• Journal of Chest Surgery
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• v.51 no.2
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• pp.146-148
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• 2018

Left atrial appendage (LAA) aneurysm is a rare, pathologic condition that may lead to atrial tachyarrhythmia or thromboembolic events. A 49-year-old man presented with aggravated palpitation and dizziness. He suffered from refractory atrial fibrillation despite a previous history of radiofrequency catheter ablation. Echocardiography revealed a 57-mm LAA aneurysm. Surgical ablation was performed through a right mini-thoracotomy, and the LAA aneurysm was obliterated with a 50-mm AtriClip (Atricure Inc., Westchester, OH, USA). However, follow-up computed tomography showed residual communication, so the patient is still taking warfarin. We report that a minimally invasive strategy for treating LAA aneurysm can be considered, but incomplete closure may occur; thus, caution is needed.

• Journal of Trauma and Injury
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• v.34 no.4
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• pp.294-298
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• 2021

Extrahepatic biliary tract and gallbladder injuries following blunt abdominal trauma are uncommon. Traumatic cystic duct transection is even rarer, which has frequently caused missed diagnosis and delayed treatment. An 18-year-old female patient with no past medical history was transferred to the Trauma Center of Kyungpook National University Hospital after falling from a height of approximately 20 meters. She became hemodynamically stable after initial resuscitation, and initial contrast-enhanced abdominal computed tomography (CT) showed right kidney traumatic infarction and multiple intrahepatic contusions with minimal fluid collection but no extravasation of the contrast. She was admitted to the intensive care unit. On the second day of hospitalization, her abdomen became distended, with follow-up CT showing a large collection of intra-abdominal fluid. Laparoscopic exploration was then performed, which revealed devascularization of the gallbladder with complete transection of the cystic duct and artery. Laparoscopic cholecystectomy was performed, as well as primary closure of the cystic duct orifice on the common bile duct using a 4-0 Prolene suture. After surgery, no clinical evidence of biliary leakage or common bile duct stricture was observed.

• The Journal of the Petrological Society of Korea
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• v.23 no.3
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• pp.239-247
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• 2014

The (U-Th)/He dating utilizes the production of alpha particles ($^4He$ atoms) during natural radioactive decays of $^{238}U$, $^{235}U$ and $^{232}Th$. (U-Th)/He age can be determined from the abundances of the parent nuclides $^{238}U$, $^{235}U$ and $^{232}Th$ and the radiogenic $^4He$. Because helium is one of the noble gases (non-reactive) with a relatively small radius, it diffuses rapidly in many geological materials, even at low temperatures. Therefore, ingrowth of $^4He$ during radioactive decay competes with diffusive loss at elevated temperatures during the geologic time scale, determining the amount of $^4He$ existing today in natural samples. For example, He diffusion in apatite is known to be very rapid compared to that in most other minerals, causing a significant diffusive loss at ${\sim}80^{\circ}C$ or higher. At ${\sim}40^{\circ}C$, He diffusion in apatite becomes slow enough to preserve most $^4He$ in the sample. Thus, an apatite's (U-Th)/He age represents the timing when the sample passed through the temperature range of $80-40^{\circ}C$. The crustal depth corresponding to this temperature range is called a "partial retention zone." Normal closure temperatures for a typical grain size and cooling rate are ${\sim}60-70^{\circ}C$ for apatite and ${\sim}200^{\circ}C$ for zircon and titanite. Because the apatite He closure temperature is lower than that of most other thermochronometers, it can provide critical constraints on relatively recent or shallow-crustal exhumation histories.

• Archives of Plastic Surgery
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• v.36 no.3
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• pp.351-355
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• 2009

Purpose: Cervical necrotizing fasciitis tends to involve the deep soft tissues and spread caudally to the anterior chest and mediastinum, often resulting in major complications and death. It may rapidly spread into the thorax along fascial planes, and the associated diagnostic delay results in this descending necrotizing mediastinitis. So, aggressive multidisciplinary therapy with surgical drainage is mandatory. We present a very rare case of descending necrotizing mediastinitis with literature review. Methods: A 53 years old male visited our department 7 days after trauma in neck. His premorbid conditions and risk factors of necrotizing fasciitis were concealed hepatoma, trauma history, chronic liver disease, and nutrition deficit. Computed tomographic scans of the head and neck region were performed in this patient : signs of necrotizing fasciitis, were seen in the platysma, sternocleidomastoid, trapezius muscle and strap muscles of the neck. Fluid accumulations involved multiple neck spaces and mediastinum. At the time, he diagnosed as necrotizing fasciitis on his neck and anterior chest. Necrotic wound was excised serially and we treated this with the Vacuum - assisted closure(VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge and achieving additional 3 pieces drainage tubes in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was utilized for a period of 12 days. Results: We obtained satisfactory results from wide excision, abscess drainage with the VAC system, and then split thickness skin graft. The postoperative course was uneventful. Conclusion: The refined technique using the VAC system can provide a means of simple and effective management for the descending necrotizing mediastinitis, with better cosmetic and functional results. Finally, the VAC system has been adopted as the standard treatment for deep cervical and mediastinal wound infections as a result of the excellent clinical outcome.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.14 no.2
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• pp.90-101
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• 2009

Analysis of multi-channel seismic reflection data from the Southern Ulleung Basin reveals that Plio-Quaternary section in the area consists of nine stacked sedimentary units separated by erosional unconformities. On the southern slope, these sedimentary units are acoustically characterized by chaotic seismic facies without distinct internal reflections, interpreted as debris-flow bodies. Toward the basin floor, the sedimentary units are defined by well-stratified facies with good continuity and strong amplitude, interpreted as turbidite/hemipelagic sediments. The seismic facies distribution suggests that deposition of Plio-Quaternary section in the area was controlled mainly by tectonic movement and sea-level fluctuations. During the Pliocene, sedimentation was mainly controlled by tectonic movements related to the back-arc closure of the East Sea. The back-arc closure that began in the Miocene caused compressional deformation along the southern margin of the Ulleung Basin, resulting in regional uplift which continued until the Pliocene. Large amounts of sediments, eroded from the uplifted crustal blocks, were supplied to the basin, depositing Unit 1 which consists of debris-flow deposits. During the Quaternary, sea-level fluctuations resulted in stacked sedimentary units (2-9) consisting of debris-flow deposits, formed during sea-level fall and lowstands, and thin hemipelagic/turbidite sediments, deposited during sea-level rise and highstands.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.175-182
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• 2005

Skull base tumors have been determined inoperable because it is difficult to accurately diagnose the extent of the involvement and to approach and excise the tumor safely. However, recently, the advent of sophisticated diagnostic tools such as computed tomography and magnetic resonance imaging as well as the craniofacial and neurosurgical advanced techniques enabled an accurate determination of operative plans and safe approach for tumor excision. Resection of these tumors may sometimes result in massive and complex extirpation defects that are not amenable to local tissue closure. The purpose of this study is to analyze experiences of skull base reconstruction and to evaluate long term survival rate and complications. All cranial base reconstructions performed from July 1993 to September 2000 at Department of Plastic and Reconstructive Surgery of the Seoul National University Hospital were observed. The medical records were reviewed and analysed to assess the location of defects, reconstruction method, existence of the dural repair, history of preoperative radiotherapy and chemotherapy, complications and causes of death of the expired patients. There were 12 cases in region II, 8 cases in region I and 1 case in region III according to the Irish classification of skull base. Cranioplasty was performed in 4 patients with a bone graft and microvascular free tissue transfer was selected in 17 patients to reconstruct the cranial base and/or mid-facial defects. Among them, 11 cases were reconstructed with a rectus abdominis musculocutaneous free flap, 2 with a latissimus dorsi muscluocutaneous free flap, 1 with a fibular osteocutaneous free flap, 2 with a scapular osteocutaneous free flap, and 1 with a forearm fasciocutaneous free flap, respectively. During over 3 years follow-up, 5 patients were expired and 8 lesions were relapsed. Infection(3 cases) and partial flap loss(2 cases) were the main complications and multiorgan failure(3 cases) by cancer metastasis and sepsis(2 cases) were causes of death. Statistically 4-years survival rate was 68%. A large complex defects were successfully reconstructed by one-stage operation and, the functional results were also satisfactory with acceptable survival rates.

• Korean Journal of Cleft Lip And Palate
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• v.16 no.1
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• pp.37-49
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• 2013

Cleft lip is a common congenital facial deformity which might cause speech, hearing, appearance, and psychological disorder. For the purpose of appropriate management for the cleft lip patients according to their individual situations, reviews of the historical evolution for the cleft lip treatment were summarized. More than 15 English written articles with 4 related historical books were reviewed, and the chronology of the cleft lip management from ancient to recent twenty first century, via middle ages and Renaissance, were summarized. Multifactorial causes of cleft lip, before the modern understanding of embryological background of it, most management of cleft lip has been explained under the basis of religions and/or superstitions. As the anatomic and embryologic knowledges were known and revealed, various misconceptions were corrected continously, and the simple closure of the lip defect was also evoluted to the applications of plastic concept. Recently, cosmetic outcomes with functional results, such as speech, hearing, psychological status, have been considered importantly, under the multidiciplinary care system. For the better understanding of cleft lip management as a routine esthtetic and funtional reconstructive procedure, the various historical treatment trends were reviewed and summarized as time goes on. This review presentation will discuss the appropriate management for cleft lip patients.

• Archives of Plastic Surgery
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• v.38 no.3
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• pp.309-314
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• 2011

Purpose: Necrotizing fasciitis is a life-threatening, destructive soft tissue infection with a very high rate of mortality that needs early diagnosis and aggressive treatment. Systemic Lupus Erythematosus (SLE) is a systemic, autoimmune disease and it's major cause of mortality is an infection. But necrotizing fasciitis in SLE is very rare and there have been only 22 cases reported in the literatures. We reported a patient of necrotizing fasciitis with SLE and reviewed 22 others from literature research. Methods: A 40-year-old female patient with a history of SLE for 6 years came to the emergency room. The patient complained of severe pain and swelling on her right leg. She was diagnosed as necrotizing fasciitis and underwent emergency fasciotomy. As wound cultures showed variable organisms, she was treated with broad-spectrum antibiotics and underwent several surgical debridements. Then, the wound was treated with the V.A.C (Vacuum Assisted Closure) device and split thickness skin grafting was performed two times. Results: Skin graft was well taken within 2 weeks after operations and the patient was discharged to outpatient follow up. There was no complication related with surgery and she could walk without cane after 3 months. Conclusion: We treated a necrotizing fasciitis in a patient with SLE and reviewed 22 others from literature research. The case presented here suggests that necrotizing fasciitis is a rare disease in SLE patients, but should be considered in the differential diagnosis of soft tissue infection in SLE patients. A high index of suspicion is needed for early diagnosis and proper management in these patients.

• Journal of the Korean Society of Costume
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• v.65 no.8
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• pp.110-124
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• 2015

This study examined a phenomenon of exaggerated hairstyle in the history of Western custom through publications related with Western costume and research papers. By adopting the criteria of Delong, M. R. to analyze visual forms shown by interaction between human body and costume worn over the body, it analyzed the formative characteristics by the interaction between hairstyle and costume. In addition, it inferred the aesthetic characteristics through content analysis of examined phenomenon focusing on socio-cultural background and costume socio-psychological precedent studies. Formative characteristics of exaggerated hairstyle applied by analysis criteria of Delong, M. R. were in pursuit of the emphasis style. This was clearly and intensively recognized by forming spaces for mostly closure style, part style, three dimensional style, determinate style, and space separation style. Regarding the interaction between hair and ornamentations, 'precedence of ornamentation' was pursued as ornamentations were recognized earlier than the hair itself. It means associative meanings of the surface effect were accompanied by emotions of 'intensiveness' and the pursuit of the attractive style. As for the interaction between hairstyle and costume, there were many cases of pursuing 'continuity' mutually and visually by connecting the hairstyle and the costume. Aesthetic characteristics of exaggerated hairstyle were inferred as 1) the expression of the sprite of the age(i.e. art, culture, politics, society, ideology, religion), 2) symbols of wealth, class, authority, and excellence, 3) pursuit of addicted desire to ornament, and 4) harmony through continuity with costume. This study verified that hairstyle was connected as a part of costume, or formed as a way to express deeper human psychology beyond just a part of a costume. It was also confirmed that hairstyle was an expressive method to express the spirit of the age, such as art, culture, society, religion, ideology.

• Journal of Chest Surgery
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• v.28 no.9
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• pp.822-828
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• 1995

This paper reports 15 native valve endocarditis cases had surgical operation in the past 10 years at the department of Cardiovascular and Thoracic Surgery, Chonbuk National University Hospital. In this study, 10 cases out of 15 were in class I or II by the New York Heart Association functional classification. None of the cases had a history of taking addictive drugs. Five cases were congenital heart disease, three cases were rheumatic heart disease and two cases were degenerative heart disease. Thus 10 cases had the underlying disease. All cases had antibiotics treatment for 3 to 6 weeks before operation. In the culture test, only four cases were positive in the blood culture and one case was positive in the excised valve culture. Organisms on blood and valve culture were Streptococcus epidermis, Streptococcus viridans, Staphylococcus aureus and Staphylococcus epidermidis. In the 10 cases without ventricular septal defect, the aortic valve was involved in four, mitral in four, both in two and involved valves in the 5 cases with ventricular septal defect were tricuspid in three, pulmonic in two. Eight cases had operation because they showed moderate congestive heart failure due to valvular insufficiency and vegetation with or without embolism. Seven cases had operation because they showed persistent or progressive congestive heart failure and/or uncontrolled infection. Five cases with ventricular septal defect underwent the closure of ventricular septal defect, vegetectomy and leaflet excision of the affected valves without valve replacement. In the cases without ventricular septal defect, the affected valves were replaced with St. Jude mechanical prosthesis. Postoperative complications were recurrent endocarditis in two, embolism in one, allergic vasculitis in two, spleen rupture in one and postpericardiotomy syndrome in one. At the first postoperative day, one case died of cerebral embolism. At the 11th postoperative month, one case died of recurrent endocarditis and paravalvular leakage in spite of a couple of aortic valve replacement. In the survived cases[13 cases in this study , all cases but one became class I or II by the New York Heart Association functional classification.