• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.13 no.2
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• pp.140-151
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• 2000

Acne is a common chronic disease which most frequently affects the face, appearing in both males and females near puberty, and in most cases becomes less active as adolescence ends. The intensity and duration of activity vary for each individual. The disease may be minor, with only a few comedones or papules, or it may occur as the highly inflammatory and diffusely scarring acne conglobation. Permanent scarring of the skin and psyche can result from such inaction. The disease, however, has implications far beyond the few marks that may appear on the face. The lesions cannot be hidden under clothing; each is prominently displayed and detracts significantly from one's personal appearance and self-esteem. Recently many of acne patients are visiting to Oriental Medicine Hospitals. They want to receive the treatment of acne related another disease and causes, or worry about side effects of antibiotics and hormone therapy. This study was performed at Pundang Cha Oriental Medicine Hospital Department of Dermatology from March 1, 1997 to February 29, 2000 in 31 patients with recurrent acne. We investigated the clinical findings, included distribution of age & sex, severity of acne, sites on face, related causes, duration of disease and causes of visiting Oriental Medicine Hospital and so on. The results were as follows : The peak age at onset was 20-29 years old in females with 16 cases reported. The 22 total cases patients had severe signs with most frequently sites being forehead & chin. They visited Oriental Medicine Hospital because they want to take the treatment of acne related with another body problems(12 cases) and worry about side effects of antibiotics. Twenty cases were diagnosed 肺熱血熱(20 cases). And given acupuncture treatment, herb-medication and sometimes we used external applications. Relatively, their satisfaction grade was high. Dermatologists are trying to treat new methods in order to remove scar and decrease sebaceous gland secretion,. And we, Oriental Medicine doctors, have to develop and offer to patients the most effective management and successful treatment of this disease.

• Tribology and Lubricants
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• v.36 no.3
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• pp.168-192
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• 2020

In recently designed diesel engines, the running conditions for piston-pin bearings have become severe because of the higher combustion pressure and increased temperature. Moreover, the metal removal from the bushing material has strongly reduced the ability of the antifriction material to accept asperity contacts. Therefore, it is necessary to find ways of reducing wear scar on the connecting-rod small-end bushing and piston-pin boss bearing related to the higher combustion pressure on the power cell of an engine. In this work, the position and level of material removal from the surfaces of the bushing and bearing under such severe operating conditions - for example, maximum power and torque conditions of a passenger car diesel engine - are estimated for several combinations of surface roughness. First, piston-pin rotating motion is investigated by calculating the friction coefficient at piston-pin bearings, the oil film thickness, and the frictional torques induced by hydrodynamic shear stress. Subsequently, the wear scarring on the surfaces of a connecting-rod small-end bushing and two piston-pin boss bearings related to piston-pin rotational motion is numerically calculated under the maximum power and torque operating conditions. This work is helpful to determine the reasonable surface roughness of the bushing and bearing for reducing wear volume occurring at the interface between a bearing and a shaft.

• Childhood Kidney Diseases
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• v.21 no.2
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• pp.114-120
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• 2017

Purpose: The aim of this study was to determine the clinical characteristics, frequency of renal abnormalities and benefits of a top-down approach in children with their first febrile urinary tract infection (UTI). Methods: We reviewed 308 patients retrospectively who were admitted to Yeungnam University Hospital and were treated for their first febrile UTI from February 2006 to December 2013. We performed a comparative analysis of laboratory findings and results of imaging techniques including a Tc-99m dimercaptosuccinic acid (DMSA) renal scan. Results: Among the patients, 69% (213/308) were males, and 90% (277/308) had their first UTI episode during infancy. A DMSA renal scan was performed on all patients, and showed positive findings in 60% (184/308) of cases. Laboratory indices of inflammation were significantly higher in the DMSA-positive group (P< 0.05). There was a statistically significant difference in the age distribution between the two groups. In the DMSA-positive group, 165 patients underwent voiding cystourethrography (VCUG), and 58 (35%) cases demonstrated vesicoureteral reflux. In total, 110 patients in the DMSA-positive group, underwent repeat scanning at 6 months; 33 children (30%) demonstrated static scarring, but 77 (70%) had improved completely. The concordance of the ultrasonography (US) and VCUG was low. Older patients had more renal scarring. Conclusion: DMSA is a sensitive method for assessing the severity of inflammation and kidney injury. However, the ability of US to predict renal parenchymal damage was limited. A top-down approach in children with their first febrile UTI showed significant value.

• Tribology and Lubricants
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• v.34 no.4
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• pp.146-159
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• 2018

This paper presents a wear analysis procedure for calculating the wear of journal bearings of a four-strokes and four-cylinder engine operating at a constant angular crank shaft speed during firing conditions. To decide whether the lubrication state of a journal bearing is in the possible region of wear scar, we utilize the concept of the centerline average surface roughness to define the most oil film thickness scarring wear (MOFTSW) on two rough surfaces. The wear volume is calculated from the wear depth and wear angle, determined by the magnitude of each film thickness on a set of oil films with thicknesses lower than the MOFTSW at every crank angle. To calculate the wear volume at one contact, the wear range ratio during one cycle is used. The total wear volume is then determined by accumulating the wear volume at every contact. The fractional film defect coefficient, asperity load sharing factor, and modified specific wear rate for the application of the mixed-elasto-hydrodynamic lubrication regime are used. The results of this study show that wear occurs only at the connecting-rod big-end bearing. Thus, simulation results of only the big-end bearing are illustrated and analyzed. It is shown that the wear volume of each wear scar group occurs consecutively as the crank angle changes, resulting in the total accumulated wear volume.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.245-249
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• 2005

Various surgical procedures have been described for treating osmidrosis axillare. Elimination of the apocrine glands is prime goal. Optimal operative procedure is characterized as follows: minimal axillary scar(which has cosmetic merits), less complications such as hematoma and seroma, short and less painful recuperating period, minimal damage to the skin and low recurrence rate. Three types of incision technique in subdermal shaving method have beeb commoly used. First, single incision method has an advantage of minimal scarring but more recurrence due to incomplete removal of apocrine glands may occur. Second, double incision technique(Bipedicled flap) has advantages of complete excision, low recurrence rate and relatively minimal scarring, but it could cause frequent necrosis of skin and folding of skin flap. Skoog's method is the third method, which makes four flaps by offset cruciate incisions. It is a better technique in aspect of complete excision of apocrine glands and low recurrence rate but has disadvantages such as development of hypertrophic scar or scar contracture in the line that lies perpendicular to natural axillary skin crease. We used a modified procedure which has shorter length in vertical and transverse incision compared with the classic Skoog's method. We dissected further subcutaneous tissue through the diamond-shaped incision and utilize wide operation field that provide adequate excision of subdermal tissue and proper hemostasis. Between 1999 and 2004, we operated 160 osmidrosis axillare in 80 patients in this technique. Most patients obtained satisfactory result with very low complications. Hematoma or seroma 3.1% Infection 0.6% Partial wound disruption 10% Recurrence 1.2%. Modified Skoog's method for treating osmidrosis axillae could be a optimal technique providing wide operation field for adequate excision of apocrine glands and proper hemostasis and leaving relatively inconspicuous scar and low incidence of scar contracture.

• Tribology and Lubricants
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• v.34 no.3
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• pp.93-107
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• 2018

The purpose of Part I of this study is to find the potential region of wear scarring on engine journal bearings operating at a constant angular crank shaft velocity under firing conditions. To do this, we calculate the applied loads and eccentricities of a big-end journal bearing installed on a four-stroke and four-cylinder engine at every crank angle. Then, we find potential wear regions, such as a minimum oil film thickness, at every crank angle below most oil film thickness scarring wear (MOFTSW) obtained based on the concept of the centerline average surface roughness. Thus, the wear region is defined as a set of each film thickness below the MOFTSW at every crank angle. In this region, the wear volume changes according to the wear depth and wear angle, depending on the minimum oil film thickness at every crank angle. The total wear volume is the summation during one cycle. Graphical views of the region in the two-dimensional coordinates show the crank angle and bearing angle along the journal center path, indicating the position of the minimum oil film thickness. The results of wear analysis show that the possible wear region is located at a few tens of angles behind the upper center of a big-end bearing at maximum power rpm.

• Archives of Plastic Surgery
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• v.42 no.6
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• pp.729-734
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• 2015

Background Insufficient satisfaction outcome literature exists to assist consultations for scar revision surgery; such outcomes should reflect the patient's perspective. The aim of this study was to prospectively investigate scar revision patient satisfaction outcomes, according to specified patient-selection criteria. Methods Patients (250) were randomly selected for telephone contacting regarding scar revisions undertaken between 2007-2011. Visual analogue scores were obtained for scars pre- and post-revision surgery. Surgery selection criteria were; 'presence' of sufficient time for scar maturation prior to revision, technical issues during or wound complications from the initial procedure that contributed to poor scarring, and 'absence' of site-specific or patient factors that negatively influence outcomes. Patient demographics, scar pathogenesis (elective vs. trauma), underlying issue (functional/symptomatic vs. cosmetic) and revision surgery details were also collected with the added use of a real-time, hospital database. Results Telephone contacting was achieved for 211 patients (214 scar revisions). Satisfaction outcomes were '2% worse, 16% no change, and 82% better'; a distribution maintained between body sites and despite whether surgery was functional/symptomatic vs. cosmetic. Better outcomes were reported by patients who sustained traumatic scars vs. those who sustained scars by elective procedures (91.80% vs. 77.78%, P=0.016) and by females vs. males (85.52% vs. 75.36%, P<0.05), particularly in the elective group where males (36.17%) were more likely to report no change or worse outcomes versus females (16.04%) (P<0.01). Conclusions Successful scar revision outcomes may be achieved using careful patient selection. This study provides useful information for referring general practitioners, and patient-surgeon consultations, when planning scar revision.

• Archives of Plastic Surgery
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• v.44 no.1
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• pp.34-41
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• 2017

Background The current indications of cardiac implantable electronic devices (CIEDs) have expanded to include young patients with serious cardiac risk factors, but CIED placement has the disadvantage of involving unsightly scarring and bulging of the chest wall. A collaborative team of cardiologists and plastic surgeons developed a technique for the subpectoral placement of CIEDs in young female patients via a transaxillary approach. Methods From July 2012 to December 2015, subpectoral CIED placement via an axillary incision was performed in 10 young female patients, with a mean age of 25.9 years and mean body mass index of $20.1kg/m^2$. In the supine position, with the patient's shoulder abducted, an approximately 5-cm linear incision was made along one of the deepest axillary creases. The submuscular plane was identified at the lateral border of the pectoralis major, and the dissection continued over the clavipectoral fascia until the subpectoral pocket could securely receive a pulse generator. Slight upward dissection also exposed an entrance to the subclavian vein, allowing the cardiology team to gain access to the vein. One patient with dilated cardiomyopathy underwent augmentation mammoplasty and CIED insertion simultaneously. Results One case of late-onset device infection occurred. All patients were highly satisfied with the results and reported that they would recommend the procedure to others. Conclusions With superior aesthetic outcomes compared to conventional methods, the subpectoral placement of CIEDs via a transaxillary approach is an effective, single-incision method to hide operative scarring and minimize bulging of the device, and is particularly beneficial for young female or lean patients.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.513-519
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• 2014

Background Currently, breast conservation therapy is commonly performed for the treatment of early breast cancer. Depending on the volume excised, patients may require volume replacement, even in cases of partial mastectomy. The use of the latissimus dorsi muscle is the standard method, but this procedure leaves an unfavorable scar on the donor site. We used an endoscope for latissimus dorsi harvesting to minimize the incision, thus reducing postoperative scars. Methods Ten patients who underwent partial mastectomy and immediate partial breast reconstruction with endoscopic latissimus dorsi muscle flap harvest were reviewed retrospectively. The total operation time, hospital stay, and complications were reviewed. Postoperative scarring, overall shape of the reconstructed breast, and donor site deformity were assessed using a 10-point scale. Results In the mean follow-up of 11 weeks, no tumor recurrence was reported. The mean operation time was 294.5 (${\pm}38.2$) minutes. The postoperative hospital stay was 11.4 days. Donor site seroma was reported in four cases and managed by office aspiration and compressive dressing. Postoperative scarring, donor site deformity, and the overall shape of the neobreast were acceptable, scoring above 7. Conclusions Replacement of 20% to 40% of breast volume in the upper and the lower outer quadrants with a latissimus dorsi muscle flap by using endoscopic harvesting is a good alternative reconstruction technique after partial mastectomy. Short incision benefits from a very acceptable postoperative scar, less pain, and early upper extremity movement.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.603-609
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• 2013

Background Although the conventional direct brow lift operation provides a simple means of managing lateral brow ptosis, the scars produced have been unacceptable. However, using the modifications proposed here, scarring showed remarkable improvement. This article reviews our experiences with the presented technique, mainly with respect to postoperative scarring. Methods Measured amounts of supra-eyebrow skin and subcutaneous fat were excised en bloc in the conventional manner under 'hyper-hydrated' local infiltration anesthesia. The lower flap and the edge of the upper flap were undermined above the muscular plane, and the orbicularis oculi muscle was directly suture-plicated and suspended upward to the distal frontalis muscle. Skin closure was performed in a basic plastic surgical manner. Results From April 2007 to April 2012, a consecutive series of 60 patients underwent surgery using the above method. The average width of the excised skin was 8 mm (range, 5-15 mm) at the apex of the eyebrow. Preoperative complaints were resolved without occurrence of significant complications. The surgical scars showed remarkable improvement and were negligible in the majority of the cases. Conclusions The direct brow lift operation combined with plication/suspension of the superior and lateral portion of the orbicularis oculi muscle provides a simple, safe, and predictable means of correcting lateral brow ptosis. The scars were acceptable to all of the patients. For proper management of the frontalis tone, upper blepharoplasty and/or repair of eyelid levator function must be considered in addition to brow lift procedures.