• Archives of Plastic Surgery
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• v.49 no.2
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• pp.215-220
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• 2022

Background In Japan, there is a large regional disparity in plastic surgery availability. In order for plastic surgery to be widely available for all citizens, it is essential for at least one plastic surgery facility to be located in each secondary medical zone. Methods Using the Japan Society of Plastic and Reconstructive Surgery homepage and some databases, we extracted data on secondary medical zones that do not have a plastic surgery facility. The national and regional coverage rates were calculated. The coverage rate for each group divided by the degree of population concentration was also calculated. Results We found that 147 of 344 secondary medical zones did not have a plastic surgery facility, and the area coverage rate was found to be 57.27% nationwide. The coverage rate in terms of population was 87.07% (correlation coefficient of area and population coverage = 0.983). The area coverage rates in Hokkaido-Tohoku, Kanto, Chubu, Kansai, Chugoku-Shikoku, and Kyushu-Okinawa districts were 47.46, 72.15, 76.47, 62.79, 52.08, and 32.81%, respectively. The corresponding population coverage rates were 79.92, 91.62, 94.27, 90.59, 80.68, and 69.54%, respectively. The area coverage rates in metropolitan areas, provincial cities, and rural areas were 98.08, 75.90, and 15.87%, respectively. In contrast, the area coverage rate of dermatology was 62.79% and that of orthopaedics was 97.09%. Conclusion Unfortunately, it is estimated that more than 40% of secondary medical zones are underserved by plastic surgery, and 13% of the population is not able to fully benefit from this specialty in Japan.

• Archives of design research
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• v.16 no.4
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• pp.129-140
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• 2003

As the importance of Culture Technology (music, publication, mobile, film, video, cartoon, animation, character, game, broadcasting etc) is increased, the field of character industry recently has been recognized as an independent brand value beyond the existing view point of simple designing; it also has been given much attention as a main axis leading the cultural industry of the 21 st century. The character of a local government plays roles such as a symbolic part of a region, parts of tourism and public relations, and a profit-making function, which results into generation of regional image and activation of regional economy. However, the present application strategy of the character is only limited to an early stage of regional advertisements. In this context, this study is aimed to investigate and analyze the character development of local governments, especially 31 cities and goons of Gyeonggi Province, comparing with those of local governments of Japan. In the long run, this will provide some suggestions for strategy of character applications. Then, this research is expected to be used as basic reference materials for character development of other local governments and government agencies.

• Archives of Plastic Surgery
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• v.33 no.2
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• pp.233-236
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• 2006

Merkel cell carcinoma is rare skin malignancy originated from epidermal mechanoreceptor of neural origin. The tumor usually affects older individuals at sun exposed area such as head, neck and extremity. Subclinical involvement of regional lymph node is reported frequently at the time of initial treatment. Thus even asymptomatic patients who present with clinically localized tumor should undergo evaluation with computed tomography and lymphangiography. Positron emission tomography(PET) scans can imaging the metabolic difference of malignant tumors. Increased glucose uptake of malignant tumor cells are detected by PET scanner. PET scans can provide qualitative and quantitative informations about systemic metastasis of tumors. Although there are no data that define the efficacy of PET scans in the initial diagnostic evaluation of head and neck cancer, they could be considered. Current standards of treatment of Merkel cell carcinoma is wide surgical excision and regional lymphadenectomy if there are suspicious lymph nodes. The author reported a patient with Merkel cell carcinoma of cheek. Wide surgical excision and postoperative PET/CT was done for evaluation of regional lymph node and distant metastasis. There were two hot-uptakes in patient's neck, so they were considered as metastatic node, but finally they were proved to be tuberculosis lymphadenitis after excision.

• Archives of Craniofacial Surgery
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• v.21 no.5
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• pp.294-300
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• 2020

Background: Mandibular fractures are one of the most common types of facial fractures, the treatment of which can be delayed due to the severity of the trauma resulting in an increase of complications; thus, early evaluation of trauma severity at the time of visit is important. In South Korea, trauma patients are triaged and intensively treated in designated regional trauma centers. This study aimed to analyze the relationship between trauma severity and mandibular fracture patterns. Methods: A medical records review was performed on patients who visited the regional trauma center at our hospital for mandibular fracture between 2009 and 2018. Epidemiologic data and mandibular fracture patterns were analyzed and compared with the conventional facial injury severity scale (FISS). Results: Among 73 patients, 51 were classified as non-severe trauma patients and 22 as severe trauma patients. A higher trauma severity was associated with older age (odds ratio [OR], 1.164; 95% confidence interval [CI], 1.057-1.404) and lower risk was associated with fractures located in the angle (OR, 0.001; 95% CI, 0-0.022), condylar process (OR, 0.001; 95% CI, 0-0.28), and coronoid process (OR, 0.004; 95% CI, 0-0.985). The risk was lower when the injury mechanism was a pedestrian traffic accident (OR, 0.004; 95% CI, 0-0.417) or fall (OR, 0.004; 95% CI, 0-0.663) compared with an in-car traffic accident. Higher FISS (OR, 1.503; 95% CI, 1.155-2.049) was associated with a higher trauma severity. The proposed model was found to predict the trauma severity better than the model using FISS (p< 0.001). Conclusion: Age, location of mandibular fractures, and injury mechanism showed significant relationships with the trauma severity. Epidemiologic data and patterns of mandibular fractures could predict the trauma severity better than FISS.

• Archives of Plastic Surgery
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• v.47 no.3
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• pp.223-227
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• 2020

Background After the laws regulating emergency medicine were amended in 2012, regional trauma centers were established in South Korea. Plastic surgeons specialize in the simultaneous surgical care of patients with facial trauma, burns, and complicated wounds. The objective of this study was to evaluate the role of the plastic surgery department in treating severe trauma patients. Methods From January 2012 to December 2018, we enrolled 366 severe trauma patients with an Injury Severity Score (ISS) over 15 who received treatment by specialists in the plastic surgery department. Of these patients, 298 (81.4%) were male, and their mean age was 51.35 years (range, 6-91 years). The average ISS was 22.01 points (range, 16-75 points). Results The most common diagnosis was facial trauma (95.1%), and facial bone fracture (65.9%) was most common injury within this subgroup. Patients were referred to 1.8 departments on average, with the neurosurgery department accounting for a high proportion of collaborations (37.0%). The most common cause of trauma was traffic accidents (62.3%), and the average length of stay in the general ward and intensive care unit was 36.90 and 8.01 days, respectively. Most patients were discharged home (62.0%) without additional transfer or readmission. Conclusions Through this study, we scoped out the role of the specialty of plastic surgery in the multidisciplinary team at regional trauma centers. These results may have implications for trauma system planning.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.421-426
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• 2010

Purpose: Patients with serious burns are prone to chondritis due to lack of soft tissue in the auricle, which can cause severe defects in the auricular morphology. In addition, skin damage occurs frequently in the vicinity of post-burn wounds, presenting difficulties in reconstruction surgery. An auricular reconstruction has functional and cosmetic significance. The aim of this study is to develop appropriate reconstruction methods for auricular defects. Methods: Thirty seven patients, who were treated for auricular defects from 2005 to 2009, were enrolled in this study. A local flap, multiple regional flaps and cartilage framework with or without a temporal fascial flap were applied in reconstruction surgery according to the location of the auricular defect. Results: The age of the subjects ranged from 11 to 56. Some subjects had defects that cover more than half of the helical rim with most exhibiting post-burn scars in the vicinity, for whom a multiple regional flap was used. A single use of a tubed flap was sufficient for subjects with defects that covered less than half of the helical rim. A regional flap was also used for reconstruction in subjects with defects covering both the helical rim and antehelix. Conclusion: Achieving satisfactory results from the skin flaps and skin grafts for post-burn auricular defects in both functional and cosmetic aspects is a difficult task. Therefore, selecting an appropriate surgical method through proper diagnosis of the auricular defect and the state of the available skin in the vicinity is essential.

• Archives of Craniofacial Surgery
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• v.22 no.5
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• pp.247-253
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• 2021

Background: Radiation therapy (RT) is frequently used for supportive treatment and management of advanced head and neck cancers. This study performed a retrospective review of the treatment methods that were used for intractable draining fistulas in seven patients who had received RT for head and neck cancers. Treatment methods used for two of the seven patients are presented in detail. Methods: From 2009 to 2020, seven patients underwent reconstructive surgery for intractable fistulas which occurred after RT for head and neck cancers. Patient characteristics, medical history, treatment method, and treatment outcome were reviewed for each case. The type of surgery performed, failure rate, and treatment period were also analyzed. Results: In this study, a total of seven patients received additional management for radiation-induced fistulas. Patients underwent a mean of 3.3±1.4 surgeries (maximum: six surgeries) to resolve their fistulas. The mean time interval from the first surgery to the last surgery for the patients to achieve resolution of the fistula was 8.7 months. Loco-regional flaps have performed an average of 1.9±1.5 times. However, all loco-regional flaps failed. Instead, the patients' intractable fistulas were resolved with the use of distant flaps or free tissue transfers. Conclusion: Fistulas that develop after head and neck cancer treatment following RT are difficult to treat with simple loco-regional flap procedures. Therefore, more aggressive treatment techniques, such as distant flap or free tissue transfer, may be needed to shorten patients' treatment periods and avoid unnecessary surgeries.

• Archives of Plastic Surgery
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• v.49 no.4
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• pp.531-537
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• 2022

Wide-awake, local anesthesia, no tourniquet (WALANT) is a technique that removes the requirement for operations to be performed with a tourniquet, general/regional anesthesia, sedation or an anesthetist. We reviewed the WALANT literature with respect to the diverse indications and impact of WALANT to discuss the importance of future surgical curriculum integration. With appropriate patient selection, WALANT may be used effectively in upper and lower limb surgery; it is also a useful option for patients who are unsuitable for general/regional anesthesia. There is a growing body of evidence supporting the use of WALANT in more complex operations in both upper and lower limb surgery. WALANT is a safe, effective, and simple technique associated with equivalent or superior patient pain scores among other numerous clinical and cost benefits. Cost benefits derive from reduced requirements for theater/anesthetic personnel, space, equipment, time, and inpatient stay. The lack of a requirement for general anesthesia reduces aerosol generating procedures, for example, intubation/high-flow oxygen, hence patients and staff also benefit from the reduced potential for infection transmission. WALANT provides a relatively, but not entirely, bloodless surgical field. Training requirements include the surgical indications, volume calculations, infiltration technique, appropriate perioperative patient/team member communication, and specifics of each operation that need to be considered, for example, checking of active tendon glide versus venting of flexor tendon pulleys. WALANT offers significant clinical, economic, and operative safety advantages when compared with general/regional anesthesia. Key challenges include careful patient selection and the comprehensive training of future surgeons to perform the technique safely.

• Journal of Korean Society of Archives and Records Management
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• v.2 no.2
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• pp.1-38
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• 2002

This study examines the status quo of Korean archives and records management from the Governmental as well as professional activities for the development of the field in relation to the new legislation on records management. Among many concerns, this study primarily explores the following four perspectives: 1) the Government Archives and Records Services; 2) the Korean Association of Archives; 3) the Korean Society of Archives and Records Management; 4) the Journal of Korean Society of Archives and Records Management. One of the primary tasks of the is to build the special depository within which the Presidential Library should be located. As a result, the position of the GARS can be elevated and directed by an official at the level of vice-minister right under a president as a governmental representative of managing the public records. In this manner, GARS can sustain its independency and take custody of public records across government agencies. made efforts in regard to the preservation of paper records, the preservation of digital resources in new media formats, facilities and equipments, education of archivists and continuing, training of practitioners, and policy-making of records preservation. For further development, academia and corporate should cooperate continuously to face with the current problems. has held three international conferences to date. The topics of conferences include respectively: 1) records management and archival education of Korea, Japan, and China; 2) knowledge management and metadata for the fulfillment of archives and information science; and 3) electronic records management and preservation with the understanding of ongoing archival research in the States, Europe, and Asia. The Society continues to play a leading role in both of theory and practice for the development of archival science in Korea. It should also suggest an educational model of archival curricula that fits into the Korean context. The Journals of Records Management & Archives Society of Korea have been published on the six major topics to date. Findings suggest that "Special Archives" on regional or topical collections are desirable because it can house subject holdings on specialty or particular figures in that region. In addition, archival education at the undergraduate level is more desirable for Korean situations where practitioners are strongly needed and professionals with master degrees go to manager positions. Departments of Library and Information Science in universities, therefore, are needed to open archival science major or track at the undergraduate level in order to meet current market demands. The qualification of professional archivists should be moderate as well.

• Archives of design research
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• v.19 no.5 s.67
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• pp.351-362
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• 2006

Currently, finding one's way in the underground spaces associated with subway stations in large cities is becoming a serious problem, and an environment that facilitates wayfinding is becoming more important. This study investigated interior treatments that function as visual cues in the subway stations of Seoul, Tokyo, and Taipei in order to develop design guidelines that would improve the place-cognition environment. A theoretical study has shown that there are three categories of visual cue for place cognition: marked trails, regional differentiation, and landmarks. The case study showed that marked trails involve treatments like vertical markers, confrontational positioning, and subway color codes. Regional differentiation involves patterns on the floors and walls, and accent colors on the walls and columns. Landmarks include treatments such as super graphics, symbolic features, artistic decoration and special lights. In the cases of Seoul, marked trails and regional differentiation were predominant. In addition, the Olympic symbol 'Hodori' and the ancient Korean character "Hunminjungeum" were used as landmarks. In the cases of Tokyo, regional differentiation predominated over marked trails because of the complexity of the spatial structure and subway line connection system. In the cases of Taipei, simple, unified images predominated, and there was minimal dependence on marked trails and landmarks. The need for regional differentiation was weak, because the stations studied have open structures that guarantee an open field of view. The results of this research could be used as design guidelines, after further experimental verification, that would help to improve the public environment in terms of wayfinding.