• Archives of Plastic Surgery
• /
• 제32권1호
• /
• pp.93-99
• /
• 2005

In spite of proper maneuver of total knee replacement arthroplasty, some patients suffer from skin necrosis just above the implant. From Mar. 2000 to Jan. 2004, the authors performed reconstruction of knee skin defects after total knee replacement athroplasty. Total 6 cases of flap surgery were performed and patients ranged between 43-years-old to 82-years-old. Rectus femoris perforator based reversed adipofascial flaps were used in 2 cases, medial gastrocnemius muscular island flaps were used in 2 cases and sural artery based on adipofascial rotation flap was used in 1 case. One patient with extended necrosis underwent reconstruction with dual flaps of sural artery based adipofascial rotation flap and medial gastrocnemius muscular island flap. There were no distinctive complication needing additional procedure in all cases during the long term follow up. Reconstruction of necrosis following total knee replacement arthroplasty had several characteristics different from simple knee defect. The patients might have the history of long term steroid usages, excessive skin tension due to implants, underlying disease such as diabetes, rheumatoid disease, and etc. In addition, the early ambulation is mandatory in these patients of total knee replacement arthroplasty. With regards to these special considerations, a single stage and reliable operation must be needed. The authors introduce various reconstruction methods and algorithm that may aid easy decision making.

• Archives of Plastic Surgery
• /
• 제45권1호
• /
• pp.85-88
• /
• 2018

Local flaps exhibit excellent color matching that no other type of flap can compete with. Moreover, surgery using a local flap is easier and faster than surgery using a distant or free flap. However, local flaps can be much more difficult to design. We designed 2 templates to plan a V-Y rotation advancement flap. The template for a unilateral V-Y rotation advancement flap was used on the face (n=5), anterior tibia (n=1), posterior axilla (n=1), ischium (n=1), and trochanter (n=2). The template for a bilateral flap was used on the sacrum (n=8), arm (n=1), and anterior tibia (n=1). The causes of the defects were meningocele (n=3), a decubitus ulcer (n=5), pilonidal sinus (n=3), and skin tumor excision (n=10). The meningocele patients were younger than 8 days. The mean age of the adult patients was 50.4 years (range, 19-80 years). All the donor areas of the flaps were closed primarily. None of the patients experienced wound dehiscence or partial/total flap necrosis. The templates guided surgeons regarding the length and the placement of the incision for a V-Y rotation advancement flap according to the size of the wound. In addition, they could be used for the training of residents.

• 한국방재학회 논문집
• /
• 제7권1호통권24호
• /
• pp.11-20
• /
• 2007

본 연구에서는 H형 기둥-보 접합부에서 스캘럽 주변의 파단을 피하기 위해 스캘럽을 생략하고 보와 기둥의 쉬어탭을 볼트로 체결한 후 보 플랜지의 양면에 커버 플레이트와 리브로 보강하는 방법을 제안하였다. 스캘럽을 생략함으로써 스캘럽에서의 응력집중의 빈도를 줄이고 용접부 주위에서의 취성파괴를 방지하여 건축물의 내진성능을 향상시키는데 본 연구의 목적을 둔다. 본 목적을 위해 총 4개의 실험체를 제작하고 반복 가력 실험을 실시하였다. 주요 실험변수는 패널존 강도비이고 실험체의 항복강도, 초기강성, 총소성회전에 대한각 부재의 기여도, 에너지 소산능력으로부터 제작된 실험체들이 특수모멘트골조 내진규정에 만족을 하는지와 실험에 사용된 변수에 대한 여러 영향을 밝히고자 하였다. 그 결과 모든 실험체는 층간변위 4%, 총소성회전 0.03rad.에 충분이 도달하여 1997 AISC의 내진규정에 따라 특수모멘트골조에 만족할 것이라 판단된다.

• 한국전산구조공학회:학술대회논문집
• /
• 한국전산구조공학회 1995년도 봄 학술발표회 논문집
• /
• pp.17-27
• /
• 1995

For the post-buckling and elasto-plastic analysis of shell structures, the total Lagrangian formulation is presented based upon the degenerated shell element. Geometrically correct formulation is developed by updating the direction of normal vectors in the iteration process and evaluating the total Green-Lagrange stain corresponding U total displacements. In the calculation of the stiffness matrix, the element formulation takes into account the effect of finite rotation increments by retaining second order rotation terms in the incremental displacement field. The selective or reduced integration scheme using the heterosis element is applied in order to overcome both shear locking phenomena and the zero energy mode. The load/displacement incremental scheme is adopted for geometric non-linear F .E. analysis. Based on such methodology, the computer program is developed and numerical examples to demonstrate the accuracy and the effectiveness of the proposed shell element are presented and compared with references's results.

• Archives of Plastic Surgery
• /
• 제46권4호
• /
• pp.330-335
• /
• 2019

Background The use of anatomic implants has improved the aesthetic results of breast surgery; however, implant malrotation is an uncommon, but serious complication of these procedures. Nevertheless, little research has explored implant adhesion. In this study, we investigated adhesion between the expander and the capsule. Methods Seventy-nine cases of immediate breast reconstruction via two-stage implant-based reconstruction performed between September 2016 and November 2017 were evaluated. Mentor CPX4 expanders were used in 14 breasts, and Natrelle expanders in 65. We analyzed areas of adhesion on the surfaces of the tissue expanders when they were exchanged with permanent implants. We investigated whether adhesions occurred on the cephalic, caudal, anterior, and/or posterior surfaces of the expanders. Results Total adhesion occurred in 18 cases, non-adhesion in 15 cases, and partial adhesion in 46 cases. Of the non-adhesion cases, 80% (n=12) were with Mentor CPX4 expanders, while 94.4% (n=17) of the total adhesion cases were with Natrelle expanders. Of the partial adhesion cases, 90.7% involved the anterior-cephalic surface. The type of tissue expander showed a statistically significant relationship with the number of attachments in both univariate and multivariate logistic regression analyses (P<0.001) and with total drainage only in the univariate analysis (P=0.015). Conclusions We sought to identify the location(s) of adhesion after tissue expander insertion. The texture of the implant was a significant predictor of the success of adhesion, and partial adhesion was common. The anterior-cephalic surface showed the highest adhesion rate. Nevertheless, partial adhesion suffices to prevent unwanted rotation of the expander.

• Archives of Plastic Surgery
• /
• 제43권4호
• /
• pp.311-315
• /
• 2016

In Korea, lateral canthoplasty, along with medial epicanthoplasty, has become popular over the past years to widen the horizontal length of the palpebral fissure. However, the effect of the surgery differs greatly depending on the shape and structure of the eyes. If over-widened, complications such as eversion, scarring, and conjunctival exposure may occur. Thus, the author of this study suggests a more effective and safe method for lateral canthal lengthening that causes minimal complications. A total of 236 patients underwent lateral canthoplasty between July 2007 and December 2015. For each patient, a triangular flap 4-5 mm away from the lateral canthus was elevated and rotated 45 degrees laterally while the continuity of the lower eyelid gray line was maintained. A new lateral canthus was created by fixating the rotation flap to the lateral orbital rim with minimal skin trimming and tension-free sutures, preventing relapse and maintaining a triangular shape. In more than 95% of cases, effective and satisfactory extension was achieved. On average, a 3 mm extension of the lateral canthus was achieved. There were minor complications such as wound dehiscence, webbing, and scarring, which were easily corrected. The author not only extended the lateral canthus 3-4 mm laterally but also maintained the continuity of the gray line on the lower lid as a more natural-looking triangular shape, while minimizing complications such as webbing and conjunctival exposure.

• 한국강구조학회 논문집
• /
• 제10권4호통권37호
• /
• pp.629-639
• /
• 1998

본 연구에서는 반복재하 실물대 실험에 의해 철골 모멘트접합부(column-tree 형식)의 내진거동을 평가하였다. 시험체는 $H-600{\times}200$ (보) 및 $H-400{\times}400$ (기둥) 계열의 SS41 (SS400) 압연형강으로 제작되었으며 보에 대한 패널존의 상대강도를 실험의 주요변수로 고려하였다. 본 실험결과에 의할 때 패널존의 강도가 클수록 열등한 내진성능을 보였다. 시험체의 모멘트 접합부에서 접합부의 파괴 이전까지 발휘된 총소성회전각은 1.8 (% rad)에서 3 (% rad) 범위에 있었다. 시험체의 접합부는 보플랜지 열영향부의 파단 또는 기둥플랜지 두께방향의 뽑힘으로 인하여 파괴되었다. 비록 제한된 실험자료이긴 하나 본 연구의 결과는 보에만 항복을 유발하는 것 보다는 패널존의 항복도 허용하는 것이 접합부의 전체적 소성변형능력을 높이는데 유리할 것임을 시사한다. 이러한 실험결과를 역학적으로 설명할 수 있는 모델도 제시하고자 하였다.

• 한국콘크리트학회:학술대회논문집
• /
• 한국콘크리트학회 2004년도 춘계 학술발표회 제16권1호
• /
• pp.688-691
• /
• 2004

This study summarizes results of a research project aimed at investigating the inelastic rotation capacity of beam-column joints of reinforced concrete moment frames. A total of 28 specimens were classified as special moment frame connections based on the design and detailing requirements in the ACI 318-99 provisions. Then, the acceptance criteria, originally defined for steel moment frame connections in the AISC-97 Seismic Provisions, were used to evaluate the joint connections of concrete moment frames. Twenty seven out of 28 test specimens that satisfy the design requirements for special moment frame structures provided sufficient strength and are ductile up to a plastic rotation of $3\%$ without any major degradation in strength.

• Earthquakes and Structures
• /
• 제10권2호
• /
• pp.329-350
• /
• 2016

A parametric study was conducted to investigate the seismic deformation demands in terms of drift ratio, plastic base rotation and compression strain on rectangular wall members in frame-wall systems. The wall index defined as ratio of total wall area to the floor plan area was kept as variable in frame-wall models and its relation with the seismic demand at the base of the wall was investigated. The wall indexes of analyzed models are in the range of 0.2-2%. 4, 8 and 12-story frame-wall models were created. The seismic behavior of frame-wall models were calculated using nonlinear time-history analysis and design spectrum matched ground motion set. Analyses results revealed that the increased wall index led to significant reduction in the top and inter-story displacement demands especially for 4-story models. The calculated average inter-story drift decreased from 1.5% to 0.5% for 4-story models. The average drift ratio in 8- and 12-story models has changed from approximately 1.5% to 0.75%. As the wall index increases, the dispersion in the calculated drifts due to ground motion variability decreased considerably. This is mainly due to increase in the lateral stiffness of models that leads their fundamental period of vibration to fall into zone of the response spectra that has smaller dispersion for scaled ground motion data set. When walls were assessed according to plastic rotation limits defined in ASCE/SEI 41, it was seen that the walls in frame-wall systems with low wall index in the range of 0.2-0.6% could seldom survive the design earthquake without major damage. Concrete compressive strains calculated in all frame-wall structures were much higher than the limit allowed for design, ${\varepsilon}_c$=0.0035, so confinement is required at the boundaries. For rectangular walls above the wall index value of 1.0% nearly all walls assure at least life safety (LS) performance criteria. It is proposed that in the design of dual systems where frames and walls are connected by link and transverse beams, the minimum value of wall index should be greater than 0.6%, in order to prevent excessive damage to wall members.

• 한국지진공학회논문집
• /
• 제5권3호
• /
• pp.57-64
• /
• 2001

보강된 판 및 쉘구조의 동적 비선형해석을 수행하기 위하여, 유한회전을 고려한 변형된 쉘유한요소를 이용하여 total Lagrangian formulation이 제시된다. 전단구속 (shear locking) 현상과 가상의 제로에너지 모우드를 동시에 제거하기 위하여 가정변형도 개념을 채용한다. 탄소성해석에서는 return mapping 미해rithm이 쉘구조의 붕괴 해석에 적용된다. Newmark 직접적분법을 사용하여 동하중 및 지진하중을 받는 쉘구조의 동적 비선형해석 결과를 제시한다.