• Title/Summary/Keyword: Partial Reconstruction

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Mandibular Reconstruction using Simulation Surgery with 3D RP Model in Osteoradionecrosis Patient: A Case Report

  • Park, Tae-Jun;Kim, Hong-Joon;Ahn, Kang-Min
    • Journal of International Society for Simulation Surgery
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    • v.2 no.2
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    • pp.76-79
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    • 2015
  • One of the most serious complications after head and neck radiation is osteoradionecrosis (ORN) of the jaw. The etiology of ORN is extraction, minor dental procedure or dental implant surgery. When ORN of the jaw progressed to stage III, free fibular flap is the most useful methods for reconstruction. In this case report, a 67-year-old ORN patient who underwent fibular free flap reconstruction using simulation surgery with 3-dimensional rapid prototype (3D RP) model was reviewed. After partial mandibulectomy, a osteocutaneous fibula flap was used for reconstruction. Oro-cutaneous fistula was resolved after operation. Patients reported improved food intake after operation without pus discharge. Functional and esthetic results showed successful reconstruction.

Comparison between Conservative Treatment of partial ACL Rupture and Reconstructive Surgery with BPTB Autograft in ACL Rupture (전방 십자 인대 파열후 자가 슬개건을 이용한 재건술군과 부분 손상후 보존적 치료군의 비교)

  • Lee Dong Chul;Lee Su Ho;Kim Dong Han
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.2
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    • pp.131-137
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    • 2002
  • Purpose: To evaluate and compare the functional results, activity status, and anterior stability between conservative group with partial ACL injury and reconstruction group with bone-patellar ten-don-bone autograft in ACL total rupture. Materials and Methods: Thirty-eight patients with ACL injury were diagnosed and treated with arthroscopy and followed for more than two years. The number of patients with partial injury was 12(mean age; 38.3) and reconstruction group was 26 (mean age; 25.3). Objective stability was estimated under anterior loading of 15 lb and 20 lb by KT-2000 Arthrometer (MED metric, USA). Functional evaluation using Lysholm score and Tegner activity score were performed. Results: Average functional score of Lysholm was 88.5 in partial injury group and 89.3 in reconstruction group. Average score of Tegner was 5.3 in partial injury group and 5.1 in reconstruction group(P<0.05).Average anterior displacement compared with normal side. Under loading of 20lb, 1.7$\pm$4.3 mm in partial injury group, 2.3$\pm$1.9 mm in reconstruction group were anterior displaced (P<0.05). Under loading of 15lb, 1.2$\pm$1.0 mm in partial injury group, 1.4$\pm$1.5 mm in reconstruction group were dis-placed (P<0.05). There were giving way, effusion, instability and anterior knee pain in complication. Giving way was the frequent complication in the partial injury group. Conclusions: Clinical results of both group were similar. Functional evaluation of Lysholm was good and status of Tegner activity was maintained to physical fitness activites (jogging, regular bik-ing) in both groups on average. The results of conservative treatment for the partial ACL injury (less than 50$\%$) was satisfactory and equivalent to that of reconstructive treatment for the total ACL injury.

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Load-balanced Topology Maintenance with Partial Topology Reconstruction (부분 토폴로지 재구성 기법을 적용한 부하 균형 토폴로지 유지)

  • Hong, Youn-Sik;Lim, Hwa-Seok
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.35 no.12A
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    • pp.1188-1197
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    • 2010
  • A most important thing in a connected dominating set(CDS)-based routing in a wireless ad-hoc network is to select a minimum number of dominating nodes and then build a backbone network which is made of them. Node failure in a CDS is an event of non-negligible probability. For applications where fault tolerance is critical, a traditional dominating-set based routing may not be a desirable form of clustering. It is necessary to minimize the frequency of reconstruction of a CDS to reduce message overhead due to message flooding. The idea is that by finding alternative nodes within a restricted range and locally reconstructing a CDS to include them, instead of totally reconstructing a new CDS. With the proposed algorithm, the resulting number of dominating nodes after partial reconstruction of CDS is not changed and also its execution time is faster than well-known algorithm of construction of CDS by 20~40%. In the case of high mobility situation, the proposed algorithm gives better results for the performance metrics, packet receive ratio and energy consumption.

Partial Breast Reconstruction Using Various Oncoplastic Techniques for Centrally Located Breast Cancer

  • Park, Hyo Chun;Kim, Hong Yeul;Kim, Min Chul;Lee, Jeong Woo;Chung, Ho Yun;Cho, Byung Chae;Park, Ho Yong;Yang, Jung Dug
    • Archives of Plastic Surgery
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    • v.41 no.5
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    • pp.520-528
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    • 2014
  • Background As the breast cancer incidence has increased, breast-conserving surgery has replaced total mastectomy as the predominant procedure. However, centrally located breast cancers pose significant challenges to successful breast-conserving surgeries. Therefore, we performed partial mastectomy and oncoplastic procedures on centrally located breast cancer as a means of partial breast reconstruction. The authors examined and evaluated the functional and aesthetic usefulness of this reconstruction method. Methods From January 2007 to June 2011, 35 patients with centrally located breast cancers who underwent various oncoplastic procedures based on the breast size and resection volume. The oncoplastic procedures performed included volume displacement surgical techniques such as purse-string suture, linear suture, and reduction mammaplasty. Other oncoplastic procedures included volume replacement procedures with an adipofascial, thoracoepigastric, intercostal artery perforator, thoracodorsal artery perforator, or latissimus dorsi flap. Results Mean patient age was 49 years, and mean follow-up period was 11 months. In cases of small to moderate-sized breasts and resection volumes <50 g, volume displacement procedures were performed. In cases of resection volumes >50 g, volume replacement procedures were performed. In cases of larger breasts and smaller resection volumes, glandular reshaping was performed. Finally, in cases of larger breasts and larger resection volumes, reduction mammaplasty was performed. This reconstruction method also elicits a high patient satisfaction rate with no significant complications. Conclusions In centrally located breast cancer, oncoplastic surgery considering breast size and resection volume is safe and provides appropriate aesthetic outcomes. Therefore, our method is advisable for breast cancer patients who elect to conserve their breasts and retain a natural breast shape.

PESQ-Based Selection of Efficient Partial Encryption Set for Compressed Speech

  • Yang, Hae-Yong;Lee, Kyung-Hoon;Lee, Sang-Han;Ko, Sung-Jea
    • ETRI Journal
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    • v.31 no.4
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    • pp.408-418
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    • 2009
  • Adopting an encryption function in voice over Wi-Fi service incurs problems such as additional power consumption and degradation of communication quality. To overcome these problems, a partial encryption (PE) algorithm for compressed speech was recently introduced. However, from the security point of view, the partial encryption sets (PESs) of the conventional PE algorithm still have much room for improvement. This paper proposes a new selection method for finding a smaller PES while maintaining the security level of encrypted speech. The proposed PES selection method employs the perceptual evaluation of the speech quality (PESQ) algorithm to objectively measure the distortion of speech. The proposed method is applied to the ITU-T G.729 speech codec, and content protection capability is verified by a range of tests and a reconstruction attack. The experimental results show that encrypting only 20% of the compressed bitstream is sufficient to effectively hide the entire content of speech.

Characteristics of adhesion areas between the tissue expander and capsule in implant-based breast reconstruction

  • Lim, Yoon Min;Park, Kwang Hyun;Lee, Dong Won;Lew, Dae Hyun;Roh, Tai Suk;Song, Seung Yong
    • Archives of Plastic Surgery
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    • v.46 no.4
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    • pp.330-335
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    • 2019
  • Background The use of anatomic implants has improved the aesthetic results of breast surgery; however, implant malrotation is an uncommon, but serious complication of these procedures. Nevertheless, little research has explored implant adhesion. In this study, we investigated adhesion between the expander and the capsule. Methods Seventy-nine cases of immediate breast reconstruction via two-stage implant-based reconstruction performed between September 2016 and November 2017 were evaluated. Mentor CPX4 expanders were used in 14 breasts, and Natrelle expanders in 65. We analyzed areas of adhesion on the surfaces of the tissue expanders when they were exchanged with permanent implants. We investigated whether adhesions occurred on the cephalic, caudal, anterior, and/or posterior surfaces of the expanders. Results Total adhesion occurred in 18 cases, non-adhesion in 15 cases, and partial adhesion in 46 cases. Of the non-adhesion cases, 80% (n=12) were with Mentor CPX4 expanders, while 94.4% (n=17) of the total adhesion cases were with Natrelle expanders. Of the partial adhesion cases, 90.7% involved the anterior-cephalic surface. The type of tissue expander showed a statistically significant relationship with the number of attachments in both univariate and multivariate logistic regression analyses (P<0.001) and with total drainage only in the univariate analysis (P=0.015). Conclusions We sought to identify the location(s) of adhesion after tissue expander insertion. The texture of the implant was a significant predictor of the success of adhesion, and partial adhesion was common. The anterior-cephalic surface showed the highest adhesion rate. Nevertheless, partial adhesion suffices to prevent unwanted rotation of the expander.

Bilateral Breast Reconstruction with Free TRAM Flaps (횡복직근 유리피판술에 의한 양측 유방 재건)

  • Ahn, Hee Chang
    • Archives of Reconstructive Microsurgery
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    • v.9 no.2
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    • pp.127-133
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    • 2000
  • Free TRAM flap is now increasingly suggested to patients requiring breast reconstruction after the mastectomy. This study is to introduce the experiences of bilateral free TRAM flaps for reconstruction of bilateral breasts and to suggest the way of getting the more satisfactory results. A total of 6 breasts were reconstructed in 3 patients using bilateral free TRAM flaps immediately following the mastectomy. Average operative time for bilateral breast reconstruction was 8 hours comparing to 6.5 hours for unilateral breast reconstruction. Partial or total flap loss did not occur in 6 flaps. Abdomen was repaired directly with muscle and fascia sparing technique without necessity of mesh graft. There was no complication in donor site like abdominal hernia. Bilateral breast reconstruction can achieve exceptionally good aesthetic result with low complication if it is performed with skillful technique and experience. The reason for this is that fairly good symmetry usually is obtained in the initial surgery and in most cases only minimal additional surgery is required to achieve a satisfactory aesthetic result. The one disadvantage of bilateral reconstruction with autologous tissue is the length of the surgical procedure. Although the initial bilateral breast reconstruction can be a long, tedious procedure if free flaps are used, it must be a valuable treatment option for bilaterally mastectomized patients.

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Nipple reconstruction using the C-V flap technique after breast reconstruction with the only breast expander (유방확장기만을 사용한 유방재건술 후 C-V 피판을 이용한 유두재건술)

  • Song, Jea Yong;Han, Byung Kee;Kim, Chung Hun
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.422-427
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    • 2009
  • Purpose: Breast cancer is second most common cancer in women. Almost of patients with breast cancer treated with mastectomy undergoes breast reconstruction. Nipple reconstruction is an important step in breast reconstruction. Many surgeons have investigated of nipple reconstruction using the flap technique after breast reconstruction with the autologous tissue. The objective of this study is to evaluate the results of nipple reconstruction using the C - V flap technique after breast reconstruction with the only breast expander. Methods: From April 2006 to May 2008, the authors treated 17 patients of nipple reconstruction using C - V flap technique, who were received breast reconstruction with the only breast expander. We have predicted decrease of the size of reconstructed nipple and designed flap a little larger than wanted nipple size. Nipple splint was applied for 4 - 6 months for minimizing decrease of the size of reconstructed nipple. The diameter and height of the reconstructed nipple were measured and patient's satisfaction score was assessed. Results: Mean follow-up duration was 12.5 months. Among the 17 patients, the average absorption rate by height of nipple was 47.0%. Partial necrosis was noted in 1 case, and treated well with conservative management. There was no other significant complications noted. Patient's satisfactory score was assessed by the height, design and location of the nipple. The average of satisfaction score was 85%, 68%, 62% and total average was 83%. Conclusion: The authors experienced 17 patients of nipple reconstruction using the C - V flap technique after breast reconstruction with the only breast expander. The absorption rate of the size of the nipple, complications and patient's satisfactory score of this study were similar to those of nipple reconstruction after breast reconstruction with the autologous tissue. It is expected that nipple reconstruction after breast reconstruction with the only breast expander is safe and reliable. It is considered that a long - term study is necessary.

Limberg flap reconstruction for sacrococcygeal pilonidal sinus disease with and without acute abscess: Our experience and a review of the literature

  • Sinnott, Catherine J.;Glickman, Laurence T.
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.235-240
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    • 2019
  • Background The efficacy of Limberg flap reconstruction for pilonidal sinus with acute abscess remains unclear. This study aimed to compare outcomes after Limberg flap reconstruction for pilonidal sinus disease with and without acute abscess. A secondary objective was to perform a review of the literature on the topic. Methods A retrospective chart review was conducted of all patients who underwent excision and Limberg flap reconstruction for pilonidal sinus from 2009 to 2018. Patient demographics, wound characteristics, and complication rates were reviewed and analyzed. Results Group 1 comprised 19 patients who underwent Limberg flap reconstruction for pilonidal sinus disease without acute abscess and group 2 comprised four patients who underwent reconstruction for pilonidal sinus disease with acute abscess. The average defect size after excision was larger in group 2 than group 1 ($107.7{\pm}60.3cm^2$ vs. $61.4{\pm}33.8cm^2$, respectively). There were no recurrences, seromas or cases of flap necrosis postoperatively. There was only one revision surgery needed for evacuation of a postoperative hematoma in group 1. There were comparable rates of partial wound dehiscence treated by local wound care, hematoma, need for revision surgery and minor infection between group 1 and group 2. Conclusions Limberg flap reconstruction for pilonidal sinus in the setting of acute abscess is a viable option with outcomes comparable to that for disease without acute abscess. This practice will avoid the pain and cost associated with a prolonged local wound care regimen involved in drainage of the abscess prior to flap reconstruction.