• Title/Summary/Keyword: Soft tissue change

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Plantar Soft-tissue Stress states in standing: a Three-Dimensional Finite Element Foot Modeling Study

  • Chen, Wen-Ming;Lee, Peter Vee-Sin;Lee, Tae-Yong
    • Korean Journal of Applied Biomechanics
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    • v.19 no.2
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    • pp.197-204
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    • 2009
  • It bas been hypothesized that foot ulceration might be internally initiated. Current instruments which merely allow superficial estimate of plantar loading acting on the foot, severely limit the scope of many biomechanical/clinical studies on this issue. Recent studies have suggested that peak plantar pressure may be only 65% specific for the development of ulceration. These limitations are at least partially due to surface pressures not being representative of the complex mechanical stress developed inside the subcutaneous plantar soft-tissue, which are potentially more relevant for tissue breakdown. This study established a three-dimensional and nonlinear finite element model of a human foot complex with comprehensive skeletal and soft-tissue components capable of predicting both the external and internal stresses and deformations of the foot. The model was validated by experimental data of subject-specific plantar foot pressure measures. The stress analysis indicated the internal stresses doses were site-dependent and the observation found a change between 1.5 to 4.5 times the external stresses on the foot plantar surface. The results yielded insights into the internal loading conditions of the plantar soft-tissue, which is important in enhancing our knowledge on the causes of foot ulceration and related stress-induced tissue breakdown in diabetic foot.

The Signification of Anterolateral Thigh Free Flap for Reconstruction of Soft Tissue Defect in Malignant Soft Tissue Tumor of Lower Extremity (하지에 발생한 연부 조직 종양의 광범위 절제술 후 재건술에서 전외측 대퇴부 유리 피판술의 유용성)

  • Kwon, Young Ho;Lee, Gun Woo
    • Archives of Reconstructive Microsurgery
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    • v.20 no.2
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    • pp.89-95
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    • 2011
  • Purpose: The purpose of this study was to evaluate the clinical results of anterolateral thigh free flap on soft tissue defect following wide excision in malignant soft tissue tumor of lower extremities. Methods: Between February 2005 to April 2010, we followed up 19 cases who were undergoing anterolateral thigh free flap because of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity, including 9 cases were heel, 5 cases in foot, 3 cases in ankle, 2 cases in knee and leg. We observed that of implanted area's color, peripheral circulation at 3, 5, 7 days after operation and evaluated operating time, amount of hemorrhage, implanted skin necrosis, additional operations, complications. And we also evaluated the oncologic results, including local recurrence, metastasis, and morbidity. Results: Average operation time of wide excision and anterolateral thigh free flap was 7 hour 28 minutes. 18(94.7%) of total 19 cases showed successful engraftment, on the other hand, failure of engraftment due to complete necrosis of flap in 1 case. In 18 cases with successful engraftment, reoperation was performed in 4 cases. Among them, removal of hematoma and engraftment of flap after bleeding control was performed in 3 cases, because of insufficient circulation due to the hematoma. In the remaining 1 case, graft necrosis due to flap infection was checked, and grafted after combination of wound debridement and conservative treatment such as antibiotics therapy, also skin graft was performed at debrided skin defect area. Skin color change was mainly due to congestion with hematoma, flap was not observed global congestion or necrosis except 4 cases which shows partial necrosis on margin that treated with conservative therapy. Conclusions: Anterolateral thigh free flap could be recommended for reconstruction of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity.

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Reconstruction of Soft Tissue Defect Caused by Excision of Soft Tissue Tumor Using Dorsalis Pedis Pedicled Island Flap (하지 연부조직 종양의 절제 후 발생한 결손의 재건을 위한 도서형 유경 피판술로서의 족배동맥 피판술)

  • Han, Chung-Soo;Shin, Dong-Jun;Moon, Jee-Soo;Park, Hyun-Chul
    • Archives of Reconstructive Microsurgery
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    • v.12 no.1
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    • pp.38-43
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    • 2003
  • Purpose : Various free flaps and pedicled island flaps are effective for reconstruction of soft tissue defect developed after tumor excision. We want to know the advantage of dorsalis pedis island flap for reconstruction of soft tissue defect caused by soft tissue tumor excision. Materials and Methods : Between 1992 and 2002, we performed 4 dorsalis pedis island flap procedure for reconstruction of soft tissue defect of lower limb developed after soft tissue tumor excision. Average age was 54.7 years old $(40{\sim}68)$, and male 2 cases, female 2 cases. The kinds and number of soft tissue tumors were 2 squamous cell carcinoma and 2 malignant melanoma. The procedures that we performed were all dorsalis pedis island flap. The analysis for the result of treatment was retrospectively accessed by physical examination and questionnaire for whether the change of symptom after operation, range of adjacent joint motion. Also we reviewed associated complication after operative treatment. Results : All dorsalis pedis island flaps were alive. There is no problem for activity of daily living, no skin necrosis and no limitation of motion of adjacent joint. In 1 case of them, the patients died of distant metastasis. Conclusion: Dorsalis pedis island flap procedure as a pedicled island flap procedure is very effective and easy operative procedure for reconstruction of soft tissue defect of lower limb developed after tumor excision compared to free flap procedure because there is no need for microvascular surgery, we can obtain relatively large flap and the lesion and flap donor site locate in the same limb.

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Facial asymmetry: a case report of localized linear scleroderma patient with muscular strain and spasm

  • Kim, Jae-Hyung;Lee, Suck-Chul;Kim, Chul-Hoon;Kim, Bok-Joo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.29.1-29.7
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    • 2015
  • Facial asymmetry is found in patients with or without cosmetic facial alterations. Some patients have facial asymmetry that manifests underlying skeletal problems, while others have only limited soft-tissue facial asymmetry. Orthognathic surgery brings about a dermatic change, as soft tissue covers underlying bones. Limited soft-tissue asymmetry, meanwhile, is difficult to correct. The treatment modalities for the creation or restoration of an esthetically pleasing appearance were autogenous fat grafts, cartilage graft, and silicon injections. A young female patient had right-side facial asymmetry. The clinical assessment involved visual inspection of the face and palpation to differentiate soft tissue and bone. Although the extra-oral examination found facial asymmetry with skin atrophy, the radiographic findings revealed no mandibular atrophy or deviation. She was diagnosed as localized scleroderma with muscle spasm. In conclusion, facial asymmetry patients with skeletal asymmetry can be esthetically satisfied by orthognathic surgery; however, facial atrophy patients with skin or subdermal tissue contraction need treatment by cosmetic dermatological surgery and orthodontic correction.

A Longitudinal Study of The Soft Tissue Profile Changes in 6 to 11 Years Children (E국민학교생 6~11세 아동에 있어서 악안면 연조직의 성장변화에 관한 누년적 연구)

  • Park, Young-Chel;Son, Byung-Hwa
    • The Journal of the Korean dental association
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    • v.23 no.6 s.193
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    • pp.527-538
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    • 1985
  • The purpose of this study is to evaluate the chronologic changes of the soft tissue profile in 6 to 11 years children. The author analyzed 174 cephalometric roentgenograms of 13 boys and 16 girls taken from the ages of 6 to 11 to assess the growth changes of the soft tissue profile. The results were obtained as follow: 1. Means, standard deviation and coefficient of variation of children were obtained. 2. Items which showed difference between males and females in longitudinal study were prn. Sn. A', and Ls that were greater than females variation. 3. With age, thickness of the soft tissue were increased except Ls. 4. Nasolabial angle and facial convexity had no significant change with age and sex.

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Neck metastasis of invasive ductal carcinoma of breast causing voice change: a case report (음성변화를 주증상으로 내원한 유방암의 경부연조직 전이환자 1례)

  • Lee, Hyung Min;Park, Ji hoon;Kim, Jin Hwan;Kim, Jung Won;Lee, Dong Jin
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.2
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    • pp.67-70
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    • 2017
  • We present a metastatic carcinoma from the breast to the neck soft tissue around common carotid artery, with a rare finding of voice change. A 60 year-old female patient presented with voice change for 7 months. Neck ultrasound revealed a soft tissue mass between internal jugular vein and common carotid artery. Result of fine needle aspiration biopsy was a metastatic carcinoma. Computed tomography and magnetic resonance image revealed $2.5{\times}3.0cm$ sized irregular marginated soft tissue mass in right lower neck encasing common carotid artery and internal jugular vein. Surgical resection was performed and pathologic result with immunohistochemical analysis confirmed the diagnosis of a metastatic invasive ductal carcinoma originated from breast.

SOFT TISSUE CHANGES FOLLOWING BIMAXILLARY SURGERY IN SKELETAL CLASS III MALOCCLUSION PATIENTS (골격성 III급 부정교합 환자에서 양악 수술후 연조직 변화에 대한 연구)

  • Park, Hong-Ju;Choi, Hong-Ran;Ryu, Sun-Youl
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.4
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    • pp.284-290
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    • 1998
  • The purpose of this study was to assess the soft tissue changes using twenty skeletal class III malocclusion patients who treated with bimaxillary surgery for the correction of dentofacial deformities. Patients were divided into two groups. One was impaction and advancement of maxilla with mandibular set-back (Group 1), the other was downward and advancement of maxilla with mandibular set-back (Group 2). Preoperative and postoperative one year cephalometric data were analyzed and compared. Results obtained were as follows: 1. The ratio of horizontal changes of soft tissue to hard tissue at Nt to ANS, Ls to UI, Li to LI, sPog to Pog were 1:0.60, 1:0.79, 1:0.47, 1:0.63 in group 1 respectively, and 1:0.59, 1:0.48, 1:0.83, 1:1.09 in group 2 respectively. Soft tissue changes were highly predictable at the upper lip, lower lip, and chin area. 2. The ratio of vertical changes of soft tissue to hard tissue at Nt to ANS, Li to LI were 1:0.72, 1:0.06 in group 1, and others showed no statistically significant difference. 3. The ratio of horizontal changes of Ls to hard tissue movements at LI(h) was 1:-0.82 in group 1 and at UI(h), LI(h) were 1:0.48, 1:0.01 in group 2. These ratios of group 1 were greater than those of group 2. 4. The direction of horizontal change of Li was the same as that of hard tissue change. The ratio of horizontal changes of Li to LI was 1:0.47 in group 1 and others showed no statistically significant difference. 5. The changes of upper lip thickness and length were -1.6mm, -1.4mm in group 1, and -1mm, -2.7mm in group 2. 6. The ratios of thickness of upper lip to ANS, UI, LI were 1:-0.83, 1:-0.37, 1:0.11 in group 1. There was similar trend in group 2, and there were no statistically significant difference. These results suggest that prediction of changes in soft tissue of upper lip, lower lip, and chin were 79%, 47%, and 63% in group 1, and 48%, 83%, and 109% in group 2. There was a tendency to decrease in thickness and increase in length of the upper lip.

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A cephalometric study on the velopharyngeal changes after maxillary protraction (상악골 전방견인치료후 구개범인두 변화에 대한 단기간의 측모두부방사선 계측학적 연구)

  • Lee, Nam-Ki;Cha, Bong-Kuen
    • The korean journal of orthodontics
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    • v.36 no.2 s.115
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    • pp.161-169
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    • 2006
  • The purpose of this study was to investigate cephalometrically the short term static velopharyngeal changes in 25 patients (10 boys and 15 girls, aged from 5 years 9 months to 12 years 10 months in the beginning of treatment) with skeletal Class III malocclusions who underwent nonsurgical maxillary protraction therapy with a facemask. The linear, angular and ratio measurements were made on lateral cephalograms. Only the change in hard palatal plane angle was negatively correlated with the change in maxillary depth or N-perp to A (p<0.01). The change in velar angle showed a statistically significant increase (p<0.001). This change was influenced more by the soft palatal plane angle than by the hard palatal plane angle (p<0.001). The changes in soft tissue nasopharyngeal depth and hard tissue nasopharyngeal depth showed statistically significant increases (p<0.001). Correlations between the changes in soft tissue (or hard tissue) nasopharyngeal depth and the change in soft palatal plane angle were significant (p<0.05). The increase in hard palate length was statistically significant (p<0.001). The change in hard palate length was negatively correlated with the change in soft tissue nasopharyngeal depth (p<0.05). The change in need ratio S (C) showed a statistically significant increase (p<0.001). But this difference was within the normal range reported by previous studies. These findings indicate that the velopharyngeal competence was maintained even if the anatomical condition of the static velopharyngeal area were changed after maxillary protraction.

Prediction of the change of soft tissue profile on the lower face following retraction of incisors (전치부 후방이동에 따른 하안면부 연조직 측모 변화의 예측)

  • Lee, Jang-SeoP;Sung, Jae-Hyun
    • The korean journal of orthodontics
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    • v.29 no.4 s.75
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    • pp.399-409
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    • 1999
  • The purpose of this study was to evaluate the change of soft tissue profile on lower face following retraction of incisors through orthodontic treatment. 31 Korean women with bialveolar protrusion who were treated with 4 first bicuspid extraction were selected. All of samples were treated from above 17 years of age. Lateral cephalometric head films taken before and after treatment were analyzed statistically. The results were obtained as follows. $\cdot$The ratio of upper incisor retraction to upper lip retraction and lower incisor retraction to lower lip retraction were 1.54:1 (r=0.746) and 0.92:1 (r=0.584) respectively $\cdot$It appeared during orthodontic treatment that UIS-LS was increased considerably and the others in soft tissue thickness measurements were slightly decresed. $\cdot$Analysis of correlation showed that the change of the upper lip (LS) with the change of maxillary central incisor (UIS) and the change of lower lip with the change of B point were most strongly correlated. $\cdot$The multiple regression equations were obtained to predict soft tissue profile change of lower face according to retraction of incisors.

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A CEPHALOMETRIC STUDY OF PROFILE CHANGES FOLLOWING ORTHOGNATHIC SURGERY IN PATIENTS WITH MANDIBULAR PROGNATHISM (하악전돌증환자의 악교정수술후 안면측모 변화에 관한 두부방사선 계측학적 연구)

  • Lee, Hyung Sik;Park, Yung Chael
    • The korean journal of orthodontics
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    • v.17 no.2
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    • pp.299-310
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    • 1987
  • The purpose of this study was to examine soft tissue and hardtissue changes following orthognathic surgery in patients with mandibular prognathism lateral cephalometric films were obtained immediate before surgery, 48 hours following surgery, and 6 months following surgery. 18 patients were selected (10 men, and 6 women) for this study, who had received orthognathic surgery. Statistical analysis for the each time interval differences were performed with the SPSS package The results were as follows, *In the cases of mandibular sagittal split osteotomy 1 LI point was moved backward (average 7.55mm) 48 hours following surgery. 6 months later, it was returned forward (average 1.1mm) Relapse rate was 14.6% 2 Pog was moved backward (average 8.3mm) 48 hours following surgery The ratio of horizontal change of soft tissue to hard tissue at pog is 0.95 1 *In the cases of maxillary Le-Fort I osteotomy & mandibular sagittal split osteotomy. 3. A point was moved forward (average 3.31mm) 48 hours following surgery. 6 months later, it was returned backward (average 0.31) Relapse rate was 9 4% 4 6 months later, the ratio of facial convexity angle change of soft tissue to hard tissue is 0.63 1.

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