• Journal of Gastric Cancer
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• 제2권2호
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• pp.91-95
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• 2002

Purpose: We compared the quality of life (QOL) and nutritional outcomes following both Billroth I (BI) and Billroth II (BII) reconstructions after a subtotal gastrectomy in order to identify which reconstruction would produce a better QOL and nutritional outcomes and to provide better follow-up management. Materials and Methods: We studied 273 patients without evidence of recurrent disease following a curative distal subtotal gastrectomy for gastric cancer. Among them, 135 underwent a BI reconstruction and 138 a BII reconstruction. The nutritional status was assessed by using levels of hemoglobin, serum albumin, iron, and vitamin B12 and by calculating the relative body weight, the body mass index, and the percentage of body fat. The QOL was measured by using the Troidl score and by treatment-specific symptoms based on the criteria, somewhat modified by the authors, of Korenaga and others. Results: There was no significant difference in QOL between the BI and the BII groups. More than half of the patients revealed anemia, regardless of the type of reconstruction. The serum vitamin $B_{12}$ level of the BII group was lower than that of the BI group. The BII group showed a tendency toward lower hemoglobin levels and serum iron concentrations than the BI group did. Conclusions: The quality of life was not impaired in most patients after either a BI or a BII reconstruction. However, both resulted in iron deficiency anemia, although the incidence was higher after a BII reconstruction. The patient's serum iron and vitamin B12 should be measured periodically and these must be administered if the measurements reveal a below normal range.

• Archives of Reconstructive Microsurgery
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• 제19권1호
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• pp.56-60
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• 2010

Purpose: Breast reconstruction with abdominal flap has many advantages. However, it might cause abdominal complications such as bulging or hernia. SIEA (Superficial inferior epigastric artery) flap is the most advanced form of abdominal flap which has no adverse effect on abdominal fascia. We report 2 cases of breast reconstruction with SIEA flap with reference review. Methods: From Jun 2006 to Jan 2009, 110 patients underwent breast reconstruction with free abdominal flap. We tried to find the SIEA in every cases and adopted SIEP flap if the diameter was larger than 1mm and it had visible pulsation. 2 patients underwent breast reconstruction with SIEA flap. After design of abdominal flap SIEA was investigated with portable Doppler. SIEA was usually found 4-5 cm lateral to the midline. Flap was elevated with SIEA and SIEV to their maximal length at hiatus. Results: There were no complications, such as infection, hematoma, and necrosis of flap. In both cases, flaps survived completely with excellent vascularity and breast reconstruction was successful. In one case, there was skin necrosis of mastectomy flap, and it was healed by conservative management. Conclusion: With the SIEA flap, donor site morbidity can be minimized along with reduction of operation time. If there is reliable SIEA, SIEA flap would be the preferred skills. However, the limitation of the SIEA flap is difficulty in identifying the SIEA. The reason for less availability of the flap in Korea might include high prevalence of the Caesarian section scar and relatively higher level of the lower margin of the flap.

• Archives of Plastic Surgery
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• 제36권4호
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• pp.428-431
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• 2009

Purpose: Blow out fracture resulting from facial trauma is of high frequency among facial bone fractures, and can cause severe complications. So, proper management and close observation after operation are needed. So far, Computed tomography has been the best choice in the evalution following orbit wall reconstruction. However, cost - effectiveness, accessibility to patients and hazard of radiation exposure of computed tomography require supplementary measure for the evaluation following orbit wall reconstruction. This study was performed to describe the effectiveness of ultrasonography in the evalution following orbit wall reconstruction. Methods: A retrospective study was performed on 40 patients who underwent orbit wall reconstruction from June, 2008 to July, 2008. The patients' ages ranged from 13 to 65 years (mean 27.5 years), and this group was compsoed of 27 male and 13 female patients. The follow up period ranged from 2 weeks to 28 weeks (mean 11weeks). Preoperatively, all fractures were diagnosed using computed tomography. Ultrasonography for all cases, and computed tomography for 2 cases were performed for evaluation following orbit wall reconstruction. Results: Reduction of herniated orbital soft tissue and orbit implant was identified by using ultrasonography in 38 cases out of 40 cases. In other cases which we could not identify the orbit implant, computed tomography was performed. Con clusion: Compared to computed tomography, ultrasonography is simple, inexpensive and convenient method. Ultrasonography can be used as supplementary measure to computed tomography in the evaluation following orbit wall reconstruction for elective patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권3호
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• pp.216-223
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• 2021

Preoperative patient analysis for oral cancer involves multiple considerations that are based on multiple factors; these include TNM stages, histopathologic findings, and adjacent anatomical structures. Once the decision is made to excise the lesion, the margin of dissection and its extent should be considered along with the best form of reconstruction and airway management. Treatment methods include surgical resection, radiotherapy, and chemotherapy. Although the combined method of treatment is controversial, surgical resection is considered predominantly, and immediate reconstruction after surgical resection follows. The choice of treatment is dictated by the anticipated functional and esthetic results of treatment and also by the availability of a surgeon with the required expertise. Segmental mandibulectomy with primary reconstruction has been shown to have advantages in both functional and esthetic results. A 52-year-old male patient with basaloid squamous cell carcinoma of the floor of the mouth, and the anterior portion of the mandible was treated with surgical procedures that included segmental mandibulectomy with both supraomohyoid neck dissection (SOHND) at Levels I-III and mandible reconstruction with a left fibula free flap. A 55-year-old male patient with clear cell odontogenic carcinoma of the oral cavity underwent segmental mandibulectomy with both SOHND at Levels I-III and mandible reconstruction with a left fibula free flap. The purpose of this study was to review the anatomic and functional results of patients after immediate reconstruction with a fibula free flap following resection of carcinoma in the anterior portion of the mandible and floor of the mouth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권6호
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• pp.432-437
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• 2021

Objectives: The mandible and other parts of the maxillofacial region suffer significant morbid injuries following road traffic accidents. Our study gives epidemiological description of mandibular fractures in Ghana and also evaluates the relevance of closed reduction and indirect fixation for managing mandibular fractures in low-resource health facilities in low-income countries like Ghana. Patients and Methods: This is a retrospective study involving 268 patients who reported to the Department of Oral and Maxillofacial Surgery of the Sunyani Regional Hospital with mandibular fractures from January 2010 to December 2019. Patient medical records were assessed for information on age, sex, fracture etiology, anatomic location of fracture, time of day of road traffic accident, and other associated injuries. Results: A total of 268 patients were included in this study (males, 216 [80.6%]; females, 52 [19.4%]). Motor vehicular accident (MVA) was the leading cause of mandibular fractures (202 injuries, 75.4%). Other etiologies included assault (39, 14.6%), gunshot (13, 4.9%), falls (12, 4.5%), and industrial accidents (2, 0.7%). Of the 161 male cases caused by MVA, 121 (75.2%) occurred at night and in the evening while the remaining 40 (24.8%) occurred in the morning and afternoon. Among all managed 222 patients, 212 (79.1%) were treated with closed reduction and indirect fixation technique while 10 (3.7%) were treated with open reduction and direct fixation. Conclusion: Closed reduction with indirect fixation could successfully be used to manage mandibular fractures in low resourced health facilities, especially in low-income countries. The poor lightening system on roads in Ghana is a major contributory factor to motor vehicular accidents.

• 한국정보전자통신기술학회논문지
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• 제16권6호
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• pp.369-377
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• 2023

산업 제조 분야에서 품질 관리는 불량률을 최소화하는 핵심 요소로, 미흡한 관리는 추가적인 비용 발생과 생산 지연을 야기할 수 있다. 본 연구는 제조품의 텍스쳐 결함 감지의 중요성을 중심으로, 보다 정밀한 결함 감지 방법을 제시한다. DFR(Deep Feature Reconstruction) 모델은 특징맵의 조합 및 재구성을 통한 접근법을 채택하였지만, 그 방식에는 한계가 있었다. 이에 따라, 우리는 제한점을 극복하기 위해 통계적 방법론을 활용한 새로운 손실 함수와 스킵 연결구조를 통합하고 파라미터 튜닝을 진행하였다. 이 개선된 모델을 MVTec-AD 데이터세트의 텍스쳐 카테고리에 적용한 결과, 기존 방식보다 2.3% 높은 결함 분할 AUC를 기록하였고, 전체적인 결함 감지 성능도 향상되었다. 이 결과는 제안하는 방법이 특징맵 조합의 재건축을 통한 결함 탐지에 있어서 중요한 기여함을 입증한다.

• 한국건설관리학회:학술대회논문집
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• 한국건설관리학회 2003년도 학술대회지
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• pp.460-464
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• 2003

아파트 재건축사업은 신축사업과 달리 재건축조한의 설립 등, 사업시행의 절차가 복잡하고, 개발사업의 타당성을 조사할 능력이 없는 비전문가들로 구성된 조합이 사업주체가 되어 자율적으로 추진하는 민간사업으로 재건축사업의 타당성을 분석하고 검증하는 객관적인 절차가 없는 상태에서 설계사, 시공사 등 많은 주체들이 참여함에 따라 각 주체별 이해관계가 복잡하게 얽혀있고 오해와 불신 비리와 분쟁 등 주민마찰의 온상이 되어왔다. 본 연구는 아파트 재건축사업 타당성조사 분석모델 개발을 위한 기초적인 연구로서 아파트 재건축사업을 수행한 경험이 있는 공공 및 민간업체를 대상으로 사업성분석의 절차와 분석항목, 사정기준을 조사하여 각 분석항목 및 분석정보의 흐름을 IDEF0 방법론을 이용하여 프로세스를 모델링하였다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권4호
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• pp.313-316
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• 2017

Mask ventilation, the first step in airway management, is a rescue technique when endotracheal intubation fails. Therefore, ordinary airway management for the induction of general anesthesia cannot be conducted in the situation of difficult mask ventilation (DMV). Here, we report a case of awake intubation in a patient with a huge orocutaneous fistula. A 58-year-old woman was scheduled to undergo a wide excision, reconstruction with a reconstruction plate, and supraomohyoid neck dissection on the left side and an anterolateral thigh flap due to a huge orocutaneous fistula that occurred after a previous mandibulectomy and flap surgery. During induction, DMV was predicted, and we planned an awake intubation. The patient was sedated with dexmedetomidine and remifentanil. She was intubated with a nasotracheal tube using a video laryngoscope, and spontaneous ventilation was maintained. This case demonstrates that awake intubation using a video laryngoscope can be as good as a fiberoptic scope.

• 대한두개안면성형외과학회지
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• 제23권4호
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• pp.139-151
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• 2022

Reconstructive surgery in the management of head and neck cancer has evolved to include structure-specific approaches in which organ-specific treatment algorithms help optimize outcomes. Tongue cancer management and reconstruction are surgical challenges for which well-executed reconstructive plans should be completed promptly to avoid delaying any subsequently planned oncologic treatment. Crucial considerations in tongue cancer resection are the significant functional morbidity associated with surgical defects, particularly in terms of speech and swallowing, and the consequent negative impact on patients' quality of life. With the evolution of microsurgical techniques and the development of the perforator flap concept, flap options can be tailored to the characteristics of various tongue defects. This has allowed the implementation of pliable flaps that can help restore tongue mobility and yield subsequent functional outcomes. Using an evolutional framework, we present this series of reviews related to tongue reconstruction. The first part of the review summarizes flap options and flap-related factors, such as volume and tissue characteristics. Related functional aspects are also presented, including tongue mobility, speech, and swallowing, as well as ways to evaluate and optimize these outcomes.

• 국제학술발표논문집
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• The 9th International Conference on Construction Engineering and Project Management
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• pp.1059-1066
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• 2022

In 2020, it was estimated that more than 2.4 million households in South Korea are over 30 years old. That is, more than 40% of all houses in Korea are old and that they require proper rehabilitation. The two options to improve poor living conditions are reconstruction and remodeling. Compared to reconstruction, remodeling has advantages in terms of the construction period, cost, and environmental impact. As such, the current Korean regulations are more favorable for remodeling than reconstruction. Typically, several candidate floor plans are presented in the early stages of an apartment remodeling project. Extracting information about bearing walls and other structural elements from the multiple plans to compare those plans quantitatively is one of the essential tasks during the early stage of a project. To cope with this task, an automated data extraction method for walls and slabs from before and after remodeling plans is developed. Through the developed program, load-bearing walls, non-bearing walls, slabs, and weight changes after remodeling can be analyzed and visualized in a fast and automated manner.