• Korean Journal of Head & Neck Oncology
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• v.16 no.1
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• pp.46-51
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• 2000

Objectives: Primary malignant tumors in the salivary glands are relatively rare. Because of the rarity and the different histopathologic patterns, it is difficult to establish a uniform treatment strategy. The prime treatment of salivary gland malignancy is the surgery, but the role of radiotherapy has been under debate. Radiation therapy combined with conservative surgical procedures may be as successful and perhaps more rational treatment than radical surgery alone. The aim of this study is to evaluate clinical pattern, incidence, treatment modality and outcome of the salivary gland maligancy. Materials and Methods: The medical records of 32 patients with malignant neoplasm of salivary gland who treated at the Keimyung university Dongsan hospital were analyzed retrospectively. Results: The overall 5 year survival rate was 77.9% stage I : 100%, stage II : 75%, stage III : 66.7%, stage IV : 55.6%). The 5 year survival rate according to tumor grade was 100% in low grade malignancy, 71.8% in high grade malignancy. The 5 year survival rate according to treatment modalities was as follows: Surgery only group was 83.3%, combined treatment group with surgery and posoperative radiation was 74.6%. Conclusion: The factors affecting prognosis is variable, but the stage at the time of diagnosis, site of lesion, tumor grade, histologic subtype were important factors. Surgery was the prime treatment tool and postoperative radiotherapy was also imperative in higher stage patient, high grade tumor, or patients with positive surgical margin.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.333-336
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• 2008

Purpose: Adenoid cystic carcinoma is a rare type of eccrine sweat gland carcinoma. Although it is mostly known as a neoplasm of the salivary gland, it could occur as a primary skin tumor. We present a patient with a primary cutaneous adenoid cystic carcinoma at the genital area. Methods: A 60-year-old man had a slowly growing 1 cm sized single tender mass near the left scrotum and he underwent excisional biopsy at a local clinic. A diagnosis of adenoid cystic carcinoma was made and thus he was transferred to our hospital. In physical examination, other specific findings were not detected except a linear scar caused by a previous skin biopsy near the left scrotum. In CT scan, PET-CT scan and endoscopy, there was no evidence of neoplasm in other organs. It was diagnosed as the primary cutaneous adenoid cystic carcinoma and then wide excisions were performed including total 4.5 cm margin of normal skin. Results: Microscopic findings revealed proliferation of tumor cell islands with cribriform or tubular patterns containing several round, pseudocystic structures. The tumor cells showed basaloid cells with uniform and small nuclei. Tumor cells infiltrated into the dermis and upper portion of subcutaneous tissue. There was multifocal perineural invasion of tumor cells. In postoperative 6 months, we found no recurrence and other complications. Conclusion: Herein we found a rare case of primary cutaneous adenoid cystic carcinoma at the genital area.

• Archives of Reconstructive Microsurgery
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• v.16 no.1
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• pp.39-47
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• 2007

With the advent of microsurgery, perforator free flap is nowadays considered the first choice for reconstruction of the extensive defect of the extremities because of their moderate thickness. Among them, anterior (anterolateral and anteromedial) thigh perforator free flaps provide the first choice for reconstruction of various soft tissue defects of the extremities with many advantage such as its large, uniform thickness, long vascular pedicle with proper vessel size and minimal donor site morbidity. But, it has still some criticism of unreliable perforators which makes us very careful in elevating the flap. Between March of 2006 and February of 2007, we treated 7 patients of soft tissue defects in the hand and lower extremities with anterior thigh perforator free flap at Hallym and DongGuk University Hospital. We performed 6 anterolateral thigh perforator free flaps based on the descending branch of lateral circumflex femoral artery (LCFA) and 1 anteromedial thigh perforator free flap based on the innominate branch of the LCFA. While approaching for the anterolateral thigh free flap, we happen to meet the cases which we should change into the anteromedial thigh free flap uneventfully on the operating field. In contrast to the original design of anterolateral thigh free flap, we had to harvest the anteromedial thigh perforator free flap in 1 case. All the anterior thigh perforator free flaps survived completely except 1 case of partial necrosis due to venous congestion. Donor sites were closed primarily and healed uneventfully within 2 weeks. Patients were satisfied with the functionally and aesthetically acceptable results. Although doppler sonography is strongly recommended preoperatively in planning the anterior thigh perforator free flaps, we should always remember the variation in vascular anatomy and be ready to change the flap choice from the anterolateral to anteromedial intraoperatively. we provide a review of the literature and present our series of anterior thigh perforator free flaps for reconstruction of the extremities.

• Progress in Superconductivity and Cryogenics
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• v.15 no.3
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• pp.40-48
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• 2013

Cryoablation device is a surgical instrument to produce the cooling effect to destroy detrimental biological tissue by utilizing low temperature around 110 K. Usually, this device has the concentrated cooling region, so that it is suitable for concentrated and thick target. Accordingly, it is hard to apply this device for the target which is distributed and thin target. In this study, the design procedure of a closed-loop cryoablation device with multiple J-T expansion part is developed for the treatment of incompetent of great saphenous vein. The developed cyoablation device is designed with the analysis of 1-dimensional (1-D) bio-heat equation. The energy balance is considered to determine the minimum mass flow rate of refrigerant for consecutive flow boiling to develop the uniform cooling temperature. Azeotropic mixed refrigerant R410A and zeotropic mixed refrigerant (MR) of R22 ($CHClF_2$) and R23 ($CHF_3$) are utilized as operating fluids of the developed cryoablation device to form the sufficient temperature and to verify the quality of the inside of cryoablation probe. The experimental results of R410A and the zeotropic MR show the temperature non-uniformity over the range are $244.8K{\pm}2.7K$ and $239.8K{\pm}4.7K$ respectively. The experimental results demonstrate that the probe experiences the consecutive flow boiling over the target range of 200 mm.

• Journal of the Korean Society for Precision Engineering
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• v.26 no.1
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• pp.146-154
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• 2009

In recent tissue engineering field, it is being reported that the fabrication of 3D scaffolds having high porous and controlled internal/external architectures can give potential contributions in cell adhesion, proliferation and differentiation. To fabricate these scaffolds, various solid free-form fabrication technologies are being applied. The solid free-form fabrication technology has made it possible to fabricate solid free-form 3D microstructures in layer-by-layer manner. In this research, we developed a multi-head deposition system (MHDS) and used design of experiment (DOE) to fabricate 3D scaffold having an optimized internal/external shape, Through the organization of experimental approach using DOE, the fabrication process of scaffold, which is composed of blended poly-caprolactone (PCL), poly-lactic-co-glycolic acid (PLGA) and tricalcium phosphate (TCP), is established to get uniform line width, line height and porosity efficiently Moreover, the feasibility of application to the tissue engineering of MHDS is demonstrated by human bone marrow stromal cells (hBMSCs) proliferation test.

• Journal of The Korea Institute of Healthcare Architecture
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• v.24 no.2
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• pp.27-36
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• 2018

Purpose: In the case of mass disaster, the establishment of temporary medical facilities for the first aid and treatment is required for the stable accommodation of patients caused by the disaster. However, the criteria for decision making related to the deployment of field emergency medical facilities are not specified. So, The purpose of this study is to draw considerable factors needed for the deployment of field emergency medical facilities and to make proposal for site selection process of field emergency medical facilities on the basis of the factor. Methods: This study performs text mining of disaster-related laws, guidelines and documents to derive key factors affecting site selection, also proposes a decision making process and conducts virtual deployment to validate the process. Results: The key factors for the site selection derived as the size of the damage, the size of the DMAT inputs, the location of available place, and distance to the disaster base hospital. As a result of virtual deployment following proposed decision making process, It is confirmed that the site of field emergency medical facilities is changed depending on the type of disaster, even if the scope of the disaster damage was the same. Implications: The deployment of field emergency medical facilities requires a separate criteria for each type of disaster, not uniform, as a future research a quantitative approach of the criteria needs to be performed.

• Fibers and Polymers
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• v.6 no.4
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• pp.322-331
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• 2005

Graduated compression stockings (GCS) have been widely used for the prophylaxis and treatment of venous diseases. Their gradient pressure function largely related to their fabric structure and material properties. By combing fabric physical testing and wear trials, this study investigated the GCSs fabric structure and material properties at different locations along the stocking hoses, and quantitatively analyzed the effects of fabrics on skin pressure longitudinal and transverse distributions. We concluded that, Structural characteristics and material properties of stocking fabrics were not uniform along the hoses, but a gradual variation from ankle to thigh regions, which significantly influenced the corresponding skin pressure gradient distributions; Tensile (WT, EM) and shearing properties (G) generated most significant differences among ankle, knee and thigh regions along the stocking hose, which significantly influenced the skin pressure lognitudinal gradient distribution. More material indices generating significant gradual changes occurred in the fabric wale direction along stocking hose, meaning that materials properties in wale direction would exert more important impact on the skin pressure gradient performances. And, the greater tensibility and smoother surface of fabric in wale direction would contribute to put stocking on and off, and facilitate wearers' leg extension-flexion movements. The indices of WT and EM of stocking fabrics in series A have strong linear correlations with skin pressure lognitudinal distribution, which largely related to their better performances in gradual changes of material properties. Skin pressure applied by fabric with same material properties produced pronounced differences among four different directions around certain cross-sections of human leg, especially at the ankle region; and, the skin pressure magnitudes at ankle region were more easily influenced by the materials properties, which were considered to be largely related to the anatomic structure of human leg.

• Journal of Korean Neurosurgical Society
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• v.46 no.2
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• pp.93-98
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• 2009

Objective: Although prophylactic antiepileptic drug (AED) use in patients with aneurysmal subarachnoid hemorrhage (SAH) is a common practice, lack of uniform definitions and guidelines for seizures and AEDs rendered this prescription more habitual instead of evidence-based manner. We herein evaluated the incidence and predictive factors of seizure and complications about AED use. Methods: From July 1999 to June 2007, data of a total of 547 patients with aneurysmal SAH who underwent operative treatments were reviewed. For these, the incidence and risk factors of seizures and epilepsy were assessed, in addition to complications of AEDs. Results: Eighty-three patients (15.2%) had at least one seizure following SAH. Forty-three patients (79%) had onset seizures, 34 (6.2%) had perioperative seizures, and 17 (3.1%) had late epilepsy. Younger age (< 40 years), poor clinical grade, thick hemorrhage, acute hydrocephalus, and rebleeding were related to the occurrence of onset seizures. Cortical infarction and thick hemorrhage were independent risk factors for the occurrence of late epilepsy. Onset seizures were not predictive of late epilepsy. Moreover, adverse drug effects were identified in 128 patients (23.4%) with AEDs. Conclusion: Perioperative seizures are not significant predictors for late epilepsy. Instead, initial amount of SAH and surgery-induced cortical damage should be seriously considered as risk factors for late epilepsy. Because AEDs can not prevent early postoperative seizures (< 1 week) and potentially cause unexpected side effects, long-term use should be readjusted in high-risk patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.4
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• pp.340-350
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• 2016

The Medical Service Act of Korea describes a clinic as providing services primarily to outpatients, while a large general hospital provides specialized medical services requiring a high level of expertise for treating serious diseases. The portion of medical revenue for clinics has been decreasing gradually compared with large hospitals. This article proposes two fundamental medical policies to fix the distorted medical delivery system of Korea. Firstly, uniform additional medical remuneration rates based on the type of medial institution should be divided into outpatient additional rates and inpatient additional rates. Secondly, to normalize the function of clinics and large general hospitals, an outpatient medical target budget system should be introduced. Finally, to properly implement the proposal, it is important to establish healthcare policy-making governance. The success of policy implementation strongly depends on the participation and incentives of the government, suppliers, and patients. Healthcare policy-making governance must be designed to encompass this fact and improve quality of care.

• Journal of Magnetics
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• v.21 no.2
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• pp.286-292
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• 2016

This study evaluates the change of computer tomography (CT) number in the case of the metal artifact reduction (MAR) algorithm, using the phantom. The images were obtained from dual CT using a gammex 467 tissue characterization phantom, which is similar to human tissues. The test method was performed by dividing pre and post MAR algorithm and measured CT values of nonmagnetic materials within the phantom. In addition, the changes of CT values for each material were compared and analyzed after measuring CT values up to 140 keV, using the spectral HU curve followed by CT scan. As a result, in the cases of N rod (trabecular bone) and E rod (trabecular bone), the CT numbers decreased as keV increasing but were constant above 90 keV. In the cases of I rod (dense bone) and K rod (dense bone), the CT numbers also decreased as keV increased but were uniform above 90 keV. The CT numbers from 40 keV to 140 keV were consistent in the cases of J rod (liver), D rod (liver), L rod (muscle), and F rod (muscle). For A rod (adipose), G rod (adipose), B rod (breast) and O rod (breast), the CT numbers increased as keV increased but were constant after 90 keV. The CT numbers from 40 keV to 140 keV were consistent in the cases of C rod (lung (exhale)), P rod (lung (exhale)), M rod (lung (inhale)) and H rod (lung (exhale)). Conclusively, because dual CT exhibits no changes in image quality and is able to analyze nonmagnetic materials by measuring the CT values of various materials, it will be used in the future as a useful tool for the diagnosis of lesions.