• 한국운동역학회지
• /
• 제19권2호
• /
• pp.197-204
• /
• 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.

• Archives of Reconstructive Microsurgery
• /
• 제20권2호
• /
• pp.89-95
• /
• 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.

• Archives of Reconstructive Microsurgery
• /
• 제12권1호
• /
• pp.38-43
• /
• 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.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제37권
• /
• pp.29.1-29.7
• /
• 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.

• 대한치과의사협회지
• /
• 제23권6호통권193호
• /
• pp.527-538
• /
• 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.

• 대한두경부종양학회지
• /
• 제33권2호
• /
• pp.67-70
• /
• 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.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제20권4호
• /
• pp.284-290
• /
• 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.

• 대한치과교정학회지
• /
• 제36권2호
• /
• pp.161-169
• /
• 2006

이 연구의 목적은 훼이스마스크로 상악 전방견인치료를 받은 성장기 골격성 III급 부정교합자 25명(남 10, 여 15, 평균나이 9.9세)에서 단기간의 정적인 구개범인두 변화를 측모두부방사선 계측사진상에서 선 계측, 각도 계측 및 비율 계측을 시행하여 평가하는 것이다. 경구개 평면각의 변화량은 maxillary depth 또는 N-perp to A의 변화량과 음의 상관관계를 보였다 (p<0.01). 경-연구개 각의 증가는 유의성이 있었으며, 이는 경구개 평면각의 변화보다 연구개 평면각의 변화의 영향을 더 받았다 (p<0.001). 연조직- 과 경조직- 비인두 깊이의 증가는 유의성 있었으며 (p<0.001), 이들의 변화량과 연구개 평면각의 변화량간에는 양의 상관관계를 보였다 (p<0.05). 경구개 길이의 증가는 유의성이 있었으며 (p<0.001), 이는 연조직 비인두 깊이의 증가량과 음의 상관관계를 보였다. (p<0.05). Need 비율 S (C)의 증가는 유의성이 있었으나 (p<0.001), 이러한 증가는 이전 연구에서 보고된 Need 비율 S (C)의 정상 범위 내에 있었다. 이 연구로 상악골의 전방견인 후에 정적인 구개범인두 부위에 변화가 있을지라도 구개범인두의 적격성이 유지됨을 알 수 있었다.

• 대한치과교정학회지
• /
• 제29권4호
• /
• pp.399-409
• /
• 1999

본 연구는 교정치료동안의 전치부 후방이동에 의한 하안면부 연조직 측모 변화를 평가하기 위하여 시행되었다. 치조성 양악전돌을 주소로 내원하여 상, 하악 제 1 소구치를 발거하고 전치부 후방이동을 시행한 31증례의 치료전후 측모두부X선규격사진을 이용하였으며 성장의 영향을 배제하기 위하여 17세 이상의 한국인 여성으로 대상을 제한하였다. 치료전후 각 계측치와 변화량을 이용하여 paired f-test와 상관분석 및 회귀분석을 시행한 결과 다음과 같은 결론을 얻었다. $\cdot$치아의 후방이동량과 연조직의 후방이동량의 비는, 상악 중절치 (UIS):상순 (LS)은 1.54:1, 하악 중절치 (LIS):하순 (Ll)은 0.92:1이며 각각의 상관계수는 각각 0.746과 0.584로 나타났다. $\cdot$치료동안 연조직 자체의 두께는 상순 (UIS-LS)에서만 증가가 있었고 나머지 부위에서는 약간의 감소가 있었다. $\cdot$치아 이동량과 연조직 이동량간의 상관분석에서 상순 (LS)은 상악 중절치 (UIS)와 하순(LI)은 B점과 가장 높은 상관관계를 보였다. $\cdot$치아이동에 따른 하안면부 연조직의 이동을 예측하기 위한 다중 회귀방정식을 구할 수 있었다.

• 대한치과교정학회지
• /
• 제17권2호
• /
• pp.299-310
• /
• 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.