• Archives of Plastic Surgery
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• v.41 no.4
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• pp.379-386
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• 2014

Background Vulvar defects result chiefly from oncologic resection of vulvar tumors. Reconstruction of vulvar defects restores form and function for the purpose of coitus, micturition, and defecation. Many surgical options exist for vulvar reconstruction. The purpose of this article is to present our experience with vulvar reconstruction. Methods From 2007 to 2013, 43 women presented to us with vulvar defects for reconstruction. Their mean age at the time of reconstruction was 61.1 years. The most common cause of vulvar defect was from resection of vulvar carcinoma and extramammary Paget's disease of the vulva. Method s of reconstruction ranged from primary closure to skin grafting to the use of pedicled flaps. Results The main complications were that of long term hypertrophic and/or unaesthetic scarring of the donor site in 4 patients. Twenty-two patients (51%) were able to resume sexual intercourse. There were no complications of flap loss, wound dehiscence, and urethral stenosis. Conclusions We present a subunit algorithmic approach to vulvar reconstruction based on defect location within the vulva, dimension of the defect, and patient age and comorbidity. The gracilis and gluteal fold flaps are particularly versatile and aesthetically suited for reconstruction of a variety of vulvar defects. From an aesthetic viewpoint the gluteal fold flap was superior because of the well-concealed donor scar. We advocate the routine use of these 2 flaps for vulvar reconstruction.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.564-569
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• 2013

Background Scalp defects may be caused by various etiological factors, and they represent a significant surgical and aesthetic concern. Various surgical techniques can be applied for reconstructive work such as primary closure, skin grafting, pedicled or free flaps. In this article, the authors share their clinical experience with scalp operations using the technique of local flaps and discuss the application of this method from the perspective of not only the size of the defect, but also in relation to the anatomical area, quality of surrounding tissue, and patient's condition. Methods During the period from December 2007 to December 2012, 13 patients with various scalp defects, aged 11 to 86 years, underwent reconstruction with local pedicle flaps. The indications were based on the patients' condition (age, sex, quality of surrounding tissue, and comorbidities) and wound parameters. Depending on the size of the defects, they were classified into three groups as follows: large, 20 to 50 $cm^2$; very large, 50 to 100 $cm^2$; extremely large, 100 $cm^2$. The location was defined as peripheral (frontal, temporal, occipital), central, or combined (more than one area). We performed reconstruction with 11 single transposition flaps and 1 bipedicle with a skin graft on the donor area, and 2 advancement flaps in 1 patient. Results In all of the patients, complete tissue coverage was achieved. The recovery was relatively quick, without hematoma, seroma, or infections. The flaps survived entirely. Conclusions Local flaps are widely used in scalp reconstruction since they provide healthy, stable, hair-bearing tissue and require a short healing time for the patients.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.603-609
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• 2013

Background Although the conventional direct brow lift operation provides a simple means of managing lateral brow ptosis, the scars produced have been unacceptable. However, using the modifications proposed here, scarring showed remarkable improvement. This article reviews our experiences with the presented technique, mainly with respect to postoperative scarring. Methods Measured amounts of supra-eyebrow skin and subcutaneous fat were excised en bloc in the conventional manner under 'hyper-hydrated' local infiltration anesthesia. The lower flap and the edge of the upper flap were undermined above the muscular plane, and the orbicularis oculi muscle was directly suture-plicated and suspended upward to the distal frontalis muscle. Skin closure was performed in a basic plastic surgical manner. Results From April 2007 to April 2012, a consecutive series of 60 patients underwent surgery using the above method. The average width of the excised skin was 8 mm (range, 5-15 mm) at the apex of the eyebrow. Preoperative complaints were resolved without occurrence of significant complications. The surgical scars showed remarkable improvement and were negligible in the majority of the cases. Conclusions The direct brow lift operation combined with plication/suspension of the superior and lateral portion of the orbicularis oculi muscle provides a simple, safe, and predictable means of correcting lateral brow ptosis. The scars were acceptable to all of the patients. For proper management of the frontalis tone, upper blepharoplasty and/or repair of eyelid levator function must be considered in addition to brow lift procedures.

• Journal of Chest Surgery
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• v.44 no.2
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• pp.178-182
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• 2011

Background: We analyzed the results of surgical reduction and fixation of ribs under thoracic epidural anesthesia and analgesia (TEA) in patients who had no more than 3 consecutive rib fractures with severe displacement to examine the clinical usefulness of this method. Materials and Methods: From May 2008 to March 2010, 35 patients underwent surgical reduction and fixation of ribs under TEA. We reviewed the indications for this technique, number of fixed ribs, combined surgical procedures for thoracic trauma, intraoperative cardiopulmonary events, postoperative complications, reestablishment of enteral nutrition, and ambulation. Results: The indications of TEA were malunion or nonunion of fractured ribs in 29 (82.9%; first operation) and incompletely ribs under previous general anesthesia in 6 (17.1%; second operation). The average number of fixed ribs per patient was 1.7 (range: 1~3). As a combined operation for thoracic trauma, 17 patients (48.6%) underwent removal of intrathoracic hematomas, and we performed repair of lung parenchyma (2), wedge resection of lung (1) for accompanying lung injury and pericardiostomy (1) for delayed hemopericardium. No patient had any intraoperative cardiopulmonary event nor did any need to switch to general anesthesia. We experienced 3 postoperative complications (8.6%): 2 extrapleural hematomas that spontaneously resolved without treatment and 1 wound infection treated with secondary closure of the wound. All patients reestablished oral feeding immediately after awakening and resumed walking ambulation the day after operation. Conclusion: Thoracic epidural anesthesia and analgesia (TEA) may positively affect cardiopulmonary function in the perioperative period. Moreover, this technique leads to an earlier return of gastrointestinal function and early ambulation without severe postoperative complications, resulting in a shortened hospital stay and lowered costs.

• International Journal of Naval Architecture and Ocean Engineering
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• v.11 no.2
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• pp.736-749
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• 2019

This paper employs computational tools to investigate the diffraction effects in regular head waves on the added resistance and wake on the propeller plane. The objective ships are a 66,000 DWT bulk carrier and a 3,600 TEU container ship. Fixed and free to heave and pitch conditions at design speed have been taken into account. Two-phase unsteady Reynolds averaged Navier-Stokes equations have been solved using the finite volume method; and a realizable k-ε model has been applied for the turbulent closure. The free surface is obtained by solving a VOF equation. The computations are carried out at the same scale of the model tests. Grid and numerical wave damping zones are applied to remove unwanted wave reflection at the boundaries. The computational results are analyzed using the Fourier series. The added resistances in waves at the free condition are higher than those at the fixed condition, which are nearly constant for all wavelengths. The wake velocity in waves is higher than that in calm water, and is accelerated where the wave crest locates on the propeller plane. When the vertical motion at the stern goes upward, the wake velocity also accelerated.

• Asian Journal of Atmospheric Environment
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• v.2 no.1
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• pp.1-13
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• 2008

A numerical simulation method has been developed to predict atmospheric flow and stack gas diffusion using a calculation domain of several km around a stack under complex terrain conditions containing buildings. The turbulence closure technique using a modified k-$\varepsilon$-type model under a non hydrostatic assumption was used for the flow calculation, and some of the calculation grids near the ground were treated as buildings using a terrain-following coordinate system. Stack gas diffusion was predicted using the Lagrangian particle model, that is, the stack gas was represented by the trajectories of released particles. The numerical model was applied separately to the flow and stack gas diffusion around a cubical building and to a two-dimensional ridge in this study, before being applied to an actual terrain containing buildings in our next study. The calculated flow and stack gas diffusion results were compared with those obtained by wind tunnel experiments, and the features of flow and stack gas diffusion, such as the increase in turbulent kinetic energy and the plume spreads of the stack gas behind the building and ridge, were reproduced by both calculations and wind tunnel experiments. Furthermore, the calculated profiles of the mean velocity, turbulent kinetic energy and concentration of the stack gas around the cubical building and the ridge showed good agreement with those of wind tunnel experiments.

• Nuclear Engineering and Technology
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• v.27 no.6
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• pp.825-832
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• 1995

The effect of loading variables and temperature on fatigue crack growth rate in SA508 Cl.3 nuclear pressure vessel steel was investigated in air environment Crack growth rate tests on compact tension specimen of thickness 12mm were conducted by using sinusoidal waveform. The crack length was monitored by compliance method. Test conditions were at 0.1 and 0.5 of load ratio, at 1 and 10 Hz of loading frequency, and at room temperature to 40$0^{\circ}C$. At the lower temperatures, the fatigue crack propagation was not affected by the frequency and temperature, while at the higher temperatures above 12$0^{\circ}C$, fatigue crack growth rate increased with decreasing loading frequency and increasing temperature. This accelerated fatigue crack propagation was associated with the increase of oxidation rate at the ahead of crack tip. Fatigue crack growth rate increased with in-creasing the load ratio. The effect of load ratio was more significant at the lower temperature, while the dependence on load ratio decreased with increasing temperature. The sensitivity of load ratio to temperature can be explained by crack closure with the oxidation process.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.3
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• pp.274-278
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• 2005

Purpose : Prediction for soft tissue change after orthognathic surgery is very important for the final esthetics. In this study, we have tried to get the amount of upper lip movement relative to bony segment movement after anterior segmental osteotomy by cephalmetric analysis to predict final upper lip position after surgery. Material and Methods : 20 patients was studied on whom anterior segmental osteotmy as performed by Cupar method during the years 2002 to 2003. Cephalometric radiograph were taken at 1month before surgery and 6 month after surgery. Change of upper lip was measured on landmark Ls and Sto relative to hard tissue (landmark Ia) setback on these X-rays and analyzed. Results : 1. Upper lip setback movement. Setback of upper lip showed proportional relation to the hard tissue setback and the ratio was about 84%(p=0.001). 2. Upper lip downward movement. Downward movement of upper lip showed no proportional relation to hard tissue setback And the amount was mean 1.38 mm and SD 1.21mm (p=0.922). Conclusion : The posterior movement of upper lip is affected by hard tissue movement and shows good proportional change whereas downward movement is not so much influenced by hard tissue movement. And we think slight downward movement shown in this study could be explained by the V-Y closure performed during surgery.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.35 no.8
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• pp.763-771
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• 2011

An optimization procedure for the design of a ventilation axial-flow fan is presented in this paper. Flow analyses of the preliminary fan are performed by solving three-dimensional Reynolds-averaged Navier-Stokes equations via a finite-volume solver with the shear-stress transport turbulence model as a turbulence closure. Three variables, the hub-to-tip ratio and the stagger angles at the mid and tip spans, are selected for the optimization. The Latin-hypercube sampling method as a design-of-experiments technique is used to generate twenty-five design points within the design space. and the weighted average surrogate models, WTA1, WTA2, and WTA3, are applied for find optimal designs. The results show that the efficiency is considerably enhanced.

• Journal of the Ergonomics Society of Korea
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• v.27 no.4
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• pp.109-117
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• 2008

Compared to the existing PC which uses a mouse and a keyboard, the touchscreen-based portable PC allows the user to use fingers, requiring new operation methods. However, current touchscreen-based web browser operations in many cases involve merely having fingers move simply like a mouse and click, or not corresponding well to the user's sensitivity and the structure of one's index finger, making itself difficult to be used during walking. Therefore, the goal of this study is to develop finger gestures which facilitate the interaction between the interface and the user, and make the operation easier. First, based on the frequency of usage in the web browser and preference, top eight functions were extracted. Then, the users' structural knowledge was visualized through sketch maps, and the finger gestures which were applicable in touchscreens were derived through the Meaning in Mediated Action method. For the front/back page, and up/down scroll functions, directional gestures were derived, and for the window closure, refresh, home and print functions, letter-type and icon-type gestures were drawn. A validation experiment was performed to compare the performance between existing operation methods and the proposed one in terms of execution time, error rate, and preference, and as a result, directional gestures and letter-type gestures showed better performance than the existing methods. These results suggest that not only during the operation of touchscreen-based web browser in portable PC but also during the operation of telematics-related functions in automobile, PDA and so on, the new gestures can be used to make operation easier and faster.