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김백규,장학,민경원,홍준표,고경석 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.4
Purpose: The jejunal free flap has the shorter ischemic time than other flap and requires a laparotomy to harvest it. As the evaluation of the perfusion the buried flap is very important, the perfusion of the buried jejunal free flap requires monitoring for its salvage. We tried to improve the monitoring flap method in the jejunal free flap and examined its usefulness. Methods: From March 2002 to March 2006, the monitoring flap method was applied to 4 cases in 8 jejunal free flaps for the pharyngeal and cervical esophageal reconstructions. The distal part of the jejunal flap was exposed without suture fixation through cervical wound for monitoring its perfusion. The status of perfusion was judged by the color change of jejunal mucosa and mesentery. If necessary, pin prick test was performed. Doppler sonography was applied to mesenteric pedicle of the monitoring flap in case of suspicious abnormal circulation.Results: The monitoring flap shows no change in 3 cases, but the congestion happened in one case at the 12 hours after the operation. This congestion was caused by the twisting or kinking of the mesenteric pedicle of the monitoring flap. So, we fixed up the monitoring flap close to adjacent cervical skin for prevention of rotation. Finally, the main part of transferred jejunal flap was intact.Conclusion: The success of a jejunal free flap depends on close postoperative monitoring and early detection of vascular compromise. So, various monitoring methods have been tried, for instance, direct visualization using a fiberoptic pharyngoscope, through a Silastic window placed in the neck flap, or external surface monitoring with an Doppler sonography, use of a buried monitoring probe. But, all of the above have their own shortcomings of simplicity, non-invasiveness, reliability and etc. In our experience, monitoring flap can be a accurate and reliable method.
6극 전자석 전자교반 레오캐스팅에 따른 A356의 조직적 /기계적 영향분석
김백규,노중석,방희재,허민,박진하,전충환 한국주조공학회 2020 한국주조공학회지 Vol.40 No.3
Rheo-diecasting with stirring has been used in many material industries. As the 4th Industrial Revolution approaches the world, eco-friendly high-strength and light-weight materials become more important. Casting methods have been studied and used for aluminum-alloy automobile parts. This study carried out the effect analysis of the micro-structure and mechanical properties, such as yield/ultimate tensile strength, elongation, and hardness, of A356 using the 6-pole EMS (electro-magnetic stirring) casting process with a high electromagnetic force. As a result, the hardness and elongation of the A356 after T6 heat-treatment show a significant improvement, respectively, by 20% and 50%.
레이저 유도 그래핀 및 폴리이미드 전하저장층을 활용한 액적 기반 전기 발전기
김백규,김만진,김도영,김형우,서경덕,이창렬,박상민 한국기계가공학회 2022 한국기계가공학회지 Vol.21 No.11
Droplet-based electricity generators (DEGs) are promising sustainable energy generators owing to their ubiquitous solid liquid contact and separation processes. Herein, we report a simple fabrication of a DEG based on a – laser-induced graphene (LIG) process. A DEG generally consists of contact, bottom electrode, and top electrode layers. For energy enhancement, a charge storage layer is frequently added between the contact and bottom electrode layers. In this study, the LIG process facilitated the fabrication of the bottom electrode layer and its integration with the charge storage layer, producing an LIG DEG showing an outstanding electrical performance of 154 V and 2070 – μW . Furthermore, the LIG DEG showed an excellent energy harvesting ability from a falling droplet in various – conditions, such as impact heights, angles, frequencies, and droplet types. As an energy harvester, the LIG DEG – could charge capacitors to operate electronic devices, such as calculators. Considering the facile fabrication process and excellent electrical performance, an LIG DEG has high potential for applications in smart-home systems, – wearable electronics, and blue energy harvesters.
수지 압궤 손상 후 조직 결손의 재건을 위한 유리 피판술
김백규,허찬영,은석찬,백롱민,형남경 대한수부외과학회 2011 대한수부외과학회지 Vol.16 No.3
Purpose: The crushing injury is one of the most severe type injuries in the finger. For the reconstruction of fingers with crushed and devitalized tissue, various surgical methods have been attempted to cover the soft tissue defects. We performed free flaps for finger reconstruction and investigated the results. Materials and Methods: Between March 2010 and July 2011, we retrospectively reviewed 14 patients who had soft tissue defects of fingers after severe crushing injuries. There were 8 pulp losses, 4 dorsal skin losses with bony exposure,1 nail complex loss, and 1 total loss of distal phalanx. In all cases, soft tissue defects in fingers were reconstructed with a free flap. Results: All flaps survived successfully. We could reserve the functional length without additional necrosis and amputation. Reconstructed fingers were returned to normal activity in a short time and the atrophy or deformity was not observed. Conclusion: Free flap transfer for the reconstruction of the finger defect after crushing injury is useful for the functional recovery and cosmesis. 목적: 수지의 심각한 압궤 손상은 수지에 발생한 손상 중 가장 심한 형태의 손상으로이로 인해 손실된 조직을 재건하기 위하여 여러 가지 수술적 방법들이 시도되고 있다. 본 연구에서는 유리 피판술을 시행하였으며 결과를 분석하였다. 대상 및 방법: 2010년 3월부터 2011년 4월에 걸쳐 심각한 압궤 손상 후 발생한 수지의 조직 결손에 대하여 치료받은 14명의 환자를 후향적으로 조사하였다. 결손 유형은수질부 결손이 8예, 골노출이 동반된 배부 피부 결손이 4예, 조갑 복합체 결손이 1예,원위지절 전체 결손이 1예이었다. 모든 환자에게 유리 피판술을 이용한 재건을 시행하였다. 결과: 모든 피판은 성공적으로 생존하였고 추가 괴사나 절단 없이 기능적 길이 보존이 가능하였다. 모든 환자가 단기간 내에 일상으로의 복귀가 가능하였으며 위축이나변형이 관찰되지 않았다. 결론: 압궤 손상으로 발생한 수지 조직 결손에 있어서 유리 피판술은 기능적으로나미용적으로 우수한 결과를 기대할 수 있는 유용한 방법이다.
뫼비우스 증후군에서 측두근 전위술을 이용한 역동적 재건
김백규,이윤호 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.3
Purpose: Mobius syndrome is a rare congenital disorder characterized by facial diplegia and bilateral abducens palsy, which occasionally combines with other cranial nerve dysfunction. The inability to show happiness, sadness or anger by facial expression frequently results in social dysfunction. The classic concept of cross facial nerve grafting and free muscle transplantation, which is standard in unilateral developmental facial palsy, cannot be used in these patients without special consideration. Our experience in the treatment of three patients with this syndrome using transfer of muscles innervated by trigeminal nerve showed rewarding results.Methods: We used bilateral temporalis muscle elevated from the bony temporal fossa. Muscles and their attached fascia were folded down over the anterior surface of the zygomatic arch. The divided strips from the attached fascia were passed subcutaneously and anchored to the medial canthus and the nasolabial crease for smiling and competence of mouth and eyelids. For the recent 13 years the authors applied this method in 3 Mobius syndrome cases- 45 year-old man and 13 year-old boy, 8 year-old girl.Results: One month after the surgery the patients had good support and already showed voluntary movement at the corner of their mouth. They showed full closure of both eyelids. There was no scleral showing during eyelid closure. Also full closure of the mouth was achieved. After six months, the reconstructed movements of face were maintained.Conclusion: Temporalis muscle transfer for Mobius syndrome is an excellent method for bilateral reconstruction at one stage, is easy to perform, and has a wide range of reconstruction and reproducibility.