• Archives of Plastic Surgery
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• 제35권1호
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• pp.78-85
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• 2008

Purpose: The capsular contracture has been the most common complication of augmentation with breast implant, a side effect quite difficult to treat. The latest trends in the correction of capsular contracture include total capsulectomy or conversion of implant pocket. In this study, in an attempt to correct capsular contracture, the authors performed reoperation which involved capsulectomy through peri-areolar approach and dual-plane conversion. The authors hereby report the clinical results of such correction of capsular contracture and examine the efficacy. Methods: The authors selected 46 patients who were admitted to the clinic from January 2004 to January 2007 (37 months), and performed dual-plane conversion through solely peri-areolar approach. Two types of operation were done: dual-plane conversion from subglandular plane or from submuscular plane. Results: The average follow-up time after conversion to the dual-plane position was 10 months. During the follow-up period, 83.1% of patients recovered from capsular contracture and were Baker class I, and in 10.9% the condition had relapsed into Baker class II or III contracture. Conclusion: This study has proven the effectiveness of the dual-plane conversion operation for correcting established capsular contracture after previous augmentation mammaplasty. In this study, all cases of dual-plane conversion operation was performed through peri-areolar approach, which can prevent the occurrence of visible scar on inframammary fold.

• Archives of Plastic Surgery
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• 제51권1호
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• pp.52-61
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• 2024

Background Although prepectoral implant-based breast reconstruction has recently gained popularity, dual-plane reconstruction is still a better option for patients with poor-quality mastectomy skin flaps. However, shoulder morbidity is aggravated by subpectoral reconstruction, especially in irradiated patients. This study aimed to demonstrate shoulder exercise improvement in subpectoral reconstruction by delayed prepectoral conversion with an acellular dermal matrix (ADM) inlay graft technique at the time of expander-to-implant exchange after irradiation. Methods Patients with breast cancer treated for expander-to-implant exchange after subpectoral expander insertion and subsequent radiotherapy between January 2021 and June 2022 were enrolled. An ADM inlay graft was inserted between the pectoralis major muscle and the previously inserted ADM. The ADM was sutured partially overlapping the pectoralis muscle from the medial side with the transition part, to the muscle border at the lateral side. Perioperative shoulder joint active range-of-motion (ROM) for forward flexion, abduction, and external rotation was also evaluated. Results A total of 35 patients were enrolled in the study. Active shoulder ROM significantly improved from 163 degrees preoperatively to 176 degrees postoperatively in forward flexion, 153 to 175 degrees in abduction, and 69 to 84 degrees in external rotation. There was no difference in patient satisfaction regarding the final outcome between the conventional prepectoral reconstruction group and the study group. Conclusion Shoulder exercises in irradiated patients who underwent subpectoral reconstruction were improved by delayed prepectoral conversion using an ADM inlay graft. It is recommended that subpectoral reconstruction not be ruled out due to concerns regarding muscle contracture and shoulder morbidity in radiation-planned patients with poor mastectomy skin flaps.

• 융합신호처리학회논문지
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• 제11권1호
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• pp.88-91
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• 2010

본 논문은 RF모듈과 초음파 센서들을 설치한 밀폐된 공간에서 이동 로봇을 사용해 위치인식과 속도제어에 대한 내용으로 구성하였다. 두 개의 퍼지 룩업 테이블은 설정값에 대한 듀티비 로서 선택한다. 출발점과 커브지점에서 기본퍼지규칙 보다 이중퍼지 규칙을 갖는 이동로봇이 수렴시간을 줄일 수 있었다. 또한 이중 룩업테이블의 교체시간은 e-${\Delta}e$위상 평면내의 특이점인 b1,c1,d1에서 발생한다. 룩업 테이블 중 하나는 과도영역에서 상승시간을 줄이기 위해 사용하고 다른 하나는 정상상태 오차를 줄이고 설정값에 빠르게 수렴하기 위해 사용한다. 퍼지 제어기를 갖는 실내 위치 인식 로봇 제어시스템을 통한 실험의 결과로서 퍼지 제어 알고리즘의 유용성을 확인하였고 이중 퍼지 제어 룰을 갖는 로봇이 하나의 룰 테이블을 갖는 로봇에 비해 개선된 속도 응답을 얻을 수 있음을 확인 하였다.