• Title/Summary/Keyword: Plastic Stability

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Cell-Assisted Lipotransfer for the Treatment of Parry-Romberg Syndrome

  • Castro-Govea, Yanko;De La Garza-Pineda, Oscar;Lara-Arias, Jorge;Chacon-Martinez, Hernan;Mecott-Rivera, Gabriel;Salazar-Lozano, Abel;Valdes-Flores, Everardo
    • Archives of Plastic Surgery
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    • v.39 no.6
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    • pp.659-662
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    • 2012
  • Progressive facial hemiatrophy, also known as Parry-Romberg syndrome, is a progressive and self-limited deformation of the subcutaneous tissue volume on one side of the face that creates craniofacial asymmetry. We present the case of a patient with a five-year history of progressive right facial hemiatrophy, who underwent facial volumetric restoration using cell-assisted lipotransfer (CAL), which consists of an autologous fat graft enriched with adipose-derived stem cells (ASCs) extracted from the same patient. ASCs have the capacity to differentiate into adipocytes. They also promote angiogenesis, release angiogenic growth factors, and some can survive as stem cells. The use of autologous fat as a filler in soft tissue atrophy has been satisfactory in patients with mild and moderate Parry-Romberg syndrome. Currently, CAL has showed promising results in the long term by decreasing the rate of fat reabsorption. The permanence and stability of the graft in all the injected areas has showed that autologous fat grafts enriched with stem cells could be a promising technique for the correction of defects caused by this syndrome.

Innervated Cross-Finger Pulp Flap for Reconstruction of the Fingertip

  • Lee, Nae-Ho;Pae, Woo-Sik;Roh, Si-Gyun;Oh, Kwang-Jin;Bae, Chung-Sang;Yang, Kyung-Moo
    • Archives of Plastic Surgery
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    • v.39 no.6
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    • pp.637-642
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    • 2012
  • Background Fingertip injuries involving subtotal or total loss of the digital pulp are common types of hand injuries and require reconstruction that is able to provide stable padding and sensory recovery. There are various techniques used for reconstruction of fingertip injuries, but the most effective method is functionally and aesthetically controversial. Despite some disadvantages, cross-finger pulp flap is a relatively simple procedure without significant complications or requiring special techniques. Methods This study included 90 patients with fingertip defects who underwent cross-finger pulp flap between September 1998 and March 2010. In 69 cases, neurorrhaphy was performed between the pulp branch from the proper digital nerve and the recipient's sensory nerve for good sensibility of the injured fingertip. In order to evaluate the outcome of our surgical method, we observed two-point discrimination in the early (3 months) and late (12 to 40 months) postoperative periods. Results Most of the cases had cosmetically and functionally acceptable outcomes. The average defect size was $1.7{\times}1.5$ cm. Sensory return began 3 months after flap application. The two-point discrimination was measured at 4.6 mm (range, 3 to 6 mm) in our method and 7.2 mm (range, 4 to 9 mm) in non-innervated cross-finger pulp flaps. Conclusions The innervated cross-finger pulp flap is a safe and reliable procedure for lateral oblique, volar oblique, and transverse fingertip amputations. Our procedure is simple to perform under local anesthesia, and is able to provide both mechanical stability and sensory recovery. We recommend this method for reconstruction of fingertip injuries.

Evaluation of Skeletal Stability Following Two-jaw Surgery via Surgery First Orthodontic Treatment in Class III Malocclusion (III급 부정교합에서 선수술 교정치료를 통한 양악 수술 후 안정성)

  • Hwang, Dae-Seok;Kim, Yong-Il;Lee, Jae-Yeol;Lee, Seong-Tak;Kim, Tae-Hoon;Lee, Joo-Min;Ahn, Kyung-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.5
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    • pp.407-412
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    • 2011
  • Purpose: The purpose of the present study was to evaluate the postoperative skeletal stability of two-jaw surgery (Le Fort I osteotomy and bilateral sagittal split ramus osteotomy) via surgery first orthodontic treatment (SFOT) in class III malocclusion. Methods: Thirty-two patients who had two-jaw surgery via SFOT were included in this study. Serial lateral cephalograms were obtained before (T0), immediately after (T1), and six months after (T2) surgery. Twelve variables were measured for horizontal and vertical skeletal stability as well as for dental change. All measurements were evaluated statistically by a paired t-test ($P$ <0.05). Results: The mean skeletal changes were $0.1{\pm}2.5$ mm at point A and $-12.0{\pm}7.4$ mm at the pogonion. The mean horizontal relapse was 11.6% at the pogonion, and the mean vertical surgical changes included an upward displacement of $2.1{\pm}7.1$ mm and a forward displacement of $1.4{\pm}4.6$ mm at the pogonion. Upper incisor inclination decreased after surgery and was maintained at T2, and lower incisors were proclined from T1 to T2 by postsurgical orthodontic treatment. Conclusion: Postoperative skeletal stability of two-jaw surgery via surgery first orthodontic treatment in class III malocclusion was clinically acceptable.

RESONANCE FREQUENCY ANALYSIS IN NON-SUBMERGED, INTERNAL TYPE IMPLANT WITH SINUS AUGMENTATION USING DEPROTEINIZED BOVINE BONE MINERAL (이종골을 이용한 상악동 측벽거상술과 동시 식립한 임프란트에서 안정성에 대한 공진 주파수 분석)

  • Lee, Ju-Hyon;Min, Hyun-Gi;Lee, Jin-Sook;Kim, Myung-Rae;Kang, Na-Ra
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.6
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    • pp.554-560
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    • 2008
  • In posterior maxilla, it is difficult to achieve primary stability of implants due to sinus pneumatization, alveolar bone loss, and low bone quality. The accurate and objective primary stability assessment is important for good prognosis of implants. Purpose: The aim of this study was to assess the primary stability of the non-submerged, internal type implants with maxillary sinus augmentation using deproteinized bovine bone mineral by a resonance frequency analyzer, when residual alveolar bone height is under 8mm Materials and methods: A total of 20 implants was placed into 5 grafted maxillary sinuses in 5 patients. Deproteinized bovine bone mineral (Bio-$Oss^{(R)}$) was used as graft material. SS II implants (diameter 4.1mm, and length 11.5mm, SLA suface)) were placed. All of the patients received maxillary sinus graft procedure by 1-step technique. Residual bone height was $1.3{\sim}7.8mm$ (mean 4.4mm) measured by panorama radiography. After implant placement, RFA was measured at 4,8,12,20 weeks. The results were divided into 2 groups; RFA value under 4mm and over 5mm of bone height. It was statistically analyzed. Results: 1. The primary stability of implants was increased with time 2. The RFA value was above 65 ISQ at 12 weeks 3. There was no correlation between RFA and residual alveolar bone height in maxillary sinus augmentation by 1-step technique. Conclusion: 1-step surgical procedure is a feasible option for patients with as little as 4mm residual alveolar bone height, when utilizing non-submerged, internal type implants with xenografts.

Skeletal stability after 2-jaw surgery via surgery-first approach in facial asymmetry patients using CBCT

  • Hwang, Dae Seok;Seo, Jeong Seok;Choi, Hong Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.11.1-11.8
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    • 2020
  • Background: The purpose of this study is to compare the skeletal stability of two-jaw surgery via surgery-first approach with conventional two-jaw surgery in facial asymmetry patients by measuring the skeletal changes after surgery from a three-dimensional analysis. From January 2010 to January 2014, 40 patients with facial asymmetry who underwent two-jaw surgery in Pusan National University Hospital were included in this study. They were classified into experimental group (n = 20) who underwent two-jaw surgery via surgery-first approach and control group (n = 20) who underwent conventional two-jaw surgery. After selection of 24 landmarks and the construction of horizontal and sagittal, coronal reference planes, changes in 10 linear measurements and 2 angular measurements were compared between the surgery-first approach and conventional groups in the preoperative, immediate postoperative, and postoperative periods. The paired t test and Student t test were used for statistical analysis. The mean and standard deviation of the measurement were calculated for the experimental and control groups. Results: The statistical analysis showed that changes in skeletal measurements were similar between the surgery-first approach and conventional groups, according to each period. However, U1-SRP measurement showed statistically significant changes in surgery-first approach groups at postsurgical change (T1 to T2). Also, the mean treatment duration in the treatment group was 15.9 ± 5.48 months whereas that in the control group was 32.9 ± 14.05 months. Conclusion: In facial asymmetry patients, similar results were observed in the postoperative skeletal stability when 2-jaw surgery via surgery-first approach was compared with conventional 2-jaw surgery. However, significant lateral deviation of upper incisor midline was observed. In addition, a shorter average treatment duration was observed. To stabilize the unstable occlusion after surgery, increased wearing of the stent and proactive rubber guidance will be needed.

Effect of the Residual Excess Pore Water Pressure on the Slope Stability Subjected to Earthquake Motion (잔류 과잉공극수압이 지진 하중을 받는 사면의 안정에 미치는 영향)

  • Lee, Jun-Dae;Kwon, Young-Cheul;Bae, Woo-Seok
    • Journal of the Korean Society of Safety
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    • v.21 no.2 s.74
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    • pp.107-113
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    • 2006
  • Earthquake motion is one of the most significant influence factors on the slope stability. In this paper, an effective stress analysis with the elasto-plastic model was carried out to investigate the behavior of the slope stability subjected to the successive two strong earthquake motions, fore and main shock. The major influence of fore shock to the slope stability was considered as the existence of the residual excess pore water pressure. The paper presents the influence of the existence of the fore shock to slope stability using the numerical analyses. In conclusion, the excess pore pressure by the fore shock was not dissipated during the 7hrs of consolidation. By this residual excess pore water pressure, the factor of safety at the sliding face showed the minimum values, and the deformations of slope was large when compared with the case that considered the main shock only. Furthermore, the minimum of the factor of safety came out after the end of the earthquake motion.

Fabrication of Stable Cartilage Framework for Microtia in Incomplete Synchondrosis

  • Cho, Byung-Chae;Lee, Jung-Hun;Choi, Kang-Young;Yang, Jung-Dug;Chung, Ho-Yun
    • Archives of Plastic Surgery
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    • v.39 no.2
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    • pp.162-165
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    • 2012
  • The synchondrosis between the sixth and seventh costal cartilage is usually used for the base frame in autogenous ear reconstruction. If the synchondrosis is loose, a variety of modifications can be devised. This report introduces new methods for these problems. In cases of incomplete synchondrosis, only the surface of the base block margin was smoothly tapered without carving for the removal of the conchal deepening. The secure fixation of the two segments (helix and antihelix) to the base block using fine wire sutures gave stability to the unstable basal frame. After confirming that all the segments were assembled in one stable piece, the remaining conchal deepening of the basal framework was removed, and the outer lower portion of the basal cartilage was trimmed along its whole length. A total of 10 consecutive patients with microtia, ranging from 8 to 13 years old, were treated from 2008 to 2009. The follow-up period was 6 months to 2 years. Despite incomplete synchondrosis, the stable frameworks were constructed using the authors' method and aesthetically acceptable results were achieved. The proposed method can provide an easy way to make a stable cartilage framework regardless of the variable conditions of synchondrosis.

Cyclic behavior of steel I-beams modified by a welded haunch and reinforced with GFRP

  • Egilmez, O. Ozgur;Alkan, Deniz;Ozdemir, Timur
    • Steel and Composite Structures
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    • v.9 no.5
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    • pp.419-444
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    • 2009
  • Flange and web local buckling in beam plastic hinge regions of steel moment frames can prevent beam-column connections from achieving adequate plastic rotations under earthquake-induced forces. Reducing the flange-web slenderness ratios (FSR/WSR) of beams is the most effective way in mitigating local member buckling as stipulated in the latest seismic design specifications. However, existing steel moment frame buildings with beams that lack the adequate slenderness ratios set forth for new buildings are vulnerable to local member buckling and thereby system-wise instability prior to reaching the required plastic rotation capacities specified for new buildings. This paper presents results from a research study investigating the cyclic behavior of steel I-beams modified by a welded haunch at the bottom flange and reinforced with glass fiber reinforced polymers at the plastic hinge region. Cantilever I-sections with a triangular haunch at the bottom flange and flange slenderness ratios higher then those stipulated in current design specifications were analyzed under reversed cyclic loading. Beam sections with different depth/width and flange/web slenderness ratios (FSR/WSR) were considered. The effect of GFRP thickness, width, and length on stabilizing plastic local buckling was investigated. The FEA results revealed that the contribution of GFRP strips to mitigation of local buckling increases with increasing depth/width ratio and decreasing FSR and WSR. Provided that the interfacial shear strength of the steel/GFRP bond surface is at least 15 MPa, GFRP reinforcement can enable deep beams with FSR of 8-9 and WSR below 55 to maintain plastic rotations in the order of 0.02 radians without experiencing any local buckling.