• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.35-45
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• 1996

After transplantation of groin free flap was sucessed by the Daniel and Taylor in 1973, the reconstruction of plastic surgery was extensive and universal due to rapidly developement of anatomic study of the donor site and technique of microvascular surgery. The free tissue transfers is possible to be early activity and rehabilitation by one stage operation. It currently available allow transfer of specific tissue quality as bone, muscle, nerve to achieve a functional and cosmetic result as well as the most favorable secondary defect. But free flaps require critical, skillful technique and lengthy operating time. Also it has disadvantage of donor site morbity at the large tissue transfer. Authors were transferred with 107 cases in 103 patients from May 1987 to June 1996, and then we analysed free tissue transfer to acquire more increased sucess rate, satisfactory functional and cosmetic results. The sexual distribution was male prominent in 79 cases(76.7%), female in 24(23.3%) and age was variable distribution from 3 to 76 years old. The cause of defects was most prevalent in trauma of traffic and industrial accident in 51 cases(49%). The common recipient site were lower extremities in 47 cases(43.9%), upper extremities in 28 cases(26.5%), head and neck in 25 cases(23.4%), and trunk in 7 cases(6.5%). The type of transfer were free skin flaps in 46 cases(43%), free muscle or musculocutaneous flaps in 31 cases(29%), free vasculized or osteocutaneous flaps in 10 cases(9.3%), and specilized free flaps in 20 cases(18.7%). The anastomosis of artery was end to end anastomosis in 94 cases(87.9%), end to side anastomosis in 13 cases(12.1%) and all vein was end to end anastomosis. The number of anastomosed vessels were one artery one vein in 62 cases(57.9%), one artery two vein in 45 cases(42.1%) and vein graft was performed only one case. The postoperative mornitoring were used with temperature, color of flap, capillary refilling time, ultrasonogram, bone scan, doppler, and endoscopy. The reexploration was performed in 9 cases(8.4%), and then flap was loss in 3 cases(2.8%). Accordingly overall success rate was 97.2%. The postoperative complication was early vascular occlusion, hematoma, partial necrosis and late bulkiness, scarring, color dismatch etc. Therefore, free tissue transfer is the preferred method of treatment, even through conventional local and distant flaps are available.

• Archives of Plastic Surgery
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• v.38 no.2
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• pp.199-202
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• 2011

Purpose: Hyoid bone is a U-shaped bone in the anterior of the neck. Hyoid bone fractures are exceedingly rare and represent only 0.002% of all fractures because of its protective position relative to the mandible and its suspension by elastic musculature. We report a patient who presented hyoid bone fracture associated with hypoglossal nerve palsy. We also discuss the possible complication and treatment. Methods: A 69-year-old man was transferred from another institution because of persistent purulent discharge from the left chin. He had a history of trauma in which a knuckle crane grabbed his face and neck in the construction site. A CT scan at the time of the accident demonstrated a comminuted fracture of the right side of the mandible and hyoid bone fracture at the junction between body and right greater cornua. The displaced fracture of hyoid bone and fullness in the pre-epiglottic space were noted, probably indicating some edema. The patient was transferred into ICU after treatment of emergency tracheostomy because the patient showed respiratory distress rapidly. When the patient was hospitalized in our emergency room, he complained of dysphagia and pain when swallowing. On examination of oral cavity, the presence of muscle wasting with fasciculation of the tongue was noted and the tongue deviates to the left side on protruding from the mouth. Pharyngolarygoscopy was performed to make sure that there was no evidence of progressive swelling and pharyngeal laceration. Results: The patient underwent surgical removal of dead and infected tissue from the wound and reconstruction of mandibular bony defect by iliac bone grafting. Hyoid bone fracture was managed conservatively with oral analgesics, soft diet and restricted movement. Hypoglossal nerve palsy was resolved within 7 weeks after trauma without complications. Conclusion: Closed hyoid bone fracture is usually uncomplicated and thus it can be treated conservatively. Surgical intervention for hyoid bone fracture is recommended for patient with airway compromise, pharyngeal perforation and painful symptoms which show no response to conservative care. Furthermore, since respiratory distress syndrome may develop quickly, close observation is required. Besides, hypoglossal nerve palsy is a rarely recognized complication of hyoid bone fracture.

• Korean Journal of Social Welfare Studies
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• v.44 no.3
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• pp.371-393
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• 2013

The objective of this article is to compare the characteristics and the origin of Welfare State in Korea and France. This study also finds out the causes of underdevelopment of Welfare State in Korea. In the third Republic of France, the first Industrial Accident Compensation Law was legislated in 1898. The discussion of the project of Law commenced in 1880. The Parliamentary Debate on the legislation of the Law had continued for 18 years. The leaders of the debate was the group of progressive Republicans(Radicals) in the French Parliament. In Korea, it was also in the period of the third Repulic, the President and several members of the Supreme Committee of National Reconstruction (Guk-Ga-Jai-Gun-Choi-Go-Ho-Eui), the authoritative military government who enacted and developed the Social Insurance Law of Industrial Accident Compensation, the first Law of Welfare State in Korea. However, Korea and France show more differences than similarities in the terms of the origin of the Welfare State. The motivations and goals of social policies of the two countries were quite different at the beginning stage. In France, the progressive Republicans of Parliament made welfare state policies in order to maintain the politico-social hegemony and social peace by provision of economic supports to workers. In Korea, the group of military officers had begun the welfare legislation in order to win the general election and obtain political power in 1963. Comparison on the origins of the welfare states in the two countries shows similarities as well as differences in terms of the role of actors. In France, the state and the owners of big enterprises had agreed and played positive roles in the legislation of the welfare state policies. However, the owners of small companies, merchants and farmers had played negative roles. Like the French case, Korean government and owners of big enterprises had played positive roles. The state as a major actor of the legislation of the social insurance programs in the two countries are slightly different. In Korea, the owners of small companies had played negative roles in making of medical insurance programs in 1976. Comparison of the current state of two welfare states shows substantial differences in terms of the development of the welfare state. What is the reason for such differences? Why does Korean Welfare State underdevelop? Historically, the developmentalism as an major ideology of the third Republic of Korea has continually influenced the underdevelopment of the Welfare State. It implies that Koreans have to invent a new ideology of Welfare State which can replace the developmentalism and support the development of Welfare State in the future. Without such a new ideology, it is very difficult to develop an european style welfare state in Korea.