• Title/Summary/Keyword: dead space

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Surgical Treatment of Pathologic Fracture of the Long Bone due to Metastatic Tumor (골전이로 인한 장골의 병적 골절의 수술적 치료)

  • Shin, Kyoo-Ho;Kim, Dong-Soo;Hahn, Soo-Bong;Han, Dae-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.52-59
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    • 1995
  • Metastatic cancer is the most common tumor of the skeleton. The prevalence of pathologic fracture may increase as patient survival is prolonged by improved cancer therapy. With recent advances in orthopaedic procedure and medical management of terminal cancer patients, it is generally agreed that aggressive treatment should be undertaken for patient with pathologic fracture secondary to metastatic disease, and a team approach should be utilized. The authors have reviewed twenty cases of pathologic fracture of the long bone due to metastatic tumor treated in the Department of Orthopedic Surgery, Yonsei University College of Medicine, from April 1989 to April 1994 and the following results were obtained. 1. The mean age at surgery was 58.4 years (ranged from 24years to 86years) and among 20 cases, 10 cases were male and the others were female. 2. The most frequent site of pathologic fracture in long bone is femur(15 cases, 75%), and followed by humerus(4 cases, 20%), tibia(1 case). 3. The frequently encountered primary tumors that metastases to long bone are those of the lung(7 cases, 35%), breast(4 cases, 20%), and prostate(2 cases, 10%). 4. The operative procedure was performed by resection of the tumor mass extensively, and we used polymethylmetacrylate for filling the dead space after resection, in all cases. 5. The mean survival period after operation is 9.2 months(ranged from 1 month to 4 years and 9 month). 6. The results of postoperative pain relief status were graded as fair to excellent in 17 cases(85%).

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Vastus Lateralis Muscle or Myocutaneous Flap for Trochanteric Skin Defect (외측광근을 이용한 대전자부 피부결손의 치료)

  • Jung, Sung-Weon;Kim, Chong-Kwan
    • Archives of Reconstructive Microsurgery
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    • v.15 no.2
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    • pp.65-69
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    • 2006
  • Purpose: We performed vastus lateralis (VL) muslce or myocutaneous flap for close of the trochanteric skin defect usually happened in paraplegia and report our 6 cases. Materials and Methods: Between March 2004 and August 2005 we performed 4 cases of VL muscule flap with skin graft and 2 cases of VL myocutaneous flap for close of the trochanteric skin defect in 6 paraplegia patients. There were 5 men and 1 woman and mean age was 52.2 years and mean diameters of skin defect was $8.3{\times}8.3\;cm$. The mean follow up period was 18 months. The survival of flap, complications, healing time and patient's satisfaction were evaluated. Results: All flaps were survived except 1 case of margin necrosis. In 2 cases, blood-serous discharges were continued after operation which might be due to dead space and treated with $2{\sim}3$ times debridement and delayed close. Mean time to heal the skin defect was 7.6 weeks. No infection and recurrence in follow up periods. Cosmetic results judged by patients are that 3 cases are good and 3 cases are fair. Conclusion: VL muscle and myocutaneous flap is good treatment method among the numerous methods in treatment-failed cases of trochanteric skin defects of paraplegia patients. This surgical procedure is simple, constant blood supply, good pliability, cosmetic results and also appliable to other skin defect of pelvis girdle like sacrum and ischium.

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Use of the Fix and Flap Approach to Complex Open Elbow Injury: The Role of the Free Anterolateral Thigh Flap

  • Chui, Christopher Hoe-Kong;Wong, Chin-Ho;Chew, Winston Y.;Low, Mun-Hon;Tan, Bien-Keem
    • Archives of Plastic Surgery
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    • v.39 no.2
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    • pp.130-136
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    • 2012
  • Background : Complex elbow injuries with associated nerve, muscle, or joint injury commonly develop post-inury stiffness. In order to preserve function, joint congruency, elbow stability and durable wound coverage must be achieved in a timely manner. Methods : A retrospective review of patients who underwent orthopaedic fixation followed by free anterolateral thigh (ALT) flap soft tissue coverage was performed. Five patients were identified and included in this study. Results : We present a series of 5 cases managed with this principle. Soft tissue defects ranged in size from $4{\times}9cm$ ($36cm^2$) to $15{\times}30cm$ ($450cm^2$) and were located either posteriorly (n=4) or anteriorly (n=1). Associated injuries included open fractures (n=3) and motor nerve transection (n=2). Wound coverage was achieved in a mean duration of 18.8 days (range, 11 to 42 day). There were no flap failures and no major complications. The mean postoperative active elbow motion was $102^{\circ}$ (range, $45^{\circ}$ to $140^{\circ}$). Conclusions : In our small series we have highlighted the safety and utility of using the free ALT flap in complex elbow injuries. The ALT flap has many advantages which include abundant skin and subcutaneous tissue; vascularised vastus lateralis muscle that was used in our series to obliterate dead space, provide a vascular bed for nerve grafts and combat infection; and, access to fascia lata grafts for reconstruction of the triceps tendon.

Reconstruction of the Cone-shaped Defect in the Temporal Area with Rectus Abdominis Free Flap (유리 복직근 피판을 이용한 측두부 원추형 결손의 재건)

  • Kim, Woo Ram;Chang, Hak;Park, Sang Hoon;Koh, Kyung Suck
    • Archives of Plastic Surgery
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    • v.32 no.2
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    • pp.183-188
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    • 2005
  • Defect on the temporal area caused by, surgical ablation of a tumor or an infection should be reconstructed immediately to prevent potentially life-threatening complications such as meningitis and cerebrospinal fluid leakage. The defect on the temporal area usually presents as a typical 'cone-shape'. Successful reconstruction requires sufficient volume of well-vascularized soft tissue to cover the exposed bone and dura. From 1994 through 2003, the authors applied rectus abdominis free flap for the reconstruction of the temporal defect from 1994 through 2003. There were 10 patients with a mean age of 52.1 years. Of these 10 patients, external auditory canal cancer was present in four patients, temporal bone cancer in two, parotid gland cancer in one and three patients were reconstructed after debridement of infection(destructive chronic otitis media). All the free flaps survived, and flap-related complications did not occur. Compared to a local flap, the rectus abdominis free flap can provide sufficient volume of well-vascularized tissue to cover the large defect and can be well-tolerated during an adjuvant radiation therapy. The long and flat muscle can be easily molded to fit in to the 'cone-shape' temporal defect without dead space. It is also preferred because of the low donor site morbidity, a large skin island and an excellent vascular pedicle. Two-team approach without position change is possible. In conclusion, the authors think that rectus abdominis free flap should be considered as one of the most useful method for the reconstruction of a cone-shaped temporal defect.

Optimum topology design of geometrically nonlinear suspended domes using ECBO

  • Kaveh, A.;Rezaei, M.
    • Structural Engineering and Mechanics
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    • v.56 no.4
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    • pp.667-694
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    • 2015
  • The suspended dome system is a new structural form that has become popular in the construction of long-span roof structures. Suspended dome is a kind of new pre-stressed space grid structure that has complex mechanical characteristics. In this paper, an optimum topology design algorithm is performed using the enhanced colliding bodies optimization (ECBO) method. The length of the strut, the cable initial strain, the cross-sectional area of the cables and the cross-sectional size of steel elements are adopted as design variables and the minimum volume of each dome is taken as the objective function. The topology optimization on lamella dome is performed by considering the type of the joint connections to determine the optimum number of rings, the optimum number of joints in each ring, the optimum height of crown and tubular sections of these domes. A simple procedure is provided to determine the configuration of the dome. This procedure includes calculating the joint coordinates and steel elements and cables constructions. The design constraints are implemented according to the provision of LRFD-AISC (Load and Resistance Factor Design-American Institute of Steel Constitution). This paper explores the efficiency of lamella dome with pin-joint and rigid-joint connections and compares them to investigate the performance of these domes under wind (according to the ASCE 7-05), dead and snow loading conditions. Then, a suspended dome with pin-joint single-layer reticulated shell and a suspended dome with rigid-joint single-layer reticulated shell are discussed. Optimization is performed via ECBO algorithm to demonstrate the effectiveness and robustness of the ECBO in creating optimal design for suspended domes.

A Study of the Improvement in an Anaerobic Digester for Sludge Reduction (슬러지 저감을 위한 혐기성 소화조 개선에 관한 연구)

  • Kim, Hong-Seok;Lee, Tae-Jin
    • Journal of Korean Society of Environmental Engineers
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    • v.33 no.7
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    • pp.516-522
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    • 2011
  • The largest problem of domestic anaerobic digestion is low digestion efficiency. Reasons of the problem would be low organic matters input, low mixing efficiency in digestion tank, refractory excess sludge etc.. In this study, screw attached disk-type concentration system and a mechanical mixing system, solubilization facility improvements were performed to solve problems. Through these improvements, the sludge conc. of the concentrator increased 2.6-fold and the volume reduction efficiency was increased 3.0-fold. In addition, the dead-space is reduced by mechanical agitation. Anaerobic digester gas production in the digestion tank is increased from $193.8m^3$ to $386.0m^3$ per day. Digestion efficiency is improved to 54.6% from 47.6%. Digestion gas production is increased from $0.30Nm^3/kg$ VS to $0.42Nm^3/kg$ VS.

Arthroscopic Treatment of the Prepatellar Bursitis - A Report of Three Cases of Percutaneous Mattress Suture Technique - (슬개골전 점액낭염의 관절경적 치료 - 경피적 연차봉합술 3례 보고 -)

  • Lee, Byung-Ill;Min, Kyung-Dae;Choi, Keun-Sun
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.35-39
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    • 1999
  • The authors introduce an operative technique which is simple and effective for the treatment of the large prepatellar bursitis, avoiding problems by the conventional open technique such as tender scar, infection and recurrence. We treated three cases of the large refractory prepatellar bursitis caused by acute direct trauma. Bursectomies were performed by using an arthroscope and percutaneous multiple sutures were applied to the overlying skin with mattress fashion. There were no complications after treatment over one year follow-up. We suggest that this technique is very useful, greatly minimizes the chance of recurrence and reduces the possibility of post-operative infection.

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Mapping algorithm for Error Compensation of Indoor Localization System (실내 측위 시스템의 오차 보정을 위한 매핑 알고리즘)

  • Kim, Tae-Kyum;Cho, We-Duke
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.47 no.4
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    • pp.109-117
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    • 2010
  • With the advent of new technologies such as HSDPA, WiBro(Wireless Broadband) and personal devices, we can access various contents and services anytime and anywhere. A location based service(LBS) is essential for providing personalized services with individual location information in ubiquitous computing environment. In this paper, we propose mapping algorithm for error compensation of indoor localization system. Also we explain filter and indoor localization system. we have developed mapping algorithms composed of a map recognition method and a position compensation method. The map recognition method achieves physical space recognition and map element relation extraction. We improved the accuracy of position searching. In addition, we reduced position errors using a dynamic scale factor.

A Study on the Effects of Wind Load of Membrane Roof Structures according to External Form (외형에 따른 지붕 막구조물의 풍하중 영향 고찰)

  • Ko, Kwang-Woong;Jang, Myung-Ho;Lee, Jang-Bog;Sur, Sam-Yeol
    • Proceeding of KASS Symposium
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    • 2008.05a
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    • pp.15-18
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    • 2008
  • A Spatial structure, having a curvature with a curved surface, is an extremely efficient mechanical creation considering the external load. It is resisted the out-of-plane direction load by in-plane forces using the structure's curvature. Spatial Structures include many types of structures, such as: space frames or grids; cable-and-strut and tensegrity; air-supported or air-inflated; self-erecting and deployable; cable net; tension membrane; lightweight geodesic domes; folded plates; and thin shells. Membrane structures, a kind of lightweight soft structural system, are used for spatial structures. It is very important that effects by wind load than seismic and dead load. And, wind load is different by surrounding and shape of building In this study, we analyze the results of design wind load and wind tunnel tests about the 2 stadiums which are constructed on sensitive sites by effect of wind loads.

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CONTOUR RECONSTRUCTION OF FACIAL DEFECT WITH SPLIT STERNOCLEIDOMASTOID MUSCULAR FLAP FOLLOWING PAROTIDECTOMY (이하선 적출술 후 흉쇄유돌근을 이용한 안모결손부의 외형재건)

  • KIM, Myung-Jin;KIM, Taek-Kyoung;YOU, Jun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.2
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    • pp.144-152
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    • 1991
  • Various muscular flaps are used in oral and maxillofacial reconstructive surgery for the defects caused by tumor resection and trauma or for the correction of head and neck deformities. The sternocleidomastoid(SCM) muscle may be widely used as a muscular or myocutaneous flap in these lesion. The authors used SCM muscular flap for the expected parotid defect following benign tumor related conservative parotidectomy in three cases. We expected that prevention of post-operative facial deformity, reduction of dead-space and protection of denuded facial nerve etc. is lead by SCM muscular flap. But the total SCM flap can lead to some complications such as "flat neck deformity", limitation of neck movement and overcontouring of parotid defect. Therefore, the authors used split pedicled SCM muscular flap and it lead good favorable results of post-operative functional and esthetic problems.

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