• Title/Summary/Keyword: salvage technique

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A Study on the Estimation of Economic Depreciation Rate on Industrial Property U sing Remianing Life (잔존수명을 활용한 제조설비의 경제적 감가상각률 추정방안)

  • Oh, Hyun-Seung;Cho, Jin-Hyung
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.33 no.3
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    • pp.219-224
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    • 2010
  • Depreciation accounting has as its main objective, the recovery of the original cost of plant investment less net salvage, over the estimated useful life of that plant. Accuracy of the whole life technique in meeting this objective depends entirely on the original estimates of service life and net salvages for an account. Where the whole life technique has been used and original estimates prove inaccurate, excessive or deficient accumulations in the depreciation reserve frequently occur. To overcome this, the remaining life technique is suggested to better match the challenges of accelerated technology and competition within the regulated environment. The flexibility of the remaining life technique will allow an even chance to provide a complete recovery of the original cost.

Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review

  • Tsung-Chun Huang;Jian-Jr Lee;Kuo-Hui Yang;Chia-Huei Chou;Yu-Chen Chang
    • Archives of Plastic Surgery
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    • v.50 no.6
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    • pp.557-562
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    • 2023
  • Augmentation mammoplasty is one of the most popular cosmetic surgeries, but there is a high reoperation rate (29.7%) commonly due to capsular contracture, implant malpositioning, infection, and unsatisfactory size. Although infection only accounts for 2% of cases, its management is very challenging, especially with nontuberculous mycobacteria (NTM) infection. Breast prosthetic NTM infection is a rare but is a disastrous condition with an incidence of approximately 0.013%. Immediate salvage reimplantation is usually not suggested, and most studies recommend a gap of 3 to 6 months after combination antibiotics therapy before reimplantation. However, delayed reimplantation often leads to great psychological stress and struggle between the doctor and patient. We present the case report of successful reimplantation in treating prosthetic NTM infections in a 28-year-old female. We discuss a novel technique "transaxillary capsulorrhaphy" to correct the bottoming-out deformity. One year after the combination of antibiotics and surgery, the follow-up computed tomography scan showed complete remission of NTM without recurrence. We discuss the surgical technique in detail. The 1-year follow-up assessment (photos and dynamic video) revealed good cosmesis and reliable correction using the new technique. This report is the first formal description and discussion of one-stage reimplantation following NTM infections. Transaxillary capsulorrhaphy allows for a successful salvage operation when an implant is displaced. This approach provides highly favorable result in eastern women undergoing revision augmentation mammoplasty. This study reflects level of evidence V, considering opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.

Head and neck reconstruction using free flaps: a 30-year medical record review

  • Suh, Joong Min;Chung, Chul Hoon;Chang, Yong Joon
    • Archives of Craniofacial Surgery
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    • v.22 no.1
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    • pp.38-44
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    • 2021
  • Background: The free flap surgical method is useful for the reconstruction of head and neck defects. This study retrospectively analyzed the results of head and neck reconstructions using various types of free flaps over the past 30 years. Methods: Between 1989 and 2018, a total of 866 free flap procedures were performed on 859 patients with head and neck defects, including 7 double free flaps. The causes of vascular crisis and salvage rate were analyzed, and the total flap survival rate calculated among these patients. Additionally, the survival and complication rates for each flap type were compared. Results: The 866 cases included 557 radial forearm flaps, 200 anterolateral thigh flaps, 39 fibular osteocutaneous flaps, and 70 of various other flaps. The incidence of the vascular crisis was 5.1%; its most common cause was venous thrombosis (52.3%). Salvage surgery was successful in 52.3% of patients, and the total flap survival rate was 97.6%. The success rate of the radial forearm flap was higher than of the anterolateral flap (p< 0.01), and the primary sites of malignancy were the tongue, tonsils, and hypopharynx, respectively. Conclusion: The free flap technique is the most reliable method for head and neck reconstruction; however, the radial forearm free flap showed the highest success rate (98.9%). In patients with malignancy, flap failure was more common in the anterolateral thigh (5.5%) and fibular (5.1%) flaps.

Arthroscopic Versus Mini-Open Salvage Repair of the Rotator Cuff Tear : Outcome Analysis at Two to Six Years Follow-up (회전개근 순수 관절경적 봉합술과 국소절개 구제봉합술 비교분석 : 2~6년 추시결과 분석)

  • Kim, Seung-Ho;Ha, Kwon-lck;Park, Jong-Hyuk;Kang, Jin-Seok;Oh, Sung-Kyun;Oh, Ir-Vin;Yoo, Jae-Chul
    • Clinics in Shoulder and Elbow
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    • v.5 no.2
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    • pp.88-97
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    • 2002
  • The purpose of this study was to compare the outcomes between arthroscopir repair and mini-open repair of medium and large rotator cuff tears in which arthroscopic repair was technically unsuccessful. We evaluated 76 patients of full-thickness rotator cuff tears, among them 42 patients had all-arthroscopic and 34 patients had mini-open salvage repairs. Patients who had acromioclavicular arthritis, subscapularis tear, or instability were excluded. There were 39 males and 37 females with mean age of 56 years (range,42 to 75 years). At a mean follow-up of 39 months (range, 24 to 64 months), the results of both groups were compared with regard to the UCLA and ASES shoulder rating scale s. Shoulder scores improved in all ratings in both groups (p > 0.05). Overall, sixty-six patients showed excellent or gr)of and ten patients showed fair or poor scores by the UCLA scale. Seventy-two patients satisfactorily returned to prior activity. Four showed unsatisfactory return. The range of motion, strength, and patient's satisfaction were improved postoperatively. There were no difference in shoulder scores, pain, and activity return between the arthroscopic and mini-open salvage groups (p > 0.05). However, Patients with larger size tear showed lower shoulder scores and less predictive recovery of the strength and function (p < 0.05). Postoperative pain was not different with respect to the size of the tear (p : 0.251). Arthroscopic repair of medium and large full-thickness rotator cuff tears had iln equal outcome to technically unsuccessful arthroscopic repairs, which were salvaged by conversion to a mini- open repair technique. Surgical outcome depended on the size of the tear, rather than the method of repair.

Functional Result of Limb Salvage Surgery with Tumor Prosthesis for Osteosarcoma of Proximal Tibia (근위 경골 골육종의 종양대치물을 이용한 사지 구제술 후의 기능 평가)

  • Bahk, Won-Jong;Sohn, Jong-Min;Chung, Yang-Guk;Kang, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.4
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    • pp.139-143
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    • 2001
  • Purpose : Limb salvage for osteosarcoma of proximal tibia is challenging problem due to difficulties in mobilizing or retracting the main neurovascular structure, inadequate soft tissue coverage, and unsolved problem of patellar tendon reattachment to endoprosthesis. The authors analyzed the functional result of limb salvage using tumor prosthesis with medial gastrocnemius rotation plasty for osteosarcama of the proximal tibia. Materials and Methods : Eleven patients with histologically proven osteosarcoma of the proximal tibia, treated with adjuvant and neoadjuvant chemotherapy and limb salvage operation with tumor prosthesis between January 1992 and December 1998 at our Medical Center, were selected. There were 6 male and 5 female. Age ranged from 15 years to 23.7 years with an average of 23.7 years. Follow-up period ranged from 1 year to 4.5 years with an average of 2.5 years. The final functional result was evaluated using the method by ISOLS, 1993. The factors include pain, functional activities, emotional acceptance, use of external supports, walking ability and gait. Each of the factors has been scored from 0 to 5 depending on the appropriate description or data. The rating score is determined by dividing the individual factor scores into the total score and indicates percentage of normal function. Results : The overall functional result ranged from 53,3% to 86.7% with an average of 68.3% of normal function. In details, the averages were 82.5% for pain, 62.5% for functional activities, 67.5% for emotional acceptance, 77.5% for use of external supports, 62.5% for walking ability, and 57.5% for gait. The average range of motion of the knee joint was $5^{\circ}$ extension and $85^{\circ}$ flexion. Five patients have extension lag ranged from $5^{\circ}$ to $15^{\circ}$ with an average of $10^{\circ}$. Two patients suffered postoperative infection. One was treated with antibiotics injection only, but the other needed removal of the prosthesis and knee fusion. Both of them showed unsatisfactory result. C o n c l u s i o n : The overall functional result after limb salvage using tumor prosthesis with medial gastrocnemius rotational flap for osteosarcoma of the proximal tibia was relatively satisfactory in case of no postoperative infection. The patients were less satisfactory in functional activities, emotional acceptance and gait than pain, use of external supports due to limitation of motion and extension lag. More aggressive postoperative physical therapy and protection with brace for 6~9 months as well as surgical technique is mandatory for more satisfactory result.

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Ankle Salvage Procedure without Internal Fixation for Large Bone Defect after Failed Total Ankle Arthroplasty: A Case Report (실패한 족관절 인공관절 치환술 후 큰 골결손에서 내고정 없이 시행한 족관절 구제술: 증례 보고)

  • Park, Man-Jun;Eun, Il-Soo;Jung, Chul-Young;Ko, Young-Chul;Yoo, Chong-Il;Kim, Min-Woo;Hwang, Keum-Min
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.2
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    • pp.76-79
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    • 2014
  • In treatment of failure in ankle joint replacement therapy, talar avascular necrosis with massive bone defect, talus fracture with severe comminution and bone defect and ankle dislocation, treatment of large bone defects is considerably important for ankle joint stability and union, therefore, the choice of treatment for large bone defects is use of femoral head or iliac crest bone graft and rigid internal fixation. Because first generation total ankle arthroplasty performed for the first time using a cemented fixation technique requires a large amount of bone resection during re-surgery and there is some possibility of a larger bone defect after removal of implants, in cases where prosthesis for the defect is needed, performance of palliative femoral head or iliac crest bone graft and rigid internal fixation can be difficult. We report on a case of a 48-year-old woman who had experienced ankle pain for 25 years since undergoing total ankle arthroplasty. Because the patient had little ankle motion and rigid soft tissue despite a large bone defect caused by aseptic loosening, a good outcome was obtained only for the femoral cancellous bone graft using allo femoral head without internal fixation.

Radiotherapy in prostate cancer treatment: results of the patterns of care study in Korea

  • Chang, Ah Ram;Park, Won
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.25-31
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    • 2017
  • Purpose: The purpose of this study was to describe treatment patterns of radiotherapy (RT) for prostate cancer in Korea. Materials and Methods: A questionnaire about radiation treatment technique and principles in 2013 was sent to 83 radiation oncologists and data from 57 hospitals were collected analyzed to find patterns of RT for prostate cancer patients in Korea. Results: The number of patients with prostate cancer treated with definitive RT ranged from 1 to 72 per hospital in 2013. RT doses and target volumes increased according to risk groups but the range of radiation doses was wide (60 to 81.4 Gy) and the fraction size was diverse (1.8 to 5 Gy). Intensity-modulated radiation therapy was used for definitive treatment in 93.8% of hospitals. Hormonal therapy was integrated with radiation for intermediate (63.2%) and high risk patients (77.2%). Adjuvant RT after radical prostatectomy was performed in 46 hospitals (80.7%). Indications of adjuvant RT included positive resection margin, seminal vesicle invasion, and capsular invasion. The total dose for adjuvant RT ranged from 50 to 72 Gy in 24-39 fractions. Salvage RT was delivered with findings of consecutive elevations in prostate-specific antigen (PSA), PSA level over 0.2 ng/mL, or clinical recurrence. The total radiation doses ranged from 50 to 80 Gy with a range of 1.8 to 2.5 Gy per fraction for salvage RT. Conclusion: This nationwide patterns of care study suggests that variable radiation techniques and a diverse range of dose fractionation schemes are applied for prostate cancer treatment in Korea. Standard guidelines for RT in prostate cancer need to be developed.

Osteocutaneous Turn-Up Fillet Flaps: A Spare-Parts Orthoplastic Surgery Option for a Functional Posttraumatic Below-Knee Amputation

  • Harry Burton;Alexios Dimitrios Iliadis;Neil Jones;Aaron Saini;Nicola Bystrzonowski;Alexandros Vris;Georgios Pafitanis
    • Archives of Plastic Surgery
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    • v.50 no.5
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    • pp.501-506
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    • 2023
  • This article portrays the authors' experience with a complex lower limb bone and soft tissue defect, following chronic osteomyelitis and pathological fracture, which was managed by the multidisciplinary orthoplastic team. The decision for functional amputation versus limb salvage was deemed necessary, enhanced by the principles of "spare parts" in reconstructive microsurgery. This case describes the successful use of the osteocutaneous distal tibia turn-up fillet flap that allowed "lowering the level of the amputation" from a through knee to a below-knee amputation (BKA) to preserve the knee joint function. We comprehensibly review reports of turn-up flaps which effectively lower the level of amputation, also applying "spare-parts" surgery principles and explore how these concepts refine complex orthoplastic approaches when limb salvage is not possible to enhance function. The osteocutaneous distal tibia turn-up fillet flap is a robust technique for modified BKA reconstructions that provides sufficient bone length to achieve a tough, sensate stump and functional knee joint.

Clinical Results of Arthroscopic Salvage Repair including Popliteus Tendon as a Post for Complex Lateral Meniscus Tear (복합성 외측 반월상 연골판 파열에서 슬와건을 한시적 지주로 시행한 구제적 성격의 관절경 봉합술의 임상 결과)

  • Park, Sang-Eun;Kim, Sang-Kil
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.1-6
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    • 2010
  • This study was undertaken to document the clinical results and technical aspects of arthroscopic repair including popliteus tendon as a post for the treatment of complex lateral meniscus in young people indicated as total meniscectomy. From June 2004 to May 2006, we prospectively studied arthroscopic repairs on 32 young people knees with symptomatic complex lateral meniscus that was treated by all inside repair technique using Popliteus tendon as a post. Clinical results were evaluated using Lysholm knee scores preoperatively and at final follow-up. 2nd look arthroscopy or MRI was taken at final follow-up. 80% of patients carried out MRI or 2nd look arthroscopy under permission. Most patients who follow up were able to return to their previous life activities with little or no limitation, and no reoperation was required after an average follow-up of 42.8 months. Mean Lysholm knee scores improved from 65.4 (range, 55 to 75) preoperatively to 93.9 (range, 79 to 100) at the final follow-up (P<.001). 80% meniscus healing was found on arthroscopic or MRI follow up. Conclusively, arthroscopic repair using Popliteus tendon as a post is effective for treating young people with complex lateral meniscus tear as a salvage procedure.

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Fuzzy Controller Design for Kite Flight Control (풍력발전용 연의 비행제어를 위한 퍼지 제어기 설계)

  • Cho, Dong-Hyun;Kim, Jong Chul
    • Aerospace Engineering and Technology
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    • v.12 no.1
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    • pp.137-143
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    • 2013
  • In recent years, the interest in a various energy sources is increasing. Among these energies, there are many kinds of researches for the kite which can generate the energy from high-altitude wind power. There are many attempts to apply the kite to the wind power generation and ship salvage, and it must require the flight control of the kite for this applications. In this paper, we suggest this flight controller based on the flight technique of sport kite. For this controller based on the human controller, we design the simple fuzzy controller with simple fuzzy rules.