• Archives of Plastic Surgery
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• v.40 no.5
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• pp.627-629
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• 2013

The ReCell system (Avita Medical) is a cell culture product that allows the immediate processing of a small split-thickness skin biopsy to produce a complete population of cells including keratinocytes, melanocytes, Langerhans cells and fibroblasts. This series is the first to highlight the reconstructive applications of ReCell following ablative skin cancer surgery. The ReCell system was utilized for three patients following skin cancer excision. In two cases, the cells were applied to forehead flap donor sites following nasal reconstruction. In one case, the cells were applied to the calvarial periosteum following wide local excision of a melanoma scar. Assessment of the treated area was performed using the patient and observer scar assessment scale after 1 year. The Patient and Observer Scar Assessment Scale (POSAS) scores for the 2 patients treated with ReCell following forehead flap surgery were 22 and 32. The score for the patient that underwent wide local excision of a melanoma scar was 45. The absence of a donor site, accelerated healing and the satisfactory aesthetic appearance of the mature scars in this series suggest that ReCell may play a useful role in reconstruction following skin cancer excision.

• Korean Journal of Head & Neck Oncology
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• v.24 no.2
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• pp.194-196
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• 2008

Dermoid cysts are developmental anomalies that represent the simplest form of teratoma. They are the result of the sequestration of the skin along the lines of embryonic closure. These cysts of the head and neck are uncommon and account for 7% of all dermoid cysts. They are predominantly found in the orbit, floor of mouth, and nose. As a dermoid cyst of the parotid gland is extremely rare, it is often misdiagnosed preoperatively. By way of imaging modalities such as computed tomography, MRI and ultrasongraphy along with FNAB, it can be differentiated from many other cystic lesions of the parotid gland. We report a case of dermoid cyst of the parotid gland which masqueraded as lipoma before complete surgical excision.

• Korean Journal of Cleft Lip And Palate
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• v.13 no.2
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• pp.77-84
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• 2010

Vomer flap is used to repair anterior hard palate in complete cleft lip and palate patients. As the midline structure located in between the two cleft segments of hard palate, the vomer flap is very useful because of its vicinity to cleft site and their ease of execution when it is done with primary cheiloplasty simultaneously. In addition, the quality of tissue is very similar to that of the nasal mucosa with good vascularity. In cases of simultaneous repair of cleft lip with anterior palate using vomer flap, the hard palate can be repaired at the same time with primary cheiloplasty which is earlier period than other techniques. With simultaneous close of cleft lip and cleft hard palate by vomer flap, subsequent palatoplasty does not require wide dissection, and consequently chance of oronasal fistula formation will be minimized. Additionally, surgical time will be reduced and, the harmful effects on mid-facial growth will be diminished. In this article, we will introduce the comprehensive vomer flap technique with primary lip closure and review the comparative studies of the outcome of simultaneous repair of cleft lip and cleft hard palate with vomer flap.

• Journal of Convergence Society for SMB
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• v.3 no.1
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• pp.31-41
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• 2013

There have been various recent methods proposed in detecting driver drowsiness (DD) to avert fatal accidents. This work proposes a hardware/software (HW/SW) co-design approach in implementation of a DD detection system adapted from an AdaBoost-based object detection algorithm with Haar-like features [1] to monitor driver's eye closure rate. In this work, critical functions of the DD detection algorithm is accelerated through custom hardware components in order to speed up processing, while the software component implements the overall control and logical operations to achieve the complete functionality required of the DD detection algorithm. The HW/SW architecture was implemented on an Altera DE2 board with a video daughter board. Performance of the proposed implementation was evaluated and benchmarked against some recent works.

• Proceedings of the Korean Society of Propulsion Engineers Conference
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• 2004.03a
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• pp.62-68
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• 2004

A comprehensive numerical analysis has been carried out for both non-reacting and reacting flows in a scramjet engine combustor with and without a cavity. The theoretical formulation treats the complete conservation equations of chemically reacting flows with finite-rate chemistry of hydrogen-air. Turbulence closure is achieved by means of a k-$\omega$ two-equation model. The governing equations are discretized using a MUSCL-type TVD scheme, and temporally integrated by a second-order accurate implicit scheme. Transverse injection of hydrogen is considered over a broad range of injection pressure. The corresponding equivalence ratio of the overall fuel/air mixture ranges from 0.167 to 0.50. The work features detailed resolution of the flow and flame dynamics in the combustor, which was not typically available in most of the previous studies. In particular, the oscillatory flow characteristics are captured at a scale sufficient to identify the .underlying physical mechanisms. Much of the flow unsteadiness is related not only to the cavity, but also to the intrinsic unsteadiness in the flow-field. The interactions between the unsteady flow and flame evolution may cause a large excursion of flow oscillation. The roles of the cavity, injection pressure, and heat release in determining the flow dynamics are examined systematically.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.498-500
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• 2007

Purpose: The oral teratoma is found approximately in live birth at the rate from 1 : 35,000 to 1 : 200,000. In a review of literature 16 cases of midline teratoma with cleft palate were reported. We report a case of congenital palatal teratoma with cleft palate in a 1-year-old girl. Methods: A 1-year-old girl was admitted our institution for the closure of cleft palate. On the intraoperative findings there was $4{\times}1{\times}0.5cm$ sized hairy soft mass at the midline and complete cleft palate. We did incisional biopsy intraoperatively and its pathology revealed heterotopic brain tissue. The excision of remaining mass and palatoplasty with Sommerlad's method were performed. The final pathology of the mass was mature cystic teratoma. Results: After the operation there were neither recurrence nor oronasal regurgitation. Conclusion: We report for one patient with congenital palatal teratoma associated with cleft palate and obtained an excellent result.

• Journal of Chest Surgery
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• v.22 no.5
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• pp.823-828
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• 1989

Aortoenteric fistula is an uncommon important complication of aortic reconstruction with a prosthetic graft. The complication often is difficult to diagnose and is associated with poor prognosis. Aortoenteric fistula could be divided into true aortoenteric fistula and paraprosthetic-enteric fistula. In case of true aortoenteric fistula, an actual communication between the gastrointestinal tract and the aortic lumen is present. So, massive gastrointestinal hemorrhage is the presenting manifestation. In paraprosthetic-enteric fistula, characterized by communication between the gastrointestinal tract and the external surface of synthetic vascular prosthesis without actual fistularization into the vascular lumen, the predominant clinical manifestation were sepsis, fever and anemia. We experienced one case of paraprosthetic-enteric fistula in a 16 years old male after abdominal aortic reconstruction with a prosthetic graft. The interval from the operation to onset of symptoms was 40 months. The initial clinical manifestation was sepsis, fever and anemia without massive gastrointestinal hemorrhage. Surgical treatment consists of complete excision of infected graft, two layers closure of jejunal wall defect and pledgets suture of aortic stump with surrounding health tissue. Anatomic revascularization was not able to be done: because of extensive retroperitoneal inflammation and extraanatomic revascularization did not performed due to adequate distal blood supply through rich collateral circulation. After operation, he complained numbness on left foot on moderate exertion and felt coldness on left leg compared with right leg but not showed skin color change. 43 days after operation, he discharged without gait disturbance except numbness on left foot on moderate exertion.

• Journal of Chest Surgery
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• v.27 no.5
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• pp.353-363
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• 1994

From January 1978 to December 1992, 59 patients of double chambered right ventricle were repaired. Surgical correction consisted of closure of the ventricular septal defect and resection of anomalous muscle bundles through right ventriculotomy [Group I ; 34 patients] or right atriotomy [Group II ; 25 patients]. Between these two groups, there was no difference in the operation time and the postoperative results. All patients survived. In group I, hemodynamically significant residual ventricular septal defect was found in three and reoperations were necessary. In one patient, subacute bacterial endocarditis developed postoperatively. In group II, complete atrioventricular block developed in one and mediastinitis in two. Follow-up period was from 2 to 75 months [mean 17.1 months]. There was no late death. All patients have remained in sinus rhythm except one patient. Careful evaluation of echocardiographic and catheterization data preoperatively and careful examination of the anatomy intraoperatively are necessary so that double chambered right ventricle should not be overlooked, because most ventricular septal defects are now closed through the right atrium. Repair of double chambered right ventricle is also easily performed through the atrial approach. Transatrial repair should be considered as an alternative to the transventricular approach in patients with this congenital heart defect. Successful surgical correction of double chambered right ventricle is expected with excellent long term results.

• Archives of Plastic Surgery
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• v.46 no.1
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• pp.75-78
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• 2019

It is difficult to differentiate acute skin failure (ASF) from pressure ulcer (PU). ASF is defined as unavoidable injury resulting from hypoperfusion caused by severe dysfunction of another organ system. We describe a case of ASF mistaken as PU that resulted in a legal dispute. A 74-year-old male patient was admitted to our intensive care unit with sepsis due to bacterial pneumonia. Despite the use of air cushions and regular position changes, skin ulcerations occurred over his occiput, back, buttock, elbow, and ankle. After improvement in his general condition, he was transferred to the department of plastic and reconstructive surgery. Debridement was performed immediately, followed by conservative treatment (including a vacuum-assisted closure device) for 6 weeks. The buttock and occiput wounds were treated surgically. Despite complete healing, his caregivers sued the hospital for failing to prevent PU formation. ASF is a pressure-related injury resulting from hemodynamic instability due to organ system failure. Unlike PU, ASF may occur despite the implementation of all appropriate preventive measures. Furthermore, misdiagnosis of ASF as PU can lead to litigation. Therefore, it is critical for the proper diagnosis to be made quickly, and for physicians to explain that ASF occurs despite proper preventative treatment.

• Archives of Plastic Surgery
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• v.48 no.3
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• pp.287-292
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• 2021

Background We report the efficacy of a dual-plane approach using a Dufourmentel skin flap with a purse-string suture of the de-epithelized dermis to manage pseudoaneurysm at the vascular access site for hemodialysis. Methods A retrospective analysis was conducted of 61 patients from 2013 to 2018 with pseudoaneurysms at the arteriovenous fistula or graft who were treated with rhomboid excision, vessel repair with a purse-string suture, and a full-thickness Dufourmentel skin flap. The success rate was defined as the probability of complete wound closure and intact vascular access patency without infection or other complications. Results The success rate was 93.4% at 6 months postoperatively. Complications included newly occurring pseudoaneurysms (n=2), wound dehiscence (n=1) and bleeding (n=1). There were no complications such as stenosis or thrombosis from the procedure. Conclusions A dual-plane approach using a Dufourmentel skin flap with a purse-string suture for vessel repair was shown to be a favorable option for managing stable, small (diameter <2 cm) pseudoaneurysms without infection, rapid expansion, or patency issues of the vascular access.