• Archives of Plastic Surgery
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• 제50권3호
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• pp.311-314
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• 2023

In lower extremity reconstruction, the recipient vessel often requires long-range mechanical dilation because of extensive vasospasm or plaque formation induced by concomitant atherosclerosis. While a forceps dilator can be used to manipulate and dilate vessels approximately 1 cm from their end, a DeBakey vascular dilator can dilate long-range vessels. The authors successfully performed free flap reconstruction of the lower extremity using the DeBakey vascular dilator. Of the two patients who underwent lower extremity reconstruction, one had extensive vasospasm, and the other had plaques in the recipient arteries. Irrigation with 4% lidocaine and dilation of the lumen with a forceps dilator were insufficient to restore the normal arterial blood flow. Instead, a DeBakey vascular dilator with a 1-mm diameter tip was gently inserted into the lumen. Then, to overcome vessel resistance, the dilator gently advanced approximately 10 cm to dilate the recipient artery. Normal arterial blood flow was gushed out after dilating the vessel lumen using a DeBakey vascular dilator. The vascular anastomosis was performed, and intravenous heparin 5000 IU was administered immediately after anastomosis. Prophylactic low-molecular-weight-heparin (Clexane, 1 mg/kg) was administered subcutaneously to both patients for 14 days. The reconstructed flap survived without necrosis in either patient.

• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.99-104
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• 2001

Purpose : Loss of sensibility over the finger tip resents a grave deficit and is an indication for sensible soft tissue reconstruction. This paper was performed to assess the long term results obtained by nerovascular island flap. Material and Methods : We performed neurovascular island graft for defective sensibility of finger tip loss in 94 cases since 1979 to 2000. The recipient sites were the thumb pulp defect in 79 cases, the amputated thumb in 9 cases, the amputated index in 4 cases, and the velar aspect of interphalangeal joint of thumb in 2 cases. The donor flaps were obtained from the radial side of ring finger in 63 cases, the ulnar side of the ring finger in 21 cases, and the ulnar side of the middle finger in 10 cases. A mean follow-up period was 5.7 years. Results : The flap quality was well vascularized and survived in 89 cases. The two-point discrimination was average 8.7mm. Because of scar contracture, the range of motion of the donor finger was decreased 3.5% of the normal finger in the distal interphalangeal joint, 8,2% in the proximal interphalangeal joint. A phenomenon of double sensibility occurred in 66 cases. Conclusion : This technique was excellent both aesthetically and functionally as a reconstruction of the Loss of fingertip.

• Archives of Reconstructive Microsurgery
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• 제21권2호
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• pp.131-136
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• 2012

Purpose: Arterialized venous flap is useful for reconstruction of the traumatic soft tissue defect in fingers, but insufficient circulation of the traumatic fingers makes surgeons annoying to use the flap. We have grafted flaps in 7 fingers with insufficient vascular bed hoping to expanded the category of the flap. Materials and Methods: Arterialized venous flap have transplanted in 7 fingers from March 2008 through February 2010 and followed up for 4 to 16 months(average 7.2 months). They were all male with a mean age at the time of surgery was 33. The main injury was crushing in 4 degloving, contact burn and saw injury was I respectively. Time interval from injury to flap transplantation was average 3.1. weeks(3 days to 6 weeks). Designed flap size ranges from $8cm{\times}3.5cm$to $4cm{\times}3cm$. Vessel type of flap was one artery with two veins were 5 cases and one artey with one vein 2. Flap type was cutaneous in 3, tendocutaneous 2, neurotendocutaneous 1 and neurocutaneous 1. The circulation state of recipient site was avascular in 2 cases, insufficiency 3 and tip avascular 2. Results: Arterialized venous flap was complete survived in 2 cases, partial necrosis(less than 10%) 3 and failed in 2. Conclusion: An arterialized venous free flap could be a useful procedure for reconstruction in soft tissue or combined defect of the finger despite an avascular or insufficient vascular beds if the recipient beds were free from infection.

• 대한수의학회지
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• 제29권3호
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• pp.361-371
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• 1989

This study was performed to investigate the effects of stage and quality of embryo, synchrony between donor and recipient and difficulty of transfer on pregnancy rate following non-surgical transfer of frozen-thawed bovine embryos. The results were as follows; 1. The overall pregnancy rate of this experiment was 63.4% and that of heifers(73.1%) was higher than that of cows(46.7%). 2. The pregnancy rates of recipients transferred with morulae, early blastocysts and blastocysts were 50.0%, 64.7% and 71. 4%, respectively. 3. The pregnancy rate of recipients transferred with good embryos(67.9%) was higher than that of recipients transferred with fair embryos(53.8%). 4. The pregnancy rates of embryos transferred to left and right uterine horn were 63.2% and 63.6%, respectively. 5. The pregnancy rate of recipients in estrous synchrony 0(76.2%) was higher than those of recipients in synchrony -1(55.6%) and +1(44.4%). 6. The pregnancy rate of recipients transferred with 2 embryos (71. 4%) was higher than that of recipients transferred with 1 embryo(61.8%). 7. The pregnancy rate of embryos transferred to uterine tip (72.0%) was higher than that of embryos transferred to uterine base(50.0%). 8. Ease of transfer was ranked to a scale of one to three on the basis of increasing difficulty. Transfers ranked as ease score 1 accounted for 77.8% of pregnancies and had higher pregnancy rate than ease score 2(66.7%) or 3(45.5%). 9. The pregnancy rate of recipients with excellent corpus luteum(CL) (70.0%) was higher than those of recipients with good CL(61.1%) or fair CL(61.5) %. In reviewing above results, it was considered that the factors such as embryo stage, embryo quality, estrous synchrony, corpus luteum quality, transfer site within uterus, recipient's parity and ease score affected the pregnancy rate after non-surgical transfer of frozen-thawed bovine embryos.

• Archives of Reconstructive Microsurgery
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• 제7권2호
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• pp.122-128
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• 1998

Radial forearm flap is one of the most useful skin flap in hand reconstructuion with distally based reverse pedicled or free vascularized fashion. Athors modified that flap into reverse pedicled and free vascularized flap which has advantages of both methods. The modification composed with harvesting flap on recipient side distal forearm just as free flap, than apply it as reverse distal pedicled flap fashion with microvascular anastomosis with distal vascular stump of donor radial vessels. We underwent this method in 5 cases in finger reconstruction from 1996, all of the cases had sucessful results. The advantages of this method are: 1. Thin flap which is compatible to finger skin can harvest from distal forearm with very long vascular pedicle that can be passed under the subcutaneous tunnel which avoid additional skin incisions on the hand. 2. The vessels of donor site and recipient site are same vessel in effected side of forearm, which can preserve contralateral side forearm and hand keep intact. 3. The flap can cover the defects on distal portion of the fingers which is difficult in conventional reversed radial forearm pedicled flap because of limited mobilization of flap due to limitation of pedicle length reach to tip of the fingers.

• 한국통신학회논문지
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• 제29권9C호
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• pp.1345-1351
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• 2004

최근 인터넷의 중요성으로 보다 다양한 보안 서비스가 요구되고 있다 부인방지 서비스는 새로운 보얀 요구사항이다. 인터넷뱅킹, 증권거래시스템 , 전자의무기록, 전자상거래 등의 많은 어플리케이션은 부인방지 서비스와 관련이 있다. 그러나 통신의 기밀성이나 신원확인에 대한 보안에 비교하여 부인방지에 대한 연구는 부족했다. 이론적으로, 부인방지 프로토콜이 종료되었을 때 발신자가 수산부인 방지증거를 획득하고 수신자가 발신부인 방지증거를 동시에 획득하거나 쌍방 모두 유효한 증거를 획득하지 못하였을 때 공정하다고 정의한다. 기존의 대부분의 부인방지서비스는 신뢰된 제3자인 TIP(Trusted Third Party)를 기반으로 하여 프로토콜의 단계마다 통신에 관여한다. 따라서 TIP는 통신부하를 발생시키는 단점이 있다. 제안하는 전자서명기록기는 논리적으로 부인방지의 공정 성을 보장하연서, 물리적으로 검증서버와 함께 구성하여 네트워크의 부하를 최소화한다.

• 대한두개안면성형외과학회지
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• 제20권1호
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• pp.37-43
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• 2019

Background: Tongue reconstruction is challenging with the unique function and anatomy. Goals for reconstruction differ depending on the extent of reconstruction. Thin and pliable flaps are useful for tongue tip reconstruction, for appearance and mobility. This study reports lateral arm free flap (LAFF) as a safe and optimal option for hemi-tongue reconstruction, especially for tongue tip after hemiglossectomy. Methods: Thirteen LAFFs were performed for hemi-tongue reconstruction after hemiglossectomy from 1995 to 2018. Of the 13 patients, seven were male and six were female, age varying from 24 to 64 years. Results: All flaps healed uneventfully without complications. Donor sites were closed primarily. The recipient vessels for microvascular anastomosis were mainly superior thyroidal artery, external jugular vein. All patients returned to normal diet, with no complaints regarding reconstructed tongue and donor site. Conclusion: The LAFF is hairless, thin (especially with lateral epicondyle approach), and potentially sensate. They are advantageous features for tongue tip and hemi-tongue reconstruction. Donor site sacrifices the inessential posterior radial collateral artery, and the scar is hidden under short sleeve shirts. We believe that LAFF can be considered as the first choice flap for hemitongue reconstruction, over radial forearm free flaps.

• 한국조리학회지
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• 제15권1호
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• pp.191-201
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• 2009

팁(tip) 제도는 식생활 문화 부문인 호텔 및 외식산업분야에서 빼놓을 수 없는 중요한 부분이다. 사회적으로 팁 제도가 규범화되어 있는 미국의 경우 2003년 약 264억 달러 정도의 팁의 규모를 예상할 수 있기에 식생활 문화에서 팁의 비중이 어느 정도인지 추측할 수 있다. 세계 여러 나라에서 팁 관련 연구가 활발히 진행되고 있음에도 불구하고 우리나라에서는 1979년 정부시책으로 개별 팁이 아닌 10%의 봉사료가 의무부과가 시작되어 연구의 관심 분야에서 멀어져 있었던 것이 사실이다. 본 논문의 주 목적은 팁에 대한 종사원의 인식과 태도를 Shamir, Parrett의 연구결과와 비교 검토하는 것으로, 팁수령자와 비수령자 간의 역할 갈등, 직무 만족, 급여 만족 및 고객에 대한 태도를 통계적으로 분석하였다. 국내 호텔 경영 환경의 급속한 변화 추세로 볼 때 현 봉사료 제도에 대한 다양한 고려와 제고가 필요하리라 본다. 본 연구의 후속 연구로 팁의 동기 부여 및 팁수령에 따른 종사원의 고객과 상사에 대한 갈등 관계에 대한 연구와 팁을 제공하는 고객의 행동 및 심리분석 등의 연구를 기대할 수 있을 것이다.

• Archives of Plastic Surgery
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• 제35권2호
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• pp.208-213
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• 2008

Purpose: Distally based superficial sural artery island flap has some disadvantages such as postoperative flap edema, congestion, and partial necrosis of the flap margin. Venous congestion is an area of considerable concern in distally based superficial sural artery fasciocutaneous flap and is one of the main reasons for failure, particularly when a large flap is needed. However, we could decrease these disadvantages by means of venous superdrainage. Methods: From June of 2006 to June of 2007, a total of two patients with soft tissue defects of lower one third of the leg underwent venous supercharging distally based superficial sural artery island flap transfer. The distal pivot point of this flap was designed at septocutaneous perforator from the peroneal artery of the posterolateral septum, which was 5 cm above the tip of the lateral malleolus. Briefly, this technique is performed by anastomosing the proximal end of the lesser saphenous vein and collateral vein to any vein in the area of the recipient defect site. Results: No venous congestion was noted in any of the two cases. No other recipient or donor-site complications were observed, except for minor wound dehiscence in one case. In 3 to 6 months follow-up, patients had minor complaints about lack of sensation in the lateral dorsal foot. Conclusion: The peroneal artery perforator is predictable and reliable for the design of a distally based superficial sural artery island flap. Elevation of the venous supercharging flap is safe, easy, and less time consuming. In conclusion, the venous supercharging distally based superficial sural artery island flap offers an alterative to free tissue transfer for reconstruction of the lower extremity.

• Archives of Plastic Surgery
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• 제34권6호
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• pp.785-791
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• 2007

Purpose: Paraffin has been used to augment depressed nasal contour for many years by illegally. Reported complications of nasal paraffinoma were skin thinning, displacement of nasal profile, redness, chronic inflammation and malignant change to skin cancer. The current authors report results of the secondary rhinoplasty after excision of nasal paraffinoma. Methods: Through the open rhinoplasty incision, paraffinoma was removed under direct vision. Saline irrigation and meticulous hemostasis were performed. Simultaneously, the secondary depressed nasal deformity was corrected with autogenous dermofat graft harvested from inferior gluteal fold. The dermofat was fixed to the nasofrontal area with bolster suture, and the interdormal area of the tip. Results: A total of 13 patients underwent secondary augmentation with autogenous dermofat graft after removal of paraffinoma from 2000 to 2004. The mean follow-up period was 15 months. There were no postoperative complications. All patients were satisfied with their surgical results. However, there were 10 to 20 percent resorption of the grafted dermofat. Conclusion: It is suggest that autogenous dermofat be one of good materials for the correction of the secondary deformity after removal of nasal paraffinoma. In addition, autogenous dermofat graft presented easy harvesting and manipulation for transfer, high survival rate by firm fixation to the recipient site and stable surgical results.