• Archives of Plastic Surgery
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• v.51 no.2
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• pp.156-162
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• 2024

Background Perioperative management in autologous breast reconstruction has gained focus in recent years. This study compares two pain management protocols in patients undergoing abdominal-based free flap breast reconstruction: a past protocol (PP) and a current protocol (CP)-both intended to reduce opioid consumption postoperatively. The PP entails use of a pain catheter in the abdominal wound and the CP consists of an intraoperative nerve block in addition to refinements in the oral pain management. We hypothesize that the CP reduces opioid consumption compared to PP. Methods From December 2017 to January 2020, 102 patients underwent breast reconstruction with an abdominal-based free flap. Two postoperative pain management strategies were used during the period; from December 2017 to September 2018, the PP was used which entailed the use of a pain catheter with ropivacaine applied in the abdominal wound with continuous distribution postoperatively in addition to paracetamol orally and oxycodone orally pro re nata (PRN). From October 2018 to January 2020, the CP was used. This protocol included a combination of intraoperative subfascial nerve block and a postoperative oral pain management regime that consisted of paracetamol, celecoxib, and gabapentin as well as oxycodone PRN. Results The CP group (n = 63) had lower opioid consumption compared to the PP group (n = 39) when examining all aspects of opioid consumption, including daily opioid usage in morphine milligram equivalents and total opioid usage during the stay (p < 0.001). The CP group had shorter length of hospital stay (LOS). Conclusion Introduction of the CP reduced opioid use and LOS was shorter.

• Archives of Plastic Surgery
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• v.51 no.1
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• pp.139-145
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• 2024

Background Applying into plastic surgery (PS) is competitive. Lacking a home residency program (HRP) is another barrier. Our goal is to characterize challenges faced by PS applicants without HRPs and identify solutions. Methods Surveys were designed for current integrated PS residents and applicants in the 2022 Match without HRPs. Surveys were distributed electronically. Only U.S. allopathic graduate responses were included. Results Of 182 individuals surveyed, 74 responded (39%, 33 residents, 41 applicants). Sixty-six percent reported feeling disadvantaged due to lack of an HRP. Seventy-six percent of applicants successfully matched. Of these, 48% felt they required academic time off (research year) versus 10% of unmatched applicants. Ninety-seven percent of matched applicants identified a mentor versus 40% of unmatched applicants (p < 0.05). Matched applicants identified mentors through research (29%) and cold calling/emailing (25%). Matched versus unmatched applicants utilized the following resources: senior students (74 vs. 10%, p < 0.05) and social media (52 vs. 10%, p < 0.05). Among residents, 16 had PS divisions (48%). Thirty-six percent with divisions felt they had opportunities to explore PS, compared with 12% without divisions. Residents without divisions felt disadvantaged in finding research (94 vs. 65%, p < 0.05), delayed in deciding on PS (50 vs. 28%), and obtaining mentors (44 vs. 35%) and letters of recommendation (31 vs. 24%). Conclusion PS residents and applicants without HRPs reported feeling disadvantaged when matching. The data suggest that access to departments or divisions assists in matching. We identified that external outreach and research were successful strategies to obtain mentorship. To increase awareness for unaffiliated applicants, we should increase networking opportunities during local, regional, and national meetings.

• Archives of Plastic Surgery
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• v.50 no.6
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• pp.578-585
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• 2023

An artificial sphincter implanted in the bulbous urethra to treat severe postprostatectomy urinary incontinence is effective, but embedding-associated complications can occur. We assessed the feasibility, efficacy, and safety of urethral graciloplasty cross-innervated by the pudendal nerve. A simulation surgery on three male fresh cadavers was performed. Both ends of the gracilis muscle were isolated only on its vascular pedicle with proximal end of the obturator nerve severed and transferred to the perineum. We examined whether the gracilis muscle could be wrapped around the bulbous urethra and whether the obturator nerve was long enough to suture with the pudendal nerve. In addition, surgery was performed on a 71-year-old male patient with severe urinary incontinence. The postoperative 12-month outcomes were assessed using a 24-hour pad test and urodynamic study. In all cadaveric simulations, the gracilis muscles could be wrapped around the bulbous urethra in a γ-loop configuration. The length of the obturator nerve was sufficient for neurorrhaphy with the pudendal nerve. In the clinical case, the postoperative course was uneventful. The mean maximum urethral closure pressure and functional profile length increased from 40.7 to 70 cm H₂O and from 40.1 to 45.3 mm, respectively. Although urinary incontinence was not completely cured, the patient was able to maintain urinary continence at night. Urethral graciloplasty cross-innervated by the pudendal nerve is effective in raising the urethral pressure and reducing urinary incontinence.

• The Korean Journal of Archival Studies
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• no.47
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• pp.51-93
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• 2016

This study is on management present and improvements on National Records Designation System. National Records Designation System is a system that supports management and preservation of changes of records designated by the government through consideration that such records are worth preserving permanently nationally among records acquired by individual or organization. This system is meaningful in a way that it established systematic foundation to hand down by informatizing historic private records which are in danger to be lost or damaged due to lack of proper care. However, compared to the number of designated records, the information that could be practically drawn from such records are limited. This triggered this study to be launched. National Archive sometimes promotes designation and management of National Designated records. Yet archival information service offering access of user to national designated records are very rare. I conducted survey and interview of managers, field research, and documentary research of 10 records holding institution that keeps national designated records currently. I considered that current management status of National Records Designation System can be figured out minutely through these research. As a result of such research, most of the records holding institutions offered display as their least archival information service. The objective of records informatization was to utilize the records. Also further plans on information service related to records and various utilization were suggested. records holding institution manager did not give positive answer on effect of designating national designated records and cooperation between National Archive. Support to National Archive only focused on preservation. For national designated records holding institution designated after 2011 were not getting proper support. In addition, National Archive's support rarely met records holding institution's need. In such circumstances, things to consider for improvements of National Records Designation System is as following. First, designation of national designated records should be based on the utilization of the record. Each records holding institution's willingness to utilize corresponding records and National Archive's ability to draw the willingness out should be considered. Also, it shouldn't be left as mere complementary policy of National Archive's selecting policy. Second, for National Records Designation System to be managed permanently, it should be changed as the system that supports enhancement of private records management. The aim should point to the direction where private can manage and preserve the records on their own. Third, There needs to be changes on the subject and process of national designated records designation. National designated record is the record that was considered valuable by the government among private records. Thus, such records should be the best one to show private field. Accordingly, records that represent contemporary society and include various states and contents should be chosen to be designated. Moreover, public discussion be formed by citizens and related professionals in order to properly select the record.

• Archives of design research
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• v.12 no.4
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• pp.149-159
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• 1999

It is already a well-known fact, that Korean attend the funeral ceremonies with their courteous etiquette being derived from their customs succeeded from the old ancient times to the contemporary one, regarding it as of great importance. Especially in the age of Lee Dynasty, the etiquette has been a way of Confucian ideas, which has exerted a harmful influences to Korean society due to the reflection of the dutiful conciousness to the tomb customs, and that the change of the burial site and its construction works became more and more serious and excessive. In the meantime, the population has been increased according to the development of the modern industrialization and the number of the dead has also been increased, which caused the issue on the effective use of the limited national land relating to the tomb culture, as the passing of the time. Consequently, in this study on the design of the charnel house, three aspects, humane aspect pursuing the human value, like naturalism or equalitarianism, circumstancial aspect presenting minimum space and convenient space, and formative aspect expressing convenient space, and formative aspect expressing convenient charnel function, unique form and symbolism, have been considered, in order that the tomb space could be transferred to the place for the meditation looking back the meaning of the life, or the place for the comfort. Above all, the special emphasis has been put on the creation of the tomb culture, harmonizing relaxation, exercise and refinement in everyone's life. And in order to realize it, the special interest and investment should be directed not only to the materialistic culture caused from the whole hearted devotion to the development for advancing society, but to the related parts to the value of the life or spiritual culture, such a sideology, culture or environment etc., which would be led to the entrance to the real advaced country members.

• Archives of design research
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• v.19 no.4 s.66
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• pp.31-40
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• 2006

For a long time, we have been good at the static image, 'the country of calm morning' as reminding Korea. But, it became a chance that we were recognized newly and actively through the success of the Olympic games in 1988 and World cup games in 2002 all over the world. And foreigners' interest and expectation for Korea becomes much higher by these reasons. Moreover, the importance of our cultural industry, recognition for new cultural improvement have been changing step by step by the oriental trend in Asia in these days. So, this study intends to realize the Korean symbol with showing Korean Identity and its image's applying to the street furniture design through the making of special street which expresses well the Korean Image. There is a purpose of this study not to use as just street furniture but to make characterized Korean culture through showing examples which are based on Korean culture. The way of the improvement for the street furniture design using Korean image are these we analyze the character of Korean international image with the previous data for the change of Korean Image. We understand the symbol of changed Korean international Image, and extract the design elements. We analogize the shape, material and color image of the street furniture which is joined with both the Korean national image and formative traditional elements. At last, we formalize its symbolic image by applying to the street furniture according to the design improvement process with the analogized image. The formal study using Korean image makes more cleary the Korean Identity, and it doesn't influence only the actual change but also Korean cultural value equipment.

• Archives of Plastic Surgery
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• v.39 no.1
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• pp.46-50
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• 2012

Background : The purpose of our study was to analyze scientific papers published by South Korean plastic surgeons in journals included in the Science Citation Index Expanded (SCIE), and to evaluate the publication and research activities of Korean plastic surgeon. Methods : We conducted a survey of SCIE papers in the field of plastic surgery published by South Korean authors between 2001 and 2010 using Web of Science software. We further analyzed these results according to the number of publications per year, journals, institution, and type of papers. We also compared the total number of citations to published scientific papers. We analyzed the rank of South Korea among other countries in representative journals. Results : Overall, 667 papers were published by South Korean authors between 2001 and 2010. The number of publications increased dramatically from 2003 (n=31) to 2010 (n=139). Subsequently, the ten most productive Korean medical colleges were identified. All published papers received 2,311 citations and the citation to paper ratio was 3.49. The rank of Korea among other countries in terms of the number of published papers remained in the top 10 during the recent 10 years. Conclusions : Publication output of Korean plastic surgeon over the last 10 years showed a remarkable growth in terms of quantity and quality. Currently, Korea is among the top six countries in representative plastic surgery journals. Korean plastic surgeons have played a central role in this progress, and it is anticipated that they will continue to do so in the future.

• Archives of design research
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• v.18 no.2 s.60
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• pp.189-200
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• 2005

Paper currency is a cultural symbol sign representing identity of a nation as well as a tool of barter system and a measure of value. The purpose of this study is to analyze the design characteristics shown in the pattern of the paper currencies of advanced countries and Korea and to make comparative analysis of the image type of each nation as a cultural code. The results show that 1) the usability of paper currency design was evaluated by denominations, size type, color, braille system and the paper currencies of Switzerland and EU were judged superior to those of the other counties. 2) The national image type represented paper currencies was classified as 'state oriented type' and 'culture & art oriented type'. The countries of Korea, U.S.A, Japan etc. have on the paper currencies the ruling class who contributed to organizing the national system foundation emphasizing their nationalism. In the case of European countries, their paper currencies reveal a variety of citizen who have contributed to art, science, music, architecture without distinction of gender and this fact puts an emphasis on egalitarianism and equality of both senders and importance or cultural art. 3) Paper currency design of Switzerland, Netherlands, France, U.K. was visualized as an art work with utilization of work-type subject, brilliant color, CG technique, unique layout etc. This study provides us with a valuable opportunity to examine the present state of the Korean paper currencies design in Comparison With those of the world's advanced countries. It is expected that this study could be a resource material for new paper currency design and emphasize the importance of the paper currencies representing a national image as a cultural design.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.335-342
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• 2005

This study was undertaken to investigate possibility of the allogenic type I collagen inducing osteoinduction or osteoconduction at critical sized bone defect in the rabbit. Twenty Newzealand white rabbit, weighted from 2.8 kg to 3.5 kg, were used in this study. The skull was exposed and two bony defects were created with diameter of 10 mm. Group I(n=10), the bony defects was grafted from the other side bone. Group II(n=10), the bony defects was grafted by the allogenic type I collagen with bone morphogenic protein(BMP). Group III(n=10), the bony defects was grafted by the allogenic type I collagen only. Group IV(n=10), the bony defects was lefted with no grafts. The grafted bones and allogenic type I collagen were investigated with radiologic densitometry, histologic analysis and immunohistochemistry after 12 weeks. No major difference was observed in the gross finding between Group I, II, III, but dura mater was exposed in bony defect,the Group IV. The radiologic study demonstrated more bony opacity in the Group I, but the other groups did not demonstrate a significant difference. In the histologic study, grafted bone edge was completely consolidated with original bone in group I and new bone ingrew into the grafted allogenic type I collagen(group II, III),but there is no bone regeneration from the original bony edge in the group IV. The percent of the new bone formation by cross-sectional area was considered statistically significant at a p value of less than 0.05(p<0.05). In the immunohistochemistry study about BMP antibodies, the group IV demonstrated osteogenic activity in front of advancing original bone edge, in which the osteoblast stained strongly for BMP antibodies, but other group does not demonstrated any osteoblastic expression. There was no immunologic rejection. In conclusion, this results do not demonstrate that the allogenic type I collagen is useful for bone substitute, but the characters of the collagen, such as pliability, easy-handling, sponge-like structure, are useful in interpositional bone graft substitutes. The further evaluation of long term results about the resorption, immunologic tissue reaction, response of applied tissue growth factor to the allogenic collagen is needed.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.298-304
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• 2007

Purpose: This study was undertaken to investigate the osteogenic induction potential of PGA & FBS mixture on a calvarial defect in the rabbit. Methods: Twenty New zealand white rabbit, weighing from 3.5-4kg were allocated into each of the three groups. Four 8 mm sized bone defects were made on the parietal bone by drilling. In group I, the bony defects were implanted with $50{\mu}m$ thickness film containing mixture of PGA and FBS. In group II, with PGA only film, & in group III, the bony defects were left with no implants. Results were evaluated by using morphologic change, radiographic study, biochemical study and histologic examination at 1 week (group I n=7, group II n=7, group III n=14), 2 weeks (group I n=6, group II n=6, group III n=12) and 3 weeks (group I n=7, group II n=7, group III n=14) following implantation. Results: In the morphologic & radiographic study, the formation and corticalization of callus were observed earlier in group I than in groups II and III (p < 0.05). In histological examination, group I showed more abundant and faster new bone formation than in group II and III. In biochemical analysis, group I displayed more activity than in group II and III. Group I also showed more abundant osteopontin, osteocalcin than groups II and III. Conclusion: In conclusion, the results demonstrate that the mixture of PGA and FBS has an effect on osteoblastic formation in the rabbit model. It is considered that further evaluation of long term results on resorption, immunologic tissue reaction and response of applied mixture in the human model will be needed.