• Archives of Plastic Surgery
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• v.37 no.5
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• pp.571-576
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• 2010

Purpose: Reconstruction of soft tissue defects of the foot often requires free-flap transfer. Free muscle flap transfer and skin grafts on the muscle has been an option for these defects. Here we present our experiences of foot reconstruction using an endoscopy-assisted free muscle flap harvest. Methods: Using endoscopy-assisted free muscle flap harvests, four patients with soft tissue defects of the foot were treated with a free muscle flap and skin graft. The gracilis muscle was used for two patients and the rectus abdominis muscle for two. A single small transverse skin incision was placed on the lower abdomen for the rectus abdominis muscle. A small transverse skin incision on the proximal thigh was the only incision for harvesting the gracilis muscle flap. The small incisions were enough for the muscle flap to be pulled through. Results: The flaps survived successfully in all cases. Contours were good from both functional and aesthetic aspects. No breakdowns or ulcerations of the flap developed during long-term follow-up. Resultant scars were short and relatively hidden. Functional morbidities such as abdominal bulging were not noted. Conclusion: Endoscopy-assisted harvest of muscle flap and transfer with skin graft is a good option for soft tissue defects of the foot. Morbidities of the donor site can be minimized with endoscopic flap harvest. This method is preferable for young patients who want a small donor site scar.

• Archives of Plastic Surgery
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• v.45 no.1
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• pp.51-57
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• 2018

Background The free anterolateral thigh (ALT) flap has been widely used for various kinds of reconstructions. However, delayed healing at the donor site occasionally occurs due to wound dehiscence or the partial loss of grafted skin at the donor site. The aim of the present study was to identify reliable predictive factors for delayed healing at the donor site after the harvest of a free ALT flap. Methods This study included 52 patients who underwent reconstructive procedures using free ALT flaps. The delayed healing group included patients with wounds at the donor site that had not healed over 3 weeks after surgery, and the normal healing group included patients who showed wound healing within 3 weeks after surgery. Multivariate logistic regression models were created to identify the risk factors for delayed healing at the ALT flap donor site. Results Among the 52 patients, 24 (46.2%) showed delayed healing at the donor site, and 6 patients required additional operative treatment. A high preoperative body mass index (BMI), smoking, and skin grafting were found to be significantly associated with delayed healing at the ALT donor site. Of the 37 patients who underwent skin grafting, 23 (62%) experienced delayed healing at the donor site. Conclusions A high preoperative BMI, smoking, and skin grafting were risk factors for delayed healing at the free ALT donor site. Skin grafting at the ALT donor site should be avoided in patients with a high BMI or a habit of smoking.

• 대한공업교육학회지
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• v.34 no.1
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• pp.129-154
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• 2009

The purpose of this study was to find the effect of intuitive free association and systematic free association on the creativity of high school students group in the conceptual design process. Based on this study result, the conclusion can be summarized as follows. 1. There was meaningful relation between intuitive free association and creativity factor of high school students. Mean value of experimental group A 's creativity and it's factor originality, practicality, elaboration, and fluency which treated intuitive free association was increased. 2. There was meaningful relation between systematic free association and creativity factor of high school students. Mean value of experimental group B 's creativity and it's sub factors: originality, problem solving, elaboration, and fluency which was treated systematic free association was increased. 3. It was found that two different divergent thinking does not show any meaningful difference in creativities of two groups. However, the meaningful difference was found in post creativity test in each groups sub-factors. There was meaningful difference in practicality factor, though there was no meaningful difference in originality, elaboration, fluency factors. Using the obtained results, it was concluded that intuitive thinking and systematic thinking play different roles in practicality which is one of sub-factors of the creativity of high school students. Consequently, it can be concluded that systematic thinking which leads students to take a step to solve a given problem can elicit more scientific thinking, and helps students create more practical solution in problem solving than intuitive thinking that emphasize the quantitative aspect of ideas.

• Archives of Reconstructive Microsurgery
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• v.6 no.1
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• pp.103-110
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• 1997

Since R.Y. Song(1982) has reported anatomic studies about septocutaneous perforator flap, various experiences especially on thigh flaps pedicled on septocutaneous artery were reported. Baek(1983) reported an anatomic study through the cadavers dissections on medial, lateral thigh area and provided the first new cutaneous free flap of thigh for clinical use. Song, et a1.(1984) reported anterolateral thigh free flap, Koshima, et al.(1989) reported pedicle variations and its versatile clinical usages. According to their reports, accessory branches of lateral femoral circumflex artery are placed in comparatively constant location and proved to be the effective pedicle of this flap. The advantages of anterolateral thigh free flap are 1) comparatively thin 2) can obtain sufficiently large flap 3) can contain cutaneous nerve 4) can be easy to approach anatomically because pedicle is located in comparatively constant position 5) minimal donor site morbidity. We report the experience of 10 cases of anterolateral thigh free flap coverage for soft tissue defects: 4 cases of soft tissue defects on foot area, 2 cases of soft tissue defects on hand, 3 cases of partial tongue defects owing to tongue cancer ablation, and 1 case of soft tissue defect on nasal alar.

• Archives of Plastic Surgery
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• v.44 no.6
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• pp.545-549
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• 2017

When foot reconstruction is performed in the pretibial area, the ankle, or the dorsum of the foot, the need for a reliable flap remains a challenge. We found that the superficial inferior epigastric artery (SIEA) free flap can be used as an alternative tool for this purpose, as it helps to solve the problems associated with other flaps. We describe 2 cases in which we reconstructed the foot using an SIEA free flap, which was pliable enough to fit the contours of the area. Postoperatively, the flaps were intact and showed excellent aesthetic results. Thus, the SIEA free flap can be an alternative tool for patients with a low body mass index who undergo reconstructive surgery involving the pretibial area, ankle, knee, or dorsum of the foot, all of which require a soft and flexible flap.

• The Bulletin of The Korean Astronomical Society
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• v.44 no.2
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• pp.71.3-71.3
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• 2019

Previously we developed a method of coronal force-free field construction using vector potentials. In this method, the boundary normal component of the vector potential should be adjusted at every iteration step to implement the boundary normal current density, which is provided by observations. The method was a variational method in the sense that the excessive kinetic energy is removed from the system at every iteration step. The boundary condition imposing the normal current density, however, is not compatible with the variational procedure seeking for the minimum energy state, which is employed by most force-free field solvers currently being used. To resolve this problem, we have developed a totally new method of force-free field construction. Our new method uses a unique magnetic field description using two scalar functions. Our procedure is non-variational and can impose the boundary normal current density exactly. We have tested the new force-free solver for standard Low & Lou fields and Titov-Demoulin flux ropes. Our code excels others in both examples, especially in Titov-Demoulin flux ropes, for which most codes available now yield poor results. Application to a real active region will also be presented.

• Journal of Science Education
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• v.37 no.1
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• pp.203-220
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• 2013

The purpose of this study was to investigate how 'free inquiry' was implemented in middle school science classrooms. In order to do this, survey and interviews were administered. The subject of survey was 165 science teachers at 58 middle schools and interviewees were 4 teachers and 10 students. As a result, 49.6% of science teachers in school year 2010, and 34.1% in 2011 applied 'free inquiry'. Teachers applied 'free inquiry' during one semester, and they let the students select topic of 'free inquiry'. Teachers grouped students according to students' opinion or their gender and ability, and one group was consisted of 4 students. The effect of applying 'free inquiry' was that students improved the interest on science, science inquiry ability and self directed learning capability. Students were interested in doing 'free inquiry', and they wanted to do it again. Teachers claimed that it took much time and effort to apply 'free inquiry', and students lacked science inquiry skills and interest on science. The teachers who did not apply 'free inquiry' stated reasons such as the shortage of instructional time, and they didn't think that 'free inquiry' should be implemented. For the effective implementation of 'free inquiry', this study suggested that teachers should be recognized the intention of 'free inquiry', teaching-learning materials about 'free inquiry' be developed and provided, and laboratory assistants be employed.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.7
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• pp.26-35
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• 2019

The purpose s of this study is to verify the status of barrier-free certification in an elementary school. To achieve this, the architectural characteristics of an elementary school and proposed opinions about the process of barrier-free certification were analyzed. The results of this study are as follows: (1) barrier-free certification in an elementary school is valid for inclusive education and accessibility for students with disabilities. (2) Regarding the school district and safe accessibility for the school, it is necessary to minimize the differences in land levels around the school. (3) Considering the opinions on intermediate facilities from the road to the main entrance, it is necessary to set the finish level of the first floor and to minimize the establishment of ramp or steps to prevent the backflow of rainfall.

• BMB Reports
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• v.32 no.1
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• pp.25-27
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• 1999

Otitis media with effusion (OME) is an inflammatory disease of the middle ear cleft. Oxygen free radicals have been implicated in a variety of inflammatory disorders. Oxygen free radicals may also be involved in the pathogenesis of OME. To evaluate the involvement of oxygen free radicals in the pathogenesis of OME, the level of malondialdehyde, which gives an index of lipid peroxidation by oxygen free radicals, was measured by the reaction with thiobarbituric acid. Malondialdehyde level in the middle ear fluid from the OME group was higher than that in the normal control group. Malondialdehyde level in the middle ear fluid from a mucoid subgroup was higher than that in the serous subgroup. Malondialdehyde levels in the middle ear fluid from the serous subgroup was significantly correlated with symptom duration. The Pearson correlation coefficient between malondialdehyde levels in the middle ear fluid from the serous subgroup and symptom duration was 0.842 (P<0.05). These results indicate that lipid peroxidation by oxygen free radicals may be involved in the pathogenesis of human OME.

• Archives of Plastic Surgery
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• v.38 no.1
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• pp.27-34
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• 2011

Purpose: Anterolateral thigh (ALT) perforator free flap is commonly used because of its various benefits. The author reports important factors of preoperative and perioperative ALT perforator free flap and causes of failure. Methods: 84 patients who were treated with ALT perforator free flap from December 2004 to 2008, and February 2010 to April 2010 were studied. 61 patients were male and 23 were female. The mean age of patients was 51.1. The main cause was neoplasm and the main reconstructive areas were head and neck area. The size of flap was various from $3{\times}4$ to $12{\times}18$ cm. 6 patients received split thickness skin graft at donor site. Preoperative angiography was checked to all patients. Results: Among the 84 patients, partial necrosis of flaps occurred in 4 patients because of atherosclerosis, varicose vein, or inattention of patient, etc. And total flap necrosis in 5 patients because of abnormal vessels of recipient area or delay of operation, etc. One case of serous cyst was found as the complication of donor area. Two cases of skin graft on donor site were done because of suspected muscle compartment syndrome, 4 cases of that because of large flap. Septocutaneous perforators were found in 7 cases. The author couldn't find reliable perforator in 3 cases, ipsilateral anteromedial thigh perforator and contralateral ALT perforator and latissimus dorsi musculocutaneous free flap were done instead of ALT. There was no case which needed reoperation because of the impairment of blood supply, and 3 cases were revised by leech because of the burn injury by a lamp or venous congestion. Conclusion: Although ALT perforator free flap is widely used with its various merits, many factors such as preoperative condition of donor or recipient area, morphology of defect and operating time need to consider to prevent flap necrosis. And operators should need careful technique because septocutaneous perforator is uncommon, and musculocutaneous perforator is common but difficult to dissect.