• Archives of Plastic Surgery
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• v.46 no.1
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• pp.39-45
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• 2019

Background The dorsolateral branch of the posterior intercostal artery (DLBPI) can be easily found while harvesting a latissimus dorsi (LD) musculocutaneous flap for breast reconstruction. However, it remains unknown whether this branch can be used for a free flap and whether this branch alone can provide perfusion to the skin. We examined whether the DLBPI could be reliably found and whether it could provide sufficient perfusion. Methods We dissected 10 fresh cadavers and counted DLBPIs with a diameter larger than 2 mm. For each DLBPI, the following parameters were measured: distance from the lateral margin of the LD muscle, level of the intercostal space, distance from the spinal process, and distance from the inferior angle of the scapula. Results The DLBPI was easily found in all cadavers and was reliably located in the specified area. The average number of DLBPIs was 1.65. They were located between the seventh and eleventh intercostal spaces. The average length of the DLBPI between the intercostal space and the LD muscle was 4.82 cm. To assess the perfusion of the DLBPIs, a lead oxide mixture was injected through the branch and observed using X-rays, and it showed good perfusion. Conclusions The DLBPI can be used as a pedicle in free flaps for small defects. DLBPI flaps have some limitations, such as a short pedicle. However, an advantage of this branch is that it can be reliably located through simple dissection. For women, it has the advantage of concealing the donor scar underneath the bra band.

• Archives of Plastic Surgery
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• v.50 no.4
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• pp.354-360
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• 2023

Background The Island transverse rectus abdominis musculocutaneous (TRAM) flap is well vascularized with very reliable blood flow, because all perforators of the zone I are included when it is harvested. The number of perforators, topographic mapping, and their relationship with reconstructed outcomes were investigated. Methods Fifty patients with Island TRAM breast reconstruction from September 2021 to August 2022 were investigated. The zone I was divided into a total of eight sections. Under the loupe magnification, all perforators larger than 0.5 mm in zone I were counted with fine dissection, and photographs were taken in background of vessel loops. Complications like flap necrosis, seroma, and hematoma were also investigated. Result There are 12 ideal perforators on average in zone I such as one perforator in section I, II, IV, V, VI, VIII, and three perforators in section III and VII. However, two perforators (M6 and L6) below arcuate line were sacrificed in the time of flap harvest to prevent hernia. Island TRAM included 10 perforators on average (5 perforators in each side) above arcuate line to be transferred to the recipient site. Only minor complications were identified. Conclusion The Island TRAM flap includes 10 perforators to get the vigorous blood flow. The periumbilical to upper medial perforators become more dominant in the perfusion of the flap after deep inferior epigastric artery division. Well preserved perforators will guarantee the satisfactory breast reconstruction with the least complication.

• Proceedings of the Plant Resources Society of Korea Conference
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• 2021.04a
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• pp.9-9
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• 2021

Mutation breeding is useful for improving agronomic characteristics of various crops. In this study, we constructed soybean Mutant Diversity Pool (MDP) from 1,695 gamma-irradiated mutants through two selection phases over M1 to M12 generations; we selected 523 mutant lines exhibiting at least 30% superior agricultural characteristics, and, second, we eliminated redundant morphological phenotypes in the M12 generation. Finally, we constructed 208 MDP lines and investigated 11 agronomic traits. We then assessed the genetic diversity and inter-relationships of these MDP lines using target region amplification polymorphism (TRAP) markers. Among the different TRAP primer combinations, polymorphism levels and PIC values averaged 59.71% and 0.15, respectively. Dendrogram and population structure analyses divided the MDP lines into four major groups. According to an analysis of AMOVA, the percentage of inter-population variation among mutants was 11.320 (20.6%), whereas mutant inter-population variation ranged from 0.231 (0.4%) to 14.324 (26.1%). Overall, the genetic similarity of each cultivar and its mutants were higher than within other mutant populations. In an analysis of the genome-wide association study (GWAS) using based on the genotyping-by-sequencing (GBS), we detected 66 SNPs located on 13 different chromosomes were found to be highly associated with four agronomic traits: days of flowering (33 SNPs), flower color (16 SNPs), node number (6 SNPs), and seed coat color (11 SNPs). These results are consistent with those previously reported for other genetic resource populations, including natural accessions and recombinant inbred line. Our observations suggest that genomic changes in mutant individuals induced by gamma rays occurred at the same loci as those of natural soybean population. This study has demonstrated that the integration of GBS and GWAS can serve as a powerful complementary approach to gamma-ray mutation for the dissection of complex traits in soybean.

• Journal of Gastric Cancer
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• v.23 no.4
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• pp.598-608
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• 2023

Purpose: Lymph node (LN) metastasis is a crucial factor in the prognosis of patients with gastric cancer (GC) and is known to occur more frequently in cases with an advanced T stage. This study aimed to analyze the survival data of patients with advanced LN metastasis in T1 GC. Materials and Methods: From January 2008 to June 2018, 677 patients with pathological stage II GC who underwent radical gastrectomy were divided into an early GC group (EG: T1N2 and T1N3a, n=103) and an advanced GC (AGC) group (AG: T2N1, T2N2, T3N0, T3N1, and T4aN0, n=574). Short- and long-term survival rates were compared between the 2 groups. Results: A total of 80.6% (n=83) of the patients in the EG group and 52.8% (n=303) in the AG group had stage IIA AGC. The extent of LN dissection, number of retrieved LNs, and short-term morbidity and mortality rates did not differ between the 2 groups. The 5-year relapse-free survival (RFS) of all patients was 87.8% and the overall survival was 84.0%. RFS was lower in the EG group than in the AG group (82.2% vs. 88.7%, P=0.047). This difference was more pronounced among patients with stage IIA (82.4% vs. 92.9%, P=0.003). Conclusions: T1 GC with multiple LN metastases seems to have a worse prognosis compared to tumors with higher T-stages at the same level. Adjuvant chemotherapy is highly recommended for these patients, and future staging systems may require upstaging T1N2-stage tumors.

• Archives of Plastic Surgery
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• v.50 no.6
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• pp.627-634
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• 2023

In recent decades, a number of simulation models for microsurgical training have been published. The human placenta has received extensive validation in microneurosurgery and is a useful instrument to facilitate learning in microvascular repair techniques as an alternative to using live animals. This study uses a straightforward, step-by-step procedure for instructing the creation of simulators with dynamic flow to characterize the placental vascular tree and assess its relevance for plastic surgery departments. Measurements of the placental vasculature and morphological characterization of 18 placentas were made. After the model was used in a basic microsurgery training laboratory session, a survey was given to nine plastic surgery residents, two microsurgeons, and one hand surgeon. In all divisions, venous diameters were larger than arterial diameters, with minimum diameters of 0.8 and 0.6 mm, respectively. The majority of the participants considered that the model faithfully reproduces a real microsurgical scenario; the consistency of the vessels and their dissection are similar in in vivo tissue. Furthermore, all the participants considered that this model could improve their surgical technique and would propose it for microsurgical training. As some of the model's disadvantages, an abundantly thick adventitia, a thin tunica media, and higher adherence to the underlying tissue were identified. The color-perfused placenta is an excellent tool for microsurgical training in plastic surgery. It can faithfully reproduce a microsurgical scenario, offering an abundance of vasculature with varying sizes similar to tissue in vivo, enhancing technical proficiency, and lowering patient error.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.22 no.2
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• pp.223-234
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• 1992

The purpose of this study was to investigate the changes of periodontal tissues in the irradiated mandibular bone in rats which were fed normal diet and low calcium diet In order to carry out this experiment, 64 seven-week old Sprague-Dawley strain rats weighing about 150gms were selected and equally divided into one experimental group of 32 rats and one control group with the remainder. The experimental group and the control group were then subdivided into two groups when the rats reached the age of 10 weeks, 16 rats were allotted for each subdivided group was composed of 16 rats and exposed to irradiation. The two groups were irradiated a single dose of 20Gy on the only jaw area and irradiated with a cobalt-60 teletherapy unit The rats in the control and experimental groups were serially dissected by fours on the 3rd, the 7th, the 14th, and the 21st day after irradiation. After each dissection, both sides of the dead rat mandibular bodies were removed and fixed with 10% neutral formalin. The specimens sectioned and observed in histopathological. histochemical. and immunocellular chemical methods. The obtained results were as follows: 1. In the mandibles of rats with low calcium diet the increased number of fibroblasts of periodontal ligaments. many small capillaries and irregular arrangement of loose collagen fibers were detected and the partial resorption of dentin and cementum could be found by the microscopic studies. 2. In the group of irradiated rats, degenerated periodontal tissues led to the condition of irregular arrangement of collagen fibers and the decreased number of fibroblasts. But this condition was somewhat restored after 21 days of experiment. 3. Periodontal tissues of the irradiated rat group with low calcium diet were destroyed earlier than those of the irradiated rat group with normal diet. Soon this condition was restored and then high cellularity and dense collagen fibers were observed. 4. Many periodontal cells bearing tumor necrosis factor could be clearly observed in the nonirradiated group of rats with normal diet, whereas could not be observed on the 7th day and reappeared on 14th day in the irradiated group of rats with normal diet. A few of them could be observed in the group of rats with low calcium diet, but they could be clearly observed in the both groups after 21 days of experiment.

• Journal of Gastric Cancer
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• v.9 no.1
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• pp.14-17
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• 2009

The clinical significance of hepatic resection for gastric metastases is controversial, even though hepatic resection has been widely accepted as a modality for colorectal metastases. Very few patients with gastric hepatic metastases are good candidates for hepatic resection because of multiple bilateral metastases, extrahepatic disease, or advanced cancer progression, such as peritoneal dissemination or extensive lymph node metastases. Therefore, several authors have reported the clinical significance of hepatic resection for gastric metastases in a small number of patients. Considering the present results with previous reports. The number and distribution of tumors in hepatic metastases from gastric cancer was considered based on the present and previous reports. Several authors have reported significantly better survival in patients with metachronous metastasis than in those with synchronous disease. However, metachronous hepatic resection necessitates the dissection of adhesions between the pancreas, liver, and residual stomach to prepare for Pringle's maneuver. Patients with unilobar liver metastasis, and/or metastatic tumors <4 cm in diameter may be good candidates for hepatic resection. Synchronous metastasis is not a contraindication for hepatic resection. Most of the long-term survivors underwent anatomic hepatic resection with a sufficient resection margin. After hepatic resection, the most frequent site of recurrence was the remaining liver, which was associated with a high frequency of mortality within 2 years. A reasonable strategy for improvement in survival would be to prevent recurrence by means of adjuvant chemotherapy and careful follow-up studies.

• Annals of Occupational and Environmental Medicine
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• v.34
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• pp.30.1-30.13
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• 2022

Background: Although working hours have decreased in Korea, they are still high compared to that of other countries. In Korea, cardiovascular and cerebrovascular diseases (CCVDs) related to overwork in Korea continually occur, and the social burden from overwork is estimated to be high. This study investigated the amendment of regulations affecting the approval rate of occupational CCVDs. Methods: The change in approval rate of occupational CCVDs and related regulations were investigated using the Act and public notice on the standards for recognition of occupational CCVDs and the yearbooks of the Ministry of Employment and Labor. The CCVD mortality was estimated using data on the number of deaths according to the cause of death, the number of employed people, and resident registration population aged 15-64 years. The cumulative mortality of CCVDs was estimated using the Kaplan-Meier method. Results: Since the establishment of the standards for recognition in Korea in 1982, the scope of occupational diseases has been expanded to include intracerebral hemorrhage, subarachnoid hemorrhage, cerebral infarction, myocardial infarction, and aortic dissection. In 2013, the concept of working hours was introduced in chronic overwork. The approval rate of occupational CCVDs was 44.7% in 2006, which decreased to 12.9% in 2011. After the improvement of related regulations, the approval rate increased to 41.3% in 2018. From 2000 to 2017, the CCVD mortality of both the unemployed and employed tended to decrease, and their cumulative CCVD mortalities were 549.3 and 319.7 per 100,000 people, respectively. Conclusions: CCVDs are recognized as occupational diseases in Korea. The amendments to the standards for recognition, the introduction of the Occupational Disease Adjudication Committee, the principle of presumption, and the reduction of working hours have changed the approval rate of occupational CCVDs. A strategic approach is needed to further reduce the incidence of CCVDs.

• Radiation Oncology Journal
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• v.15 no.4
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• pp.357-367
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• 1997

Purpose : To identify variable prognostic factors and analyse failure patterns in the uterine cervix cancer after radical operation and adjuvant radio-therapy, a retrospective analysis was undertaken. Materals and Methods : I analysed one hundred and twenty four patients with uterine cervix cancer, FIGO stage IB, IIA and IIB, treated with radical hysterectomy and pelvic lymph node dissection followed by adjuvant radio-therapy between May 1985 and May 1994. Minimum follow up period was 24 months. All of them were treated with full dose external radiotherapy with linear accelerator and/or high dese rate intracavitary radiation. Results : Overall 5 year survival rate and relapse free survival rate were $75.4\%,\;73.5\%$, respectively. Significant prognostic factors by relapse free survival were wall involvement thickness, lymph node location and number, parametrium involvement, tumor size, stage, uterine body involvement, vaginal resection margin involvement. By multivariate analysis, lymph node matastasis. tumor size and vaginal resection margin involvement were significant prognostic factos. Treatment related failure were 33 cases. Locoregional failure were more likely in the stage IIB, lymph node positive or vaginal resection margin positive patients whereas distant failures were relatively more frequent in stage IB, IIA and lymph node, vaginal resection negative patients. In stage IIB, 5 year relapse free survival rate was only $56\%$ and nine of twenty two patients recurred. Conculsion : Postoperative radiotherapy results are good for patients with relatively low risk factor. But the results are poor for patients with multiple, high risk factors or stage IIB. To control recurrence for patients with high risk factors, postoperative adjuvant radiotherapy is not sufficient treatment method. To raise control rate adding other methods such as radiosensitizing agent or chemotherapy is necessary and prospectively randomized study is needed for evaluation of postoperative radiotherapy efficacy and /or other methods. And it is reasonable to treat primary radical radiotherapy for patients with stage IIB cervical cancer instead of radical operation and adjuvant radiotherapy and/or chemotherapy regimen.

• Journal of the Korean Geographical Society
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• v.39 no.1
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• pp.27-44
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• 2004

Upper reach of Soyang River at the northernmost area around Taebaek Mountains in South korea is profitable area to understand paleo-environment during the Quaternary such as tectonic process and climate change in the Korean Peninsula. This study explained paleo-environment affect to channel development by geomorphic distribution and characteristics of terrace surfaces, and analysis of deposits at 58 fluvial terraces in upper reach of Soyang River. Fluvial terraces were classified from T1 to T6. Most terraces are distributed on the point bar in meandering channel and one side along river valley. Terraces tend to decrease in number and superficial dissection rate to be higher and channel slope to be steeper if it takes long time from T1 to 6. The paleo-channel of Soyang River is supposed to be stronger meandering in period of T2 than T3. The weathering rind of gravel is generally thicker in older terrace, however, differs by contents of water and air in deposits. Based on the data of stratigraphy, grain size analysis, pollen analysis and rubification index in deposit, formation age of T5 terrace in Soyang River are estimated in MIS(Marine Oxygen Isotope Stage) 10, and T2 terrace are estimated in MIS 6.