• Archives of Reconstructive Microsurgery
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• v.15 no.2
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• pp.92-100
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• 2006

Radial forearm free flap (RFFF) has been established itself as a versatile and widely used method for reconstruction of the head and neck, although it is still criticized for high mortality of donor site. Delayed wound healing, cosmetic deformity, vascular compromise and potentially reduced wrist function have many plastic surgeons hesitate to adapt it as a first choice in micro-reconstruction. To overcome these drawbacks, some techniques for donor-site repair such as V-Y advancement with full thickness skin graft (FTSG), application of artificial dermis ($Terudermis^{(R)}$) or acellular dermal matrix ($AlloDerm^{(R)}$), and double-opposing rhomboid transposition flap have been reported. Authors performed 4 cases of RFFF in old-aged patients of the head and neck cancer from April 2005 to February 2006. We compared the outcomes of donor site of RFFF which were resurfaced with split thickness skin graft (STSG) only and STSG overlying an $AlloDerm^{(R)}$. Patients were all males ranging from 59 to 74 years old (mean, 67.5). Three of them had tongue cancers, and the other showed hypopharyngeal cancer. All cases were pathologically confirmed as squamous cell carcinomas. We included the deep fascia into the flap, so called subfascially elevated RFFF in three cases, and in the other one, we dissected the RFFF suprafascially leaving the fascia intact. The donor site of the suprafascially elevated RFFF was resurfaced with STSG only. Among three of subfascially elevated RFFFs, donor-sites were covered with thin STSG only in one case, and STSG overlying $AlloDerm^{(R)}$ in two cases. All RFFFs were survived completely without any complication. The donor site of the suprafascially elevated RFFF was taken well with STSG only. But, the partial graft loss exposing brachioradialis and flexor carpi radialis muscle was unavoidable in all the subfascially elevated RFFFs irregardless of $AlloDerm^{(R)}$ application. Considering that many patients of the head and neck cancer are in old ages, we believe the RFFF is still a useful and versatile choice for resurfacing the head and neck region after cancer ablation. Its reliability and functional characteristics could override its criticism for donor site in old-aged cancer patients.

• Journal of Chest Surgery
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• v.31 no.8
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• pp.763-769
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• 1998

Background: Supravalvular aortic stenosis is a rare form of congenital cardiac anomaly involving ascending aorta distal to coronary orifice. Materials and methods: We operated 12 cases of supravalvular aortic stenosis between July 1986 and March 1997. Age ranged from 4 to 17(mean 10.2) years and 11 of them were male. Nine patients had clinical features of Williams syndrome. We experienced two types of supravalvular aortic stenosis, including 10 hour glass type and 2 diffuse type. Results: Preoperative transaortic pressure gradient ranged from 40 to 180(mean 92) mmHg by cardiac catheterization. Pulmonary stenosis was associated in 5 and 2 of them required angioplasty. Operative techniques included 6 standard aortoplasty with elliptical patch, 4 extended aortoplasty with inverted Y shaped patch, and 2 modified Brom's repair. There were no operative deaths. Postoperative echocardiographic evaluation was done at a mean interval of 12 months. Grade I or II aortic regurgitation was found in 3 cases. Postoperative cardiac catheterization revealed a mean transaortic pressure gradient of 26 (range 0 to 75) mmHg. A mean pressure drop was 78(range 30 to 114) mmHg. All patients were followed up for a mean of 40(range 1 to 67) months with uneventful clinical course. Conclusions: Our data proved the low mortality and excellent hemodynamic improvement after surgical relief of supravalvular aortic stenosis in children.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.96-99
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• 2009

We report here on a case of a ruptured sinus of a valsalva aneurysm into the left ventricle with the rupture site communicating with both the left coronary sinus and the noncoronary sinus in a 37-year-old male who presented with symptoms of congestive heart failure. Echocardiography showed a sac-like structure around the sinus of valsalva, an enlarged left ventricle (LV) and severe aortic regurgitation, which all suggested a ruptured sinus of a valsalva aneurysm or an aortic-left ventricular tunnel. The operative findings revealed that both the left coronary sinus and the noncoronary sinus had an opening into the left ventricle. The proximal opening into the LV was closed with bovine pericardium and the aortic root was replaced with a composite graft (a 21 mm St. Jude Epic Supra tissue valve and a 24 mm Hemashild graft) by the modified Bentall procedure. The patient was discharged on the 15th postoperative day, and he was regularly followed up for 2 months. We report on this case due to its rarity and to describe the surgical repair techniques.

• Journal of Conservation Science
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• v.30 no.4
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• pp.457-466
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• 2014

Rigorous analysis was performed to identify the structure and materials of the murals to study techniques used on mural tombs of ancient Daegaya era(6th century). The murals were painted by applying mortar on the walls and the ceiling after building a stone chamber and creating ground layers on mortar layers. Mud was applied on most of the mortar layers on four sides of the walls except the ceiling. Sand was not used in mortar but was made of materials with pure calcium substances. In addition, shells in irregular sizes with incomplete calcination were mixed; and the mortar's white powder was inferred as lime obtained by calcination of oyster shells. Kaolinite($Al_2Si_2O_5(OH)_4$) was used in the ground layer, Cinnabar(HgS) was used for red pigment, Malachite($Cu_2CO_3(OH)_2$) for green and Lead white($PbCO_3{\cdot}Pb(OH)_2$) for white. Mud plaster was applied on the mortar and was composed thinly and densely using clayey of particle size smaller than that of medium sand. It was assumed that the finishing was for repair after long time had passed since the mortar layer came off. Using lime made with oyster shells as mortar is unprecedented in ancient Korean mural tombs and its durability was very poor, suggesting that Gaya's mortar production technique was relatively behind compared to that of Koguryo's in the same era.

• Journal of the Korean Society for Nondestructive Testing
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• v.33 no.4
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• pp.368-375
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• 2013

Failure of small bore piping welds is a recurring problem at nuclear power plants. And the socket weld cracking in small bore piping has caused unplanned plant shutdowns for repair and high economic impact on the plants. Consequently, early crack detection, including the detection of manufacturing defects, is of the utmost importance. Until now, the surface inspection methods has been applied according to ASME Section XI requirements. But the ultrasonic inspection as a volumetric method is also applying to enforce the inspection requirement. However, the conventional manual ultrasonic inspection techniques are used to detect service induced fatigue cracks. And there was uncertainty on manual ultrasonic inspection because of limited access to the welds and difficulties with contact between the ultrasonic probe and the OD(outer diameter) surface of small bore piping. In this study, phased array ultrasonic inspection technique is applied to increase inspection speed and reliability. To achieve this object, the 3.5 MHz phased array ultrasonic transducer are designed and fabricated. The manually encoded scanner was also developed to enhance contact conditions and maintain constant signal quality. Additionally inspection system is configured and inspection procedure is developed.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.59-66
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• 2010

Purpose: In the finger, there are three major palmar arches in the arterial system. The location of this arches are constant. The middle and distal transverse arches are consistently large (almost 1 mm) and may be used for arterial vessel repairs either proximally or distally, depending on the length and direction needed. This paper describes our experiences in reconstruction and replantation of the finger using rerouting the transverse digital palmar arch. Methods: 31 patients with injuries according to our classification were treated from March of 2005 to October of 2008. In this study the authors subdivided injuries into those with amputation distal to the insertion of the flexor digitorum profundus (Class I, 31 fingers); those with amputation distal to the insertion of the flexor digitorum superficialis (Class II, 4 fingers). Replantation was performed using the artery-only technique with neither vein nor nerve repair. Because the artery has been damaged, it is still possible to make a direct suture by transposing the arterial arch in an inverted Y to I arterial configuration or converting the arch. Venous drainage was provided by an external bleeding method with partial nail excision, medical leech, and repaired margin. Results: The success rate was 87% (n=27) in class I and 75% (n=4) in class II. The authors conclude that crushing and complete avulsion injuries & amputations are salvageable, with acceptable functional results in select patients, especially those with amputation distal to the insertion of the flexor digitorum superficialis. Conclusion: We performed replantation and reconstruction with only-arterial transposing anastomosis successfully, resulting in good recovery of aesthetic and functional outcome. Three major digital palmar arches, especially distal two branches, give us additional treatment options. In the finger replantation and reconstructive techniques using rerouting healthy the transverse digital palmar arch increase the survival rate of the finger.

• Journal of Trauma and Injury
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• v.22 no.1
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• pp.5-11
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• 2009

Purpose: The mortality and the amputation rates due to vascular trauma remain high despite advanced vascular surgical techniques and supportive management. The clinical features of patients with vascular trauma have not been well studied in the Korean population. The aim of this study was to analyze the clinical characteristics of patients with vascular trauma and to develop a database and guidelines for improving the outcomes of treatment. Methods: The medical records of 37 patients with traumatic vascular injuries who had visited in an emergency center between January 2002 and December 2006 were retrospectively reviewed and statistically analyzed. Results: The mean age was 37.8 years, and the male-to-female ratio was 5.2 : 1. The mechanism of vascular trauma was penetrating in 18 patients and blunt in 19 patients. Upper extremities were most frequently injured (39.4%). The treatment methods were primary repair in 21 patients, exploratory laparotomies in 7, radiological interventions in 3, resections and graft interpositions of the pseudoaneurysm in 3, observations in 3 and a bypass graft in 1. Four out of the 37 patients died, and three of these who died had injuried abdominal vessels. Twenty-five of the patients recovered completely, four expired, seven had neuropathy in the course of treatement, one had his limb amputated, and one experienced wound necrosis. Conclusion: Peripheral vessel injuries are commonly accompanied by nerve, muscle, or tendon injuries. Patients without associated fractures or compartment syndrome had good prognosis. Although the time intervals from hospital arrival to definite treatment were the shortest among patients with blunt abdominal vascular injuries, three expired. Therefore, we offer a 'ritical pathway'to improve the outcomes of patients with blunt abdominal vascular injury.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.170-174
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• 2010

Purpose: As techniques and instruments for video-assisted thoracic surgery (VATS) have been evolving, attempts to perform VATS for chest trauma have been increasing. Several studies have demonstrated the feasibility and safety of VATS for thoracic trauma. We reviewed our experience to evaluate the clinical feasibility and safety of VATS for thoracic trauma. Methods: Fifty-two patients underwent thoracic surgery for chest trauma in Asan Medical Center from January 1990 to December 2009. VATS was performed in 21 patients who showed stable vital signs. We reviewed retrospectively the medical records of those patients to investigate the results of VATS for thoracic trauma. Results: Thoracic exploration for chest trauma was performed in 52 patients. There were 46 males (88.5%) and 6 females (11.5%). The median age was 46.0 years (range: 11~81 years). There were 39 blunt and 13 penetrating traumas. A standard posterolateral thoracotomy was performed in 31 patients, and VATS was tried in 21 patients. We performed successful VATS in 13 patients; 11 males (84.5%) and 2 females (15.5%) with a median age of 46.0 years (range: 24~75 years). The indication of VATS was persistent intrathoracic hemorrhage in 10 patients and clotted hemothorax in 3 patients. There were no complications, but there were two mortalities due to multiple organ failure after massive transfusion. In 8 patients, VATS was converted to a standard posterolateral thoracotomy for several reasons. The reason was inadequate visualization for bleeding control or evacuation of the hematoma in 5 patients. In 3 patients, VATS was performed to evaluate diaphragmatic injury. After the diaphragmatic injury had been confirmed, a standard posterolateral thoracotomy was performed to repair the diaphragm. Conclusion: VATS should be safe and efficient method for diagnostic evaluation and surgical management of stable patients with thoracic trauma.

• Journal of the Society of Cosmetic Scientists of Korea
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• v.36 no.3
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• pp.215-219
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• 2010

In this study, we investigated effects of Monegy (mixture of Sophorae Radix, Panax ginseng, Salvia miltiorrhiza BUNGE) on epilate-induced hair-loss in dorsal region of C57/BL6 mice and external structure of human hair. For morphological and histological analysis in scalp of epilate-induced hair-loss animal model, we utilized several microscopic techniques, such as confocal laser scanning microscopy (CLSM) and LAS 4000. Confocal analysis showed the distribution of FITC-conjugated Monegy and penetration depth compared with normal and control group. Furthermore, when Monegy was topically administrated onto a C57BL6 mouse, it penetrated very well. The fluorescence intensity was increased upto 205 and 113 folds compared to normal and control group, respectively. Also, area of fluorescence was increased to upto 255 to 127 folds compared to normal and control group. Broad scale area of fluorescence in dermis region was observed in the Monegy-treated mice. Furthermore, Monegy induced upto 75% hair repair against depilation. It might be promoted via the induction of growth factors in hair follicle.

• Journal of the Korean Recycled Construction Resources Institute
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• v.7 no.4
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• pp.323-332
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• 2019

Non-curable rubberized polymer asphalt waterproof coating materials in Korea and China are manufactured without advanced quality control techniques and common standard, And they are exposed consistent water leakage problems. Import and application of Korean waterproofing products and installation methods is difficult in the present situation as the Chinese standard(JC/T 2428) is different in nature with the Korean counterpart products, And quality assurance is inevitable based on mutual standards. In order to resolve this issue, alternatives such as using standards provided by the ISO (International Organization for Standardization) are generally employed, but there is no such ISO standard as a waterproof material for non-curable rubberized polymer asphalt material. Furthermore, it is unreasonable to develop the ISO standard for rubber asphalt seals for exchange in terms of time and cost. This study proposes that the establishment of a quality standard that can be applied for both countries will be required via an joint international standard that outlines the properties of materials if applied in mutual trade exchange.