• 제목/요약/키워드: Partial defect

검색결과 447건 처리시간 0.022초

전외측 대퇴 유리피판술을 이용한 연부조직 결손의 재건 (Reconstruction of Soft Tissue Defects using Anterolateral Thigh Free Flap)

  • 박명철;이영우;이병민;김관식
    • Archives of Reconstructive Microsurgery
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    • 제6권1호
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    • pp.103-110
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    • 1997
  • Since R.Y. Song(1982) has reported anatomic studies about septocutaneous perforator flap, various experiences especially on thigh flaps pedicled on septocutaneous artery were reported. Baek(1983) reported an anatomic study through the cadavers dissections on medial, lateral thigh area and provided the first new cutaneous free flap of thigh for clinical use. Song, et a1.(1984) reported anterolateral thigh free flap, Koshima, et al.(1989) reported pedicle variations and its versatile clinical usages. According to their reports, accessory branches of lateral femoral circumflex artery are placed in comparatively constant location and proved to be the effective pedicle of this flap. The advantages of anterolateral thigh free flap are 1) comparatively thin 2) can obtain sufficiently large flap 3) can contain cutaneous nerve 4) can be easy to approach anatomically because pedicle is located in comparatively constant position 5) minimal donor site morbidity. We report the experience of 10 cases of anterolateral thigh free flap coverage for soft tissue defects: 4 cases of soft tissue defects on foot area, 2 cases of soft tissue defects on hand, 3 cases of partial tongue defects owing to tongue cancer ablation, and 1 case of soft tissue defect on nasal alar.

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(Ti1-xAlx)N계 질화물의 소결특성에 미치는 Co, Co-Ti 금속결합제의 영향 (Effects of Co-Ti Addition on the Sintering Characteristics of (Ti1-xAlx)N Ntride Powder)

  • 이영기;손용운
    • 열처리공학회지
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    • 제11권3호
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    • pp.177-185
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    • 1998
  • The purpose of this research is to investigate the effects of Co, Co-Ti addition on the sintering characteristic of $(Ti_{1-x}Alx)N$ material synthesized by the direct nitriding method for a application as a cermet material. The observed shrinkage rates of $(Ti_{1-x}Alx)N$ pellets increase with the additive (Co, Co-Ti) content, temperature and time, and also the pellets with the same additive content exhibit the shrinkage behavior that depends on the Ti/Al ratio. However, although the shrinkage rates in this study is the mast higher (36%), the density of the sintered $(Ti_{1-x}Alx)N$ pellet is below 80% density in theory because of the partial segregation and the dense band defect of AlCo compound. Consequentely, it is considered that Co was not effective as a binder material because the wettability of liquid Co metal on $(Ti_{1-x}Alx)N$ materials is poor, In $(Ti_{1-x}Alx)N$ with Ti-Co additive, the stoichiometric TiN is transformed by the under-stoichiometric TiNx(x<1.0) during sintering, leading to the good properties such as hardnees and hot oxidation.

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Reconstruction of Large Defects in the Perineal Area Using Multiple Perforator Flaps

  • Sung, Ki Wook;Lee, Won Jai;Yun, In Sik;Lee, Dong Won
    • Archives of Plastic Surgery
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    • 제43권5호
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    • pp.446-450
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    • 2016
  • Background Perineal defects are commonly encountered during the treatment of conditions such as malignancy, infectious disease, and trauma. Covering large defects in the perineal area is challenging due to its complicated anatomy and the need for functional preservation. Methods Fourteen patients who underwent reconstructive surgery with multiple perforator flaps for defects >$100cm^2$ in the perineal area were included in this retrospective cohort study. Characteristics of the perforator flap operation and postoperative outcomes were reviewed. Results Reconstruction was performed using 2 perforator flaps for 13 patients and 3 perforator flaps for 1 patient. Internal pudendal artery perforator flaps were mainly used for covering the defects. The average defect size was $176.3{\pm}61.8cm^2$ and the average size of each flap was $95.7{\pm}31.9cm^2$. Six patients had minor complications, such as wound dehiscence and partial necrosis of the flap margin, which were corrected with simple revision procedures. Conclusions Multiple perforator flaps can be used to achieve successful reconstructions of large perineal defects that are difficult to reconstruct with other coverage methods.

대동맥축착 동맥관개존 좌공정맥을 합병한 다발성혈관기형의 수술치험예 (Successful Correction of Coarctation of the Aorta, the Patent Ductus Arteriosus, and Persistent Left Superior Vena Cava)

  • 김근호
    • Journal of Chest Surgery
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    • 제7권1호
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    • pp.93-100
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    • 1974
  • This is a case report of successful surgical correction of coarctation of the aorta associated with the patent ductus arteriosus and the persistent left superior vena cava. The patient was a 15 year old girl and congenital heart anomaly was suspected at the sixth month after birth. Afterward there has been no embarrassing symptoms until the day of operation except slight dyspnea on exertion, The diagnosis of coarctation of the aorta and the patent ductus arteriesus detected by physical signs and X-ray studies including aortography. In the first place, coarctation of the aorta was corrected with following procedure: partial resections of the aortic wall just above and below the coarctating line of the aorta and removal of diaphragmatic structure of coarctation performed by. cross clamping aorta above and below coarctation, and then the defect of the aortic wall was closed by lateral aortorrhapic suture with atraumatic needle 3-0 silk continuously [Fig. 6]. In the second place, the patent ductus arteriosus was closed with double ligation method. The persistent left superior vena cava left as it has been, because there has been no evidence of hemodynamic abnormal shunt. After operation, excellent result was obtained; blood pressure in the upper and lower extremities was normalized and subjective complains of hypertension in the upper extremity was disappeared.

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삼방심의 외과적 치료 -수술치험 24례- (Surgical Treatment of Cor Triatriatum)

  • 김영태;노준량
    • Journal of Chest Surgery
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    • 제27권4호
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    • pp.259-265
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    • 1994
  • Cor triatriatum is a relatively rare cardiac anomaly, whose major feature is a fenestrated membrane separating an upper common pulmonary venous chamber from a lower true left atrial cavity. Interatrial communications may be present between the right atrium and the common pulmonary venous chamber or the true left atrium. From April 1981 to April 1992, 24 patients with cor triatriatum were treated at Seoul National University Hospital. Ages ranged from 1 month to 24 years with mean of 7.4 years. Twenty patients had interatrial communications through a patent foramen ovale, primum or secundum defect of the atrial septum. Four had no interatrial communications. Fourteen patients had associated anomalies; partial anomalous pulmonary venous connection in 3, total anomalous pulmonary venous connection in 2, persistent left superior vena cava in 3, and other anomalies in 6 patients. Surgical corrections were performed through right atriotomy in 18 patients, left atriotomy in 4, and both atriotomy in 2. Three patients [12.5%] died early after operation; two of them were associated with single ventricle. Six out of 21 survivors [28.6%] experienced complications; recurrent pneumonia, pulmonary embolism, ischemic encephalopathy, diaphragmatic palsy and tachyarrhythmias. At the time of follow up, all survivors, except one, were in functional class I. Surgical correction of cor triatriatum restored normal hemodynamic status with relatively low operative mortality, especially in patients not complicated with severe anomalies. This report summarizes the clinical diagnosis, associated anomalies, interatrial communications, surgical approach and late result of 24 patients underwent surgical corrections in our hospital.

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Modified Anterior Craniofacial Osteotomy Using Partial Nasal Bone Division and Reconstruction in Frontoethmoidal Sinus Meningioma

  • Park, Eon Ju;Kim, Hong Il;Park, Jin Hyung;Yi, Hyung Suk
    • 대한두개안면성형외과학회지
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    • 제18권2호
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    • pp.117-121
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    • 2017
  • Typical transcranial approaches are insufficient for adequate visualization and resection of skull base tumors. Different approaches with multiple modifications have been attempted. Here, we describe a new approach for a lesion that is central and hard to treat by conventional craniotomy and successful reconstruction with calvarial bone graft and titanium mesh plate. A 69-year-old female patient presented with recurrent meningioma. The tumor had invaded the frontal lobe, right supraorbital rim, and ethmoidal bone. We performed a modified anterior craniofacial approach that fully exposed the tumor and invaded bone. In consideration of the patient's age and cosmetic result, the tumor and invaded bone was resected and the defect area was reconstructed with titanium mesh and calvarial bone graft. At 6 months postoperative the patient had no complications and was satisfied with the esthetic result. We report this case to demonstrate the successful approach and reconstruction using this technique.

Hinged multiperforator-based extended dorsalis pedis adipofascial flap for dorsal foot defects

  • Abd Al Moktader, Magdy A.
    • Archives of Plastic Surgery
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    • 제47권4호
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    • pp.340-346
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    • 2020
  • Background Adipofascial flaps covered with a skin graft address the challenges involved in reconstructing dorsal foot defects. The purpose of this study was to describe a large adipofascial flap based on the perforators of the dorsalis pedis artery for large foot defects. Methods Twelve patients aged 5-18 years with large soft tissue defects of the dorsal foot due to trauma were treated with an extended dorsalis pedis adipofascial flap from May 2016 to December 2018. The flap was elevated from the non-injured half of the dorsum of the foot. Its length was increased by fascial extension from the medial or lateral foot fascia to the plantar fascia to cover the defect. All perforators of the dorsalis pedis artery were preserved to increase flap viability. The dorsalis pedis artery and its branches were kept intact. Results The right foot was affected in 10 patients, and the left foot in two patients. All flaps survived, providing an adequate contour and durable coverage with a thin flap. Follow-up lasted up to 2 years, and patients were satisfied with the results. They were able to wear shoes. Donor-site morbidity was negligible. Two cases each of partial skin graft loss and superficial necrosis at the tip of the donor cutaneous flap occurred and were healed by a dressing. Conclusions The hinged multiperforator-based extended dorsalis pedis adipofascial flap described herein is a suitable method for reconstructing dorsal foot defects, as it provides optimal functional and aesthetic outcomes with minimal donor site morbidity.

소아 환자에서 유리피판술을 이용한 연부 조직 결손의 재건 (Reconstruction of Soft Tissue Defect with Free Flap in Pediatric Patients)

  • 송진우;홍준표
    • Journal of Trauma and Injury
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    • 제23권2호
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    • pp.157-162
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    • 2010
  • Purpose: Free flap reconstruction in the pediatric population is difficult. However, microsurgery has had remarkable success rates in children. The aim of study is to present our clinical experience using free flap for reconstruction of soft tissue defects in children and to describe long-term follow-up results. Methods: Between June 2002 and July 2010, 30 cases of pediatric reconstruction were performed with free flap. The authors analyzed several items, such as the kind of flap, associated complications, and growth problems. Results: Among the 30 cases, 21 cases were due to traffic accidents, 5 to cancer, and 4 to falls and other soft tissue defects. The lower leg and foot were the most common sites of the lesion. In the free flap operations we have done, 20 cases involved an anterolateral thigh perforator free flap, 6 a superficial circumflex iliac perforator free flap, and 4 an upper medial thigh perforator free flap. In early postoperative complications, partial necrosis was seen in 2 cases, infection in 1 case, and the hematoma in 1 case. A satisfactory success rate and functional results were achieved. Conclusion: Free flap reconstruction in children allows satisfactory function with no significant effect on growth. Free flaps are regarded as the primary choice for selective pediatric reconstructive cases.

임상가를 위한 특집 3 - 기능별 뼈이식재의 임프란트 적용방법 (Clinical application of bone graft materials in dental implant)

  • 안강민
    • 대한치과의사협회지
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    • 제48권4호
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    • pp.275-279
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    • 2010
  • Dental implant restoration in partial or full edentulous state has become the standard treatment in recent years. Bone graft with guided bone regeneration technique has been regarded as one of the most reliable methods to restore the bone defect area due to periodontal disease or dental trauma. Bone graft materials and membrane are the essential component of guided bone regeneration; however, a variety of bone graft materials confuse us in implant dentistry. Autogenous bone is the recognized standards in implant dentistry owing to its osteogenesis potential. Despite of its disadvantages, grafting autogenous bone is the most reliable methods. Even though the development of new bone grafts materials, autogenous bone is useful in exposed implant thread and total lack of buccal or lingual bone. Allogenic, xenogenic and synthetic bone have the osteoconductive and osteoinductive potential. These materials could be used successfully in self-contained cavity such as sinus cavity and three-wall defects. In this article, application of bone graft material is suggested according to the function of bone graft materials.

고체절연체의 연면방전에 따른 방사전자파 분포 특성 (The Characteristics of Electromagnetic waves by surface discharge in solid insulator)

  • 김충년;이현동;김기채;박원주;이광식;이동인;이춘하
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 2000년도 하계학술대회 논문집 C
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    • pp.1862-1864
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    • 2000
  • Recently diagnostic techniques have been investigated to detect a partial discharge(PD) associated with a dielectric material defect in a high-voltage electrical apparatus. Among the PD measuring method, detecting electromagnetic wave generated by PD is one of the most effective method because PD radiates wide frequency of electromagnetic wave up to UHF. From the above points of view, we have investigated the polarization and distance characteristics of electromagnetic wave radiated by an insertion of solid insulators between needle-plane electrodes in the air. According to the magnitude of applied voltage, the frequency spectrum of radiated electromagnetic waves were increased about under 100(MHz), compared with background noise. The electromagnetic wave magnitude is attenuated about 4$\sim$7.6[dB] at the point 3[m] away from PD.

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