• Archives of Reconstructive Microsurgery
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• v.21 no.2
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• pp.111-117
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• 2012

Purpose: To report the clinical results of the perforated-based propeller flap for lower extremity soft tissue reconstruction. Materials and Methods: Between January 2010 and June 2012, a total of 16 defects in the lower extremities were covered with perforator-based propeller flaps. Retrospective data for location and size of the defect, flap dimension, pedicle artery, pedicle rotation, complications were obtained. Results: Peroneal artery-based perforator flap were used in eleven cases, posterior tibial artery-based perforator flap in two cases, anterior tibial artery-based perforator flap in one case and medial plantar artery-based perforator flap in two cases. The average size of the flaps was $63cm^2$. The marginal skin necrosis of the flaps as a complication was developed in two cases, one of which was covered with split-thickness skin graft. There were no functional deficits from the donor site. Conclusion: For the reconstruction of lower extremities, the perforator-based propeller flap could be a reasonable alternative as it is a simple, safe and versatile technique.

• Korean Journal of Head & Neck Oncology
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• v.20 no.1
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• pp.29-32
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• 2004

Fibrous dysplasia of the mandible is an unusual manifestation of the disease that is usually benign, occurs in young individuals, and is managed by conservative curettage or debridement. We present a case of persistent fibrous dysplasia complicated by pain and abscess formation that was successfully managed by radical resection and reconstruction with a free fibular flap. Although mandibular fibrous dysplasia is preferentially managed conservatively, treatment of this disease has evolved to a point where total excision and immediate reconstruction may be the treatment of choice and offer the best outcome.

• Archives of Plastic Surgery
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• v.32 no.4
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• pp.441-446
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• 2005

Sole reconstruction should consider both functional and aesthetic aspects; durable weight bearing surface, adequate contour for normal footwear, protective sensation and solid anchoring to deep tissue to resist shearing. The anterolateral thigh perforator free flap has such favorable characteristics as long pedicle, reliable perforators and minimal donor site morbidity. This flap can be safely thinned to 3-4 mm. It can also be elevated with sufficient bulk with muscles like vastus lateralis for complex defect. Between June 2002 and December 2004, 48 cases of sole reconstruction were performed with anterolateral thigh perforator free flaps. Follow up period ranged from 4 to 34 months with a mean of 14.7 months and with exception of one case, all flaps survived. One case of total flap loss was noted due to infection in a patient who was administered lifetime immunosuppressant. Partial necroses developed in three cases but were treated conservatively. Satisfactory aesthetic and functional results were achieved and acceptable gait recovery was noted. Seventy-eight percent of the patients regained protective sensation by 6 months and earlier sensory recovery was noted in sensate flap group. The authors also present a standardized protocol for preoperative patient evaluation and postoperative management and rehabilitation.

• Journal of Biomedical Engineering Research
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• v.22 no.4
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• pp.311-319
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• 2001

Statistical reconstruction methods in the context of a Bayesian framework have played an important role in emission tomography since they allow to incorporate a priori information into the reconstruction algorithm. Given the ill-posed nature of tomographic inversion and the poor quality of projection data, the Bayesian approach uses regularizers to stabilize solutions by incorporating suitable prior models. In this work we show that, while the quantitative performance of the standard filtered backprojection (FBP) algorithm is not as good as that of Bayesian methods, the application of spline-regularized smoothing to the sinogram space can make the FBP algorithm improve its performance by inheriting the advantages of using the spline priors in Bayesian methods. We first show how to implement the spline-regularized smoothing filter by deriving mathematical relationship between the regularization and the lowpass filtering. We then compare quantitative performance of our new FBP algorithms using the quantitation of bias/variance and the total squared error (TSE) measured over noise trials. Our numerical results show that the second-order spline filter applied to FBP yields the best results in terms of TSE among the three different spline orders considered in our experiments.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.2
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• pp.113-118
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• 2007

Surgical treatment of pelvic bone tumors represent one of the most complicated problem in musculoskeletal oncology. Because of three dimensional anatomy of the pelvis, tumors reach huge sizes and the diagnosed late relatively to a similar tumors in extremity. Especially, there are limited reconstruction methods to keep the function of hip joint after resection of periacetabular tumors, and the results of reconstruction is not so promissing. We present one case of periacetabular metastatic tumor from renal cell carcinoma, which was resected with wide margin and reconstructed with composite of pasteurized autogenous bone graft and constrained total hip arthroplasty.

• Journal of Korean Foot and Ankle Society
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• v.20 no.4
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• pp.192-195
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• 2016

Diffuse pigmented villonodular synovitis (PVNS) involving ankle joint needs complete mass excision and total synovectomy to reduce recurrence rate, while surrounding ligaments can be easily damaged. So the concurrent ligament reconstruction should be considered for post-excisional instability in subtalar joint as well as lateral ankle joint. We describe our experience in the management of a diffuse type PVNS, invades lateral talocrural joint extended to subtalar joint and introduce a new technique of all-in-one reconstruction for anterior talofibular,calcaneofibular and cervical ligament. Our new reconstruction technique applying modified Chrisman and Snook technique is useful in stabilization for deficiencies of the ligament complexafter PVNS excisionat lateral ankle and subtalar joint.

• Proceedings of the Korean Vacuum Society Conference
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• 2010.02a
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• pp.340-340
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• 2010

Various structures of vacancy defects in graphene layers and carbon nanotubes have been reported by high resolution transmission electron microscope (HR-TEM) and those arouse an interest of reconstruction processes of vacancy defects. In this talk, we present reconstruction processes of vacancy defects in a graphene and a carbon nanotube by tight-binding molecular dynamics (TBMD) simulations and by first principles total energy calculations. We found that a structure of a dislocation defect with two pentagon-heptagon (5-7) pairs in graphene becomes more stable than other structures when the number of vacancy units is ten and over. The simulation study of scanning tunneling microscopy reveals that the pentagon-heptagon pair defects perturb the wavefunction of electrons near Fermi level to produce the $\sqrt{3}\;{\times}\;\sqrt{3}$ superlattice pattern, which is in excellent agreement with experiment. It is also observed in our tight-binding molecular dynamics simulation that 5-7 pair defects play a very important role in vacancy reconstruction in a graphene layer and carbon nanotubes.

• Archives of Reconstructive Microsurgery
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• v.11 no.1
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• pp.19-28
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• 2002

From 1994-2001, 25 mutilated digits were reconstructed with immediate toe-to-hand transfer in acute hand injury in 21 patients. There were 15 cases of great toe-to-hand transfer(partial great toe transfer 8 cases, modified wrap-around procedure 2 cases, and trimmed great toe transfer 2 cases) for thumb reconstruction, 2 cases of second toe transfer for index reconstruction, and 4 cases of simultaneous two toe-to-hand transfer(great toe & second toe transfer 1 case, bilateral second-toe transfer 2 cases, combined second & third toe transfer 1 case) for reconstruction of multiple digit amputations. Two cases of emergency exploration(2/25, 8%) were successfully salvaged. The incidence of emergency exploration and postoperative infection was not significantly different from that of the elective toe-to-hand transfer cases. Duration of industrial insurance coverage was 225 days, which is much shorter than that of elective cases. Among 43% of patients maintained their original job even after injury and immediate toe-to-hand transfer. The subjective satisfaction self- assessment scores of aesthetic appearance and function on the new reconstructed thumb were 80 and 88 in average, respectively, over a total score of 100. These were higher than those of reconstruction of other digits, but lower than those of elective reconstruction. The donor site after harvest of the great toe was mostly unsatisfied in a view of appearance. Immediate toe-to-hand transfer provides many advantages over elective procedure in acute hand injuries such as single stage reconstruction, shortened convalescent period, early return to work and efficient socio-economic factor. Furthermore because there were no significant differences in success rate, frequency of complications or ultimate functional result, immediate toe-to-hand transfer is a safe and reliable procedure in case of limited indications for acute digits loss.

• Archives of Plastic Surgery
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• v.47 no.5
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• pp.419-427
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• 2020

Background This study evaluated the Blossom system, an innovative self-filling, rate-controlled, pressure-responsive saline tissue expander (TE) system. We investigated the feasibility of utilizing this technology to facilitate implant-based and combined flap with implant-based breast reconstruction in comparison to conventional tissue expansion. Methods In this prospective, single-center, single-surgeon pilot study, participants underwent either implant-based breast reconstruction or a combination of autologous flap and implantbased breast reconstruction. Outcome measures included time to full expansion, complications, total expansion volume, and pain scores. Results Fourteen patients (TEs; n=22), were included in this study. The mean time to full expansion was 13.4 days (standard error of the mean [SEM], 1.3 days) in the combination group and 11.7 days (SEM, 1.4 days) in the implant group (P=0.78). The overall major complication rate was 4.5% (n=1). No statistically significant differences were found in the complication rate between the combination group and the implant group. The maximum patient-reported pain scores during the expansion process were low, but were significantly higher in the combination group (mean, 2.00±0.09) than in the implant group (mean, 0.29±0.25; P=0.005). Conclusions The reported average duration for conventional subcutaneous TE expansion is 79.4 days, but this pilot study using the Blossom system achieved an average expansion duration of less than 14 days in both groups. The Blossom system may accommodate single-stage breast reconstruction. The overall complication rate of this study was 4.5%, which is promising compared to the reported complication rates of two-stage breast reconstruction with TEs (20%-45%).

• Archives of Plastic Surgery
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• v.33 no.6
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• pp.715-722
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• 2006

Purpose: The main advantages of the perforator flap are minimal donor site morbidity, preservation of any main source artery and its thin characteristics. Most perforator flaps for hand reconstruction need primary and secondary procedures such as a flap debulkiness and liposuction etc. However, flap thickness of calf area is thinner than any other perforator flaps. Methods: We performed an anatomical study and clinical application of medial sural artery perforator flap. We found that there are two or more medial sural perforators located on a straight line drawn from the mid-point of popliteal crease to the mid-point of medial malleolus. Most pathway of medial sural artery comes along with this line. It is possible to observe the first perforators almost exactly 8 cm from midpoint of popliteal crease in a distal half circle drawn with a radius of 2 cm. Results: We report 12 cases in 11 patients of hand reconstruction with medial sural perforator free flap from Febrary 2003 to Febrary 2006. Complete healing was possible in 11 cases. Total flap loss for venous insufficiency was in 1 patient. During the follow-up, good contour and full range of motion was observed on hand reconstruction with medial sural perforator free flap. Conclusion: In the authors' experience, this anatomical study made it possible to prepare a diagram of the exact location of the medial sural perforators. This flap can be used to achieve acceptable functional and aesthetic results for hand reconstruction because of its thin characteristics.