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Reconstruction of the Extended Region of the Upper Auricle Using the Superior Auricular Artery Island Flap (상이개동맥 도상피판을 이용한 이개상부 및 그 주변부의 재건)

  • Kyung, Hyun Woo;Oh, Sang-Ha;Seo, Young Joon;Kim, Dong-Woon
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.289-293
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    • 2009
  • Purpose: The retroauricular flap has many advantages for facial reconstruction and is being performed by many surgeons. However, it is difficult for the retroauricular flap to perform reconstruction of the upper region of the auricle and its surroundings, due to limited rotation arc and length of pedicle. We successfully reconstructed the upper region of the auricle and its surroundings with retroauricular flap by using the superior auricular artery as a supplying pedicle. The purpose of this study is to present an anatomic study about the superior auricular artery and its clinical application. Methods: We investigated the relationship between the superior auricular artery and its surrounding structures through anatomic studies with 7 fresh cadavers and then applied the findings clinically. From February to December 2008, we performed 7 cases of the superior auricular artery island flap to reconstruct the defects in patients operated on skin cancer. Sizes of the defects varied form $0.8{\times}0.8cm$ to $3.5{\times}3.0cm$. Results: We found that the superior auricular artery is a reliable pedicle for the retroauricular flap, based on anatomical studies. All wounds of the patients were successfully closed. The flap donor site was primary closed except in one patient with a large defect. The aesthetic outcomes of the donor and recipient sites were satisfying. Conclusions: The superior auricular artery island flap has several advantages. Therefore, we suggest that the superior auricular artery island flap is a treatment of choice for reconstructing soft tissue defect at the upper region of the auricle and its surrounding area.

Ultrastructural Study on Development of the Superior Cervical Ganglion of Human Fetuses (인태아 상경신경절 발육에 관한 전자현미경적 연구)

  • Kim, Dae-Young
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.7-22
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    • 1998
  • The development of the superior cervical ganglion was studied by electron microscopic method in human fetuses ranging from 40 mm to 260 mm of crown-rump length(10 to 30 weeks of gestational age). At 40 mm fetus, the superior cervical ganglion was composed of clusters of undifferentiated cell, primitive neuroblast, primitive supporting cell, and unmyelinated fibers. At 70 mm fetus, the neuroblasts and their processes were ensheated by the bodies or processes of satellite cells. The cytoplasm of the neuroblast contained rough endoplasmic reticulum, mitochondria, Golgi complex, Nissl bodies and dense-cored vesicles. As the neuroblasts grew and differentiated dense-cored vesicles moved away from perikaryal cytoplasm into developing processes. Synaptic contacts between the cholinergic axon and dendrites of postganglionic neuron and a few axosomatic synapses were first observed at 70 mm fetus. At 90 mm fetus the superior cervical ganglion consisted of neuroblasts, satellite cells, granule-containing cells, and unmyelinated nerve fibers. The ganglion cells increased somewhat in numbers and size by 150 mm fetus. Further differentiation resulted in the formation of young ganglion cells, whose cytoplasm was densely filled with cell organelles. During next prenatal stage up to 260 mm fetus, the cytoplasm of the ganglion cells contained except for large pigment granules, all intracytoplasmic structures which were also found in mature superior cervical ganglion. A great number of synaptic contact zones between the cholinergic preganglionic axon and the dendrites of the postganglionic neuron were observed and a few axosomatic synapses were also observed. Two morphological types of the granule-containing cells in the superior cervical ganglion were first identified at 90 mm fetus. Type I granule-containing cell occurred in solitary, whereas type II tended to appeared in clusters near the blood capillaries. Synaptic contacts were first found on the solitary granule-containing cell at 150 mm fetus. Synaptic contacts between the soma of type I granule-containing cells and preganglionic axon termials were observed. In addition, synaptic junctions between the processes of the granule-containing cells and dendrites of postganglionic neuron were also observed from 150 mm fetus onward. In conclusion, superior cervical ganglion cells and granule-containing cells arise from a common undifferentiated cell precursor of neural crest. The granule-containg cells exhibit a local modulatory feedback system in the superior cervical ganglion and may serve as interneurons between the preganglionic and postganglionic cells.

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Treatment of a Carotid-Cavernous Sinus Fistula via the Superior Ophthalmic Vein Approach: A Case Report (상안정맥을 이용한 해면정맥동루의 색전술 치험례)

  • Moon, In-Sun;Shin, Han-Kyung;Kim, Dong-Il
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.116-119
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    • 2010
  • Purpose: Arteriovenous fistulas that involve the cavernous sinus often produce ophthalmologic symptoms and signs. Transvenous endovascular access is the method of choice for a carotid-cavernous sinus fistula. The superior ophthalmic vein is a safe and reasonable alternative route for the transvenous embolization of carotid-cavernous sinus fistula. We report a case of the embolization of a carotid-cavernous sinus fistula using the superior ophthalmic vein approach. Methods: A 58 year old female had conjunctival congestion, periocular pain and diplopia with a 2 month duration. Diagnostic orbital CT, brain MRI and cerebral angiography revealed a carotid-cavernous sinus fistula. The fistula occlusion was treated by coil embolization using the superior ophthalmic vein approach. Results: The initial presenting symptoms, conjunctival congestion, periocular pain and diplopia, decreased after surgery. Coil embolization via the superior ophthalmic vein approach was difficult because of the venous tortuosity and friability. During the follow up period, the patient was in a good condition without complications. Conclusion: Surgical exposure of the superior ophthalmic vein provides direct venous access to the cavernous sinus as well as an effective and safe treatment approach. The cooperation of the plastic surgeon and interventionist is a factor in successful treatment.

A study on the Image Perception of Golf Wear Brand - Focusing on the Daks and Superior Golf wear - (골프웨어브랜드의 이미지 지각 분석 - 닥스와 수페리어 골프웨어를 중심으로 -)

  • Koo, In-Sook
    • Journal of Fashion Business
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    • v.13 no.1
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    • pp.1-16
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    • 2009
  • The purpose of this study was to evaluate the clothing image of the Daks and Superior golf wear, and to compare the perceiver's image perception with clothing image in fashion industry, and to find out the differences of image perception between the buying groups and non-buying groups of the Daks and Superior golf wear, for developing the possibility and strategy of the golf wear market for the apparel marketers and manufacturers. In this study, the data obtained from 193 respondents were analyzed by the descriptive statistics, average analysis. The results from the data were as follows : The questionnaire of the image evaluation rated on 7 point Likert-type scales in the 17 features were evaluated by perceivers. The clothing images by 103 respondents(Daks group) were not in accord with the clothing images expressed on homepage of the Daks golf wear. In the other hands, the clothing images by the 90 respondents(Superior group) were in accord with the clothing images expressed on homepage of the golf wear. There were significant differences in evaluating the clothing images between the buying groups and non-buying groups of the Daks and Superior golf wear. The buying groups of the Daks and Superior golf wear perceived the clothing image of the Daks and Superior golf wear more dynamic, positive than the non-buying groups.

Superior Orbital Fissure Syndrome after Repair of Blow Out Fracture (안와골절 정복술 후 발생한 상안와열증후군의 치험례)

  • Lee, Young-Bae;Kim, Peter Chan-Woo;Park, Dae-Hwan
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.879-882
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    • 2011
  • Purpose: Superior orbital fissure syndrome is a rare neurological complex. Superior orbital fissure syndrome may result from a variety of inflammatory, infectious, neoplastic, iatrogenic, traumatic, vascular cause. The author report a patient who suffered from superior orbital fissure syndrome after inferior orbital wall reduction. Methods: A 26-year-old female suffered from inferior orbital wall fracture with inferior gaze limitation and orbital soft tissue herniation. On posttrauma 10 day, inferior orbital wall was reduced using endoscope and porous polyethylene ($Medpor^{(R)}$) was inserted. On immediate postoperation, she reported that extraocular movement was limited in almost any directions. She underwent exploration surgery to release the presence of extraocular muscle impingement. But, there was no observation of extraocular muscle impingement. On postoperative one day, high-dose steroid therapy was started to release superior orbital fissure syndrome which was defined in postoperative computed tomography. Results: After one month of high-dose steroid therapy, extraocular movement limitations improved progressively in all directions. In four months, extraocular movement recovered completely. Conclusion: Superior orbital fissure syndrome may occur after surgical procedure of orbital wall reduction. Prompt diagnosis and treatment with mega-dose corticosteroid is an effective option for avoiding disaster from compressive syndrome.

Comparative Analysis on the Capital Structure of Superior Hospital and Bankrupt Hospital (우량병원과 도산병원의 자본구조 비교분석)

  • Ahn, Young-Chang;Kim, Jai-Myung;Ham, U-Sang
    • Korea Journal of Hospital Management
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    • v.11 no.4
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    • pp.19-36
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    • 2006
  • This study aims to examine the influence of growth rate, profitability and current ratio, which are confronted with static trade-off theory and pecking order theory, on capital structure of superior hospital and bankrupt hospital. Firstly, superior hospitals show positive correlation between growth rate and short-term loans, long-term loans, and short-term liabilities while bankrupt hospitals represent negative correlation. Superiority hospital and bankruptcy hospital show different financing behaviors, especially, short-term loan is the significant characteristic that discriminates between superior hospital and bankrupt hospital. Secondly, this paper studied the correlation between profitability and short-term loan, which the superior hospitals shows negative correlation, to contrast, bankrupt hospital have positive correlation. Consequently, the short-term loan is the most distinguishable factor between the superior hospital and bankrupt hospitals in terms of profitability. To conclude, this study shows that excess short-term loans can be the most important cause for hospital's bankrupt. Accordingly, strategic and effective policy about the short-term loan will be required in order to protect hospital's bankrupt.

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The Relationships of Superior's Leadership to Supervisory Trust and Organizational Commitment of Nurses (간호사가 인지한 상사의 리더십과 상사신뢰 및 조직몰입과의 관계)

  • Lee, So-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.2
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    • pp.208-218
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    • 2007
  • Purpose: This study aimed to identify the relationships of superior's leadership to supervisory trust and organizational commitment of nurses. Method: Subjects were 386 nurses in 8 general hospitals at G city and Seoul. Data were collected with self-administered questionnaires and analyzed using SAS 8.12 by applying ttest, ANOVA, Pearson correlation coefficient, and Stepwise multiple regression. Results: Superior's transformational leadership was $3.54{\pm}0.53$ and transactional leadership was $3.40{\pm}0.36$. Supervisory trust was $3.14{\pm}0.46$ and organizational commitment was $3.18{\pm}0.53$. Superior's transformational leadership was positively correlated with transactional leadership, supervisory trust and organizational commitment with each others. The level of supervisory trust and organizational commitment were different significantly by age, educational status, clinical career, position and superior's leadership level. Major factor that affect to supervisory trust and organizational commitment of nurses was transformational leadership, which had an explanation of 45.9% and 29.8%. Conclusions: The more nurses perceived the superior's transformational leadership, the higher nurses perceived supervisory trust and organizational commitment. Therefore, these variables generally screened and other factors should be analyzed. And if specified nursing intervention program which increase superior's transformational leadership will be developed, it may contribute to strengthen the effectiveness of nursing.

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Dual Perforator Flap for Reconstruction of Large Sacral Defects: Superior Gluteal Artery Perforator Super-Flap with Parasacral Perforator

  • Tae, Sang Pil;Lim, Seong Yoon;Song, Jin Kyung;Joo, Hong Sil
    • Archives of Reconstructive Microsurgery
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    • v.26 no.1
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    • pp.14-17
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    • 2017
  • The superior gluteal artery perforator flap technique has increasingly been used for soft tissue defects in the sacral area following its introduction nearly 25 years ago. Advantages in covering sacral defects include muscle sparing, versatility in design, and low donor side morbidity. The bilateral superior gluteal artery perforator flap procedure is planned in cases of large sacral defects that cannot be covered with the unilateral superior gluteal artery perforator flap. Here, we report two cases of large sacral defects in which patient factors of poor general health, such as old age, pneumonia, and previous operation scar, led to use of a large unilateral superior gluteal artery perforator super-flap with parasacral perforator. The approach was utilized to reduce the operation time and prevent unpredictable flap failure due to the large flap size. Even though the parasacral perforator was included, the versatility of the large superior gluteal artery perforator flap was preserved because sufficient perforator length was acquired after adequate dissection.