• 제목/요약/키워드: Secondary Defects

검색결과 191건 처리시간 0.027초

Analysis of 120 Pectoralis Major Flaps for Head and Neck Reconstruction

  • You, Young Sun;Chung, Chul Hoon;Chang, Yong Joon;Kim, Kuyl Hee;Jung, Sung Won;Rho, Young Soo
    • Archives of Plastic Surgery
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    • 제39권5호
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    • pp.522-527
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    • 2012
  • Background A pectoralis major flap is one of the standard tools for the reconstruction of defects of the head and neck. Despite the technical advancement in free tissue transfer in head and neck reconstruction, the benefits of a pectoralis major flap should not be overlooked. The purpose of this study is to evaluate our 17 years of experience in reconstructing defects of the head and neck region using the pectoralis major flap. Methods We retrospectively reviewed the medical records of 112 patients (120 cases) who underwent pectoralis major flap operations for head and neck reconstruction during a period ranging from 1994 to 2010. Results In our series, no total necrosis of the flap occurred. Of the total cases, 30.8% presented with flap-related complications. Major complications occurred in 20% of all of the cases but were then all successfully treated. The male sex was correlated with the occurrence of overall complications (P=0.020) and major complications (P=0.007). Preoperative albumin levels of <3.8 g/dL were correlated with the formation of fistula (P=0.030). Defects of the hypopharynx were correlated with the occurrence of major complications (P=0.019) and the formation of fistula (P=0.012). Secondary reconstructions were correlated with the occurrence of overall complications (P=0.013) and the formation of fistula (P=0.030). Conclusions A pectoralis major flap is still considered to be a safe, versatile one-stage reconstruction procedure in the management of the defects of head and neck and the protection of the carotid artery.

Sternoclavicular Joint Infection: Classification of Resection Defects and Reconstructive Algorithm

  • Joethy, Janna;Lim, Chong Hee;Koong, Heng Nung;Tan, Bien-Keem
    • Archives of Plastic Surgery
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    • 제39권6호
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    • pp.643-648
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    • 2012
  • Background Aggressive treatment of sternoclavicular joint (SCJ) infection involves systemic antibiotics, surgical drainage and resection if indicated. The purpose of this paper is to describe a classification of post resectional SCJ defects and highlight our reconstructive algorithm. Defects were classified into A, where closure was possible often with the aid of topical negative pressure dressing; B, where parts of the manubrium, calvicular head, and first rib were excised; and C, where both clavicular, first ribs and most of the manubrium were resected. Methods Twelve patients (age range, 42 to 72 years) over the last 8 years underwent reconstruction after SCJ infection. There was 1 case of a type A defect, 10 type B defects, and 1 type C defect. Reconstruction was performed using the pectoralis major flap in 6 cases (50%), the latissimus dorsi flap in 4 cases (33%), secondary closure in 1 case and; the latissimus and the rectus flap in 1 case. Results All wounds healed uneventfully with no flap failure. Nine patients had good shoulder motion. Three patients with extensive clavicular resection had restricted shoulder abduction and were unable to abduct their arm past $90^{\circ}$. Internal and external rotation were not affected. Conclusions We highlight our reconstructive algorithm which is summarised as follows: for an isolated type B SCJ defect we recommend the ipsilateral pectoralis major muscle for closure. For a type C bilateral defect, we suggest the latissimum dorsi flap. In cases of extensive infection where the thoracoacromial and internal mammary vessels are thrombosed, the pectoralis major and rectus abdominus cannot be used; and the latissimus dorsi flap is chosen.

초기 산소 농도가 고에너지 이온 주입시 발생하는 산소 축적 및 불순물 확산에 미치는 영향 (Effcets of Initial Oxygen Concentration on Oxygen Pileup and the Diffusion of Impurities after High-energy Ion Impaltation)

  • 고봉균;곽계달
    • 전자공학회논문지D
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    • 제36D권4호
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    • pp.48-56
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    • 1999
  • 본 논문에서는 초기 산소 농도가 고에너지 이온 주입시 결정 격자 손상에 의해 발생하는 산소 축적(pileup) 현상 및 주입된 불순물의 확산에 미치는 영향을 실험적으로 고찰하였다. 초기 산소 농도가 11.5, 15.5 ppma인 p-type (100)실리콘 웨이퍼에 \sup 11\B\sup +\ \sup 31\P\sup +\ 이온을 각각 1.2 MeV, 2.2 MeV 의 에너지로 1×10\sup 15\cm\sup 2\ 주입하고, 700℃(20시간)+1000℃(10시간)의 2단계 열처리를 거치 후 주입된 불순물 및 산소 농도의 분포를 이차이온질량분석기 (Secondary Ion Mass Spectrometry, SIMS)로 관찰하였으며 잔류 2차 결함의 분포는 투과전자현미경(Transmission Electron Microscopy, TEM)으로 관찰하였다. SIMS 측정 결과 산소의 축적이 {{{{ { R}_{ } }}}}\sub p\(projected range) 부근에서 관찰되었으며 열처리 후에도 상당한 양의 2차 결합 띠가 {{{{ { R}_{ } }}}}\sub p\부근에서 관찰되는 것으로 보아 2차 결함에 의해 산소가 포획되었음을 알 수 있다. 또한 붕소와 인의 확산은 웨이퍼의 초기 산소 농도가 클수록 벌크 방향으로의 확산이 증대되는 현상을 볼 수 있었다.

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Cytokinin signaling promotes root secondary growth and bud formation in Panax ginseng

  • Kyoung Rok Geem;Yookyung Lim;Jeongeui Hong;Wonsil Bae;Jinsu Lee;Soeun Han;Jinsu Gil;Hyunwoo Cho;Hojin Ryu
    • Journal of Ginseng Research
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    • 제48권2호
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    • pp.220-228
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    • 2024
  • Background: Panax ginseng, one of the valuable perennial medicinal plants, stores numerous pharmacological substrates in its storage roots. Given its perennial growth habit, organ regeneration occurs each year, and cambium stem cell activity is necessary for secondary growth and storage root formation. Cytokinin (CK) is a phytohormone involved in the maintenance of meristematic cells for the development of storage organs; however, its physiological role in storage-root secondary growth remains unknown. Methods: Exogenous CK was repeatedly applied to P. ginseng, and morphological and histological changes were observed. RNA-seq analysis was used to elucidate the transcriptional network of CK that regulates P. ginseng growth and development. The HISTIDINE KINASE 3 (PgHK3) and RESPONSE REGULATOR 2 (PgRR2) genes were cloned in P. ginseng and functionally analyzed in Arabidopsis as a two-component system involved in CK signaling. Results: Phenotypic and histological analyses showed that CK increased cambium activity and dormant axillary bud formation in P. ginseng, thus promoting storage-root secondary growth and bud formation. The evolutionarily conserved two-component signaling pathways in P. ginseng were sufficient to restore CK signaling in the Arabidopsis ahk2/3 double mutant and rescue its growth defects. Finally, RNA-seq analysis of CK-treated P. ginseng roots revealed that plant-type cell wall biogenesis-related genes are tightly connected with mitotic cell division, cytokinesis, and auxin signaling to regulate CK-mediated P. ginseng development. Conclusion: Overall, we identified the CK signaling-related two-component systems and their physiological role in P. ginseng. This scientific information has the potential to significantly improve the field-cultivation and biotechnology-based breeding of ginseng.

Safety of long-term subcutaneous free flap skin banking after skin-sparing mastectomy

  • Verstappen, Ralph;Djedovic, Gabriel;Morandi, Evi Maria;Heiser, Dietmar;Rieger, Ulrich Michael;Bauer, Thomas
    • Archives of Plastic Surgery
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    • 제45권2호
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    • pp.146-151
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    • 2018
  • Background A persistent problem in autologous breast reconstruction in skin-sparing mastectomies is skin restoration after skin necrosis or secondary oncological resection. As a solution to facilitate reconstruction, skin banking of free-flap skin has been proposed in cases where the overlying skin envelope must be resected, as this technique spares the patient an additional donor site. Herein, we present the largest series to date in which this method was used. We investigated its safety and the possibility of skin banking for prolonged periods of time. Methods All skin-sparing mastectomies and immediate autologous breast reconstructions from December 2009 until June 2013 at our institution were analysed. Results We identified 31 patients who underwent 33 free flap reconstructions in which skin banking was performed. Our median skin banking period was 7 days, with a maximum duration of 171 days. In 22.5% of cases, the banked skin was used to reconstruct overlying skin defects, and in 9.6% of cases to reconstruct the nipple-areolar complex. Microbiological and histological investigations of the banked skin revealed neither clinical infections nor malignancies. Conclusions In situ skin banking, even for prolonged periods of time, is a safe and cost-effective method to ensure that skin defects due to necrosis or secondary oncological resection can be easily reconstructed.

Secondary Phase and Defects in Cu2ZnSnSe4 Solar Cells with Decreasing Absorber Layer Thickness

  • Kim, Young-Ill;Son, Dae-Ho;Lee, Jaebaek;Sung, Shi-Joon;Kang, Jin-Kyu;Kim, Dae-Hwan;Yang, Kee-Jeong
    • Current Photovoltaic Research
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    • 제9권3호
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    • pp.84-95
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    • 2021
  • The power conversion efficiency of Cu2ZnSnSe4 (CZTSe) solar cells depends on the absorber layer thickness; however, changes in the characteristics of the cells with varying absorber layer thickness are unclear. In this study, we investigated the changes in the characteristics of CZTSe solar cells for varying absorber layer thickness. Five absorber thicknesses were employed: CZTSe1 2.78 ㎛, CZTSe2 1.01 ㎛, CZTSe3 0.55 ㎛, CZTSe4 0.29 ㎛, and CZTSe5 0.15-0.23 ㎛. The efficiency of the CZTSe solar cells decreased as the absorber thickness decreased, resulting in power conversion efficiencies of 10.45% (CZTSe1), 8.67% (CZTSe2), 7.14% (CZTSe3), 3.44% (CZTSe4), and 1.54% (CZTSe5). As the thickness of the CZTSe absorber layer decreased, the electron-hole recombination at the grain boundaries and the absorber-back-contact interface increased. This caused an increase in the current loss, owing to light loss in the long-wavelength region. In addition, as the thickness of the CZTSe absorber layer decreased, more ZnSe was produced, and the resulting defects and defect clusters led to an open-circuit voltage loss.

유경 횡복직근피판술 후 발생한 부분 피판괴사 및 지방괴사의 넓은등근피판을 이용한 재건 치험례 (Case Report : Latissimus Dorsi Flap for Secondary Breast Reconstruction after Partial TRAM Flap Loss)

  • 송재민;양정덕;이상윤;정기호;정호윤;조병채
    • Archives of Plastic Surgery
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    • 제36권1호
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    • pp.75-79
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    • 2009
  • Purpose: The transverse rectus abdominis musculocutaneous(TRAM) flap is the most commonly used autogenous tissue flap for breast reconstruction. Postoperatively, partial flap loss or fat necrosis are relatively common and it may result in a smaller breast volume with marked contour irregularities. These defects are not easy to reconstruct with local tissue rearrangement or with breast implants. The current authors present the results of 2 patients who underwent Latissimus dorsi(LD) flap reconstruction to correct partial flap or fat necrosis that developed after TRAM flap breast reconstruction. Method: Case1: A 50 - year - old woman with left breast cancer visited for breast reconstruction after radical mastectomy. Initially, breast reconstruction with pedicled TRAM was performed. Postoperatively partial flap necrosis was developed. Secondary breast reconstruction using LD flap was done. Case2: A 51 - year - old woman with left breast cancer visited for breast reconstruction after radical mastectomy. Initially, breast reconstruction with pedicled TRAM was performed. Postoperatively fat necrosis was developed. Secondary breast reconstruction using LD flap was done. Results: Secondary breast reconstruction using LD flap survived completely and produce successful reconstruction. There was no significant complication in both patients. Conclusion: LD flap provides sufficient, vascularized skin and soft tissue. The flap can be molded easily to replace deficient tissue in all areas of the breast. These attributes make it an ideal candidate for salvage of the partially failed TRAM flap breast reconstructio.

선천성 흉벽질환의 교정 (Surgical Treatment of Congenital Chest Wall Defects)

  • 김주현
    • Journal of Chest Surgery
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    • 제20권1호
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    • pp.161-170
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    • 1987
  • Fifty-nine cases of congenital chest wall defects experienced in the department of thoracic surgery of Seoul National University Hospital were analyzed and the relevant literatures were reviewed. They are 52 cases of funnel chest, 3 cases of pigeon breast, one case of superior sternal fissure, one case of costochondral incurvation, one case of Cantrell`s pentalogy, and one case of Poland`s syndrome. Funnel chest affected males more frequently than females by 44 to 8. All of the funnel deformities were corrected by Ravitch operation or its modification except one which was the first case of this series and was corrected by a sterno-turnover. Two cases required a mechanical ventilation for 3 days and 5 days respectively. Four minor complications which were two cases of skin wound infection and 2 cases of fluid accumulation were noted. Skin would infection was repaired by a secondary closure and fluid accumulation was treated by aspiration only. The result are all excellent without recurrence or reoperation. In 3 cases of pigeon breast, they were treated by subperichondrial resection of all of the involved costal cartilages and shortening their course with reefing sutures in the perichondrium with excellent result. The superior sternal fissure which was combined by a ventricular septal defect was treated by a simple wire closure with a good result. The costochondral incurvation was corrected by subperichondrial resection of deformed cartilages and a rib graft removed from the contralateral normal side. The Poland syndrome and the Cantrell`s pentalogy was already presented previously.

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Immediate Near-Total Scalp Reconstruction with Artificial Dermis on Exposed Calvarium

  • Park, Sooyeon;Han, Ki Taik;Kim, Min Cheol;Lim, Jin Soo
    • 대한두개안면성형외과학회지
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    • 제17권4호
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    • pp.233-236
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    • 2016
  • Scalp defect management is complicated secondary to reduced laxity in the scalp and forehead area. For reconstruction of larger defects with exposed bone and loss of the periosteal layer, free flap reconstruction is one option for single-stage surgery, although the procedure is lengthy and includes the possibility of flap loss. We successfully performed a single-stage reconstruction of a large scalp defect using a combination of artificial dermis, split-thickness skin graft, and full-thickness skin graft following wide excision of a cutaneous angiosarcoma, and present our method as one option for the treatment of large oncologic surgical defects in patients who are poor candidates for free flap surgery.

변형된 정중옆 이마피판을 이용한 코끝 재건례 (Modified Paramedian Forehead Flap for Nasal Tip Reconstruction)

  • 강석주;김남훈;김진우;선욱
    • 대한두개안면성형외과학회지
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    • 제13권2호
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    • pp.143-146
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    • 2012
  • Purpose: The typical reconstructive option for the nasal tip is paramedian forehead flap. However, the forehead flap is too bulky for nasal tip reconstruction and does not look natural, and therefore, secondary operations for debulking are required. Methods: We treated a 46-year-old woman who suffered from a nose tip soft tissue defect using a modified paramedian forehead flap. The flap was elevated from the hair line of the forehead and had 3-layered structure. The distal part included skin and subcutaneous tissue, the middle part included frontalis muscle, and the proximal part had periosteum. Results: The nasal tip was not bulky and looked natural in terms of height, shape, and had 3-dimensional structure without debulking procedure. The patient was satisfied with the outcome. Conclusion: The authors' modified paramedian forehead flap may be a useful option for the treatment of nasal tip, columella, and alar defects. With these modifications, the paramedian forehead flap can provide an aesthetically acceptable nasal tip appearance without debulking.