• 대한화상학회지
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• 제24권2호
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• pp.46-49
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• 2021

An anatomically normal first web space is essential for optimal prehensile movements of the thumb and hand. A 28-year-old woman presented with severe scarring and contractures of the first web space of both hands, following a flame burn injury sustained 25 years prior to presentation. First web space contracture may occur secondary to severe injuries, burns (as observed in our patient), or congenital hand anomalies. A significant amount of additional skin is required to release a severe first web space contracture. Reconstruction of wide areas of contractures using only local flaps is challenging. Among other free flaps used in clinical practice, the thinned lateral arm free flap provides flexible vascularized tissue for reconstruction of the skin after severe first web space contracture release. Reconstruction using lateral arm free flaps facilitated thumb abduction and opposition (which were initially difficult) and improved hand function in our patient.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.648-651
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• 2006

Purpose: Tarsal tunnel syndrome is characterized by pain and paresthesia of the entire posterior tibial nerve and its branches of the lower extremity. The cause of the tarsal tunnel syndrome is usually unknown but, rare case of space occupying benign tumors such as a ganglion may be one of the causes. We report our experiences of surgical treatment of the tarsal tunnel syndrome caused by ganglion we have encountered recently. Methods: A 54-year-old male patient presented with paresthesia, burning pain, positive Tinnel's sign without preceeding trauma, infection or any other causes of event. With surgical intervention, we completely removed the space occupying ganglion and with performed surgical release of the posterior tibial nerve and its branches. Results: At a 14-month follow up examination, the symptoms of paresthesia, burning pain, sensory disturbance was much improved compared to the preoperative conditions. Takakura's rating scale was elevated from 4(Poor) to 8(Good). Conclusion: We report our surgical experience of a rare case of tarsal tunnel syndrome caused by a ganglion, with a review of literature.

• Archives of Plastic Surgery
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• 제37권1호
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• pp.83-86
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• 2010

Purpose: Authors present the case of 2 patients who underwent extended Latissimus dorsi myocutaneous flap to reconstruct postburn breast deformity. Methods: A 39-year-old woman and 18-year-old woman with postburn breast deformity visited for reconstruction. The nipples were preserved but normal breast development did not occur due to scar contracture. Burn scar contracture was released by excision of the restricting burn scar and breast mound was reconstructed with extended Latissimus dorsi myocutaneous flap. Additional contracture release with multiple z-plasty was performed at the axillae and medial portion of breast. Results: Postburn breast reconstruction using Latissimus dorsi myocutaneous flap showed natural shaped breast mound and inframammary fold. There was no significant complication in both cases. Conclusion: Latissimus dorsi myocutaneous flap provide sufficient skin and soft tissue and it could be an effective method for reconstruction of postburn breast deformity.

• Archives of Plastic Surgery
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• 제39권4호
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• pp.426-430
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• 2012

Dupuytren's contracture is a condition commonly encountered by hand surgeons, although it is rare in the Asian population. Various surgical procedures for Dupuytren's contracture have been reported, and the outcomes vary according to the treatment modalities. We report the treatment results of segmental fasciectomies with multiple transverse incisions for patients with Dupuytren's contracture. The cases of seven patients who underwent multiple segmental fasciectomies with multiple transverse incisions for Dupuytren's contracture from 2006 to 2011 were reviewed retrospectively. Multiple transverse incisions to the severe contracture sites were performed initially, and additional incisions to the metacarpophalangeal (MCP) joints, and the proximal interphalangeal (PIP) joints were performed if necessary. Segmental fasciectomies by removing the fibromatous nodules or cords between the incision lines were performed and the wound margins were approximated. The mean range of motion of the involved MCP joints and PIP joints was fully recovered. During the follow-up periods, there was no evidence of recurrence or progression of disease. Multiple transverse incisions for Dupuytren's contracture are technically challenging, and require a high skill level of hand surgeons. However, we achieved excellent correction of contractures with no associated complications. Therefore, segmental fasciectomies with multiple transverse incisions can be a good treatment option for Dupuytren's contracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권3호
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• pp.270-275
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• 2011

Pierre Robin Sequence (PRS) is known as an anomaly consisting of respiratory obstruction with glossoptosis, micrognathia and cleft palate in a newborn. The etiology of PRS is not known, but several factors may be involved simultaneously. Mortality rate of PRS is about 5~30% and the treatment method is divided into both conventional treatments and surgical interventions. If the respiratory obstruction is not resolved by the conventional method, surgical treatment, such as subperiosteal release of the floor of the mouth, tongue-lip adhesion, tracheostomy, distraction osteogenesis may be needed. This study reports a case of PRS in a newborn male at 20 days, with dyspnea and feeding difficulties. Clinical examination showed micrognathia with glossoptosis and cleft palate as the typical PRS triad. We tried surgical intervention with subperiosteal release of the floor of the mouth and tongue-lip adhesion and surgery was successful. At $19^{th}$ months, we also repaired the incomplete cleft palate successfully using 2-Flap palatoplasty.

• 한국안전학회지
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• 제28권4호
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• pp.14-18
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• 2013

Blades of horizontal axis are nowadays made of composite materials. Generally, composite materials satisfy design provides lower weight and good stiffness, while laminate composites have often damages as like the delamination and cracks at the interface of laminates. The box spar and tail parts of a blade are composed of the CFRP/GFRP hybrid laminate composites. However, delamination and the interfacial crack often occur in the interface of CFRP/GFRP hybrid laminate composites under the mixed mode fracture condition, especially mode I and mode II. Therefore, there is a need for the evaluation of the mixed mode fracture behavior during the delamination of CFRP/GFRP hybrid laminates. This study shows the experimental results for the delamination fracture toughness in CFRP/GFRP hybrid laminate composites. Fracture toughness experiments and estimation are performed by using DMMB(Dissimilar mixed mode bending) specimen. The materials used in the test are a commercial woven type CFRP(Carbon fiber reinforced plastic) prepreg(CF3327) and UD type GFRP(Glass fiber reinforced plastic) prepreg(HD224A). A CFRP/GFRP hybrid laminate composite is composed by the 10 plies CFRP and GFRP prepreg for DMMB. A thickness of CFRP and GFRP layer is 2.5mm and 3.0mm, respectively. Also the fulcrum location which is a loading parameter is changed from 80 to 100mm on the specimen of length 120mm because it defines the ratio of mode I to mode II. In this study, the effects of the fulcrum location are evaluated in the viewpoint of energy release rate in mode I and mode II contribution. The results show that the delamination crack initiates at higher displacement and lower load according to the increase of the fulcrum location ratio. And the variation of the energy release rate for mode I and II contributions for the mode mixity are shown.

• Steel and Composite Structures
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• 제35권3호
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• pp.439-447
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• 2020

This paper presents two sets of full three-dimensional thermoelastic finite element analyses of superimposed thermo-mechanically loaded Spar Wingskin Joints made with laminated Graphite Fiber Reinforced Plastic composites. The study emphasizes the influence of residual thermal stresses and material anisotropy on the inter-laminar delamination behavior of the joint structure. The delamination has been pre-embedded at the most likely location, i.e., in resin layer between the top and next ply of the fiber reinforced plastic laminated wingskin and near the spar overlap end. Multi-Point Constraint finite elements have been made use of at the vicinity of the delamination fronts. This helps in simulating the growth of the embedded delamination at both ends. The inter-laminar thermoelastic peel and shear stresses responsible for causing delamination damage due to a combined thermal and a static loading have been evaluated. Strain energy release rate components corresponding to the Mode I (opening), Mode II (sliding) and Mode III (tearing) of delamination are determined using the principle of Virtual Crack Closure Technique. These are seen to be different and non-self-similar at the two fronts of the embedded delamination. Residual stresses developed due to the thermoelastic anisotropy of the laminae are found to strongly influence the delamination onset and propagation characteristics, which have been reflected by the asymmetries in the nature of energy release rate plots and their significant variation along the delamination front.

• The Korean Journal of Physiology and Pharmacology
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• 제4권6호
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• pp.525-530
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• 2000

During reperfusion of skeletal muscle after ischemia, lipid mediators, mainly eicosanoids, are released and may have a role in the pathogenesis of reperfusion injury. To validate the role of eicosanoids in the ischemia-reperfusion induced functional deficits in skeletal muscle, we compared muscle edema and the changes of eicosanoid concentration in the rat hind limb after ischemia-reperfusion injury by application of tourniquet. After 4 hours of ischemia, reperfusion was established for 4 hours by releasing tourniquet. To assess tissue damage, edema, and wet/dry weight ratios were determined and the eicosanoid concnentrations were measured by the HPLC. The muscle edema and the release of cyclooxygenase metabolites were not induced by the ischemia itself rather they were significantly increased by reperfusion. Indomethacin treatment ameliorated limb edema and decreased the release of $6-keto-PGF_{1{\alpha}},$ thromboxane $B_2,$ and $PGE_2$ inducedby reperfusion. But the inhibitory effect of indomethacin on edema (35%) was relatively low than the inhibitory effect on release of cyclooxygenase metabolites (up to 69%) by reperfusion. These results support the view that cyclooxygenase products may play a significant role in the formation of muscle injury by ischemia-reperfusion and suggest that nonsteroidal antiinflammatory agents might be partially beneficial to the management of acute limb ischemia-reperfusion injury.

• 한국화재소방학회논문지
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• 제32권6호
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• pp.55-62
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• 2018

국내 성능위주소방설계(PBD)에 신뢰성이 향상된 예측결과를 기여하고자 판매시설 가연물 중 플라스틱으로만 이루어진 제품을 대상으로 실규모 화재실험이 수행되었다. 이때 판매시설의 경우 다양한 가연성 물질이 진열된 판매대의 간섭 또는 상품 적재 등으로 인한 화재확산의 검토를 위하여 단일 및 다수가연물로 분리되어 실험조건이 선정되었다. 이에 따라 최대 열 발생률에 따른 가연물의 노출 면적 및 중량은 대략 93%와 89%의 매우 선형적인 관계를 확인할 수 있다. 또한 다양한 가연물에 대한 가스농도의 분석 결과 이산화탄소($CO_2$)는 최대 열 발생률에 대하여 선형적인 관계를 나타내는 반면 일산화탄소(CO)는 지수함수의 형태를 나타낸다. 이러한 결과는 판매시설에서 발생되는 플라스틱 화재의 PBD에 신뢰성있는 화원정보로서 적용될 수 있다. 추후 실제 판매시설에서 적용되는 진열대의 면적이 적용된 추가적인 실험을 통하여 판매시설의 플라스틱 화재에 대표되는 화원 정보로서 적용할 수 있을 것이라 기대된다.

• Archives of Plastic Surgery
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• 제39권6호
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• pp.659-662
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• 2012

Progressive facial hemiatrophy, also known as Parry-Romberg syndrome, is a progressive and self-limited deformation of the subcutaneous tissue volume on one side of the face that creates craniofacial asymmetry. We present the case of a patient with a five-year history of progressive right facial hemiatrophy, who underwent facial volumetric restoration using cell-assisted lipotransfer (CAL), which consists of an autologous fat graft enriched with adipose-derived stem cells (ASCs) extracted from the same patient. ASCs have the capacity to differentiate into adipocytes. They also promote angiogenesis, release angiogenic growth factors, and some can survive as stem cells. The use of autologous fat as a filler in soft tissue atrophy has been satisfactory in patients with mild and moderate Parry-Romberg syndrome. Currently, CAL has showed promising results in the long term by decreasing the rate of fat reabsorption. The permanence and stability of the graft in all the injected areas has showed that autologous fat grafts enriched with stem cells could be a promising technique for the correction of defects caused by this syndrome.