reduces seroma formation. We investigated any statistically significant differences in postoperative drainage and seroma formation when utilizing the fibrin sealant on the site of the latissimus dorsi myocutaneous flap harvested for immediate breast reconstruction after skin-sparing partial mastectomy. Methods A total of 46 patients underwent immediate breast reconstruction utilizing a latissimus dorsi myocutaneous island flap. Of those, 23 patients underwent the procedure without fibrin sealant and the other 23 were administered the fibrin sealant. All flaps were elevated with manual dissection by the same surgeon and were analyzed to evaluate the potential benefits of the fibrin sealant. The correlation analysis and Mann-Whitney U test were used for analyzing the drainage volume according to age, weight of the breast specimen, and body mass index. Results Although not statistically significant, the cumulative drainage fluid volume was higher in the control group until postoperative day 2 (530.1 mL compared to 502.3 mL), but the fibrin sealant group showed more drainage beginning on postoperative day 3. The donor site comparisons showed the fibrin sealant group had more drainage beginning on postoperative day 3 and the drain was removed 1 day earlier in the control group. Conclusions The use of fibrin sealant resulted in no reduction of seroma formation. Because the benefits of the fibrin sealant are not clear, the use of fibrin sealant must be fully discussed with patients before its use as a part of informed consent.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권2호
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• pp.84-89
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• 2015

We report the eventually successful treatment of a huge bone defect and peri-implantitis following reconstruction of a previously failed intra-mobile cylinder implant system (IMZ) implant site using distraction osteogenesis (DO). In the anterior mandible, two IMZ implants failed and surgical debridement was performed in accordance to the patient's needs. Thereafter, mobility and suppuration were decreased and the patient visited the dental clinic on a regular basis for oral health maintenance. However, the inflammation did not resolve, and the bone destruction around the implants progressed for 4 years. Finally, the implants failed and a severe bone defect remained after implant removal. To reconstruct the bone defects, we attempted bone graft procedures. Titanium mesh was unsuccessfully used to obtain bone volume regeneration. However, DO subsequently was used to obtain sufficient bone volume for implant placement. The new implants were then installed, followed by prosthetic procedures. In conclusion, progression of peri-implantitis could not be arrested despite surgical intervention and repeated maintenance care for 3 years. Reconstruction of the peri-implantitis site was complicated due to its horizontal and vertical bone defects. Lesions caused by implant failure require an aggressive regenerative strategy, such as DO. DO was successful in reconstruction of a peri-implantitis site that was complicated due to horizontal and vertical bone defects.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2014년도 춘계학술대회
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• pp.695-698
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• 2014

화물 검색용으로 사용되고 있는 X-선 검색장치는 대상물의 단면 정보만을 제공하고 있기에 검색 대상체의 식별에 어려움이 있어 이에 대한 개선이 요구되어 왔다. 또한 대량의 화물 검색을 효율적으로 수행하기 위해서는 검색시스템에 대한 자동화가 요구되며 자동화를 위해서는 대상체를 식별하기 위한 다양한 식별자가 필요하다. 스테레오 X-ray 시스템은 기존의 검색 장치에 라인센서를 추가하여 검색 대상체에 대한 추가적인 정보를 제공함으로써 검색 효율을 높이도록 고안되었다. 본 논문에서는 선행 연구를 통해 개발된 스테레오 X-선 검색장치를 이용하여 다양한 물체에 대한 검색을 수행하며 형상정보를 복원하여 실제 값과의 비교를 통해 스테레오 방사선 스캔장치에 대한 성능분석을 수행하였다. 또한 본 논문에서 제시하는 3차원 형상복원 알고리즘을 통해 검색시스템을 자동화할 수 있는 새로운 식별자의 제공이 가능하다고 판단된다. 본 연구의 결과는 대형 화물 스캔 장치 및 고속화물 스캔 장치 개발을 위해 활용될 수 있다.

• Composites Research
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• 제34권1호
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• pp.70-75
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• 2021

본 논문은 단섬유 칩으로 구성된 Sheet Molding Compound(SMC) 복합재료를 실험적으로 관찰된 특징들을 바탕으로 메소스케일(meso-scale) 대표체적요소(RVE: Representative Volume Element)를 재구성하는 새로운 알고리즘을 제시한다. 전산해석을 이용하여 SMC 복합재료의 비등방성 거동의 정확한 예측은 어려운 문제이다. 이를 극복하기 위해, SMC 복합재료를 위한 일련의 이미지 프로세싱 기술과 재구성 알고리즘 및 유한요소(FE: Finite Element) 생성기로 구성된 SMC RVE 모델을 개발하였다. 첫째, micro-CT 이미지 프로세싱은 SMC 물성에 직접적인 상관관계를 가지는 섬유칩의 배향 및 분산의 확률적 분포를 평가한다. 둘째, 해당 통계적 분포를 바탕으로 섬유칩 간의 겹침효과를 고려한 섬유칩 팩킹 재구성 알고리즘을 개발한다. 마지막으로, SMC 복합재료 멀티스케일 해석을 이용하여 매크로스케일(macro-scale)에서의 거동을 파악하고 실험데이터를 통해 검증을 수행한다.

• Archives of Plastic Surgery
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• 제51권1호
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• pp.62-66
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• 2024

Gestational gigantomastia is characterized by the rapid growth of breasts during pregnancy. The treatment method of gestational gigantomastia is unclear; if the medical treatment is ineffective, surgery is considered. However, sufficient research on which method is best to perform breast reconstruction for the gestational gigantomastia patient has not yet been conducted. Our patient was young and had aesthetic needs; thus, we did not recommend modified radical mastectomy. However, it was difficult for the patient to consider active reconstruction using an implant or autologous tissue because of the expected complications and economic problems. The patient had a thin body shape and very large breasts compared with the trunk. Therefore, breast volume was not significantly required after reconstruction. Additionally, we expected that a considerable portion of skin would remain after mastectomy as a tubular-shaped breast. It was expected that the Goldilocks technique would be sufficient to meet the patient's volume needs. Therefore, we proceeded with total mastectomy and reconstruction using the Goldilocks procedure. No complications were recorded after the operation; most of the patient's discomfort was resolved, and the shape and size of the breasts were satisfactory.

• Korean Journal of Radiology
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• 제24권4호
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• pp.294-304
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• 2023

Objective: We aimed to investigate whether image standardization using deep learning-based computed tomography (CT) image conversion would improve the performance of deep learning-based automated hepatic segmentation across various reconstruction methods. Materials and Methods: We collected contrast-enhanced dual-energy CT of the abdomen that was obtained using various reconstruction methods, including filtered back projection, iterative reconstruction, optimum contrast, and monoenergetic images with 40, 60, and 80 keV. A deep learning based image conversion algorithm was developed to standardize the CT images using 142 CT examinations (128 for training and 14 for tuning). A separate set of 43 CT examinations from 42 patients (mean age, 10.1 years) was used as the test data. A commercial software program (MEDIP PRO v2.0.0.0, MEDICALIP Co. Ltd.) based on 2D U-NET was used to create liver segmentation masks with liver volume. The original 80 keV images were used as the ground truth. We used the paired t-test to compare the segmentation performance in the Dice similarity coefficient (DSC) and difference ratio of the liver volume relative to the ground truth volume before and after image standardization. The concordance correlation coefficient (CCC) was used to assess the agreement between the segmented liver volume and ground-truth volume. Results: The original CT images showed variable and poor segmentation performances. The standardized images achieved significantly higher DSCs for liver segmentation than the original images (DSC [original, 5.40%-91.27%] vs. [standardized, 93.16%-96.74%], all P < 0.001). The difference ratio of liver volume also decreased significantly after image conversion (original, 9.84%-91.37% vs. standardized, 1.99%-4.41%). In all protocols, CCCs improved after image conversion (original, -0.006-0.964 vs. standardized, 0.990-0.998). Conclusion: Deep learning-based CT image standardization can improve the performance of automated hepatic segmentation using CT images reconstructed using various methods. Deep learning-based CT image conversion may have the potential to improve the generalizability of the segmentation network.

• 한국HCI학회:학술대회논문집
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• 한국HCI학회 2007년도 학술대회 1부
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• pp.982-987
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• 2007

The necessity of data compression scheme for volume data has been increased because of the increase of data capacity and the amount of network uses. Now we have various kinds of compression schemes, and we can choose one of them depending on the data types, application fields, the preferences, etc. However, the capacity of data which is produced by application scientists has been excessively increased, and the format of most scientific data is 3D volume. For 2D image or 3D moving pictures, many kinds of standards are established and widely used, but for 3D volume data, specially time-varying volume data, it is very difficult to find any applicable compression schemes. In this paper, we present a compression scheme for encoding time-varying volume data. This scheme is aimed to encoding time-varying volume data for visualization. This scheme uses MPEG's I- and P-frame concept for raising compression ratio. Also, it transforms volume data using Daubechies D4 filter before encoding, so that the image quality is better than other wavelet-based compression schemes. This encoding scheme encodes time-varying volume data composed of single precision floating-point data. In addition, this scheme provides the random reconstruction accessibility for an unit, and can be used for compressing large time-varying volume data using correlation between frames while preserving image qualities.