• Archives of Plastic Surgery
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• 제37권1호
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• pp.26-30
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• 2010

Purpose: Common complications of immediate breast reconstruction with implant are capsular contracture, malposition of implant, hematoma and seroma. Especially, the most severe complication is implant exposure caused by inflammation or necrosis of skin flap margin of mastectomy site. This article reports the experience of cases of salvage in such an exposure of implant. Methods: From July, 2002 to Feb., 2009, sixty-five patients who underwent immediate breast reconstruction with implant were retrospectively analyzed. Exposure of implant was happened in 5 of 65 patients and they were treated at out patient district. Two of five patients were reconstructed with saline implnt and all of them underwent the enveloping of the implant with AlloDerm$^{(R)}$ and Serratus muscle flap. Remaning three patients were reconstructed with silicone implant and all of them underwent the enveloping of the implant with AlloDerm$^{(R)}$. Results: In the group of patients who underwent reconstruction with saline implant, implant exposure was found in one patient due to partial necrosis of the margin of skin flap and debridement and primary repair were done. In the other one patient, dressing with antibiotic ointment were done. And debridement and primary repair were proceeded. In the group of patients who underwent reconstruction with silicone implant, implant exposure was found in one patient. After removal of the implant, tissue expansion was done and a new silicone implant was inserted. Implant exposure were found in the other two patients, antibiotics ointment application and primarily repaired. Conclusion: It was the common knowledge that the exposed implant should be removed. But salvage of the exposed implants may be possible with proper treatment. Four of five patients (80%) with exposed breast implant were salvaged with conservative management.

• Archives of Plastic Surgery
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• 제39권1호
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• pp.36-41
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• 2012

Background : Poststernotomy mediastinitis is a rare, but life-threatening complication, thus early diagnosis and proper management is essential for poststernotomy mediastinitis. The main treatment for mediastinitis is aggressive debridement. Several options exist for reconstruction of defects after debridement. The efficacy of immediate debridement and reconstruction with a pectoralis major muscle flap designed for the defect immediately after the diagnosis of poststernotomy mediastinitis is demonstrated. Methods : Between September 2009 and June 2011, 6 patients were referred to the Department of Plastic and Reconstructive Surgery and the Department of Thoracic and Cardiovascular Surgery of Ajou University Hospital for poststernotomy mediastinitis. All of the patients underwent extensive debridement and reconstruction with pectoralis major muscle flaps, advanced based on the pedicle of the thoracoacromial artery as soon as possible following diagnosis. A retrospective review of the 6 cases was performed to evaluate infection control, postoperative morbidity, and mortality. Results : All patients had complete wound closures and reduced severity of infections based on the erythrocyte sedimentation rate and C-reactive protein levels and a reduction in poststernal fluid collection on computed tomography an average of 6 days postoperatively. A lack of growth of organisms in the wound culture was demonstrated after 3 weeks. There were no major wound morbidities, such as hematomas, but one minor complication required a skin graft caused by skin flap necrosis. No patient expired after definitive surgery. Conclusions : Immediate debridement and reconstruction using a pectoralis major muscle flap is a safe technique for managing infections associated with poststernotomy mediastinitis, and is associated with minimal morbidity and mortality.

• Journal of Digestive Cancer Research
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• 제5권1호
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• pp.23-27
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• 2017

Although laparoscopic pancreaticoduodenectomy (LPD) is considered as minimally invasive surgery, an advanced level of laparoscopic skill is still required. LPD comprises various procedures including reconstruction. Therefore, establishment of a safe approach at each step is needed. Prevention of intraoperative bleeding is the most important factor in safe completion of LPD. The establishment of effective retraction methods is also important at each site to prevent vascular injury. I also recommend the "uncinate process first" approach during initial cases of LPD, in which the branches of the inferior pancreaticoduodenal artery are dissected first, at points where they enter the uncinate process. This approach is performed at the left side of the superior mesenteric artery (SMA) before isolating the pancreatic head from the right aspect of the SMA, which allows safe dissection without bleeding. Safe and reliable reconstruction is also important to prevent postoperative complications. Laparoscopic pancreatojejunostomy requires highly skilled suturing technique. Pancreatojejunostomy through a small abdominal incision, as in hybrid-LPD, facilitates reconstruction. In LPD, the surgical view is limited. Therefore, we must carefully verify the position of the pancreaticobiliary limb. A twisted mesentery may cause severe congestion of the pancreaticobiliary limb following reconstruction, resulting in severe complications. We must secure the appropriate position of the pancreaticobiliary limb before starting reconstruction. We describe the incidence of intraoperative and postoperative complications and appropriate technique for safe performance of LPD.

• 가족자원경영과 정책
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• 제9권2호
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• pp.93-110
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• 2005

Improving the quality and level of the research of institutional household management is one of major issues in the field of study on family resource management and human ecology In this context the purposes of this study were to develop the scheme for the theoretical reconstruction of the subsystem in the institutional household management and to present the applicational contents focused on the marketing management. This study reached a conclusion that the marketing management has to include more practical contents such as PR(public relations), the development and management of supporters and volunteers in order to enhance the useful community resources.

• 한국건설관리학회논문집
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• 제16권6호
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• pp.12-21
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• 2015

1970년대 중반 이후 건립된 노후 공동주택 단지들에 대한 재정비 사업의 일환으로 재개발과 리모델링이 도입되었고 각 사업의 활성화를 위한 정부의 정책도 지속적으로 변화해왔다. 하지만 정책의 빈번한 변화는 사업 방식을 선택하는데 있어서 사업 주체간의 갈등과 대립을 야기 시켰고 이러한 사업 초기 단계부터의 갈등은 사업의 전체적인 진행에 차질을 주었다. 따라서 이러한 갈등을 해결하기 위하여 재건축과 리모델링의 장단점을 고려한 합리적인 사업 선택 모델 구축이 필요하게 되었다. 이에 본 연구에서는 재건축과 리모델링의 사업을 선택함에 있어서 어떠한 요소들이 얼마나 영향을 미치는지에 대하여 알아보기 위하여 두 사업에 대한 비교 분석을 통해 사업 선택 요소를 도출하였고 전문가들을 통한 적정성 검증으로 4개 분야 26항목의 선택요소들을 최종 선별하였다. 이후 AHP 기법을 이용하여 각 선택 요소가 재건축과 리모델링 사업선택에 미치는 상대적 중요도 및 영향값을 분석하여 우선순위를 도출하였다. 이처럼 재건축과 리모델링의 사업선택 요소에 대한 영향력 분석을 통해 얻은 결론을 바탕으로 여러 사례검증을 통한 연구를 지속적으로 진행하여 소유자들간의 갈등을 해결하고 사업을 합리적인 방향으로 선택 할 수 있기를 기대한다.

• 한국건설관리학회:학술대회논문집
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• 한국건설관리학회 2007년도 정기학술발표대회 논문집
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• pp.190-196
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• 2007

노후 공동주택의 수가 급격하게 증가하면서 주거 환경적인 문제, 구조성능의 저하, 설비의 노후화에 따른 성능저하등으로 인하여 노후 공동주택에 다양한 형태의 결함 및 문제점이 발생되고 있으며, 향후 이 같은 문제는 더욱 범위가 넓고 다양하게 발생될 것이다. 이러한 노후 공동주택을 개선하기 위한 방법으로 현재 사업추진의 용이성 때문에 재건축이 가장 많이 활용되고 있으나 천연골재의 부족, 폐기물 발생으로 인한 자연환경 파괴, 국가적 자원의 낭비, 재건축이 가장 많이 활용되고 있으나 천연골재의 부족, 폐기물 발생으로 인한 자연환경 파괴, 국가적 자원의 낭비, 재건축단지 인근 지역의 전세대란 초래 등으로 인하여 향후 급격하게 증가하는 노후 공동주택을 대상으로 산업적, 정책적인 측면에서 더 이상 재건축을 적극적으로 추진하기 어려운 실정이다. 따라서 노후 공동주택 성능 개선을 위한 방안으로 무분별한 재건축 추진을 억제하고 리모델링을 활성화 하는 것이 필요하다. 이를 위해 본 연구에서는 수요자의 요구사항을 바탕으로 한 요구 성능을 파악하고, 이를 근간으로 요소기술을 도출하였으며, 도출된 요소기술을 설계, 구조, 설비, 시공의 각 분야별로 묶어 연구를 진행함으로써 리모델링 활성화에 기여하고자 한다.

• 한국멀티미디어학회논문지
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• 제8권1호
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• pp.19-26
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• 2005

본 논문에서 사용한 웨이블릿 변환의 기저 함수는 일반적인 웨이블릿 변환과 다른 리프팅 스킴을 사용하여 만들어 졌다. 리프팅 스킴은 푸리에 변환을 사용하여 기저 함수를 생성하지 않는 새로운 쌍직교 웨이블릿 기저 함수를 생성하는 방법이다 본 본문은 리프팅 스킴을 이용한 새로운 영상 압축 및 에지 검출 방법을 제안하고 있다. 그리고 이 방법은 부분 복원과 공간 복원을 할 수 있어 데이터 가시화를 향상시킬 수 있다. 다양한 해상도에서의 근사 영상은 원래 영상으로부터 적은 정보만으로 다양한 크기의 특징을 뽑아낼 수 있고, 적은 양의 스케일링 계수를 사용하여 생성된 근사 영상은 빠르게 원래 영상의 대략적인 개요만이 필요할 때 유용하게 사용된다. 본 논문에서 제안한 영상 압축 및 에지 검출 기법은 멀티미디어 데이터베이스에서 데이터 관리와 데이터 가시화를 향상시킬 수 있는 좋은 기틀을 마련해 준다.

• ETRI Journal
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• 제42권3호
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• pp.376-387
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• 2020

Massive computation of the reconstruction algorithm for compressive sensing (CS) has been a major concern for its real-time application. In this paper, we propose a novel high-speed architecture for the orthogonal matching pursuit (OMP) algorithm, which is the most frequently used to reconstruct compressively sensed signals. The proposed design offers a very high throughput and includes an innovative pipeline architecture and scheduling algorithm. Least-squares problem solving, which requires a huge amount of computations in the OMP, is implemented by using systolic arrays with four new processing elements. In addition, a distributed-arithmetic-based circuit for matrix multiplication is proposed to counterbalance the area overhead caused by the multi-stage pipelining. The results of logic synthesis show that the proposed design reconstructs signals nearly 19 times faster while occupying an only 1.06 times larger area than the existing designs for N = 256, M = 64, and m = 16, where N is the number of the original samples, M is the length of the measurement vector, and m is the sparsity level of the signal.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.703-708
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• 2008

Purpose: Microtia is a congenital anomaly resulting from abnormal development of the branchial apparatus. Although significant modification and improvement of operative procedures for the reconstruction of the auricle with a natural appearance have been reported, postoperative complications, such as infection, flap necrosis and deformity, still remain serious problems in patients. Many studies with long-term results have focused mainly on operative procedures for an acceptable auricular shape without consideration of possible complications. Methods: We conducted a retrospective study on postoperative complications at the recipient sites of 183 patients who underwent auricular reconstruction with autologous rib cartilage grafts from November 1987 to January 2007 at the Division of Pediatric Plastic Surgery, Seoul National University Children's Hospital. Patients were analyzed in terms of the kinds and incidences of complications, and their treatment options. Results: Postoperative complications included wound dehiscence, flap necrosis, infection, hypertrophic scar, auricular deformity and absorption of rib cartilage grafts. The complications occurred in 47 patients with a complication rate of 25.7%. Fourteen patients were successfully managed with conservative treatment. However, surgical treatment was required in 51 reoperations(33 patients) of total 329 operations. Conclusion: Postoperative complications at the recipient sites of autologous rib cartilage grafts occurred with relatively high incidences and required long-term treatments and multiple surgeries. The results of this study may provide information on the causes and proper management of postoperative complications as well as safe procedures for the reconstruction of the auricle.

• 대한두경부종양학회지
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• 제30권2호
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• pp.115-118
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• 2014

Papillary thyroid carcinoma is known as its relatively high cure rate after surgical treatment. But invasion of the trachea by thyroid carcinoma is poor prognostic factor and the best management is en bloc surgical resection of the tumor invading the trachea. A 55-year-old man was diagnosed as papillary thyroid cancer with tracheal invasion. We treated the patient by total thyroidectomy with window resection of invading trachea followed by immediate reconstruction with sternohyoid muscle flap and tracheostomy. At 48 days after surgery, tracheostoma was closed and the patient had no functional complication by the surgical process. Until 10 months after surgery, there was no sign of recurrence and the patient led social life without any discomfort. We present this case with a review of the related literatures.