솔레노이드 인젝터와 피에조 인젝터의 파형과 분사량 분석을 위한 실험적 연구

강성구,김철수 한국기계기술학회 2020 한국기계기술학회지 Vol.22 No.1

In this paper, we investigate the relationship between control system of Bosch system and that of Delphi system by measuring the high and low voltage waveform, current waveform and fuel injection quantity of D-2 and R- engines. Waveform measurements are used the PICO scope and the CDS tester. The injectors of D-2 and R-engines were tested under no load condition using injector with normal fuel injection quantity, injector with small fuel injection quantity and injector with many fuel injection quantity. The relation between current energy and fuel injection quantity shows that the injector variation rate of D2-engine is much larger than that of R-engine. The injector current energy of the D2-engine was more linear than that of the R-engine, therefore making the system more stable. Although the control system of the D2-engine is a more stable system only in terms of the durability of the internal parts of the injector, the injector of the R-engine has a good response because the current value is large.

구순열 환자의 비 성형술

민승기,이의석,이동근 大韓顎顔面成形再建外科學會 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.1

한국인에서의 미용적 유방 수술

정재훈,민경원,이민구,노종훈 대한미용성형외과학회 2005 Archives of Aesthetic Plastic Surgery Vol.11 No.1

Breast surgery is fully justified only in aesthetic perspectives. Although there are largely two areas in breast surgery, reconstruction and aesthetic, they frequently overlap each other. A reconstructed breast, therefore, should be aesthetically as natural as possible and similar to the contralateral one, even if this means reproducing some little defects. The authors present our experience of recent 6 years in breast reconstruction with an aesthetic eye and an artistic touch, and illustrate personal tips and technical adjustments: use of anatomical prostheses, autologous tissue transfer, axillary fold and nipple-areola complex reconstruction, including augmentation mammaplasty(implant, fat injection) and reduction mammaplasty.In 6 years, 178 cases of breast surgery were performed. Breast reconstruction(post-mastectomy, post burn deformity, congenital deformity etc) was 106 cases. There were 83 TRAM free flap cases, 10 Latissimus dorsi free flap cases. 7 cases using tissue expander and breast implant and 6 were fat graft cases. Number of breast augmentation was 35(25 submuscular, 10 subglandular). Breast reduction procedure was performed in 37 cases(13 periareolar, 8 vertical, 14 inferior pyramidal and 2 free nipple graft technique).The factors characterizing aesthetic results are profiles of breast(projection, inframammary fold location, superficial evenness, and ptosis), symmetry, axillary fold, areola, and nipple. In every procedure, we take account above factors, and results were satisfactory both surgically and aesthetically.

Hair Control during Scalp Surgery Using a Sterile Gel Technique

Jae Kyoung Kang,Myoung-Soo Shin,Jung-Kook Song,Byung Min Yun 대한미용성형외과학회 2018 Archives of Aesthetic Plastic Surgery Vol.24 No.1

It is necessary to organize and arrange the hair before performing surgery on the scalp. The hair is preserved in most cases, and the remaining hair makes it difficult to apply and maintain the drape. Moreover, hair that has not been properly sterilized can be a risk factor for infection. Accordingly, the authors of the present study benchmarked a method of hair control within the operative field using a sterile gel. Prior to surgery, the hair around the lesion can be organized and rearranged to the desired shape by using a sterile medical gel as a hairstyling product. Subsequently, chlorhexidine-isopropyl alcohol can be used for aseptic skin preparation, followed by draping for surgery. By controlling the hair using this method, hair can be prevented from falling into the operative field, thereby reducing the risk of surgical site infection.

Adverse Hemodynamic Effects of Nefopam in Patients Undergoing Plastic and Aesthetic Surgery: A Single- Center Retrospective Study

Sang Kyu Choi,Cheol Keun Kim,조동인,Myung Chul Lee,Jee Nam Kim,최현곤,신동혁,김순흠 대한미용성형외과학회 2018 Archives of Aesthetic Plastic Surgery Vol.24 No.1

Background Nefopam is used to improve postoperative hypothermia in the field of plastic and aesthetic surgery. However, there is a paucity of data about its adverse hemodynamic effects and safety. We therefore assessed its adverse hemodynamic effects in patients undergoing plastic and aesthetic surgery. Methods We conducted a single-center retrospective study of 148 patients, in whom we measured hemodynamic parameters using sphygmomanometry (systolic blood pressure [SBP], diastolic blood pressure [DBP], arterial blood pressure [ABP], and heart rate [HR]). Moreover, we also assessed myocardial oxygen demand using the rate pressure product (RPP). Results The patients included 96 men and 52 women, with a mean age of 34.7±8.5 years. There were no significant differences in SBP, DBP, ABP, HR, or RPP before and after nefopam administration (P>0.05). However, a significant difference was found in the number of the patients with an HR of >100 beats per minute or with an RPP of >12 U before and after nefopam administration (P=0.001). Conclusions Surgeons should consider the possibility of tachycardia and increased blood pressure in the management of postoperative hypothermia in patients with cardiac arrhythmia, ischemic heart disease, or essential hypertension. Nonetheless, further prospective, large-scale, multi-center, randomized, controlled studies are warranted to confirm our results.

Bilateral Autologous Breast Reconstruction in a Patient with Unilateral Breast Cancer: A Case Report

Young Chul Kim,Byungho Son,Eun Key Kim 대한미용성형외과학회 2018 Archives of Aesthetic Plastic Surgery Vol.24 No.1

Various reconstructive and/or oncoplastic options are available for breast cancer patients. In properly selected patients, autologous tissue-based reconstruction usually results in aesthetic, natural breasts. The choice of a reconstructive option for a breast cancer patient is a multifactorial decision that should consider the patient’s values and preferences, as well as oncologic variables. A case of a 47-year-old woman who underwent bilateral skin-sparing mastectomy (SSM) and bilateral abdominally-based reconstruction despite having unilateral breast cancer. Right SSM and left lumpectomy were indicated for ductal carcinoma in situ in the right breast and benign tumors with microcalcifications in the left breast. The patient had very small breasts and wished for larger breasts, using her own tissue, to be created in a single-stage operation. Right SSM and left subcutaneous mastectomy were followed by bilateral free transverse rectus abdominis flap reconstruction and nipple sharing.

Quantitative assessment of nipple perfusion with laser-assisted indocyanine green imaging in nipple-sparing mastectomy with breast reconstruction

김재우,김일국,Ung Sik Jin,Hak Chang 대한미용성형외과학회 2019 Archives of Aesthetic Plastic Surgery Vol.25 No.1

Background It remains unknown whether perfusion mapping using the SPY system can predict mastectomy skin flap necrosis in each type of breast surgery. We analyzed intraoperative indocyanine green (ICG) angiography images of breast cancer patients who underwent nipple-sparing mastectomy (NSM) with implant-based breast reconstruction, and evaluated the perfusion of the nipple-areolar complex (NAC) with the SPY Elite system to predict NAC necrosis with a single quantitative value. Methods We analyzed nipple perfusion in 30 patients from October 2016 to November 2018. After NSM, ICG injection and SPY angiography were performed to characterize NAC perfusion before immediate reconstruction. The nipple perfusion rate was measured by analyzing fluorescence at the central point of the nipple, and the presence of NAC necrosis was evaluated at 5 days and 1 month postoperatively. Results Three of the 30 patients developed NAC necrosis that secondarily healed within 1 month, and five developed NAC necrosis and underwent surgical debridement within 1 month. Seven of eight patients with a perfusion rate <13% developed NAC necrosis, and all four patients with a perfusion rate <10% needed partial surgical debridement or total NAC excision. Conclusions The nipple perfusion rate could be useful for predicting NAC necrosis before immediate reconstruction. For patients at a high risk for NAC necrosis, tissue expander insertion rather than a direct-to-implant procedure may be considered, and close follow-up with thorough wound management should be done to reduce complications.

A Quick and Easy Technique for Lateral Canthoplasty Using Reverse V-Y Advancement: A Case Report

Jae Yeon Park,Hyo Joong Kim,Seil Lee,Sung Gyun Jung 대한미용성형외과학회 2018 Archives of Aesthetic Plastic Surgery Vol.24 No.1

Cosmetic lateral canthoplasty has become popular among Asians in the last few decades, but few techniques have withstood the test of time to be accepted as both effective and noninvasive, with minimal complications. Novel techniques have been developed, but are not free from complications. Moreover, these methods often have limited indications and may require a rather long learning curve to master. Herein, the authors present their experiences performing a simple lateral canthoplasty procedure in 61 patients using a slightly modified V-Y advancement flap, previously known as the Uchida method.

The Efficacy of Midline Barbed Absorbable Sutures in Progressive Tension Closure of Abdominal Flap Donor Sites

Bommie Florence Seo,Junho Lee,오득영 대한미용성형외과학회 2018 Archives of Aesthetic Plastic Surgery Vol.24 No.1

Background The donor site of abdominal flaps for breast reconstruction consists of a wide suprafascial cavity that poses a risk of seroma formation. The authors evaluated the efficacy of continuous progressive tension sutures (PTS) using unidirectional barbed absorbable sutures for decreasing the volume of fluid collection and the risk of seroma at the abdominal donor site. Methods Between March 2013 and February 2015, 37 consecutive patients underwent breast reconstruction using a deep inferior epigastric artery perforator flap. Two patients who underwent salvage operations were excluded. Ten patients underwent standard abdominal flap donor site closure without PTS. Seven received donor site closure with interrupted Vicryl PTS between the abdominal flap and abdominal muscle fascia. Eighteen patients underwent closure with continuous PTS using unilateral barbed absorbable sutures. Body mass index, the approximate flap area, the duration of drain maintenance, the total drained volume, and the incidence of seroma were compared across these 3 groups. The operative time and subjective difficulty perceived by the surgeon was compared between the 2 PTS groups. Results The total drained volume was lower and the duration of drain maintenance was shorter in both PTS groups than in the standard closure group. There were no cases of seroma in the PTS groups, and 2 that resolved with conservative care in the standard closure group. More time was required and the subjective difficulty score was significantly higher for interrupted PTS than for continuous PTS. Conclusions Continuous PTS effectively reduced the duration of drain insertion, the total volume of drained fluid, and was swifter and easier to perform than interrupted PTS.

Relapsed Bilateral Gigantomastia Caused by Pseudoangiomatous Stromal Hyperplasia after Reduction Mammoplasty

Jun Hyeok Kim,Seung Eun Baek,Tae Kyung Yoo,이아원,오득영 대한미용성형외과학회 2018 Archives of Aesthetic Plastic Surgery Vol.24 No.2

Gigantomastia is an abnormal proliferation of breasts by excessive mammary tissue. Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign disease due to nonspecialized fibrous mammary stroma. The incidence of gigantomastia caused by bilateral diffuse PASH is extremely rare. The authors experienced a unique case of recurrent PASH-caused gigantomastia after reduction mammoplasty. Recurrent PASH-caused gigantomastia has never been reported in the literature so far. A 33-year-old woman who suffered of gigantomastia underwent bilateral reduction mammoplasty 4 years ago. Recurrence occurred, and she visited our department. Both breasts were dense without palpable mass. Mammography revealed extremely dense breasts with a bilateral complex glandular pattern. Mastectomy with Wise-pattern incision line was performed. Nipple was reconstructed at the same time using the triangular skin flaps. Pathologic examination revealed numerous slit-like stromal clefts lined by endothelial-like spindle cells were present in well demarcated nodules and diffuse hyperplastic stromas. The finding was consistent with PASH. Reconstruction of aesthetic breast was impossible due to thinned remaining skin and subcutaneous fat tissues. Nevertheless, patient was satisfied, for her anxiety about relapse and discomfort was gone.