• Archives of Hand and Microsurgery
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• 제23권4호
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• pp.281-289
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• 2018

목적: 우리는 미세혈관 유방 재건술 수술 계획에 참고하기 위하여 컴퓨터 단층 촬영(computed tomography, CT)혈관 조영술을 이용하여 심하복벽혈관과 천공지의 주행을 세부 유형으로 나누어 보고 영상 및 임상 소견의 상관성과 각 유형의 빈도를 보고하고자 한다. 방법: 하복부 조직을 이용한 유방 재건을 받은 연속한 115명의 환자를 전향적으로 분석하였다. 심하복벽동맥과 천공지를 주로 근육 내 주행의 특징에 따라 박리하기 용이한 것과 박리에 곤란한 것으로 특징짓고 각각의 빈도를 조사하였다. 결과: 확인된 425개의 천공지 중 89개(20.9%)의 천공지는 박리에 용이한 주행을 하였으며 긴 근육 아래 주행(34.8%), 긴 근막 아래 주행(15.6%), 근육 주위 주행(13.9%)이 그에 속하였다. 반면 심하복벽동맥이 없거나 적절한 천공지가 조영되지 않는 경우가 3예와 8예에서 보고되었다. 총 65명(56.5%)의 환자가 적어도 한 개 이상의 박리가 용이한 천공지를 가지고 있었다. 결론: 수술 전 CT 혈관 조영술을 통하여 심하복벽동맥과 천공지의 주행을 분석하여 박리에 용이한 유형과 곤란한 유형을 미리 파악함으로써 수술 계획의 수립에 도움을 받을 수 있다.

• 한국감성과학회:학술대회논문집
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• 한국감성과학회 2000년도 춘계 학술대회 및 국제 감성공학 심포지움 논문집 Proceeding of the 2000 Spring Conference of KOSES and International Sensibility Ergonomics Symposium
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• pp.113-119
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• 2000

The Pansori is a Korean traditional vocal music that has a unique story and melody which converts deep emotion into art. It has both verbal and emotional components. which can be coordinated by large-scale neural network. The purpose of this study is to illustrate the cortical network activated by a Korean traditional opera, Pansori, with different emotional valence using functional MRI (fMRI).Nine right-handed volunteers participated. Their mean age was 25.3 and the mean modified Edinburgh score was +90.1. Activation tasks were designed for the subjects to passively listen to the two parts of Pansories with sad or hilarious emotional valence. White noise was introduced during the control periods. Imaging was conducted on a 1.5T Siemens Vision Vision scanner. Single-shot echoplanar fMRI scans (TR/TE 3840/40 ms, flip angle 90, FOV 220, 64 x 64 matrix, 6mm thickness) were acquired in 20 contiguous slices. Imaging data were motion-corrected, coregistered, normalized, and smoothed using SPM-96 software.Bilateral posterior temporal regions were activated in both of Pansori tasks, but different asymmetry between the tasks was found. The Pansori with sad emotion showed more activation in the light superior temporal regions as well as the right inferior frontal and the orbitofrontal areas than in the right superior temporal regions as well as the right inferior frontal and the orbitofrontal areas than in the left side. In the Pansori with hilarious emotion, there was a remarkable activation in the left hemisphere especially at the posterior temporal and the temporooccipital regions as well as in the left inferior and the prefrontal areas. After subtraction between two tasks, the sad Pansori showed more activation in the right temporoparietal and the orbitofrontal areas, in contrast, the one with hilarious emotion showed more activation in the left temporal and the prefrontal areas. These results suggested that different hemispheric asymmetry and cortical areas are subserved for the processing of different emotional valences carried by the Pansories.

• Journal of Yeungnam Medical Science
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• 제33권2호
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• pp.166-169
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• 2016

Afferent loop obstruction following gastrectomy is a rare but fatal complication. Clinical features of afferent loop obstruction are mainly gastrointestinal symptoms. A 56-year-old female underwent radical total gastrectomy with Roux-en-Y esophagojejunostomy for treatment of advanced gastric cancer. After fourteen months postoperatively, she showed gradual development of edema of both legs. Computed tomography (CT) scan showed disease progression at the jejunojejunostomy site and consequent dilated afferent loop, which resulted in inferior vena cava (IVC) compression. A drainage catheter was placed percutaneously into the afferent loop through the intrahepatic duct and an IVC filter was placed at the suprarenal IVC, and self-expanding metal stents were inserted into bilateral common iliac veins. With these procedures, sympotms related with afferent loop obstruction and deep vein thrombosis were improved dramatically. The follow-up abdominal CT scan was taken 3 weeks later and revealed the completely decompressed afferent loop and improved IVC patency. Surgical treatment should be considered as the first choice for afferent loop obstruction; however, because it is more immediate and less invasive, non-surgical modalities, such as percutaneous catheter drainage or stent placement, can be effective alternatives for inoperable cases or risky patients who have severe medical comorbidities.

• Archives of Plastic Surgery
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• 제41권6호
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• pp.693-701
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• 2014

Background A thin perforator flap is one of the best methods for covering defects. This study aimed to revisit and further test the rapidly advancing field of flap thinning techniques. Methods We performed two cadaveric studies to test the known flap thinning methods, and then applied these methods to a clinical series. In the first study, five cadavers were used to observe the anatomical relation of the perforator with the subdermal plexuses and the subcutaneous fat layer by injecting a colored latex solution. The second study was done on four cadavers independently from the first study. Last, a clinical series was performed on 15 patients. Results The areolar fat lobules of 10 anterolateral thigh perforator (ALT), seven deep inferior epigastric artery perforator (DIEAP), and six thoracodorsal artery perforator (TAP) flaps were dissected to reduce the flap thickness guided by the colored vascular pattern. On average, the ALT, DIEAP, and TAP flaps were reduced to $32.76%{\pm}9.76%$, $37.01%{\pm}9.21%$, and $35.42%{\pm}9.41%$, respectively. In the second study, the areolar fat lobules were directly dissected in six ALT, six TAP, and four MSAP flaps, and an average reduction in flap thickness of $53.41%{\pm}5.64%$, $52.30%{\pm}2.88%$, and $47.87%{\pm}6.41%$, respectively, was found. In the clinical series, 13 out of the 15 cases yielded satisfactory outcomes with an average thickness reduction of $37.91%{\pm}7.15%$. Conclusions These multiple studies showed that the deep fat layer could be safely removed to obtain a thin yet viable perforator flap. This evidence suggests that the macroscopic flap thinning technique can achieve thin flaps. Surgeons should consider this technique before embracing the latest technique of supermicrosurgery.

• Archives of Plastic Surgery
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• 제44권2호
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• pp.109-116
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• 2017

Background The effect of liposuction on the perforators of the lower abdominal wall has been investigated in several studies. There are controversial results in the literature that have primarily demonstrated the number and patency of the perforators. The aim of this study was to determine the effect of liposuction on the perfusion of perforator-based abdominal flaps using a combined laser-Doppler spectrophotometer (O2C, Oxygen to See, LEA Medizintechnik). Methods Nine female patients undergoing classical abdominoplasty were included in the study. Perforators and the perfusion zones of the deep inferior epigastric artery flap were marked on the patient's abdominal wall. Flap perfusion was quantitatively assessed by measuring blood flow, velocity, capillary oxygen saturation, and relative amount of hemoglobin for each zone preoperatively, after tumescent solution infiltration, following elevation of the flap on a single perforator, and after deep and superficial liposuction, respectively. Results The measurements taken after elevation of the flap were not significantly different than measurements taken after the liposuction procedures. Conclusions The liposuction procedure does not significantly alter the perfusion of perforator-based abdominal flaps in the early period. The abdominal tissue discarded in a classic abdominoplasty operation can be raised as a perforator flap and has been demonstrated to be a unique model for clinical research.

• Restorative Dentistry and Endodontics
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• 제17권1호
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• pp.1-9
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• 1992

The intradental nerve activity was recorded from single pulp nerve unit dissected from the inferior alveolar nerve in canine teeth of anesthetized cats. The effects of various test solutions on intradental nerve activity evoked by 4M NaCl applied to the deep dentinal cavities were investigated. 1. Total 15 single pulp nerve units were recorded. Of these 9 were Mi - fibers and 6 were C -fibers. The mean conduction velocity and electrical threshold of $A{\delta}$ - fiber were $6.3{\pm}3.7m/sec$, $1.2{\pm}0.7V$ and those of C - fiber were $1.0{\pm}0.2m/sec$, $2.3{\pm}1.3V$, respectively. The response to cold stimuli of $A{\delta}$ - fiber began immediately and that of C - fiber began after a latency. 2. When applied to deep dentinal cavity, 4M NaCl induced irregular bursts of action potential in 4 $A{\delta}$ - fibers and 3 C - fibers, which continued until the solution was washed away. 3. In the $A{\delta}$ - fiber, histamine failed to induce any nerve acitivity and did not produce an increase in intradental nerve activity evoked by 4M NaCl. However following the application of 1M KCl, the response to 4M NaCl was eliminated. 4. In the C - fiber, histamine generated some nerve activity and produced a significant increase in intradental nerve activity evoked by 4M NaCl, but 5M $CaCl_2$ did not abolish this enhandced response.

• 대한원격탐사학회지
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• 제38권1호
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• pp.103-110
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• 2022

Since satellite images generally include clouds in the atmosphere, it is essential to detect or mask clouds before satellite image processing. Clouds were detected using physical characteristics of clouds in previous research. Cloud detection methods using deep learning techniques such as CNN or the modified U-Net in image segmentation field have been studied recently. Since image segmentation is the process of assigning a label to every pixel in an image, precise pixel-based dataset is required for cloud detection. Obtaining accurate training datasets is more important than a network configuration in image segmentation for cloud detection. Existing deep learning techniques used different training datasets. And test datasets were extracted from intra-dataset which were acquired by same sensor and procedure as training dataset. Different datasets make it difficult to determine which network shows a better overall performance. To verify the effectiveness of the cloud detection network such as Cloud-Net, two types of networks were trained using the cloud dataset from KOMPSAT-3 images provided by the AIHUB site and the L8-Cloud dataset from Landsat8 images which was publicly opened by a Cloud-Net author. Test data from intra-dataset of KOMPSAT-3 cloud dataset were used for validating the network. The simulation results show that the network trained with KOMPSAT-3 cloud dataset shows good performance on the network trained with L8-Cloud dataset. Because Landsat8 and KOMPSAT-3 satellite images have different GSDs, making it difficult to achieve good results from cross-sensor validation. The network could be superior for intra-dataset, but it could be inferior for cross-sensor data. It is necessary to study techniques that show good results in cross-senor validation dataset in the future.

• Archives of Plastic Surgery
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• 제46권6호
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• pp.599-602
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• 2019

We report a case of autologous breast reconstruction in which a thoracodorsal vessel was used as a recipient vessel after a hypoplastic internal mammary vessel was found on preoperative computed tomography (CT) angiography. A 46-year-old woman with no underlying disease was scheduled to undergo skin-sparing mastectomy and breast reconstruction using a deep inferior epigastric artery perforator flap. Preoperative CT angiography showed segmental occlusion of the right subclavian artery with severe atherosclerosis and calcification near the origin of the internal mammary artery, with distal flow maintained by collateral branches. The thoracodorsal artery was selected to be the recipient vessel because CT showed that it was of adequate size and was not affected by atherosclerosis. The patient experienced no postoperative complications, and the flap survived with no vascular complications. The breasts were symmetrical at a 6-month follow-up. This case highlights that preoperative vascular imaging modalities may help surgeons avoid using diseased vessels as recipient vessels in free flap breast reconstructions.

• Archives of Plastic Surgery
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• 제44권3호
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• pp.238-242
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• 2017

The most common anatomic variant seen in donor kidneys for renal transplantation is the presence of multiple renal arteries, which can cause an increased risk of complications. Accessory renal arteries should be anastomosed to the proper source arteries to improve renal perfusion via the appropriate vascular reconstruction techniques. In microsurgery, 2 kinds of vascular augmentation methods, known as 'supercharging' and 'turbocharging,' have been introduced to ensure vascular perfusion in the transferred flap. Supercharging uses a distant source of the vessels, while turbocharging uses vascular sources within the same flap territory. These technical concepts can also be applied in renal transplantation, and in this report, we describe 2 patients who underwent procedures using supercharging and turbocharging. In one case, the ipsilateral deep inferior epigastric artery was transposed to the accessory renal artery (supercharging), and in the other case, the accessory renal artery was anastomosed to the corresponding main renal artery with a vascular graft (turbocharging). The transplanted kidneys showed good perfusion and proper function. No cases of renal failure, hypertension, rejection, or urologic complications were observed. These microsurgical techniques can be safely utilized for renal transplantation with donor kidneys that have multiple arteries with a lower complication rate and better outcome.

• 대한두개안면성형외과학회지
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• 제19권2호
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• pp.157-161
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• 2018

A sialocele is a subcutaneous cavity containing saliva, most often caused by facial trauma or iatrogenic complications. In subcondylar fractures, most surgeons are conscious of facial nerve injury; however, they usually pay little attention to the parotid duct injury. We report the case of a 41-year-old man with a sialocele, approximately $5{\times}3cm$ in size, which developed 1 week after subcondylar fracture reduction. The sialocele became progressively enlarged despite conservative management. Computed tomography showed a thin-walled cyst between the body and tail of the parotid gland. Fluid leakage outside the cyst was noted where the skin was thin. Sialography showed a cutting edge of the inferior interlobular major duct before forming the common major duct that seemed to be injured during the subcondylar fracture reduction process. We decided on prompt surgical treatment, and the sialocele was completely excised. A duct from the parotid tail, secreting salivary secretion into the cyst, was ligated. Botulinum toxin was administrated to block the salivary secretion and preventing recurrence. Treatment was successful. In addition, we found that parotid major ducts are enveloped by the deep lobe and extensive dissection during the subcondylar fracture reduction may cause parotid major duct injury.