• Archives of Plastic Surgery
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• 제36권4호
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• pp.411-416
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• 2009

Purpose: Malignant melanoma is recognized as the most serious skin cancer. We examined anatomical distribution and 5 - year survival rate of each stage of malignant melanoma on lower leg. Methods: We retrospectively analyzed the medical records of 91 patients(46 males and 45 females) with malignant melanoma on lower leg from 1985 to 2008. Age, sex, anatomical distribution and 5 - year survival rates of each stage of malignant melanoma on lower leg were investigated. Also, 5 - year survival rates of each stage and invasion depth of malignant melanoma on heel pad were investigated. Results: On lower leg, most frequently 32 cases(35.1%) occurred on heel pad, 27 cases(29.7%) occurred on dorsum of foot, 18 cases(19.8%) in toe and 14 cases(15.4%) on others in lower leg. We used the excision margin as 3 ~ 5 cm. After wide excision, in stage III, IV, the patients underwent the immunologic / chemo - therapy. The incidences of each stage were 22 cases(24.2%) in stage I, 47(51.6%) in II, 17(18.7%) in III and 5(5.5%) in IV. The 5 - year survival rates of each stage were 85%, 53.2%, 47.1% and 40%. On heel pad, the incidences of each stage were 5 cases(15.6%) in stage I, 19 cases(59.4%) in II, 7 cases(21.9%) in III and 1 case(3.1%) in IV. The 5 - year survival rates of each stage were 80%, 63.2%, 42.9% and 100%. On heel pad, incidence of local recurrence was 2 and 5 - year survival rate of this case was 100%. And systemic recurrence was 9 and 5 - year survival rate of this case was 55.6%. Conclusion: The 5 - year survival rate of malignant melanoma on heel pad was higher than previous study. To maintain the weight - bearing function of foot, we recommend the active reconstructive surgery for heel pad reconstruction after wide excision of heel pad malignant melanoma.

• 기록학연구
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• 제7호
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• pp.37-74
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• 2003

An Old document(Diploma) is a historical and unique record, so it must be collected, arranged, and preserved for research as soon as possible. Especially, for the effective use of the Old Document(Diploma), it is needed to arrange and describe the material systematically on the ground of modern archival theory. The Kyujanggak Archives in the Seoul National University has published 23 volumes of Old document(Diploma) material Old Document(Diploma). But they seem to cause the readers inconvenience, because the materials are classified and gathered only by genre, the titles or the orders of the materials are not standardized, and there is no description about the content of each Old document(Diploma). Jangseo-gak Library in The Academy of Korean Studies has also published the series of Old document(Diploma) material Old Document(Diploma) Collection. However the case is not different, since they are all mixed up with materials classified and gathered by genre, family, academy, or local school. And a great part of the materials have no titles and no description about the content of each Old document(Diploma), either. About the arrangement and description of the records, European and American archival science has established the theory of l)the principle of provenance, 2)the principle of original order, 3)levels of control, 4)collective description. These theories are valuable for the effective use of Old document(Diploma). On the viewpoint of the principle of provenance, Old document(Diploma) materials should not be classified by subject and genre, but by family and person. Then, the Old document(Diploma) materials, after collected by the unit of family or person on the viewpoint of the principle of provenance, should be arranged in their original order for more detailed arrangement and furthermore, for the work to find their relationship. This is so called the principle of original order. The hierarchical management of the Old document(Diploma) materials, for example, classifying by record group, sub-group, series, item and so on, is the concept of the levels of control, and comprehensive description of the each hierarchical structure is the concept of the collective description. Let's apply these archival theories to 34 pieces of the Chung, Man-Seok's material in the series of Old document(Diploma) material Old Document(Diploma). First, collect the Old document(Diploma) materials into Chung, Man-Seok's collection(the principle of provenance), which were scattered in the series classified by genre. Secondly, rearrange them chronologically(the principle of original order), and then we can find the comprehensive information about Chung, Man-Seok. For the hierarchical management of the Old document(Diploma) materials, we should establish a few concepts from the general, large group to specific, small item. The concepts can be organized as following; l)record group(Chung, Man-Seok record group) - 2)sub-group(personnel document, property document, family document, social activity document, political activity document, etc) - 3)series(gyoji-series, gyoseo-series, yuji-series etc. in the personnel document) - 4)folder(document with additions) - 5)item(one document). According to the the theory of the collective description, in the level of record group, there should be a collective description of Chung, Man-Seok's biography or a summary of record group. Similarly, there should be a collective description of a summary of sub-group in the level of sub-group and a summary of series in the level of series.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.808-814
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• 2011

Purpose: Despite wide clinical use of breast implants, there is continued concern about the lifespan of these devices. The causes of explantation were infection, deflation of implant and patient's want. The deflation of saline-filled breast implant was related to strength and durability of implant shell. The purpose of this study is to evaluate the clinical durability of saline-filled breast implant through the analysis of duration until deflation occurred, causes, incidence and influencing factors. Methods: Retrospective analyses were conducted on clinical records for 19 cases of deflation of saline-filled breast implant from 201 cases of breast reconstruction with saline-filled implant between May 1995 and June 2011. The authors had been analyzed the causes of deflation, survival duration, symptom, sign, nipple excision, volume of implant, saline filling, method of reoperation, breast cancer stage and combined capsular contracture. Results: The causes of deflation were attributed to the cases that cannot be evaluated the causes in 15 cases, fall down in 1 case, mammography in 2 cases, accidental needle injury in 1 case. Mean survival duration was 4 years and 5 months. The duration of survival was less than 1 year for 5 cases, 1 year to 10 years for 10 cases, more than 10 years for 4 cases. The volume between 201 and 250 cc of deflated breast implant was rated as high by 14.0 percent. The deflation rate of underfilled implants was 11.4 percent, adequate filled implants was 9.3 percent. None of overfilled implant was deflated. The deflation of smooth surface implant was 5 of 152 cases. Textured implant was 14 of 49 cases. The capsular contracture of non-deflated breast implant was 28 of 182 cases and that of deflated breast implant was 6 of 19 cases. Conclusion: The patients who underwent saline-filled breast implant implantation should be informed that their implant could deflate. The analysis of clinical durability and causes of deflation in breast implant was important for the prediction and prevention of reopeation. The authors could suppose the causes of deflation of saline-filled breast implant through history, duration of survival, inspection of the shell of implant.

• Archives of Plastic Surgery
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• 제43권1호
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• pp.10-18
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• 2016

Background Lymphatic malformation (LM) is a form of congenital vascular malformation with a low incidence. Although LM has been studied, no consensus has emerged regarding its cause or treatment. Methods In this study, we retrospectively evaluated 40 patients who visited our vascular anomalies center for the treatment of cervicofacial LM, which is a common manifestation of LM. The medical records of patients over a period of 12 years were reviewed and analyzed for commonalities regarding the diagnosis and the results of treatment. Results Suspected cervicofacial LM was confirmed through imaging studies. No difference in incidence was observed according to sex, and 73% of patients first presented with symptoms before the age of two years. The left side and the V2-V3 area were most commonly affected. No significant differences in incidence were observed among the macrocystic, microcystic, and combined types of LM. A total of 28 out of 36 patients received sclerotherapy as the first choice of treatment, regardless of the type of lesion. Complete resolution was achieved in only 25% of patients. Conclusions LM is important to confirm the diagnosis early and to choose an appropriate treatment strategy according to the stage of the disease and each individual patient's symptoms. When treatment is delayed or an incorrect treatment is administered, patient discomfort increases as the lesion gradually spreads. Therefore, more so than is the case for most other diseases, a team approach on a case-by-case basis is important for the accurate and appropriate treatment of LM.

• Archives of Plastic Surgery
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• 제39권5호
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• pp.483-488
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• 2012

Background Pediatric hand burns are a difficult problem because they lead to serious hand deformities with functional impairment due to rapid growth during childhood. Therefore, adequate management is required beginning in the acute stage. Our study aims to establish surgical guidelines for a primary full-thickness skin graft (FTSG) in pediatric hand burns, based on long-term observation periods and existing studies. Methods From January 2000 to May 2011, 210 patients underwent primary FTSG. We retrospectively studied the clinical course and treatment outcomes based on the patients' medical records. The patients' demographics, age, sex, injury site of the fingers, presence of web space involvement, the incidence of postoperative late deformities, and the duration of revision were critically analyzed. Results The mean age of the patients was 24.4 months (range, 8 to 94 months), consisting of 141 males and 69 females. The overall observation period was 6.9 years (range, 1 to 11 years) on average. At the time of the burn, 56 cases were to a single finger, 73 to two fingers, 45 to three fingers, and 22 to more than three. Among these cases, 70 were burns that included a web space (33.3%). During the observation, 25 cases underwent corrective operations with an average period of 40.6 months. Conclusions In the volar area, primary full-thickness skin grafting can be a good indication for an isolated injured finger, excluding the web spaces, and injuries of less than three fingers including the web spaces. Also, in the dorsal area, full-thickness skin grafting can be a good indication. However, if the donor site is insufficient and the wound is large, split-thickness skin grafting can be considered.

• Archives of Plastic Surgery
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• 제44권1호
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• pp.26-33
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• 2017

Background The purpose of this study was to assess the correlation between the 2-dimensional (2D) extent of orbital defects and the 3-dimensional (3D) volume of herniated orbital content in patients with an orbital wall fracture. Methods This retrospective study was based on the medical records and radiologic data of 60 patients from January 2014 to June 2016 for a unilateral isolated orbital wall fracture. They were classified into 2 groups depending on whether the fracture involved the inferior wall (group I, n=30) or the medial wall (group M, n=30). The 2D area of the orbital defect was calculated using the conventional formula. The 2D extent of the orbital defect and the 3D volume of herniated orbital content were measured with 3D image processing software. Statistical analysis was performed to evaluate the correlations between the 2D and 3D parameters. Results Varying degrees of positive correlation were found between the 2D extent of the orbital defects and the 3D herniated orbital volume in both groups (Pearson correlation coefficient, 0.568-0.788; $R^2=32.2%-62.1%$). Conclusions Both the calculated and measured 2D extent of the orbital defects showed a positive correlation with the 3D herniated orbital volume in orbital wall fractures. However, a relatively large volume of herniation (>$0.9cm^3$) occurred not infrequently despite the presence of a small orbital defect (<$1.9cm^2$). Therefore, estimating the 3D volume of the herniated content in addition to the 2D orbital defect would be helpful for determining whether surgery is indicated and ensuring adequate surgical outcomes.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.445-450
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• 2011

Purpose: The objective of this study is to analyze the epidemiological characteristics of pediatric burn patients and to determine the targets for a pediatric burn prevention program. Methods: A retrospective review of all medical records of acute pediatric burn patients (age < 15 years old) admitted to our hospital between January 2005 and December 2009 was performed. Results: 1472 males and 1323 females were investigated, with a male to female ratio of 1.11 : 1. The greatest number of burn patients were those with an age of 1~2 years (1,463, 52.3%). Scalding burn was the most common cause of injury, which accounted for 2183 (78.1%) patients, followed by contact burns (10.5%), flame burn (4.9%), steam burn (3.6%). Especially steam burn was the second cause of injury in the age under 1 year, while flame burn was the second cause of injury in the age over 7 years. During recent 5 years, incidence of flame burn, steam burn, electrical burn gradually decreased. Variation of seasonal incidence is minimal and most of the patients (2,716 cases, 97.2%) had burns less than 20% TBSA (Total body surface area). The median hospital stay was 18.79 days, and the rate of operation was 28.6% with a high rate in electrical burn (76.2%), flame burn (50.0%), steam burn (46.1%). 6 patients died in this series, which yielded a mortality rate of 0.2%. Conclusion: Prevention efforts should reflect recent study results. Focused prevention program and campaign to make people aware of risk factors and their avoidance is required to reduce the number of burn accidents in children.

• 정보관리학회지
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• 제33권1호
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• pp.247-268
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• 2016

연구주제와 관련된 다양한 자료들 중에서 특정 문헌이 참고문헌으로 선택되어 이용되는 인용과정은 오랫동안 많은 과학자들의 다양한 관점에 따라 연구되어 왔지만 아직까지 인용행태의 본질과 복잡성은 명확히 밝혀지지 않았다. 특히 한국의 경우 인용행태 연구에 있어 서지학적 요인에 대한 통계적 분석 연구방법이 주로 이용되었는데, 이 방법은 인용의 역동적이며 복잡한 인지적 측면을 밝히는데 한계가 있었다. 이에 본 연구는 설문조사를 통해 인용동기와 서지학적 요인에 대한 인용자들의 인식을 직접 알아보고, 응답결과를 인용자 특성에 따라 비교해 보았다. 문헌분석을 통해 22가지 인용동기와 21가지 서지요인을 추출하여 5점 Likert 척도문항을 구성한 뒤, 설문지를 이메일에 첨부하여 배포, 총 354부의 유효표본을 확보하였다. SPSS 22.0을 이용하여 빈도분석, 독립표본 t검정, 일원분산분석을 실시한 결과, 가장 중요하게 고려되는 인용동기는 '주장에 대한 증거제공'이었으며 '사회적 친분관계', '자기인용' 등은 영향력이 거의 없는 것으로 나타났다. 서지요인의 경우, 학술지의 명성이 인용선택에 가장 영향력이 크다고 인지되었으며 페이지수, 저자수, 저자성별의 영향력은 거의 없었다. 또한 전공분야, 연구활동경력에 따라 이러한 인식에 유의한 차이가 나타났다. 연구결과를 통해 선행연구를 실증하고, 인용빈도에 영향력이 크다고 가정되어온 요인들이 의도된 것인지를 확인할 수 있었으며, 전문도서관이나 학술데이터베이스의 검색지점 설정에 제언할 수 있었다.

• Archives of Plastic Surgery
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• 제34권2호
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• pp.209-216
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• 2007

Purpose: The ischial area is by far the most common site of pressure sores found in wheel chair bound paraplegic patients, because greatest pressure is exerted from the body on this area in a sitting position. Even after a series of successful pressure sore treatments, the site is very prone to relapse by the simplest ordinary tasks of everyday life. Therefore, it is crucial to preserve the main pedicle during primary surgery. Various surgical procedures employed to treat pressure sores such as myocutaneous flap and perforator flap have been introduced. After introduction of ischial sore treatment using the inferior gluteal artery perforator (IGAP) has been made, the authors experienced favorable clinical results of patients who have undergone IGAP flap procedure in a three year time period. Methods: A total of 17 patients received IGAP flap surgery in our hospital from January 2003 to May 2006, among which 14 of them being males and 3 females. Surgery was performed on the same site again in 6(35%) patients who had originally relapsed after receiving the conventional method of pressure sore surgery. Patients' average age was 49.4(27-71) years old. Most of the patients were paraplegic(11 cases, 65%) and others were either quadriplegic(4 cases, 23%) or ambulatory(2 cases, 12%). Based on hospital records and clinical photographs, we have attempted to assess the feasibility and practicability of the IGAP flap procedure through comparative analysis of several parameters: size of defective area, treatment modalities, occurrence of relapses, complications, and postoperative treatments. Results: The average follow-up duration of 17 subjects was 25.4 months(5-42 months). All flaps survived without any necrosis. Six cases were relapsed cases from conventional surgical procedures. All of them healed well during our follow-up study. Postoperative complications such as wound dehiscence and fistula developed in some subjects, but all were well healed through secondary treatment. A total of 2 cases relapsed after surgery. Conclusion: The inferior gluteal artery perforator flap is an effective method that can be primarily applied in replacement to the conventional ischial pressure sore reconstructive surgery owing to its many advantages: ability to preserve peripheral muscle tissue, numerous possible flap designs, relatively good durability, and the low donor site morbidity rate.

• Archives of Plastic Surgery
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• 제45권3호
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• pp.229-238
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• 2018

Background Nipple-sparing mastectomies (NSMs) are increasingly performed to obtain the best aesthetic and psychological outcomes in breast cancer treatment. However, merely preserving the nipple-areolar complex (NAC) does not guarantee a good outcome. Darkly pigmented NACs and a tendency for poor scarring outcomes are particular challenges when treating Asian patients. Herein, we review the reconstructive outcomes following NSM at Singapore General Hospital. Methods All breasts reconstructed following NSM over an 11-year period from 2005 to 2015 were reviewed. Information was collected from the patients' records on mastectomy indications, operative details, and complications. Patient satisfaction, breast sensation, and aesthetic outcomes were evaluated in 15 patients. Sensation was quantified using the Semmes-Weinstein monofilament test. Results A total of 142 NSMs were performed in 133 patients for breast cancer (n=122, 85.9%) or risk reduction (n=20, 14.1%). Of the procedures, 114 (80.2%) were autologous reconstructions, while 27 (19.0%) were reconstructions with implants. Complications occurred in 28 breasts (19.7%), with the most common complication being NAC necrosis, which occurred in 17 breasts (12.0%). Four breasts (2.8%) had total NAC necrosis. The overall mean patient satisfaction score was 3.0 (good). The sensation scores were significantly diminished in the skin envelope, areola, and nipple of breasts that had undergone NSM compared to non-operated breasts (P<0.05). Half of the subset of 15 patients in whom aesthetic outcomes were evaluated had reduced nipple projection. Conclusions Immediate reconstruction after NSM was performed with a low complication rate in this series, predominantly through autologous reconstruction. Patients should be informed of potential drawbacks, including NAC necrosis, reduced nipple projection, and diminished sensation.