• Archives of Plastic Surgery
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• v.43 no.5
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• pp.470-473
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• 2016

Nipple-areolar complex (NAC) reconstruction is the final step in the long journey of breast reconstruction for mastectomy patients. Successful NAC reconstruction depends on the use of appropriate surgical techniques that are simple and reliable. To date, numerous techniques have been used for nipple reconstruction, including contralateral nipple sharing and various local flaps. Recently, it has been common to utilize local flaps. However, the most common nipple reconstruction problem encountered with local flaps is the loss of nipple projection; there can be approximately 50% projection loss in reconstructed nipples over long-term follow-up. Several factors might contribute to nipple projection loss, and we tried to overcome these factors by performing nipple reconstructions using a boomerang flap technique, which is a modified C-V flap that utilizes the previous mastectomy scar to maintain long-term nipple projection.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.139-150
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• 1985

From 1977 through 1984, 97 patients of V.S.D. were treated surgically at Department of Thoracic and Cardiovascular Surgery, Korea University college of Medicine. Among 97 patients, 3 patients were treated by PDA ligation, 3 patients were treated by PDA ligation and subclavian flap aortoplasty, 1 patient were treated by pulmonary artery banding. All of the above patients were analyzed clinically. The results were as follows; 1. Of the patients, 52 patients were male [55.5%] and 45 patients were female [44.5%]. Their age ranged from 7 days to 32 year, and the mean age was 9 year of age and 28.9% of patients were between 4 and 8 year of age. 2. The most common clinical symptoms were frequent U.R.l. and D.O.E.. 3. The most common chest PA findings were cardiomegaly and increased pulmonary vascularity. 4. Associated anomaly was founded in 27 cases and PDA was most common associated anomaly and others were A.S.D., pulmonary stenosis, aortic regurgitation, D.C.R.V.. 5. Pulmonary hypertension was founded in 37 patients and it`s incidence was increased by patient age and shunt amount. 6. On Kirklin`s anatomical classification, type 11 defect was most common [45.5%], and type 1 was 35.5%, and type 111 was 4.4%, and type 1V was 4.4%. 7. Mean E.C.C. time was 69.1 min. and varied by closing method and associated anomaly as in case of simple closure; 47.8 min., in case of patch closure; 77.2 min., in cases with associated anomaly; 92.7 min.. 8. Mean postoperative ventilatory assisted time was 7.3 hour and varied by preoperative pulmonary artery pressure and E.C.C. time, as the group with pulmonary hypertension; 10.5 hour, the group without pulmonary hypertension; 5.5 hour, the group of short E.C.C time [within 1 hour]; 4.4 hour, the group of long E.C.C. time [over 1 hour]; 8.4 hour. 9. Overall operative mortality was 9.3% [9 cases].

• The Korean Journal of Soil Zoology
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• v.4 no.2
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• pp.89-100
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• 1999

Four new and a known spacies of the order Mononchida were described and illustrated. Iotonchus obtusus sp. n. was 2.8 mm long, a=33, b=4.2, c=61, V=68%, buccal cavity=61${\times}$45 mm, and is characterized by having basally situated dorsal tooth, presence of vulval papillae and in having short, hemispherical tail with thick cuticle at terminus. Miconchus vulvapapillatum sp. . was 2.7-3.6 mm long, a=29-36, b=4.1-4.5, c=18.4-21, V=65-69%, buccal cavity=53-61${\times}$29-33 mm, spicules=132-137 mm, ventromedian supplements 28-31, and was characterized by having 5-8 pre- and post vulval papillae in contiguous series, and three pairs of vulval glands. Clarkus koreanus sp. n. was 1.1-1.3 mm long, a=27.5-28.8, b=3.5-3.9, c=12-14.5, V=60-64%, buccal cavity=24-28${\times}$13.5-15 mm, and was characterized by well offset lip region, amphids situated well below to dorsal tooth apex, and vulva elevated, with vulval flap. Coomansus ulsani sp. n. was 1.2-1.5 mm long, a=23.5-26, b=3.4-3.8, c=13.6-14.8, V=65-68%, buccal cavity=36-39${\times}$21-23 mm and was characterized by well offset lip region and a thin longitudinal ridge on vertical walls of stoma.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2889-2894
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• 2015

Background: To investigate the impact of the breast size, shape, maximum heart depth (MDH), and chest wall hypotenuse (the distance connecting middle point of the sternum and the length of lung draw on the selected transverse CT slice) on the volumetric dose to heart with whole breast irradiation (WBI) of left-sided breast cancer patients. Materials and Methods: Fifty-three patients with left-sided breast cancer undergoing adjuvant intensity-modulated radiotherapy (IMRT) were enrolled in the study. The primary breast size and shape, MHD and DCWH (chest wall hypotenuse) were contoured on radiotherapy (RT) planning CT slices. The dose data of hearts were obtained from the dose-volume histograms (DVHs). Data were analyzed by one-way analysis of variance (ANOVA), Student's t-test and linear regression analysis. Results: Breast size was independent of heart dose, whereas breast shape, MHD and DCWH were correlated with heart dose. The shapes of breasts were divided into four types, as the flap type, hemisphere type, cone type and pendulous type with heart mean dose being $491.8{\pm}234.6cGy$, $752.7{\pm}219.0cGy$, $620.2{\pm}275.7cGy$, and $666.1{\pm}238.0cGy$, respectively. The flap type of breasts shows a strong statistically reduction in heart dose, compared to others (p=0.008 for V30 of heart). DCWH and MHD were found to be the most important parameters correlating with heart dose in WBI. Conclusions: More attention should be paid to the heart dose of non-flap type patients. The MHD was found to be the most important parameter to correlate with heart dose in tangential WBI, closely followed by the DCWH, which could help radiation oncologists and physicsts evaluate heart dose and design RT plan in advance.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.553-558
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• 2013

Background Skin-sparing mastectomy with immediate breast reconstruction is increasingly becoming a proven surgical option for early-stage breast cancer patients. Areola-sparing mastectomy (ASM) has also recently become a popular procedure. The purpose of this article is to investigate the reconstructive and aesthetic issues experienced with one-stage nipple and breast reconstruction using ASM. Methods Among the patients who underwent mastectomy between March 2008 and March 2010, 5 women with a low probability of nipple-areolar complex malignant involvement underwent ASM and immediate breast reconstruction with simultaneous nipple reconstruction using the modified C-V flap. The cosmetic outcomes of this series were reviewed by plastic surgeons and patient self-assessment and satisfaction were assessed via telephone interview. Results During the average 11-month follow-up period, there were no cases of cancer recurrence, the aesthetic outcomes were graded as excellent to very good, and all of the patients were satisfied. Two patients developed a gutter-like depression around the reconstructed nipple, and one patient developed skin erosion in a small area of the areola, which healed with conservative dressing. The other complications, such as necrosis of the skin flap or areola, seroma, hematoma, or fat necrosis did not occur. Conclusions Since one-stage nipple and breast reconstruction following ASM is an oncologically safe, cost-effective, and aesthetically satisfactory procedure, it is a good surgical option for early breast cancer patients.

• Archives of Plastic Surgery
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• v.46 no.2
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• pp.129-134
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• 2019

Background Nipple-areolar complex (NAC) reconstruction is the final stage of breast reconstruction. Ideal reconstruction of the NAC requires symmetry in position, size, shape, texture, pigmentation, and permanent projection, and although many technical descriptions of NAC reconstruction exist in the medical literature, there is no gold standard technique. The technique devised by the authors is very versatile, with excellent results, and it enables 1-step reconstruction with optimal results in terms of shape and nipple projection. Methods Our technique consists of a combination of modified local flaps and a full-thickness skin graft. Patients were observed for 18 months to estimate the amount of retraction. This procedure was performed in 40 patients, four of them bilaterally. The duration of the follow-up was 30 months. Complications occurred in 10% of patients, and included infections (5%), ischemia (2.5%), and hematoma (2.5%). Results No cases of total nipple necrosis were reported. The NAC shape remained optimal in all cases, with a very small reduction of the vertical and horizontal diameters of the areola, which maintained its designed round shape well, and negligible retraction in the diameter and projection of the nipple. Conclusions The oval technique represents a major step forward, involving a combination of existing techniques, such as the C-V flap and the cutaneous graft, to achieve excellent results regarding areola shape and nipple projection, significantly reducing the cases of nipple ischemia. These results were substantially obtained through subcutaneous equatorial sutures, skin grafting, and flattening of the apexes of the flap.

• Transactions of the Korean Society for Noise and Vibration Engineering
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• v.15 no.11 s.104
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• pp.1232-1240
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• 2005

The purpose of this paper is that investigates the dynamic behavior characteristic of W.T.S (wind turbine system) and carries out the evaluation analysis during operating W.T.S. To investigate the dynamic behavior characteristic of W.T.S, the experiments to measure vibration of the blade from the attached accelerometer on the flap and edge section of the blade that is one of the most important elements of dynamic characteristic of W.T.S are performed. Natural frequency and mode shape are calculated with commercial program ( ANSYS) using the measured vibration acceleration that receives the signal with F.F.T Analyzer from the accelerometer For validation of these experiments, the finite element analysis is performed with commercial F.E.M program (ANSYS) on the basis of the natural frequency and mode shape. The results indicate that experimental values have good agreements with the finite element analysis.

• Journal of the Korean Society for Marine Environment & Energy
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• v.9 no.1
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• pp.45-54
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• 2006

The study was to review methods by which a ship can unfold and tow an oil boom by attaching the opening apparatus to an oil boom through experiments. The shape and dimension of the opening apparatus were designed with the measurement value of the towing tension load of the oil boom and the dimension of winch drum of the oil boom installed in the ship considered. For the field experiment to identify the performance of the opening apparatus, opening apparatuses were prepared to have the dimension of $3.0m^2$ and $6.0m^2$ which is 91% and 75% of the calculation value for type B and C respectively. As a result, T(kg), the value of tension in type B oil boom according to the towing speed(v) change when two ships are towed together were proved to be $T=920v^{1.1}\;and\;T=500v^{0.9}$ in case the distance is 100 m and 50 m. Based on the result, the dimension of the opening apparatus for type B and C oil boom was calculated as $3.3m^2$ and $8.0m^2$ respectively. When unfolding and towing by attaching the opening apparatus and 200 m of towing line at both ends of type B and type C oil boom, the maximum width of the opening apparatus was shown as 114 m and 95 m in average(width of opening/total length of oil boom: 33% and 57%) in the towing speed of 1.5 kt. It was evaluated that the opening apparatus could concentrate the spilled oil in a good performance. However as far as the increase rate of oil boom opening width according to the length of the towing line is debatable, the increase rate is remarkably reduced when it is lengthened from 100 m to 150 m and to 200 m although it showed extreme increase of 31% and 40% when the length of the towing line was changed from 50 m to 100 m. Therefore, it is inferred that the towing line should be maintained more or less 100 m to get good spread efficiency of the opening apparatus. Additionally, if the towing speed is faster than 1.5 kt, the opening width was narrowed because of the reduced spread efficiency and the shape of the oil boom can be unstable because of the partial sinking of the oil boom, run over waves, or flap of skirt. Thus the reasonable towing speed can be within 1.5 kt for the operation of the opening apparatus.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.156-162
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• 2008

Purpose: Open fractures of the foot and ankle require prompt repair of the wound due to the complexity of anatomy, insufficiency of soft tissues and inadequate blood supply. Early flaps and skin grafts are used for this purpose yet general condition of the patient as well as local wound environment often precludes such treatment options. Vacuum- Assisted Closure (VAC) is recently being used in such cases. This study was done to validate the use of VAC together with silver antimicrobial dressing materials in contaminated open fracture wounds. Materials and Methods: We have selected 10 patients with Gustillo-Anderson type III open fractures of the foot & ankle treated with VAC and silver antimicrobial dressing materials from March 2007 to January 2008. The relationship between duration of treatment with wound size, contamination, and degree of soft tissue damage was analyzed. Results: The average age of patients was 36.6 years. The average amount of VAC application time was 23.4 days. Silver dressing materials were used for 16.8 days. Average wound healing time was 51.9 days. Statistically significant relationship was found between wound size, VAC application time and silver dressing material application time. No complications such as osteomyelitis were found after treatment. Conclusion: VAC technique is recently being used in open fractures with wide skin and soft tissue defects, producing good results. A wide array of dressing materials such as silver dressing is in development. We have incorporated the VAC technique together with silver dressing materials in the treatment of open fractures and achieved complication free results.