• Archives of Plastic Surgery
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• 제50권1호
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• pp.10-16
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• 2023

Background The chest wall defects can be caused by various reasons. In the case of malignant tumor resection of the chest wall, it is essential to reconstruct the chest wall to cover the vital tissue and restore the pulmonary function with prevention of paradoxical motion. With our experience, we analyzed and evaluated the results and complications of the chest wall reconstructions followed by malignant tumor resection. Methods From 2013 to 2022, we reviewed a medical record of patients who received chest reconstruction due to chest wall malignant tumor resection. The following data were retrieved: patients' demographic data, tumor type, type of operation, method of chest wall reconstruction of the soft and skeletal tissue and complications. Results There were seven males and six female patients. The causes of reconstruction were 12 primary tumors and one metastatic carcinoma. The pathological types were seven sarcomas, three invasive breast carcinoma, and three squamous cell carcinomas. The skeletal reconstruction was performed in six patients. The series of the flap were eight pedicled latissimus dorsi (LD) myocutaneous flaps, two pectoralis major myocutaneous flap, two vertical rectus abdominis myocutaneous free flap, and one LD free flap. Among all the cases, only one staged reconstruction and successful reconstruction without flail chest. Most of the complications were atelectasis. Conclusion In the case of accompanying multiple ribs and sternal defect, skeletal reconstruction would need skeletal reconstruction to prevent paradoxical chest wall motion. The flap for soft tissue defect be selected according to defect size and location of chest wall. With our experience, we recommend the reconstruction algorithm for chest wall defect due to malignant tumor resection.

• Archives of Craniofacial Surgery
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• 제10권2호
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• pp.71-75
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• 2009

Purpose: Recently, orbital wall fracture is common injuries in the face. Facial CT is essential for the accurate diagnosis and appropriate treatment to reconstruct of the orbital wall. The objective of this study was to report the method for accurate measurement of area and shape of the bony defect in the blow-out fractures using facial CT in prior to surgery. Methods: The authors experienced 46 cases of orbital wall fractures and examined for diplopia, sensory disturbance in the area of distribution of the infraorbital nerve, and enophthalmos in the preoperation and followed 1 months after surgery, from August 2007 to May 2008. Bony defect was predicted by measuring continuous defect size from 3 mm interval facial CT. Copying from the defect model (template), we reconstructed orbital wall with resorbable sheet (Inion $CPS^{(R)}$ Inion Oy, Tampere, Finland). Results: One months after surgery using this method, 26 (100%) of the 26 patients improved in the diplopia and sensory disturbance in the area of distribution of the infraorbital nerve. Also 8 (72.7%) of the 11 patients had enophthalmos took favorable turn. Conclusion: This accurate and time-saving method is practicable for determining the location, shape and size of the bony defect. Using this method, we can reconstruct orbital wall fracture fastly and precisely.

• Journal of Applied Reliability
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• 제18권3호
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• pp.240-249
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• 2018

Purpose: The purpose of this research is to find which technique, between the PAUT (Phased array ultrasonic test) that has been used widely in practice and RT (Radiographic test) that was used widely in the past, has the higher reliability as a non-destructive testing of welding points in water wall tubes. Methods: To evaluated the reliability of non-destructive testing, eleven test pieces that were fabricated intentionally, which have the most frequently occurred defect types in water wall tubes and then both the PAUT and RT were performed on those eleven test pieces to compare their reliability. Results: The differences of type of defect, length are occurred due to the characteristics of nondestructive testing. The RT could not detect the lack of fusion defect type in specimen #4 and #8 while PAUT could not detect the lateral crack and 1 mm size small porosity in specimen #11. Conclusion: It is concluded that applying both the RT and PAUT result the best reliability rather than applying only one test method, if it is possible, in nondestructive testing of weld water wall tube in thermal power plant boiler case.

• Journal of the Korean Society for Nondestructive Testing
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• 제32권1호
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• pp.12-19
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• 2012

This study conducted infrared (IR) thermography tests using pipe and plate specimens with artificial wall-thinning defects to find an optimal condition for IR thermography test on the wall-thinned nuclear piping components. In the experiment halogen lamp was used to heat the specimens. The distance between the specimen and the lamp and the intensity of halogen lamp were regarded as experimental parameter. When the distance was set to 1~2 m and the lamp intensity was above 60 % of full power, a single scanning of IR thermography detected all artificial wall-thinning defects, whose minimum dimension was $2{\Theta}=90^{\circ}$, d/t=0.5, and $L/D_o=0.25$, within the pipe of 500 mm in length. Regardless of the distance between the specimen and the lamp, the image of wall-thinning defect in IR thermography became distinctive as the intensity of halogen lamp increased. The detectability of IR thermography was similar for both plate and pipe specimens, but the optimal test condition for IR thermography depended on the type of specimen.

• Archives of Plastic Surgery
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• 제40권4호
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• pp.335-340
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• 2013

Background In patients with medial orbital wall fracture, predicting the correlation between the degree of enophthalmos and the extent of fracture is essential for deciding on surgical treatment. We conducted this retrospective study to identify the correlation between the two parameters. Methods We quantitatively analyzed the correlation between the area of the bone defect and the degree of enophthalmos on computed tomography scans in 81 patients with medial orbital wall fracture who had been left untreated for more than six months. Results There was a significant linear positive correlation between the area of the medial orbital wall fracture and the degree of enophthalmos with a formula of E=0.705A+0.061 (E, the degree of enophthalmos; A, the area of bone defect) (Pearson's correlation coefficient, 0.812) (P<0.05). In addition, that there were no cases in which the degree of enophthalmos was greater than 2 mm when the area of the medial orbital wall fracture was smaller than $1.90cm^2$. Conclusions Our results indicate not only that 2 mm of enophthalmos corresponds to a bone defect area of approximately $2.75cm^2$ in patients with medial orbital wall fracture but also that the degree of enophthalmos could be quantitatively predicted based on the area of the bone defect even more than six months after trauma.

• Journal of Microbiology
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• 제41권3호
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• pp.224-231
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• 2003

The null pigmentation mutant (npgA1) of Aspergillus nidulans was previously characterized by its production of no pigment at any stage of its life cycle, its reduction in hyphal branching, and its delay in the asexual spore development. The chemical composition of the cell wall was also altered in npgA1 mutants that became more sensitive to Novozyme 234$\^$TM/, which is possibly due to a structural defect in the cell wall. To investigate the effects of the cell wall structure on these pleiomorphic phenomena, we examined the ultrastructure of the cell wall in the npgA1 mutant (WX17). Scanning electron micrographs (SEM) showed that after being cultured for six days, the outermost layer of the conidial wall of WX17 peeled off. Although this phenotype suggested that the cell wall structure in WX17 may be modified, examination using TEM of the fine structure of cross-sectioned hyphal wall of WX17 did not show any differences from that of FGSC4. However, staining for carbohydrates of wall layers showed that the electron-translucent layer of the cell wall was missing in WX17. In addition, the outermost layer H1 of the hyphal wall was also absent in WX17. The ultrastructural observation and cytochemical analysis of cell walls suggested that the pigmentation defect in WX17 may be attributed to the lack of a layer in the cell wall.

• Journal of Chest Surgery
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• 제14권3호
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• pp.302-306
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• 1981

Aorticopulmonary window is a rare anomaly among congenital heart disease. Various terms have been suggested including A-P window, A-P fenestration, fistula, aorticseptal defect etc. The defect lies usually between the left side of the ascending aorta and right wall of the pulmonary artery just anterior to the origin of the right main pulmonary artery. We have experienced one case of aorticopulmonary septal defect which was diagnosed as V5D with pulmonary hypertension in 1 4/12 year old, 7.2 Kg, male patient. Operation was done under the hypothermic cardiopulmonary bypass using 5t. Thomas cardioplegic solution. Vertical right ventriculotomy over the anterior wall of RVOT revealed no defect in the ventricular septum, and incision was extended up to the main pulmonary artery to find the source of massive regurgitation of blood through MPA. Finger tip compression of the aorticopulmanary window was replaced with Foley bag catheter balloon, and the $7{\times}10$ mm aorticoseptal defect located 15mm above the pulmonic valve was sutured continuously wih 3-0 nylon suture during azygos flow of cardiopulmonary cannula which was located distal to the window resulted massive air pumping systemically, and temporary reversal of pumping was tried to minimize cerebral air embolism. Remained procedure was done as usual, and pump off was smooth and uneventful. Postoperatively, patient was attacked frequent opistotonic seizure with no recovery sign mentally and p.hysically. Vital signs were gradually worsen with peripheral cyanosis and oliguria, and cardiac activity was arrested 1485 minutes after operation. Autopsy was performed to find the sutured window and massive edema of the brain.

• Archives of Reconstructive Microsurgery
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• 제24권1호
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• pp.28-31
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• 2015

A case report of a patient who developed radiation-induced sarcoma in the left chest wall is presented. The patient had partial mastectomy and adjuvant radiation therapy (total dose, 5,220 cGy) and chemotherapy. Five years later, she visited with rapidly growing mass with central ulceration in the irradiated chest wall. The mass was diagnosed as malignant fibrous histiocytoma. The chest wall mass resected en bloc ($23{\times}18cm$) including five consecutive ribs. After the defected thoracic cage was reinforced using a polytetrafluoroethylene patch, omental flap and split thickness skin graft was done for soft tissue coverage. We applied negative pressure wound closer system for effective suction of omeantal exudate. The wound healed without complications. The patient suffered no perioperative pulmonary complications. Pulmonary function tests showed no significant changes. Each of Gore-Tex, omental flap, negative pressure wound therapy and skin graft is widely used method. However, If these methods are used in combination, we can reconstruct the large defect of chest wall including multiple ribs without any repiratory function problems.

• Journal of the Korean Society of Safety
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• 제30권1호
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• pp.144-149
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• 2015

This study aims to quantitatively evaluate failure pressure of wall-thinned elbow under combined load along with internal pressure, by conducting real-scale burst test and finite element analysis together. For quantitative evaluation, failure pressure data was extracted from the real-scale burst test first, and then finite element analysis was carried out to compare with the test result. For the test, the wall-thinning defect of the extrados or intrados inside the center of 90-degree elbow was considered and the loading modes to open or close the specimen maintaining a certain load or displacement were applied. Internal pressure was applied until failure occurred. As a result, when the bending load was applied under the load control condition, the intrados of the defect was more affected by failure pressure than the extrados, and the opening mode was more vulnerable to failure pressure than the closing mode. When the bending load was applied under the displacement control, it was hardly affected by failure pressure though it was slightly different from the defect position. The result of the finite element analysis showed a similar aspect with the test. Moreover, when major factors such as material properties and pipeline thickness were calibrated to accurate values, the analytical results was more similar to the test results.

• Korean Journal of Head & Neck Oncology
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• 제37권1호
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• pp.63-66
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• 2021

Supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP) involves the removal of the whole thyroid cartilage, both true and false vocal cords, the ventricles, and the paraglottic spaces, sparing the cricoid cartilage, hyoid bone, and at least one functional and mobile cricoarytenoid unit. Reconstruction is performed by suturing of the cricoid cartilage up tightly to the hyoid bone, so trachea-releasing procedures are needed to prevent leakage at anastomosis site. In case of advanced tranglottic cancer invading tracheal tracheal wall, we need to perform additional circumferentrial circumferential tracheal wall resection. However, when we perform SCPL, circumferential resection of tracheal wall is limited because SCPL procedure itself needs releasing of tracheal length. We report a case of advanced transglottic cancer involving tracheal wall treated with induction chemotherapy and SCPL including tracheal wall resection with reconstruction of tracheal defect by sternocleidomastoid muscle flap covered with skin graft.