• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.3
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• pp.269-273
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• 1998

To clarify the clinical utility of the calvarial bone graft in the maxillofacial reconstruction, we performed on anatomical study by measuring the regional thickness of the parietal bone on 17 Korean adult dry skulls. Before the sectioning the calvarium, the anatomical landmarks were marked on each specimens. And then we measured the total thickness of the parietal bone, the thickness of the outer and inner cortical plates on various points in each sections of parietal bones using a digital caliper under the stereomicroscope. The total thickness of the parietal bone was ranged from 5.17mm to 7.50mm, and there were no statistical difference in the total thickness of the parietal bone on the same points bilaterally. But there was a tendency that the thickness of the parietal bone was thicker toward to the lambda point than the coronal suture area. At the other hand, the thickness of the outer and inner plate of the parietal bone was the thickest at the first point of the right aspect on the line 1, the first point of the left aspect on the line 5, respectively. In conclusion, this study showed that the donor site of the parietal bone for the maxillofacial reconstruction should be located at more posterior and medial area of the parietal bone than the prevalent known donor site.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.4
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• pp.455-464
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• 2011

Purpose : This study is to investigate difference in the isometric muscular function of knee joints according to the time of participation in rehabilitation exercise in patients who had anterior cruciate ligament reconstruction. Methods : The subjects of this study were patients by sports injury or accident in the sports rehabilitation center of G hospital. The early exercise program group (n=7) started functional ability exercise from 2 weeks after the surgery and the late exercise program group (n=7) from 6 weeks after the surgery. Statistical analysis was used repeated measure ANOVA to test mean difference by using SPSS 18.0 for windows. Results : First, as to quadriceps femoris muscle according to the time of participation in exercise program, significant difference was observed according to interaction and time. Second, as to hamstring muscle according to the time of participation in exercise program, significant difference was observed in muscle strength according to time. Conclusion : This results suggest that if the effect of exercise program is similar between the early starting group and the late starting group, it is not necessary to have a long period of fixation as in the late exercise program group but is desirable to start functional ability exercise early in order to relieve pains in the knee joints.

• Land and Housing Review
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• v.2 no.3
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• pp.259-268
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• 2011

Space extension and the increase of the number of households are helpful to raise business value of the remodeling through the renovation of apartment houses that is required by residents of new cities and large-scaled apartment. However, in the case of accepting this demand, it could have a bad influence on the landscape of a complex in terms of the structure of apartment houses and the safety of construction and urban planning, and a problem occurs in the aspect of fairness for reconstruction. For the study, the current status related to the remodeling system through laws, related articles since 2000 and research data was analyzed. In addition, the individual quantitative analysis was conducted in the four aspects to judge whether households expansion for remodeling is plausible:1) Statistical data to comprehend the changes of population and social structure 2) Survey data of floor space index and the building-to-land ratio of new cities at the intial stage for the review of the effect of architectural planning and urban environment 3) Surveys of experts on structural safety in order to judge whether the demand of expansion is accepted or not. 4) Quantitative analysis of each item to compare fairness with reconstruction. Therefore, this study is intended to understand problems of the remodeling system that is currently operated. Moreover, it will be further reviewed that the expansion of households is feasible through the permission of expansion and it will be discussed that the revitalization of the apartment remodeling has a positive impact on the residential environment.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.52-58
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• 2010

Purpose: The digital artery perforator flap was recently introduced and has been proven to be useful for reconstruction of various finger defects. Short operative time, less invasive surgery, and reliable flap circulation are the major advantages of this flap. The authors presented the clinical cases of the digital artery perforator flap and compared them with the distant flaps within a hand (thenar and hypothenar flaps) to reveal their differences. Methods: From May of 2006 to February of 2009, the authors performed reconstructions of finger defects with the digital artery perforator flaps in 10 patients as with the distant flaps within hand in 9 patients (7 thenar and 2 hypothenar flaps). In these two groups of the patients, flap size, use of skin graft, length of stay in hospital, healing time, complications were reviewed retrospectively and compared with statistical analysis (Student's t-test). Results: All flaps survived completely. The mean size of the perforator flap was $0.9{\times}1.9\;cm$ and the mean distant flap within a hand was $1.9{\times}2.0\;cm$. The use of skin graft was reduced in the perforator group because the donor site of the flap was closed primarily. The hospitalization period and healing time also reduced significantly in the perforator group. Minor complications (partial flap loss) were noted in small percentages in both groups but resolved with conservative management. Mean follow-up period was about 6 weeks. Conclusion: The digital artery perforator flap was smaller than the distant flap but its reconstruction of finger defects was reliable and comparable to the conventional distant flaps within a hand. This flap would be not only an alternative method but very useful in the management of various finger defects, because of ease of operative technique, less invasive surgery, decreased need of skin graft, and shorter period of hospitalization and healing time.

• Archives of Reconstructive Microsurgery
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• v.25 no.2
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• pp.43-48
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• 2016

Purpose: Perforator flap-using ischial sore reconstruction is performed in a prone position. But after the surgery, recurrence frequently occurs in a sitting position. In this sense, we introduce modified flap insetting method which closely resembles patient's sitting position to lessen the flap tension surgically. Materials and Methods: Authors tried to check a skin tension difference between prone position and sitting position in normal people group and to find out the importance of performing flap insetting in hip flexion position. Healthy volunteers were collected (n=20) and designed the same length of 4 divided sections around the ischium. Lengths of each section were measured when hip joint was flexed to 90 degree and when both hip and knee joints were flexed to 90 degree and the statistical evaluation was performed. Twenty cases with ischial sore underwent reconstructive surgery using perforator flap under hip flexion position and followed-up for any recurrences. Results: There was a meaningful difference between the joint flexed skin length and that of the neutral position. Flap showed sufficient thickness over 12 months. Conclusion: It seems that recurrence could be reduced when the reconstructed flap could sufficiently cover in a sitting position regarding its significant length difference in normal people group.

• Journal of the Korean Society of Clothing and Textiles
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• v.33 no.3
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• pp.401-409
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• 2009

The shape of crotch area is very important to develop functional clothing as well as other ergonomic goods such as chair or saddle etc. However, it is inevitable that 3D scanned image of crotch would have missing part due to its folded shape including overlapping legs nearby. Therefore, the objectives of this research was to compare reconstruction methods of missing parts at crotch using seven dummies of real men's replicas. Two reconstruction methods adopted were kinds of 'fill- hole' in Rapidform 2004, one was 'smooth' and the other was 'curvature'. Each restored image was compared with the original shape of the dummies. As results, the average distance was 0.66mm between original and 'smooth' treated images and 0.59mm between original and 'curvature' treated, which was not statistically different. Average area of restored crotch region was $8740.04cm^2$ by 'smooth' method and $8405.02cm^2$ by 'curvature' method which is close to the original area of $8413.76cm^2$. Statistical difference was found between images of original and 'smooth' ones$(p=0.04^*)$. However, there was no difference between original and 'curvature' treated images, which indicates that 'curvature' method is more useful to fill the hole compared with 'smooth' method.

• Archives of Plastic Surgery
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• v.34 no.1
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• pp.70-76
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• 2007

Purpose: Full-thickness skin grafts are usually used in facial reconstruction, but on occasion, split-thickness skin graft is also used from the scalp due to the limitation of donor site. However, there were complications, such as alopecia, folliculitis and blood loss. In addition, it can not be used in patients with baldness. Under the circumstances, we used medial arm skin as split-thickness skin graft donor site in lieu of scalp. We investigated the efficacy of the medial arm skin as a donor site of facial skin graft in comparison with scalp. Methods: From 2000 to 2005, the split-thicknesss skin grafts were performed using the medial arm skin in 10 patients and the scalp in 10 patients. We inspected the skin color match, texture match by the visual analogue scale. Scar contracture was estimated by the Visitrak $grade^{(R)}$(Smith & Nephew). The statistical analysis was performed by SPSS 12.0. Results: There was a more satisfaction in color match, texture, and scar contracture in medial arm skin than in scalp. Conclusion: According to these results, medial arm skin may be used efficiently as an alternative donor site of scalp in the facial reconstruction.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.599-606
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• 2021

Background Postoperative dehiscence and surgical site infection after spinal surgery can carry serious morbidity. Multidisciplinary involvement of plastic surgery is essential to minimizing morbidity and achieving definitive closure. However, a standardized approach is lacking. The aim of this study was to identify effective reconstructive interventions for the basis of an evidence-based management protocol. Methods A retrospective review was performed at a single tertiary institution for 45 patients who required 53 reconstruction procedures with plastic surgery for wounds secondary to spinal surgery from 2010 to 2019. Statistical analysis was performed for demographics, comorbidities, and treatment methods. Primary outcomes were postoperative complications, including dehiscence, seroma, and infection. The secondary outcome was time to healing. Results The overall complication rate was 32%, with dehiscence occurring in 17%, seroma in 15% and infection in 11% of cases. Median follow-up was 10 months (interquartile range, 4-23). Use of antibiotic beads did not affect rate of infection occurrence after wound closure (P=0.146). Use of incisional negative pressure wound therapy (iNPWT) was significant for reduced time to healing (P=0.001). Patients treated without iNPWT healed at median of 67.5 days while the patients who received iNPWT healed in 33 days. Demographics and comorbidities between these two groups were similar. Conclusions This data provides groundwork for an evidence-based approach to soft tissue reconstruction and management of dehiscence after spinal surgery. Timely involvement of plastic surgery in high-risk patients and utilization of evidence-based interventions such as iNPWT are essential for improving outcomes in this population.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.1
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• pp.34-42
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• 2019

Objectives: Various bone graft substitute materials are used to enhance bone regeneration in the maxillofacial skeleton. In the recent past, synthetic graft materials have been produced using various synthetic and natural calcium precursors. Very recently, eggshell-derived hydroxyapatite (EHA) has been evaluated as a synthetic bone graft substitute. To assess bone regeneration using EHA in cystic and/or apicectomy defects of the jaws through clinical and radiographic evaluations. Materials and Methods: A total of 20 patients were enrolled in the study protocol (CTRI/2014/12/005340) and were followed up at 4, 8, 12, and 24 weeks to assess the amount of osseous fill through digital radiographs/cone-beam computed tomography along with clinical parameters and complications. Wilcoxon matched pairs test, means, percentages and standard deviations were used for the statistical analysis. Results: The sizes of the lesions in the study ranged from 1 to 4 cm and involved one to four teeth. The study showed significant changes in the formation of bone, the merging of material and the surgical site margins from the first week to the first month in all patients (age range, 15-50 years) irrespective of the size of the lesions and the number of teeth involved. Bone formation was statistically significant from the fourth to the eighth week, and the trabecular pattern was observed by the end of 12 weeks with uneventful wound healing. Conclusion: EHA showed enhancement of bone regeneration, and healing was complete by the end of 12 weeks with a trabecular pattern in all patients irrespective of the size of the lesion involved. The study showed enhancement of bone regeneration in the early bone formative stage within 12 weeks after grafting. EHA is cost effective and production is environment friendly with no disease transfer risks. Thus, natural bioceramics will play an important role in the reduction of costs involved in grafting and reconstruction.

• Journal of Gastric Cancer
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• v.22 no.3
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• pp.220-234
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• 2022

Purpose: The incidence of adenocarcinoma of the esophagogastric junction (AEG) has increased in recent years, and the optimal surgical strategy for AEG remains highly controversial. We aimed to evaluate the safety and efficacy of proximal gastrectomy with double-tract reconstruction (PG-DT) for the treatment of patients with AEG. Materials and Methods: We retrospectively analyzed patients with Siewert type II/III AEG between January 2013 and July 2018. Clinicopathological characteristics, survival, surgical outcomes, quality of life (QOL), and nutritional status were compared between the PG-DT and total gastrectomy with Roux-en-Y anastomosis (TG-RY) groups. Results: After propensity score matching, 33 patients in each group were analyzed. There were no statistical differences between the 2 groups in terms of disease-free survival and overall survival. The surgical option was not an independent prognostic factor based on the multivariate analysis. In addition, no differences were found in terms of surgical complications. There were no significant differences in QOL assessed by the Visick grade, Gastrointestinal Symptom Rating Scale, or endoscopic findings. Furthermore, the long-term nutritional advantage of the PG-DT group was significantly greater than that of the TG-RY group. Conclusions: PG-DT is a safe and effective procedure for patients with local Siewert type II/III AEG, regardless of the TNM stage.