• Archives of Plastic Surgery
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• 제44권6호
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• pp.530-538
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• 2017

Background A pharyngocutaneous fistula is a common and difficult-to-manage complication after head and neck reconstruction. It can lead to serious complications such as flap failure, carotid artery rupture, and pharyngeal stricture, and may require additional surgery. Previous radiotherapy, a low serum albumin level, and a higher T stage have been proposed as contributing factors. We aimed to clarify the risk factors for pharyngocutaneous fistula in patients who underwent flap reconstruction and to describe our experiences in treating pharyngocutaneous fistula. Methods Squamous cell carcinoma cases that underwent flap reconstruction after cancer resection from 1995 to 2013 were analyzed retrospectively. We investigated several significant clinical risk factors. The treatment modality was selected according to the size of the fistula and the state of the surrounding tissue, with options including conservative management, direct closure, flap surgery, and pharyngostoma formation. Results A total of 127 cases (18 with fistulae) were analyzed. A higher T stage (P=0.048) and tube-type reconstruction (P=0.007) increased fistula incidence; other factors did not show statistical significance (P>0.05). Two cases were treated with conservative management, 1 case with direct closure, 4 cases with immediate reconstruction using a pectoralis major musculocutaneous flap, and 11 cases with direct closure (4 cases) or additional flap surgery (7 cases) after pharyngostoma formation. Conclusions Pharyngocutaneous fistula requires global management from prevention to treatment. In cases of advanced-stage cancer and tube-type reconstruction, a more cautious approach should be employed. Once it occurs, an accurate diagnosis of the fistula and a thorough assessment of the surrounding tissue are necessary, and aggressive treatment should be implemented in order to ensure satisfactory long-term results.

• Smart Structures and Systems
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• 제25권3호
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• pp.369-384
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• 2020

A wavefield sparse reconstruction technique based on compressed sensing is developed in this work to dramatically reduce the number of measurements. Firstly, a severely underdetermined representation of guided wavefield at a snapshot is established in the spatial domain. Secondly, an optimal compressed sensing model of guided wavefield sparse reconstruction is established based on l₁-norm penalty, where a suite of discrete cosine functions is selected as the dictionary to promote the sparsity. The regular, random and jittered undersampling schemes are compared and selected as the undersampling matrix of compressed sensing. Thirdly, a gradient projection method is employed to solve the compressed sensing model of wavefield sparse reconstruction from highly incomplete measurements. Finally, experiments with different excitation frequencies are conducted on an aluminum plate to verify the effectiveness of the proposed sparse reconstruction method, where a scanning laser Doppler vibrometer as the true benchmark is used to measure the original wavefield in a given inspection region. Experiments demonstrate that the missing wavefield data can be accurately reconstructed from less than 12% of the original measurements; The reconstruction accuracy of the jittered undersampling scheme is slightly higher than that of the random undersampling scheme in high probability, but the regular undersampling scheme fails to reconstruct the wavefield image; A quantified mapping relationship between the sparsity ratio and the recovery error over a special interval is established with respect to statistical modeling and analysis.

• 한국정보전자통신기술학회논문지
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• 제16권6호
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• pp.369-377
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• 2023

산업 제조 분야에서 품질 관리는 불량률을 최소화하는 핵심 요소로, 미흡한 관리는 추가적인 비용 발생과 생산 지연을 야기할 수 있다. 본 연구는 제조품의 텍스쳐 결함 감지의 중요성을 중심으로, 보다 정밀한 결함 감지 방법을 제시한다. DFR(Deep Feature Reconstruction) 모델은 특징맵의 조합 및 재구성을 통한 접근법을 채택하였지만, 그 방식에는 한계가 있었다. 이에 따라, 우리는 제한점을 극복하기 위해 통계적 방법론을 활용한 새로운 손실 함수와 스킵 연결구조를 통합하고 파라미터 튜닝을 진행하였다. 이 개선된 모델을 MVTec-AD 데이터세트의 텍스쳐 카테고리에 적용한 결과, 기존 방식보다 2.3% 높은 결함 분할 AUC를 기록하였고, 전체적인 결함 감지 성능도 향상되었다. 이 결과는 제안하는 방법이 특징맵 조합의 재건축을 통한 결함 탐지에 있어서 중요한 기여함을 입증한다.

• Communications for Statistical Applications and Methods
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• 제4권3호
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• pp.817-825
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• 1997

Images reconstructed with EM algorithm have been observed to have checkerboard effects and have large distortions near edges as iterations proceed. We suggest a aimple algorithm of applying line process to the EM and Bayesian EM to reduce the distortions near edges. We show by simulation that this algorithm improves the clarity of the reconstructed image and has good properties based on root mean square error.

• 대한의용생체공학회:의공학회지
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• 제22권4호
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• pp.311-319
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• 2001

Statistical reconstruction methods in the context of a Bayesian framework have played an important role in emission tomography since they allow to incorporate a priori information into the reconstruction algorithm. Given the ill-posed nature of tomographic inversion and the poor quality of projection data, the Bayesian approach uses regularizers to stabilize solutions by incorporating suitable prior models. In this work we show that, while the quantitative performance of the standard filtered backprojection (FBP) algorithm is not as good as that of Bayesian methods, the application of spline-regularized smoothing to the sinogram space can make the FBP algorithm improve its performance by inheriting the advantages of using the spline priors in Bayesian methods. We first show how to implement the spline-regularized smoothing filter by deriving mathematical relationship between the regularization and the lowpass filtering. We then compare quantitative performance of our new FBP algorithms using the quantitation of bias/variance and the total squared error (TSE) measured over noise trials. Our numerical results show that the second-order spline filter applied to FBP yields the best results in terms of TSE among the three different spline orders considered in our experiments.

• Archives of Plastic Surgery
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• 제49권1호
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• pp.91-98
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• 2022

Background Predicting the need for post-traumatic reconstruction of lower extremity injuries remains a challenge. Due to the larger volume of cases in adults than in children, the majority of the medical literature has focused on adult lower extremity reconstruction. This study evaluates predictive risk factors associated with the need for free flap reconstruction in pediatric patients following lower extremity trauma. Methods An IRB-approved retrospective chart analysis over a 5-year period (January 1, 2012 to December 31, 2017) was performed, including all pediatric patients (<18 years old) diagnosed with one or more lower extremity wounds. Patient demographics, trauma information, and operative information were reviewed. The statistical analysis consisted of univariate and multivariate regression models to identify predictor variables associated with free flap reconstruction. Results In total, 1,821 patients were identified who fit our search criteria, of whom 41 patients (2.25%) required free flap reconstruction, 65 patients (3.57%) required local flap reconstruction, and 19 patients (1.04%) required skin graft reconstruction. We determined that older age (odds ratio [OR], 1.134; P =0.002), all-terrain vehicle accidents (OR, 6.698; P<0.001), and trauma team activation (OR, 2.443; P=0.034) were associated with the need for free flap reconstruction following lower extremity trauma in our pediatric population. Conclusions Our study demonstrates a higher likelihood of free flap reconstruction in older pediatric patients, those involved in all-terrain vehicle accidents, and cases involving activation of the trauma team. This information can be implemented to help develop an early risk calculator that defines the need for complex lower extremity reconstruction in the pediatric population.

• 대한영상의학회지
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• 제84권1호
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• pp.240-252
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• 2023

목적 소아 환자에서 두부 컴퓨터단층촬영(이하 CT)에 대한 딥러닝 이미지 재구성(deep learning image reconstruction; 이하 DLIR; TrueFidelity; GE Healthcare, Milwaukee, WI, USA)의 효과를 평가하고자 한다. 대상과 방법 총 126개의 소아 두부 CT 이미지를 수집했으며, adaptive statistical iterative reconstruction (이하 ASiR)-V를 사용한 반복적 재구성 및 세 가지 수준의 DLIR을 사용한 재구성을 시행하였다. 각 이미지 세트 그룹은 환자의 연령에 따라 4개의 그룹으로 구분하였으며 각 연령군의 임상 및 방사선량 관련 데이터를 검토하였다. 양적 매개 변수에는 signal to noise ratio (이하 SNR) 및 contrast to noise ratio (이하 CNR)가 포함되었으며 질적 매개 변수로 영상의 잡음(noise), 회백질의 구분 정도, 선명도, 인공물 및 수용 가능성(acceptability), 영상의 질감이 포함되었고 이에 대한 평가와 비교를 시행하였다. 결과 모든 연령 그룹의 모든 수준의 SNR 및 CNR은 높은 수준의 DLIR 사용 시 증가하였다. ASiR-V와 비교했을 때 높은 수준의 DLIR은 SNR 및 CNR이 개선되었다(p < 0.05). 그리고 DLIR의 수준이 증가될수록 순차적인 잡음 감소, 회백질 구분 개선, 선명도 개선이 나타났다. 이러한 변수들에서 높은 수준의 DLIR 사용 시 ASiR-V와 유사한 정도의 수치가 측정되었다. 인공물과 수용 가능성의 경우에 적용된 DLIR 수준 간에 큰 차이를 보이지 않았다. 결론 소아 두부 CT에 고수준 DLIR을 적용하면 영상의 노이즈를 줄일 수 있으나 인공물 처리에 대한 개선이 필요하다.

• Archives of Plastic Surgery
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• 제34권5호
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• pp.617-621
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• 2007

Purpose: With the necessity of comprehensive care for the breast cancer patients, Breast Care Center of our hospital started to work in March 2004. This study examined the 3-year execution of Breast Care Center. The role of Breast Care Center was evaluated in aspect of clinical activities in quality and quantity. Methods: A retrospective review was carried out from 2001 to 2007 with breast cancer patients. The number and type of breast cancer surgery and breast reconstruction procedure were compared before and after Breast Care Center's foundation. Time required for the diagnosis and treatment was also compared. Regression analysis and T-test were used to identify the statistical significance. Results: The number of breast cancer surgery did not statistically increase compared with progressive increase of breast cancer. QUART(quadrantectomy, axillary dissection, radiotherapy) procedure statistically significantly increased and MRM(Modified Radical Mastectomy) procedure decreased for breast cancer surgery after foundation of Breast Care Center. The number of breast reconstruction procedures statistically significantly increased. The number of immediate TRAM free flap (Transverse Rectus Abdominal muscle free flap) procedures has grown 3.8 times after foundation of Breast Care Center. The time required for diagnosis and treatment was also shortened. Conclusion: After foundation of Breast Care Center, the number of breast reconstruction surgery increased, while the counselling time in breast reconstruction was reduced. Breast Care Center provided a prompt and comprehensive care to the breast cancer patients through the multidisciplinary therapeutic approaches.

• The Journal of Korean Physical Therapy
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• 제17권3호
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• pp.297-310
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• 2005

Open kinetic chain exercise has lost favour in rehabilitation after cruciate ligament reconstruction due to concerns that this exercise is harmful to the graft and will be less effective in improving function. Therefore rehabilitation has focused over the past decade on closed kinetic chain exercise. Open kinetic chain and closed kinetic chain exercises were compared for their effects on proprioception, muscle strength and knee instability in the early period of cruciate ligament reconstruction rehabilitation. The study subjects were 14 patients in 28weeks from cruciate reconstruction surgery(11 male, 3 female; mean age = 44.36 years). Closed kinetic chain exercise group used ball, balance pad and air cushion, to perform weightbearing exercises and the open kinetic chain exercise group used elastic rope and N-K table, to perform non-weightbearing exercises. Between tests, subjects trained 5 times per week for 2 weeks. Statistical analysis was by Wilcoxon signed rank test and Mann Whitney U test. In result, this study shows that both open and closed kinetic chain exercise programs lead to an improved muscle strength and Lysholm score. But there was no improvement in proprioception at both exercises. Closed versus open kinetic chain exercise in early period of rehabilitation after cruciate ligament reconstruction surgery do not differ in their effects on knee proprioception, muscle strength and instability. But the effect of closed kinetic chain exercises was showed more improvement than open kinetic chain exercises between pre-post exercises. Therefore further study is required to assess effect of both groups in more long period.

• Clinics in Orthopedic Surgery
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• 제10권4호
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• pp.413-419
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• 2018

Background: We aimed to examine the factors that influence synovialization of the grafted tendon after double-bundle anterior cruciate ligament (ACL) reconstruction based on second-look arthroscopic findings. Methods: Out of 205 knees that were treated between August 2008 and May 2016 with double-bundle ACL reconstruction using bio-absorbable cross-pins and Endobuttons for femoral tunnel fixation, we enrolled 65 knees (64 patients) that underwent second-look arthroscopy with hardware removal at 1 year postoperatively. Measured clinical outcomes included the Lysholm score and Tegner activity score that were evaluated preoperatively and during the final follow-up. We analyzed the relationship between synovial coverage and patient age, length of the preserved remnant tissue on the tibial side, type of bundle (anteromedial or posterolateral), type of graft (autograft or allograft), and time from injury to surgery. Results: The area of synovial coverage showed a significant statistical correlation with patient age and the length of the preserved remnant tissue on the tibial side. The average synovial coverage was significantly better for the anteromedial bundle than for the posterolateral bundle, better for the autograft than for the allograft reconstruction, and better when treated in the acute stage than in the chronic stage. However, synovialization of grafted tendon did not correlate to clinical outcomes. Conclusions: While we were able to identify several factors influencing synovialization of the grafted tendon after double-bundle ACL reconstruction, including patient age, length of preserved remnant tissue of the torn ACL, type of bundle, type of graft, and time from injury to surgery, we found no evidence that increased synovialization improves clinical outcomes at 1 year postoperatively.