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Microsurgical reconstruction in tumour surgery
R W H PHO 가톨릭중앙의료원 가톨릭암센터 1997 암심포지움 Vol.- No.1
In the management of musculoskeletal sarcoma, the challenge has been the precise assessment of local and systemic involvement of tissue and the understing of tumour biology. Surgical excision remains the most effective method of removing the tumour mass when compared to other adjunct treatments such as radiotherapy and chemotherapy. However, escaiating medical costs, practising in an increasingly unfriendly surgical environment and the flooding of untested surgical and medical products onto the market continues to challenge doctors and the surgical team to constantly seek new solutions in the management of musculoskeletal tumour. In the last two decades, the author has applied the concept and the technique of reconstructive microsurgery as an option in the management of musculoskeletal tumour. Surgicai resection and reconstruction has been employed with vascularised tissue transfer as a method of treatment. The skin and fascia as coverage are not major limiting factors in terms of vascularised tissue transfer in vessel size, length and donor site. They are, however, more demanding in terms of their specialised function as gliding bed and special anatomical sites, for instance in sole and palm reconstruction. The vessel has not been a limiting factor because it can be bridged with a graft or use as cross digit or cross limb vessel transfer. The nerve still remains a challenging area as we are dealing mainly with the extension of cells. The result can be unpredictable in terms of real and useful recovery. The muscle has been useful as a soft tissue contour because it resurfaces and introduces a new vascular bed. Nevertheless, it can be unpredictable as a contractile unit in strength, fatiouability, speed and coordination for fine manipulative skills in reconstruction. The introduction of vascularised bone graft has been the main forte in bony reconstruction to provide structural support or act as a spacer. Its advantages of incorporating the skin and muscle as composite tissue transfer has been widely applied. The length of bone graft using vascularised fibula can be as long as 30cm. The bone strength can be augmented by using double barreled vascularised fibular graft, or by reinforcing with a non-vascularised bone graft or an autoclaved bone or an allograft. The major limiting factor associated with vascularised fibular graft has been in their application for joint reconstruction or as a growing unit in reconstruction of the extremities of children. We have used fibular diaphysis together with proximal fibular epiphysis as a growing unit in upper limb reconstruction.
홍윤표,이태원 國立金烏工科大學校附設生産技術硏究所 1991 産業技術開發硏究 Vol.7 No.-
In cutting a workpiece by lathe, a lot of cutting processing can be used by skilled workers. There are various tool selection and tool pathes to cut the same one. Hence, it is quite possible that a beginner fails in cutting because of wrong selections for tool and tool path. In order to solve this problems, the present software which automatically determine tool path is developed. the characteristics of this program are as follows: ⅰ) Maximum cutting area is shown for a selected tool. ⅱ) Tool path is automatically generated. ⅲ) Cutting processing is animated at each time step.