• Archives of Plastic Surgery
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• v.50 no.3
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• pp.240-247
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• 2023

More than 40 years have passed since the description of the first "free abdominoplasty flap" for breast reconstruction by Holmström. In the meantime, surgical advances and technological innovations have resulted in the widespread adoption of autologous breast reconstruction to recreate the female breast after mastectomy. While concepts and techniques are continuing to evolve, maintaining an overview is challenging. This article provides a review of current trends and recent innovations in autologous breast reconstruction.

• Journal of Korean Society of Environmental Engineers
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• v.27 no.8
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• pp.813-821
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• 2005

This paper presents a modeling study of thermal dynamics and turbid current in the Obong Lake, Kangreung. The lake formed by the artificial dam in 1983 for agricultural water supply, is currently under consideration of reconstruction in order to expand the volume of reservoir for water supply and flood control in downstream area. The US Army Corps of Engineers' CE-QUAL-W2, a two-dimensional laterally averaged hydrodynamic and water quality model, was applied to the lake after reconstruction as well as the present lake. The model calibration and verification were conducted against surface water levels and temperature of the lake measured during the years of 2001 and 2003. The model results showed a good agreement with fold measurements both in calibration and verification. Utilizing the validated model, an impact of dam reconstruction on vertical temperature and hydrodynamics were predicted. The model results showed that steep temperature gradient between epilimnion and hypolimnion would be formed during summer, along with extension of cold deep water after reconstruction. During winter and spring seasons, however, the vertical temperature profiles was predicted to be quite similar both before and after reconstruction. This results indicated that thermal stratification would become stronger during summer and stay longer after dam reconstruction. From the examination of predicted water movements, it was noticed that the upstream turbid current would infiltrate into the interface between metalimnion and hypolimnion and then suspended solids would slowly settle down to the bottom before reconstruction. After reconstruction, however, it was shown that the upstream turbid current would stay longer in metalimnion with similar density due to strong stratification. The model also predicted that dam reconstruction would make suspended solids near the dam location significantly decrease.

• Archives of Craniofacial Surgery
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• v.10 no.2
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• pp.81-85
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• 2009

Purpose: The inferior orbital wall is the most vulnerable to injury and inadequate reconstruction of inferior orbital fracture result in postoperative complications include enophthalmos, ocular dystopia and diplopia. Although the anatomical reconstruction of the inferior orbital wall is necessary to prevent these complications, the complexity of inferior orbital wall makes it difficult. We fabricated and remodeled the titanium micro-mesh plate for the anatomical reconstruction of inferior orbital wall. Methods: Twenty-nine patients with inferior orbital wall blow-out fracture were operated and twelve of them presented large extensive fracture. We intraoperatively fabricated and remodeled the Titanium-micro mesh to angulated lazy S shape similar to contralateral uninjured orbit. The preoperative and postoperative facial CT scan verified the 3-dimensional and anatomical reconstruction of the fractures. The mean follow-up was 19.7 months and postoperative complications was evaluated. Results: All cases showed the exact anatomical reconstruction, but there were minor complications in two cases. one patient had postoperative diplopia until 3months after surgery and the other patient had persistent enophthalmos (2 mm), but no further surgical correction was required. Conclusion: The comprehensive understanding of orbital convexity is the most important factor for anatomical reconstruction of inferior orbital fracture. We could prevent postoperative complications after inferior orbital wall reconstruction by intraoperative fabrication and anatomical remodeling of Titanium micro-mesh.

• Archives of Plastic Surgery
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• v.46 no.6
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• pp.580-588
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• 2019

Background There are various reconstructive options for nail bed defects. However, it is challenging not to leave a deformity. In this study, we investigated differences in outcomes depending on the reconstruction method, attempted to determine which method was better, and analyzed other factors that may affect outcomes. Methods The long-term outcomes of nail bed reconstruction were reviewed retrospectively. We performed three types of reconstruction depending on the defect type: composite grafts of severed segments, nail bed grafts from the big toe, and two-stage surgery (flap coverage first, followed by a nail bed graft). Subsequent nail growth was evaluated during follow-up, and each outcome was graded based on Zook's criteria. The reconstruction methods were statistically analyzed. Other factors that could contribute to the outcomes, including age, the timing of surgery, germinal matrix involvement, defect size, and the presence of bone injuries, were also compared. Results Twenty-one patients (22 digits) who underwent nail bed reconstruction were evaluated. The type of reconstruction method did not show a significant relationship with the outcomes. However, patients who sustained injuries in the germinal matrix and patients with a defect larger than half the size of the nail bed had significantly worse outcomes than the comparison groups. Conclusions The results suggest that no operative method was superior to another in terms of the outcomes of nail bed reconstruction. Nevertheless, involvement of the germinal matrix and defect size affected the outcomes.

• The Journal of the Korea Contents Association
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• v.20 no.6
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• pp.445-459
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• 2020

The purpose of this study was to verify the mediating effect of decentering between centrality of event and meaning reconstruction, based on relational loss experiences. To do so, surveys were conducted on 295 people(male: 109, female: 186) who would experience relational loss and be over 20 years old in the country using a questionnaire including a relational loss history checklist, the CES(Centrality of Event Scale), the Decentering Scale and the GMRI(Grief and Meaning Reconstruction Inventory). And the valid data were statistically processed using SPSS 22.0 program. The results of the study was followed. First, both centrality of event and decentering had positive corrleations with meaning reconstruction. Second, decentering completely mediated relationship of centrality of event and meaning reconstruction. Centrality of event had no direct effect on meaning reconstruction and the entire effect of centrality of event on meaning reconstruction was transmitted only through the path of decentering. Based on these results, limitations and implications of this study and suggestions for future studies were discussed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.4
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• pp.248-255
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• 2013

Reconstruction techniques of orofacial defects caused by wide excision of the intraoral malignant lesions are various. Although radial forearm free flap is a common donor site on reconstruction of soft tissue defect, anterolateral thigh (ALT) free flap also has an established site in orofacial soft tissue reconstruction as the favored donor flap with recent progress of the microsurgical technique. A 59-year-old female complained of hyperplastic mass on the right retromolar and buccal cheek, which was diagnosed as a squamous cell carcinoma (SCC) by an incisional biopsy. Before the operation, we planned a wide excision of the SCC lesion, supraomohyoid neck dissection, reconstruction with radial forearm free flap (RFFF), and split thickness skin graft. We accidentally found an arterial variation of the forearm area during elevation of RFFF, and changed the plan of reconstruction operation to reconstruction with ALT free flap. Operative sites was healed well during the post-operative period, and we referred to the department of radiation oncology for post-operative radiotherapy.

• Korean Journal of Head & Neck Oncology
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• v.1 no.1
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• pp.35-61
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• 1985

The surgical treatment of advanced carcinomas and some benign tumors having clinically malignant behaviors of the head and neck region often require extensive resection, necessitating large flaps for reconstruction. Since the original upper arm flap was described by Tagliacozzi in 1597, a variety of technique such as random pattern local flap, axial flap, distant flap, scalping flap, myocutaneous flap, free flap etc. have been proposed for reconstruction of head, face and neck defects. Reconstruction of the facial defects usually require the use of distant tissue. Traditionally, nasal reconstruction has been carried out with a variety of forehead flaps. In recent years, there has been more acceptance of immediate repairs following the removal of these tumors. As a result, patients are more willing to undergo these extensive resections to improve their chances of cure, with the reasonable expectation that an immediate reconstruction will provide an adequate cosmetic result. Authors experienced 13 cases of head and neck tumor during last three and half years that required wide excision and immediate reconstruction with various flaps, not with primary closure or simple skin graft. We present our experience with varied flaps for reconstruction after wide resection of head and neck tumors 3 cases of defect of dorsum of nose or medial canthus with island forehead flaps, lower eyelid defect with cheek flap, cheek defect with Limberg flap, orbital floor defect with Temporalis muscle flap, lateral neck defects with Pectoralis major myocutaneous flap or Latissimus dorsi myocutaneous free flap, subtotal nose defect with scalping flap, wide forehead defect with Dorsalis pedis free flap and 3 cases of mandibular defect or mandibular defect combined with lower lip defect were reconstructed with free vascularized iliac bone graft or free vascularized iliac bone graft concomitantly combined with free groin flap pedicled on deep circumflex iliac vessels We obtained satisfactory results coincided wi th goal of treatment of head and neck tumors, MAXIMAL CURE RATE with MINIMAL MORBIDITY, OPTIMAL FUNCTION, and an APPEARANCE as close to normal as possible.

• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.172-178
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• 2000

With esthetic concern in the reconstruction of skin and soft tissue defects of face, the use of local flap has been the method of choice. However, when there is extensive tissue loss in the face, local flaps do not provide satisfactory results. The amazing development of microsurgical technique has decreased the percentage of free flap failure, thus making free flap use in reconstruction of facial soft tissue defects. Many free flaps has been applied for reconstruction of face defects. Especially, the radial forearm flap has numerous advantages with which facial reconstruction is made possible. But, its disadvantages are ; the sacrifice of one major artery supplying the hand and donor site complications. In order to circumvent these disadvantages, we employed posterior interosseous artery(PIA) forearm free flap for the reconstruction of the face defects. The posterior interosseous forearm island flap was first described by Zancolli and Angrigiani(1985). Currently, the PIA island flap and free flap have been used for hand reconstructions. The disadvantages of the PIA flap are ; the small caliber of the pedicle, different locations of the perforating branches, and the proximity of the motor branch of the radial nerve. But, its advantages lies in preserving the major artery of the hand, minimal donor site morbidity, and fairly well matched skin texture and color, and that the flap volume is sufficient, not too bulky with convenient handling. By using this flap, we performed 1 case of tumor resection and 1 case of traumatic defect. From our experiences we conclude that it is one of many useful methods in the reconstruction of the skin and soft tissue defects of the face. We also have discussed advantages and some limitations of various free flaps for reconstruction of the face.

• Archives of Plastic Surgery
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• v.33 no.6
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• pp.688-694
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• 2006

Purpose: Reconstruction of the craniofacial defects can be carried out with autogenous tissues, allogenic implants, or alloplastic materials. Titanium mesh systems have been used for bony reconstruction in non load-bearing areas. They offer several advantages: immediate availibility without any donor site morbidity, easy handling, stable 3-D reconstruction, and low susceptibility to infection. The aim of this study is to evaluate the usefulness and complications of titanium mesh system in the reconstruction of the craniofacial defects. Methods: From Jan. 2000, to Dec. 2004, we performed reconstruction of craniofacial bone defects in 21 patients who had benign or malignant tumor and fracture events in the cranium, orbit, nasal bone, maxilla, zygoma and the mandible. The size of the defects ranged from $1.0{\times}1.5cm$ to $12{\times}10cm$. Two different mesh systems, micro-titanium augmentation mesh and dynamic mesh was used for bony reconstruction in non load-bearing areas. The patients were evaluated from 1 to 4 yrs clinically and radiographically with a mean follow up period of 1.5 yrs. Results: There were no serious complications, including wound infection, foreign body reaction, exposures or loos of the mesh, central infection and pathologic findings of bone around mesh exception of one patient, who had expired of skull base tumor recurrence. Long-term stability of the reconstructions and the overall functional and aesthetic outcome was excellent. Conclusion: Our experiences demonstrate that the Titanium mesh system is a relatively safe and efficient method in the craniofacial reconstruction and have broadens our choices of therapeutic procedures in the craniomaxillofacial surgery.

• Transactions of the Korean Society of Automotive Engineers
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• v.16 no.1
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• pp.52-63
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• 2008

The side collision reconstruction algorithm is developed using three dimensional car crash analysis. Medium size passenger car is modeled for finite element analysis. Total 24 side collision configurations, four different speed and six different angle, are set up for making side collision database. Deformation index and degree index are built up for each collision case. Deformation index is a kind of deformation estimate averaging displacement of side door of crashed car from finite element analysis result. Angle index is constructed measuring deformed angle of crashing car. There are two kinds of angle index, one is measured at driver's side and the other is measured at passenger's side. Also a collision analysis information in side of cars is used for giving a basis for scientific and practical reason in a reconstruction of the car accident. The analysis program, LS-DYNA3D is utilized for finite element analysis program for a collision analysis. Those database are used for side collision reconstruction. Side collision reconstruction algorithm is developed, and applied to find the collision conditions before the accident occurs. Three example collision cases are tried to check the effectiveness of the algorithm. Deformation index and angle index is extracted for the case from the analysis result. Deformation index is compared to the established database, and estimated collision speed and angle are introduced by interpolation function. Angle index is used to select a specific collision condition from the several available conditions. The collision condition found by reconstruction algorithm shows good match with original condition within 10% error for speed and angle. As a result, the calculation from the reconstruction of the situation is reproducing the situation well. The performance in this study can be used in many ways for practical field using deformation index and degree index. Other different collision situations may be set up for extending the scope of this study in the future.