• Archives of Plastic Surgery
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• 제36권1호
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• pp.75-79
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• 2009

Purpose: The transverse rectus abdominis musculocutaneous(TRAM) flap is the most commonly used autogenous tissue flap for breast reconstruction. Postoperatively, partial flap loss or fat necrosis are relatively common and it may result in a smaller breast volume with marked contour irregularities. These defects are not easy to reconstruct with local tissue rearrangement or with breast implants. The current authors present the results of 2 patients who underwent Latissimus dorsi(LD) flap reconstruction to correct partial flap or fat necrosis that developed after TRAM flap breast reconstruction. Method: Case1: A 50 - year - old woman with left breast cancer visited for breast reconstruction after radical mastectomy. Initially, breast reconstruction with pedicled TRAM was performed. Postoperatively partial flap necrosis was developed. Secondary breast reconstruction using LD flap was done. Case2: A 51 - year - old woman with left breast cancer visited for breast reconstruction after radical mastectomy. Initially, breast reconstruction with pedicled TRAM was performed. Postoperatively fat necrosis was developed. Secondary breast reconstruction using LD flap was done. Results: Secondary breast reconstruction using LD flap survived completely and produce successful reconstruction. There was no significant complication in both patients. Conclusion: LD flap provides sufficient, vascularized skin and soft tissue. The flap can be molded easily to replace deficient tissue in all areas of the breast. These attributes make it an ideal candidate for salvage of the partially failed TRAM flap breast reconstructio.

• 대한두개안면성형외과학회지
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• 제13권2호
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• pp.135-138
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• 2012

Purpose: Reconstruction of the cleft earlobe is challenging. Several procedures are available to reconstruct congenital earlobe deformities. However, for large defective type, surgical procedures and designs are complex and tend to leave a visible scar. We present a simple method of reconstruction for defective type congenital cleft earlobe using a one stage technique with infraauricular transposition flap. This allows for easy and accurate size estimation and good aesthetic outcomes. Methods: A 4-year-old male patient has congenital cleft earlobe and antihelical deformity. Otoplasty for antihelical deformity correction and one stage infra-auricular transposition flap for earlobe reconstruction were performed. The flap was designed from the inferoanterior margin of the earlobe. The size of the flap was determined based on the normal side, and the width and length of the flap was 1 cm and 3 cm in size, respectively. An incision was made at the midline of the defective lobule. Further, the elevated flap was inserted. The elevated flap and the incision margins of the lobule were sutured together. Then, the donor site was closed primarily. Results: The volume and shape of the reconstructed earlobe were natural. There was no flap necrosis. The donor site had no morbidities and scar was not easily notable. Conclusion: Infra-auricular transposition flap can be designed easily and offer sufficient volume of earlobe. Furthermore, the scar is inconspicuous. In conclusion, infra-auricular transposition flap can be a good option for reconstructing a large defect type cleft earlobe.

• Archives of Reconstructive Microsurgery
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• 제22권1호
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• pp.18-23
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• 2013

Purpose: For reconstruction of lower extremity defects, various flaps can be used and the appropriate flap must be selected and applied according to the size of the defect. In particular, in cases where the defect size is small to moderate, thinner or smaller volume flaps are useful. The authors performed reconstruction of small to moderate defects on the lower extremities using superficial circumflex iliac artery perforator free flaps and are reporting the results. Materials and Methods: Fifteen patients underwent reconstruction of defects on lower extremity areas using superficial circumflex iliac artery perforator free flaps from July 2011 to July 2012 at this hospital. The flaps were elevated from above the deep fat layer, and, in all cases, the vessel diameter of the flaps was less than 1mm, with the exception of superficial vein that accompanied it. Results: The mean follow up period was 4.46 months, and, despite a partial loss in the flap in two cases, there were no total losses. All donor sites were closed with primary closure, and there was no occurrence of complications, such as hematomas, seromas, or lymphorrheas. The patients were highly satisfied with the donor site scar since it could be masked by underwear. Conclusion: Compared to other flaps, superficial circumflex iliac artery perforator free flaps are thinner in thickness and smaller in volume, which results in a more natural contour of the recipient site after the operation. In addition, since the flap can be elevated from supra-deep fat layer, the operation time can be shortened, and lymphorrhea can be prevented, which in turn lessens donor-site morbidity.

• 한국방사선학회논문지
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• 제15권5호
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• pp.603-612
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• 2021

컴퓨터단층촬영의 관상동맥 칼슘(coronary artery calcium, CAC) 점수에서 Advanced Modeled Iterative Reconstruction (ADMIRE)의 영향을 평가하였다. 89명의 환자를 대상으로 128 slice dual-source CT로 관상동맥 칼슘 영상(348개의 칼슘, 6개 그룹, 총 2088개의 칼슘)을 획득하였다. Filtered back projection(FBP)과 ADMIRE(1-5)로 재구성된 이미지로부터 Volume score, Agatston score를 측정하였다. FBP와 ADMIRE Strength(1-5) 간의 차이는 Kruskal-Wallis 검정을 통해 확인하고, 사후분석은 FBP를 기준으로 Mann-Whitney U 검정을 하였다. Volume score와 Agatston score 모두 FBP와 ADMIRE(1-5)간에 통계적으로 유의한 차이가 있었습니다(P=0.015, P=0.0.38). 추가로 사후분석 한 결과 Volume score는 FBP를 기준으로 ADMIRE 4(Z=-2.359, P=0.018)에서 9.5 %, ADMIRE 5(Z=-3.113, P=0.002)에서 13.2 % 감소하는 것으로 나타났다. Agatston score는 FBP를 기준으로 ADMIRE 4(Z=-2.051, P=0.040)에서 10.4 %, ADMIRE 5(Z=-2.718, P=0.007)에서 14.0 % 감소하는 것으로 나타났다. 높은 ADMIRE strength는 칼슘 면적의 감소로 인하여 Volume score, Agatston score에 영향을 준다. 또한, Maximum HU의 감소로 인한 Density factor 변화는 Agatston score 계산에 영향을 줄 수 있다.

• 대한토목학회논문집
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• 제26권3B호
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• pp.279-289
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• 2006

최근에 수문시계열로부터 저차원의 비선형 거동을 재구성하고자 하는 연구가 활발히 진행되고 있다. 이러한 관점에서 본 연구에서는 Support Vector Machine(SVM)을 이용하여 우수한 상태-공간 재구성 능력을 갖는 비선형 예측모형을 구성하여 Great Salt Lake(GSL) Volume에 적용하였다. SVM은 Kernel 함수로부터 유도된 고차원의 특성공간 안에서 선형함수의 가상공간을 이용하는 Machine Learning 방법론이다. 또한 SVM은 훈련자료로부터 얻어지는 평균제곱오차가 아닌 일반화된 오차를 최소화함으로써 상대적으로 기존 방법에 비해 적은 수의 매개변수와 과적합(over fitting)을 피하면서 비선형 함수의 최적화가 가능하다. 본 연구에서 제시한 SVM 회귀분석의 적용성은 미국의 GSL의 2주 간격 Volume을 대상으로 검토하였다. SVM을 이용한 비선형 예측모형은 GSL Volume의 2주(1-Step), 8주(4-Step)와 반복예측(Iterated Prediction, 121-Step)까지 적용되었다. 본 연구에서는 극치사상 즉, 급격한 감소 및 증가 구간을 예측하는데 있어서 훈련구간과 예측구간을 구분하여 모형의 신뢰성을 평가하였다. 예측결과SVM은 훈련자료로부터 적은 수의 관측치를 이용하여 동역학적 거동을 추출할 수 있었으며 실제 관측자료와 거의 유사한 예측이 가능함을 통계적 지표로 확인할 수 있었다. 따라서 비선형 수문시계열의 단기 예측을 위한 모형으로 적용이 가능할 것으로 판단된다.

• 핵의학기술
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• 제18권1호
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• pp.115-121
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• 2014

PET 영상의 질 향상과 더불어 많은 연구를 통해 다양한 프로그램의 개발이 이루어지고 있다. 그 중 Philips 사의 Astonish TF 재구성 기법은 기존보다 빠른 재구성 속도와 함께 2 mm의 영상 재구성이 가능하여 병변의 향상된 대조도를 확인할 수 있다. 본 연구에서는 전신 $^{18}F-FDG$ PET 영상에서 기존의 4 mm와 2 mm 재구성 기법에 따른 표준섭취계수(SUV)를 비교 평가하였다. GEMINI TF 64 PET/CT (Philips, Cleveland, USA)를 사용하여 팬텀실험은 NEMA IEC Body Phantom (sphere: 10, 13, 17, 22, 28, 37 mm)으로 영상을 획득하였고, 임상영상은 유방암 진단을 받은 여자 30명(연령: $55.1{\pm}11.3$세, BMI: $24.1{\pm}2.9$)을 대상으로 $^{18}F-FDG$ PET/CT 검사를 시행한 후, 각각 4 mm와 2 mm로 영상을 재구성하였다. 획득된 영상은 EBW (Extended Brilliance Workstation) NM ver.1.0을 통해 팬텀과 임상영상에 관심영역을 설정하고, 표준섭취계수를 측정하였으며, SPSS ver.17.로 통계 분석하였다. 팬텀실험에서 90 sec로 획득한 영상의 4 mm와 2 mm 재구성 영상의 $SUV_{Max}$를 비교한 결과, 열소의 크기가 작을수록 $SUV_{Max}$의 편차가 크게 나타났고, 150 sec로 획득한 영상의 4 mm와 2 mm 재구성 영상의 $SUV_{Max}$를 비교한 결과에서도 같은 성향을 나타냈다. 90 sec와 150 sec로 획득한 영상의 $SUV_{Max}$의 편차 정도는 90 sec로 영상을 획득하였을 경우 보다 150 sec로 획득한 영상에서 열소의 크기가 작을수록 큰 차이를 나타냈고, 열소의 크기가 클수록 작은 차이를 나타냈다. 임상영상에서는 4 mm와 2 mm 재구성 기법을 분석한 결과, 표준섭취계수는 4 mm보다 2 mm 재구성 기법에서 높게 나타났고, 또한 체적이 작을수록 변화율이 증가하였다. Astonish TF 재구성 기법을 적용한 팬텀실험과 임상영상의 분석 결과, 체적의 크기가 작을수록 표준섭취계수의 변화율이 증가하였다. 그러므로 임상에서 대조도 및 병변 감별력이 우수한 2 mm 재구성 기법의 정확하고 적극적인 활용을 위하여 표준섭취계수 보정에 대한 추가적인 연구가 필요할 것으로 사료된다.

• 한국분무공학회지
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• 제7권4호
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• pp.9-15
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• 2002

Convolution Fourier transformation tomographically reconstructs the spatially resolved spray injection rate from direct measuring cells. Asymmetric sprays generated from a twin-hole air shroud injector are tested with 12 equiangular projections of measurements. For each projection angle, line of sight integrated injection rate was measured at 35 positions with equal spacing measuring cells of 3 mm in width, 100 mm in length, 55 mm in depth and 0.5 mm thickness of separating wall. Interpolated data between the projection angles effectively increase the number of projections, which significantly enhances the signal-to-noise level in the reconstructed data. This modified convolution Fourier transformation scheme predicts well the structure of asymmetric sprays. Comparative study has been made between sprays with and without air shrouding. Tomograhpic reconstruction of injection rate from direct measuring cells obtained can be used to estimate the accuracy of volume fraction of spray from the LDPA tomographic reconstruction.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1989년도 춘계학술대회
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• pp.55-59
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• 1989

A true three-dimensional cone-beam reconstruction (TTCR) algorithm for the complete sphere geometry is derived, which is applicable to the direct volume image reconstruction from 2-D cone-beam projections. The algorithm is based on the modified filtered backprojection technique which uses a set of 2-D space-invariant filters and is derived from the previously developed parallel-beam true three-dimensional reconstruction(TTR) algorithm. The proposed algorithm proved to be superior in spatial resolution compared with the parallel-beam TTR algorithm.

• Applied Microscopy
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• 제46권2호
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• pp.100-104
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• 2016

Electron microscopy is currently the only available technique with a spatial resolution sufficient to identify fine neuronal processes and synaptic structures in densely packed neuropil. For large-scale volume reconstruction of neuronal connectivity, serial block-face scanning electron microscopy allows us to acquire thousands of serial images in an automated fashion and reconstruct neural circuits faster by reducing the alignment task. Here we introduce the whole reconstruction procedure of synaptic network in the rat hippocampal CA1 area and discuss technical issues to be resolved for improving image quality and segmentation. Compared to the serial section transmission electron microscopy, serial block-face scanning electron microscopy produced much reliable three-dimensional data sets and accelerated reconstruction by reducing the need of alignment and distortion adjustment. This approach will generate invaluable information on organizational features of our connectomes as well as diverse neurological disorders caused by synaptic impairments.

• Archives of Reconstructive Microsurgery
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• 제10권1호
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• pp.28-33
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• 2001

The numbers of breast cancer are increasing in Korea and the needs for breast reconstruction are also parallel with cancer frequency. The purpose of the study is to define the different state and condition between the delayed reconstruction and the immediate reconstruction of breasts and to suggest how to get more satisfactory outcome. The study included 22 patients who underwent delayed breast reconstruction using transverse rectus abdominis myocutaneous(TRAM) free flap from December, 1990 to January, 2001. Their ages ranged from 28 years to 58 years. We have used internal mammary artery and vein as a recipient vessel in 13 patients because of fibrosis and severe scarring in the axillary region and thoracodorsal artery and vein in 9 patients. When we used internal mammary artery with recipient vessel, we would use contralateral deep inferior epigastric artery with donor vessel. We obtained satisfactory result without any flap loss, and most patients satisfied with shape and volume of reconstructed breast. We found that delayed breast reconstruction have some differences compared with immediate breast reconstruction. First, we remove fibrotic and scar tissue as much as possible to achieve satisfactory shape of breast. Second, we plan preoperative design in standing position to obtain symmetrical recreation of inframammary fold. Third, we use internal mammary vessel in many cases with recipient vessel for microvascular anastomosis. Fourth, patients with delayed breast reconstruction feel more satisfaction than patients with immediate breast reconstruction do. Finally, economic burden is much higher in the delayed case than in the immediate case because of no coverage with insurance.