• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권3호
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• pp.388-395
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• 1996

본과에서는 2 증례의 사경증에 대하여 환자의 경부 운동의 범위를 증가시키고 이와 동시에 경부의 심미적인 V형태를 유지하기 위하여 Ferkel 등에 의한 Biopolar release와 Z-pasty를 이용하여 수술을 시행하였으며 술후 2주 이내에 물리치료를 시행하여 경부운동 범위의 증가와 경부의 심미적인 유지에 비교적 양호한 결과를 얻었다. 그러나 증례 2에서는 이미 안모의 변형이 초래된 성인으로 안모 변형의 개선을 위한 이차 수술을 계획중이며, 이러한안모의 변형을 방지하기 위하여는 조기에 이를 진단하고 외과적 및 비외과적인 방법을 통한 적절한 처치가 중요하리라 생각되었다. 이러한 사경증 환자의 초기 치료가 대부분 타과에서 이루어지기 때문에 구강악안면외과 의사에게는 어느정도 생소할 수 있지만 사경증에 의하여 경부나 안모의 변형 등이 발생할 수 있으므로 사경증에 대한 더 많은 관심과 연구가 이루어져야 할 것으로 사료되어 문한고찰과 함께 보고하는 바이다.

• Archives of Reconstructive Microsurgery
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• 제11권1호
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• pp.11-18
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• 2002

Large soft tissue defects around the knee joint are known to significantly diminish joint function. Severe soft tissue defects on the anterior aspect of the knee joint especially bring on significant joint motion limitation. Although simple split skin grafts can cover the skin defect, the progressing scar contracture of the grafted skin causes joint stiffness. One of the best solutions of large soft tissue defects around the knee joint is covering the defect with a good quality skin flap. Separated flaps with one vascular pedicle are good candidates for covering anterior and posterior aspects of the joint for example. Authors performed 12 cases of combined scapular and latissimus dorsi free flaps from 1984 to 2000. Among them, we experienced 5 cases of knee joint defect covering using the double free flap for coverage of the soft tissue defect with preservation of the knee joint function and satisfactory results. The system of flaps based on the subscapular artery and vein provides a variety of composite free flaps. The possible flaps that can be harvested based on this single vascular pedicle include the scapular and parascapular skin flap, the serratus anterior and latissimus dorsi muscular flap, the lateral scapular bone flap, the latissimus dorsi-rib flap, and the serratus anterior-rib flap. This combined flap is available for multiple tissue defects or complex defects because it can be incorporated with skin, muscle and bone flaps. A main advantage is the independent vascular pedicles of each component, which allow freedom in orientation of each components. Consequently it can be freely applied to any form of three dimensional defects on the upper and lower extremities. The combination of scapular cutaneous flap and latissimus dorsi musculocutaneous flap can be resurfaced for massive cutaneous defects on the extremities. We report the use of the combined scapular and latissimus dorsi free flap in five patients to reconstruct massive defects on the extremities with resultant improved joint function. There was no flap failure and minimal complications and disadvantages. The anatomy of this flap is reviewed and the indication and advantages are discussed. All of the five flaps survived and there was no scar contracture affecting the joint motion.

• Journal of Korean Neurosurgical Society
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• 제46권6호
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• pp.532-537
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• 2009

Objective : Recently, motion preservation has come to the forefront of emerging technologies in spine surgery. This is the important background information of the emergence of cervical arthroplasty as an alternative to arthrodesis that offers the promise of restoring normal spinal movement and reduces a kinematic strain on adjacent segments. The study was designed to evaluate early surgical outcome and radiological effects of $Bryan^{(R)}$ cervical disc prosthesis. Methods : The authors retrospectively reviewed radiographic and clinical outcomes in 52 patients who received the $Bryan^{(R)}$ Cervical Disc prosthesis, for whom follow-up data were available. Static and dynamic radiographs were measured by computer to determine the angles formed by the endplates of the natural disc preoperatively, those formed by the shells of the implanted prosthesis, the angle of functional spine unit (FSU), and the C2-7 Cobb angle. The range of motion (ROM) was also determined radiographically, whereas clinical outcomes were assessed using Odom's criteria, visual analogue pain scale (VAS) and neck disability index (NDI). Results : A total of 71 $Bryan^{(R)}$ disc were placed in 52 patients. A single-level procedure was performed in 36 patients, a two-level procedure in 13 patients, and a three-level procedure in 3. Radiographic and clinical assessments were made preoperatively. Mean follow-up duration was 29.2 months, ranging from 6 to 36 months. All of the patients were satisfied with the surgical results by Odom's criteria, and showed significant improvement by VAS and NDI score (p < 0.05). The postoperative ROM of the implanted level was preserved without significant difference from preoperative ROM of the operated level (p < 0.05). 97% of patients with a preoperative lordotic sagittal orientation of the FSU were able to maintain lordosis. The overall sagittal alignment of the cervical spine was preserved in 88.5% of cases at the final follow up. Interestingly, preoperatively kyphotic FSU resulted in lordotic FSU in 70% of patients during the late follow up, and preoperatively kyphotic overall cervical alignment resulted in lordosis in 66.6% of the patients postoperatively. Conclusion : Arthroplasty using the $Bryan^{(R)}$ disc seemed to be safe and provided encouraging clinical and radiologic outcome in our study. Although the early results are promising, this is a relatively new approach, therefore long-term follow up studies are required to prove its efficacy and its ability to prevent adjacent segment disease.

• 대한족부족관절학회지
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• 제16권1호
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• pp.38-46
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• 2012

Purpose: This study was performed retrospectively to evaluate clinical outcomes of distal metatarsal osteotomy using bio-compression screw as the joint preservation method for advanced hallux rigidus. Materials and Methods: Eleven cases were followed up for more than 1 year after distal metatarsal dorsal wedge osteotomy for advanced hallux rigidus. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) score and patient's satisfaction score. The range of motion, and the period to return to running exercise, tip-toeing gait, squatting, walking down the stairs were evaluated. As the radiographic evaluation, the interval of $1^{st}$ MTP (metatarsophalangeal) joint space and the period to union were measured. Results: The AOFAS hallux score had improved significantly from preoperative average 50.7 points to 87.6 points at the last follow-up (p=0.005). The subjective satisfaction score was average 90.6 points. There were no case of subsequent fusion or additional operation, and no complication associated with bio-compression screw. The period to return to running exercise, tip-toeing gait, squatting, walking down the stairs were average of 24.8 weeks, 20.4 weeks, 16.8 weeks, 18.5 weeks respectively. Dorsiflexion of $1^{st}$ MTP joint had improved significantly from preoperative average $17.5^{\circ}$ to $44^{\circ}$ (p<0.001). All cases achieved union of osteotomy site, and the period to union was average 10.4 weeks. The interval of $1^{st}$ MTP joint space had improved significantly from preoperative average 1.2 mm to 3.5 mm (p=0.014). Conclusion: Distal metatarsal osteotomy using bio-compression screw seems to be one of effective treatment methods for advanced hallux rigidus, because of restoration of the first MTP joint motion, and reliable pain relief, and needlessness of hardware removal.

• 한국전통조경학회지
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• 제36권2호
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• pp.46-53
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• 2018

본 연구는 동시대에서 요구되는 재생적 환경특성을 고려하고, 지속가능한 정원디자인을 실현하기 위한 개념적 바탕과 적용의 기초를 마련하는 것을 배경으로 한다. 그러므로 본 연구는 로빈슨의 자연주의적 가치관으로부터 영향을 받은 클레망의 정원이론에 대한 개념을 이해하며, 클레망의 정원에 구현된 자연주의적 차별특성을 로빈슨의 와일드가든과 비교하였으며 결과는 다음과 같다. 첫째, 클레망에게 있어서 정원디자인을 한다는 것은 식물의 움직임에 의해 형성되는 공간에 대한 과정의 미학으로 대상지에 정착하여 가는 생태적 프로세스를 포함한다. 그러므로 '움직이는 정원'을 실현한다는 것은 자연에 대한 신뢰를 바탕으로 자연에 순응하고, 식물들의 종자가 계획되지 않고 자연스럽게 적절한 생육환경을 찾아가도록 허용해야 하는 가능성을 디자인하는 것이다. 둘째, 야생(Wild)에 대한 가치관은 미시적 관점과 거시적 관점으로 구분되며 각각의 표현특성을 지니는데, 로빈슨의 경우 소규모의 정원으로서 기존 공간에 대한 연화(軟化) 기능을 담당하며 종속적인 특징을 가진다. 반면 클레망의 정원은 공간의 주체로서 거시적 안목에서의 전략이며, 생태적 역할의 중심이 되는 인프라스트럭쳐로서 구체화된 하향식 접근 특성을 가진다. 셋째, 로빈슨과 클레망의 정원에 대한 공간운용 관점은 자연의 자율성과 정원의 야생에 대한 불가분의 관계를 인정하며 자연에 대한 보존이 성립되어질 때 우리가 원하는 삶과 공존할 수 있다는 가치를 전달하며, 그들의 정원은 환경결정론의 관점을 바탕으로 식물이 매체가 된 환경가능론적 논지와 생태학적 입장의 중재로 유추된다.

• 한국동물생명공학회지
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• 제36권2호
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• pp.106-115
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• 2021

Sperm cryopreservation is an important method of assisted reproductive techniques and storing genetic resources. It plays a vital role in genetic improvement, livestock industrial preservation of endangered species, and clinical practice. Consequently, the cryopreservation technique is well organized through various studies, especially on Korean native cattle (Hanwoo). However, the cryopreservation technique of Korean native brindled cattle, which is one of the native cattle species in Korea, is not well organized. Therefore, it is necessary to develop a Supplementary Table technique for the cryopreservation of Korean native brindled cattle. For this purpose, it is important to first evaluate the quality of the currently produced cryopreserved sperm of Korean native brindled cattle. In this study, we randomly selected 72 individual Korean native brindled cattle semen samples collected from 8 different region research centers and used them to evaluate sperm functions. We focused on the quality evaluation of cryopreserved Korean native brindled cattle semen following the measurement of motion kinematics, capacitation status, intracellular ATP level, sperm motility, and cell viability. Then, the values of each of the eight groups were derived from various sperm parameters of nine individual samples, including sperm motility, kinematics, cellular motility, and intracellular ATP levels, which were used to compare and evaluate sperm function. Overall, differences in various sperm parameters were observed between most of the research centers. Particularly, the deviations of motility and motion kinematics were high according to the sample. Therefore, we suggest that it is necessary to develop a standard method for the cryopreservation of Korean native brindled cattle semen. We also suggest the need for sperm quality evaluation of the cryopreserved semen of Korean native brindled cattle before using artificial insemination to attain a high fertility rate.

• Archives of Plastic Surgery
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• 제33권6호
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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.

• 한국실내디자인학회논문집
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• 제18권2호
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• pp.80-92
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• 2009

Natural history museums preserve and manage the creatures living in each country, so they play unique roles for bio-diversity, and in fact, their roles are really instrumental for the collection, preservation, research, exhibition and education of creatures in the 21st century. Therefore, this research has the purpose to survey the status of our country's existing natural history museums, analyze their visual perception space structural characteristics, and ultimately utilize their characteristics as basic data in planning out and designing spaces of natural history museums to be established later on. As for the research scope, the research selected as research subjects 7 natural history museums that currently have composite set of open type and mixed type and have been accommodating comparatively active exhibitions since 2000 among 10 or so natural history museums in our country. Research method is that the research analyzed the exhibition spaces of 7 natural history museums by using depthmap program which can analyze space with visual graph analysis function, and analyzed the visibility among unit areas by each natural history museum integration and exhibition contents composition. In such analysis method, the research was able to quantitatively analyze the visual characteristics of exhibition space that induces and adjusts the motion of audience. Visual perception quantitative analysis as in this research will enhance exhibition design by considering the correlation between audience and exhibited items when planning out natural history museums space to be established later on.

• Archives of Reconstructive Microsurgery
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• 제1권1호
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• pp.31-38
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• 1992

The management of giant cell tumor involving juxta-articular portion has always been a difficult problem. In certain some giant cell tumors with bony destruction, a wide segmental resection may be needed for preventing to recur. But a main problem is preserving of bony continuity in bony defect as well as preservation of joint function. The traditional bone grafts have high incidence in recurrence rate, delayed union, bony resorption, stress fracture despite long immobilization and stiffness of adjuscent joint. We have attemped to overcome these problems by using a microvascular technique to transfer the fibula with peroneal vascular pedicle as a living bone graft. From Apr. 1984 to Nov. 1990, we performed the reconstruction of wide bone defect after segmental resection of giant cell tumor in 4 cases, using Vascularized Fibular Graft, which occur at the distal radius in 3 cases and at the proximal tibia in 1 case. An average follow-up was 2 years 8 months, average bone defect after wide segmental resection of lesion was 11.4cm. These all cases revealed good bony union in average 6.5months, and we got the wide range of motion of adjacent joint without recurrence and serious complications.

• Archives of Reconstructive Microsurgery
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• 제20권1호
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• pp.38-42
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• 2011

Purpose: To evaluate the effect of intermittent bleeding method in the distal phalanx replantation. Materials and Methods: From January 2007 through June 2009, authors have replanted 117 cases of distal phalangeal amputation in adults at Soo Hospital and Chonbuk National University Hospital. Cases of zone II were 60 cases and zone III 57 according to Allen classification. Male to female ratio was 8.7:1.3. The most common cause was machinery injury in the factory, 98 cases(83.8%), next one was belt injury of the machine, 11 cases(9.4%) and others, 8(6.8%). At least one digital artery and digital nerve were anastomosed under the operating microscope, but vein was impossible to anastomosis as unable to find out in the zone II and III. After anastomosis of one or more digital arteries and nerves, heparine(6,000-10,000 units) was kept to intravenous injection for 24 hours and at the same time fish mouth incision in 2-3 millimeter diameter was made in the distal radial and ulnar margin of the replanted distal phanlanx. From the first 30 minutes to an hour after replantation, incision site was swabbed with heparinized cotton ball for 5 minutes in every 30 to 40 minutes to make sure perfusion for 24 hours, every an hour at the second day, every two hours at the postoperative third to fifth day. Results: 92 cases(78.6%) was completely survived at average postoperative third week follow-up and satisfied with preservation of the finger nail, digit length, good range of motion of the distal interphalangeal joint and acceptable sensibility at average 1.2 years follow-up. Conclusions: Intermittant bleeding method in replantation of crushed distal phalanx impossible to anastomosis of vein at zone II and III of Allen classification was regarded as one of the notable salvage procedure.