• Archives of Reconstructive Microsurgery
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• v.14 no.2
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• pp.105-111
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• 2005

Perforator flaps have become increasingly popular in microsurgery nowadays and are being used widely for many cases of reconstruction after trauma and cancer ablation. And thoracodorsal perforator based free flap is one of them having the merits of carrying a large skin paddle with leaving intact innervation and function of the remaining latissimus dorsi muscle. We made a homogeneous thin flap excluding the main muscle with a long vascular pedicle and tried to decrease the donor site morbidity. But, it needs a long learning-curve and we have met marginal flap necrosis frequently. Besides, prolonged operation time for complete perforator dissection may be a tedious job to the microsurgeon. To overcome these disadvantages, we usually included very small portion of the latissimus dorsi muscle during this flap elevation around the pedicled 2-3 thoracodorsal perforators during this flap elevation. We performed 3 cases of thoracodorsal perforator based free flap at Hallym university sacred heart hospital between May and August 2005 for the soft tissue defect of the scalp and feet. The average flap size was $8{\times}14\;cm$. Although it is not a true perforator flap, we can get the reliability for the flap survival with much better blood circulation and save the time of one or two hours to dissect the perforators completely. All cutaneous flaps survived completely without any complication except one fatty female who had the very small superficial fat necrosis due to flap bulkiness. We believe the thoracodorsal perforator based free flap can be extended its versatility and reliability by including the very small portion of the muscle around the perforators.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.24 no.1
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• pp.33-40
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• 2013

Background and Objectives:This study is to objectively compare and analyze the acoustic changes in the patients with total thyroidectomy before and after RI therapy. Subjects and Methods:For this study, a total of 50 patients with total thyroidectomy were participated as subjects. Voice samples were obtained at the time of post-operation (Post-OP), before high-dose radioactive iodine therapy (Pre-RIT), and after high-dose radioactive iodine therapy (Post-RIT). Acoustic analysis, the maximum phonation time and K-VHI (Korea-Voice handicap index) were used for subjective evaluation. Results:According to the comparison analysis of the three periods, mFo (Hz) was significantly reduced in all of the vowels /a/ and /i/ as the hormone was discontinued. This can be related to the reduction in vocal range. As thyroid hormone was discontinued, Shim (%) and APQ (%) values, which are the parameters related to the degree of aggressiveness, showed a significant increase in the middle vowel /a/. As thyroid hormone was discontinued, emotional index was significantly decreased in VHI (voice handicap index). Conclusion:These results can be assumed that thyroid hormone suspension is related to the increased changes in the vocal intensity, the increase in noise and the reduction in vocal range. Emotionally, these data can be assumed that the responsive factors of one's own voice disorders were significantly decreased in the patients with vocal handicap.

• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.103-108
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• 2014

Thyroglossal duct cyst (TGDC) carcinoma generally shows a favorable prognosis. If metastasis is present latently, it may not threaten the patient's life immediately. It has been shown, however, that larger than 1 cm papillary carcinoma (PC), level VI metastasis to the lymph node (LN), which is the nearest to the thyroid, independently predicts a worse prognosis. In the case presented herein, a 61-year-old female patient was diagnosed with an about 3 cm PC in the TGDC, particularly the columnar variant subtype, one of the aggressive variants. She had occult papillary thyroid microcarcinoma, but no LN metastasis. Even though she underwent the Sistrunk procedure and total thyroidectomy with central compartment neck dissection followed by high-dose radioactive iodine remnant ablation, however, the cancer cells spread to level IV neck LN, and finally to the lung. Therefore, when a patient is diagnosed with an aggressive histologic variant of PC in the TGDC, even without LN metastasis, the invasive surgical approach and close postoperative surveillance are necessary, with consideration of the risk of disease progression. Therefore, if it is possible to stratify the risk for patients, higher-risk patients can be offered a more invasive therapeutic approach.

• Journal of the Optical Society of Korea
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• v.12 no.4
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• pp.309-313
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• 2008

We studied the sapphire and germanium fibers to determine which optical fiber best transmits Erbium:YAG laser for intracorporeal lithotripsy. Human calculi were ablated with an Erbium:YAG laser in contact mode using two fibers. Optical outputs at the distal end of fibers were measured before and after laser lithotripsy. Upon the irradiation on the calculus with the 50 mJ and 100 mJ pulse energy, the output energy at the distal end of germanium fiber declined to approximately 50% of the input energy. For the sapphire fiber, the output energy at the distal end remained unchanged with 100 mJ input energy; however the output energy had dropped to 50% for 200 mJ input energy. In order to examine how the types of target tissue affect the fiber damage, the sapphire fiber was tested for the irradiation on soft tissue and water as well. No energy decline was observed during soft tissue and water irradiation. We also characterized ablation craters with both optical fibers. Both fibers produced similar craters on calculi in terms of depth and diameter. Sapphire fibers are better suited than germanium fibers for Erbium:YAG lithotripsy in terms of the fiber damage.

• Archives of Craniofacial Surgery
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• v.22 no.5
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• pp.268-275
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• 2021

Background: The study aimed to evaluate nasal reconstruction techniques customized for Asians. The currently available nasal reconstruction guidelines are based on Caucasian patients, and their applicability is limited in Asian patients due to differences in anatomical and structural features. Methods: A retrospective analysis was performed of the medical records of 76 patients who underwent nasal reconstruction at a single center between January 2010 and June 2020. A comprehensive evaluation was conducted of patients' baseline demographics and clinical characteristics, including age, sex, medical history, defect size and location, reconstructive procedure, pathological diagnosis, postoperative complications, and recurrence. Results: In 59 cases (77%), nasal defects resulted from tumor ablation, and the remaining 17 cases involved post-traumatic (20%) and infection-induced (3%) tissue damage. The most common defect location was the alae, followed by the sidewalls, tip, and dorsum. Forehead flaps were the most commonly used reconstructive technique, followed by nasolabial advancement flaps, rotation flaps, and skin grafts. Each procedure was applied considering aspects of structural anatomy and healing physiology specific to Asians. Complications included nasal deformity, hypertrophic scarring, secondary infection, and partial flap necrosis, but no cases required additional surgical procedures. Tumors recurred in two cases, but tumor recurrence did not significantly affect flap integrity. Conclusion: Nasal reconstruction techniques applied considering Asians' facial features resulted in fewer postoperative complications and higher patient satisfaction than the approaches that are currently in widespread use. Therefore, this study is expected to serve as an essential reference for establishing treatment guidelines for nasal reconstruction in Asians.

• Journal of Korean Neurosurgical Society
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• v.62 no.3
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• pp.353-360
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• 2019

Epilepsy surgery that eliminates the epileptogenic focus or disconnects the epileptic network has the potential to significantly improve seizure control in patients with medically intractable epilepsy. Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has been an established option for epilepsy surgery since the US Food and Drug Administration cleared the use of MRgLITT in neurosurgery in 2007. MRgLITT is an ablative stereotactic procedure utilizing heat that is converted from laser energy, and the temperature of the tissue is monitored in real-time by MR thermography. Real-time quantitative thermal monitoring enables titration of laser energy for cellular injury, and it also estimates the extent of tissue damage. MRgLITT is applicable for lesion ablation in cases that the epileptogenic foci are localized and/or deep-seated such as in the mesial temporal lobe epilepsy and hypothalamic hamartoma. Seizure-free outcomes after MRgLITT are comparable to those of open surgery in well-selected patients such as those with mesial temporal sclerosis. Particularly in patients with hypothalamic hamartoma. In addition, MRgLITT can also be applied to ablate multiple discrete lesions of focal cortical dysplasia and tuberous sclerosis complex without the need for multiple craniotomies, as well as disconnection surgery such as corpus callosotomy. Careful planning of the target, the optimal trajectory of the laser probe, and the appropriate parameters for energy delivery are paramount to improve the seizure outcome and to reduce the complication caused by the thermal damage to the surrounding critical structures.

• Nutrition Research and Practice
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• v.13 no.4
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• pp.286-294
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• 2019

BACKGROUND/OBJECTIVES: Docosahexaenoic acid (DHA), an n-3 long chain polyunsaturated fatty acid (LCPUFA), is acquired by dietary intake or the in vivo conversion of ${\alpha}$-linolenic acid. Many enzymes participating in LCPUFA synthesis are regulated by peroxisome proliferator-activated receptor alpha ($PPAR{\alpha}$). Therefore, it was hypothesized that the tissue accretion of endogenously synthesized DHA could be modified by $PPAR{\alpha}$. MATERIALS/METHODS: The tissue DHA concentrations and mRNA levels of genes participating in DHA biosynthesis were compared among $PPAR{\alpha}$ homozygous (KO), heterozygous (HZ), and wild type (WT) mice (Exp I), and between WT mice treated with clofibrate ($PPAR{\alpha}$ agonist) or those not treated (Exp II). In ExpII, the expression levels of the proteins associated with DHA function in the brain cortex and retina were also measured. An n3-PUFA depleted/replenished regimen was applied to mitigate the confounding effects of maternal DHA. RESULTS: $PPAR{\alpha}$ ablation reduced the hepatic Acox, Fads1, and Fads2 mRNA levels, as well as the DHA concentration in the liver, but not in the brain cortex. In contrast, $PPAR{\alpha}$ activation increased hepatic Acox, Fads1, Fads2, and Elovl5 mRNA levels, but reduced the DHA concentrations in the liver, retina, and phospholipid of brain cortex, and decreased mRNA and protein levels of the brain-derived neurotrophic factor in brain cortex. CONCLUSIONS: LCPUFA enzyme expression was altered by $PPAR{\alpha}$. Either $PPAR{\alpha}$ deficiency or activation-decreased tissue DHA concentration is a stimulus for further studies to determine the functional significance.

• The Korean Journal of Pain
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• v.32 no.2
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• pp.113-119
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• 2019

Background: Discogenic pain is a common cause of disability and is assumed to be a major cause of non-specific low back pain. Various treatment methods have been used for the treatment of discogenic pain. This study was conducted to compare the therapeutic success of radiofrequency (an intradiscal procedure) and laser annuloplasty (both an intradiscal and extradiscal procedure). Methods: This single-center study included 80 patients and followed them for 6 months. Transforaminal laser annuloplasty (TFLA, 37 patients) or intradiscal radiofrequency annuloplasty (IDRA, 43 patients) was performed. The main outcomes included pain scores, determined by the numeric rating scale (NRS), and Oswestry disability index (ODI), at pre-treatment and at post-treatment months 1 and 6. Results: The patients were grouped according to procedure. In all procedures, NRS and ODI scores were significantly decreased over time. Mean post-treatment pain scores at months 1 and 6 were significantly lower (P < 0.01) in both groups, and between-group differences were not significant. The ODI score was also significantly decreased compared with baseline. Among patients undergoing TFLA, 70.3% (n = 26) reported pain relief (NRS scores < 50% of baseline) at post-treatment 6 months, vs. 58.1% (n = 25) of those undergoing IDRA. There were no statistically significant differences between the groups in ODI reduction of > 40%. Conclusions: Our results indicate that annuloplasty is a reasonable treatment option for carefully selected patients with lower back and radicular pain of discogenic origin, and TFLA might be superior to IDRA in patients with discogenic low back pain.

• Journal of Oral Medicine and Pain
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• v.43 no.4
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• pp.131-135
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• 2018

Purpose: To investigate the correlation between the amount of salivary metal ions released from fixed prostheses and the period of restoration insertion, and to evaluate the correlation between the type and amount of metal ions in saliva and oral lesions (OL). Methods: Based on the oldest prosthesis, we divided patients into two groups: more than 5 years (n=19) and less than 5 years (n=10). Patients were also divided into two groups by another criteria: the one with the presence (n=15), and the one with absence (n=14) of OL, and the amounts of metal ions were examined. Metal ions-gold (Au), copper, cobalt (Co), chromium (Cr), nickel, zinc, aluminum, palladium (Pd), tin, and platinum (Pt)-were measured using laser ablation microprobe inductively coupled plasma mass spectrometry. Results: Significantly higher quantities of Co, Pt, and Pd ions were released in patients with fixed prosthesis of more than 5 years (p<0.05). Measurement of the average amount of salivary metal ions was performed on patients with and without OL - Significantly higher amounts of Cr, Pd and Au ions were released in patients with OL (p<0.05). Conclusions: Old prostheses (${\geq}5years$) released metal ions, and among them were Co, Pt and Pd ions more than others. Patients with OL showed significantly higher levels of ion release, especially Cr, Pd and Au. There was a positive correlation between the amount of a certain kind of released metal ions, especially Pd, and the development of OL. Salivary Pd ion released from old prostheses could affect the pathogenesis of OL; therefore, long-term follow-up is important.

• Journal of the Korean Society for Aeronautical & Space Sciences
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• v.47 no.9
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• pp.629-641
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• 2019

In order to limit the temperature rise of the structure to a certain level or less while maintaining the aerodynamic shape of solid rocket nozzle by effectively blocking a large amount of heat introduced by the combustion gas of high temperature and high pressure, the heat-resistant materials such as C/C composite having excellent ablation resistance are applied to a position in contact with the combustion gas, and the heat-insulating materials having a low thermal diffusivity are applied to the backside thereof. SiC/SiC composite, which has excellent oxidation resistance, is applied to gas turbine engines and contributes to increase engine performance due to light weight and heat-resistant improvement. Scramjet, flying at hypersonic speed, has been studying the development of C/SiC structures using the endothermic fuel as a coolant because the intake air temperature is very high. In this paper, characteristics, application examples, and development trends of various heat-resistant composites used in solid rocket nozzles, gas turbine engines, and ramjet/scramjet propulsions were discussed.