• Title/Summary/Keyword: Defect Location

Search Result 274, Processing Time 0.024 seconds

Reconstruction of the Bone Exposed Soft Tissue Defects in Lower Extremities using Artificial dermis(AlloDerm®) (인공 진피(알로덤®)을 이용한 하지의 골이 노출된 연부 조직 결손의 재건)

  • Jeon, Man Kyung;Jang, Young Chul;Koh, Jang Hyu;Seo, Dong Kook;Lee, Jong Wook;Choi, Jai Koo
    • Archives of Plastic Surgery
    • /
    • v.36 no.5
    • /
    • pp.578-582
    • /
    • 2009
  • Purpose: In extensive deep burn of the lower limb, due to less amount of soft tissue, bone is easily exposed. When it happens, natural healing or reconstruction with skin graft only is not easy. Local flap is difficult to success, because adjacent skins are burnt or skin grafted tissues. Muscle flap or free flap are also limited and has high failure rate due to deep tissue damage. The authors acquired good outcome by performing one - stage operation on bone exposed soft tissue defect with AlloDerm$^{(R)}$(LifeCell, USA), an acellular dermal matrix producted from cadaveric skin. Methods: We studied 14 bone exposed soft tissue defect patients from March 2002 to March 2009. Average age, sex, cause of burn, location of wound, duration of admission period, and postoperative complications were studied. We removed bony cortex with burring, until conforming pinpoint bone bleeding. Then rehydrated AlloDerm$^{(R)}$(25 / 1000 inches, meshed type) was applicated on wound, and thin split thickness(6 ~ 8 / 1000 inches) skin graft was done at the immediately same operative time. Results: Average age of patients was 53.6 years(25 years ~ 80 years, SD = 16.8), and 13 patients were male(male : female = 13 : 1). Flame burn was the largest number. (Flame burn 6, electric burn 3, contact burn 4, and scalding burn 1). Tibia(8) was the most affected site. (tibia 8, toe 4, malleolus 1, and metatarsal bone 1). Thin STSC with AlloDerm$^{(R)}$ took without additional surgery in 12 of 14 patients. Partial graft loss was shown on four cases. Two cases were small in size under $1{\times}1cm$, easily healed with simple dressing, and other two cases needed additional surgery. But in case of additional surgery, granulation tissue has easily formed, and simple patch graft on AlloDerm$^{(R)}$ was enough. Average duration of admission period of patients without additional surgery was 15 days(13 ~ 19 days). Conclusion: AlloDerm$^{(R)}$ and thin split thickness skin graft give us an advantage in short surgery time and less limitations in donor site than flap surgery. Postoperative scar is less than in conventional skin graft because of more firm restoration of dermal structure with AlloDerm$^{(R)}$. We propose that AlloDerm$^{(R)}$ and thin split thickness skin graft could be a solution to bone exposured soft tissue defects in extensive deep burned patients on lower extremities, especially when adjacent tissue cannot be used for flap due to extensive burn.

The role of p21/CIP1/WAF1 (p21) in the negative regulation of the growth hormone/growth hormone receptor and epidermal growth factor/epidermal growth factor receptor pathways, in growth hormone transduction defect

  • Kostopoulou, Eirini;Gil, Andrea Paola Rojas;Spiliotis, Bessie E.
    • Annals of Pediatric Endocrinology and Metabolism
    • /
    • v.23 no.4
    • /
    • pp.204-209
    • /
    • 2018
  • Purpose: Growth hormone transduction defect (GHTD) is characterized by severe short stature, impaired STAT3 (signal transducer and activator of transcription-3) phosphorylation and overexpression of the cytokine inducible SH2 containing protein (CIS) and p21/CIP1/WAF1. To investigate the role of p21/CIP1/WAF1 in the negative regulation of the growth hormone (GH)/GH receptor and Epidermal Growth Factor (EGF)/EGF Receptor pathways in GHTD. Methods: Fibroblast cultures were developed from gingival biopsies of 1 GHTD patient and 1 control. The protein expression and the cellular localization of p21/CIP1/WAF1 was studied by Western immunoblotting and immunofluorescence, respectively: at the basal state and after induction with $200-{\mu}g/L$ human GH (hGH) (GH200), either with or without siRNA CIS (siCIS); at the basal state and after inductions with $200-{\mu}g/L$ hGH (GH200), $1,000-{\mu}g/L$ hGH (GH1000) or 50-ng/mL EGF. Results: After GH200/siCIS, the protein expression and nuclear localization of p21 were reduced in the patient. After successful induction of GH signaling (control, GH200; patient, GH1000), the protein expression and nuclear localization of p21 were reduced. After induction with EGF, p21 translocated to the cytoplasm in the control, whereas in the GHTD patient it remained located in the nucleus. Conclusion: In the GHTD fibroblasts, when CIS is reduced, either after siCIS or after a higher dose of hGH (GH1000), p21's antiproliferative effect (nuclear localization) is also reduced and GH signaling is activated. There also appears to be a positive relationship between the 2 inhibitors of GH signaling, CIS and p21. Finally, in GHTD, p21 seems to participate in the regulation of both the GH and EGF/EGFR pathways, depending upon its cellular location.

An Effective Application of AE Technique for the Detection of Defects in Steel Girder Bridges (강판형교에서의 효율적인 결함검출을 위한 AE기법의 적용)

  • Kim, Sang Hyo;Yoon, Dong Jin;Lee, Sang Ho;Kim, Hyung Suk;Park, Young Jin
    • Journal of Korean Society of Steel Construction
    • /
    • v.9 no.3 s.32
    • /
    • pp.287-300
    • /
    • 1997
  • In this study, an effective application method of AE technique for the detection of fatigue crack in multi-girder steel bridges has been proposed. The applicability has been examined through the laboratory works with bridge model. The proposed analytical method which evaluates the remaining fatigue lives of structural members may improve the rational determination of the priority of inspection for structural members assuming to have fatigue cracks. Laboratory tests for the application of AE technique to steel girder bridges show that the frequency bands of traffic noise are in the range between 10 show that the frequency bands of traffic noise are in the range between 100~200 kHz and the AE signal raised from fatigue cracks is concentrated around 400~500 kHz. Therefore. R30 sensor is proved to be the most suitable for the detection of cracks in steel girder bridges. A linear proportionality between the crack propagation and the frequency of AE signals has been obtained. In addition, an economic and effective source location method for steel girder bridges was studied through experiments.

  • PDF

Heterogeneity Analysis of the Male Birth Ratio Data (남아 출생률 자료에 대한 이질성 분석)

  • Lim, Hwa-Kyung;Song, Seuck-Heun;Song, Ju-Won
    • The Korean Journal of Applied Statistics
    • /
    • v.22 no.2
    • /
    • pp.365-373
    • /
    • 2009
  • Since 1990, identifying the sex of fetus and illegal abortion has brought the sex ratio imbalance at birth in Korea due to a notion of preferring a son to a daughter, socio-economic development, population policy, and so forth. Although there have been many researches such as time series analysis and region difference analysis to monitor this sex ratio imbalance, they have a defect that time and space could not be included in the analysis simultaneously. This study analyzes the sex ratio imbalance at birth, taking into account time and region at the same time. The analysis considered the numbers of male and female babies, who were born as the third or latter in their families, in 2000 and 2001 at 234 Gu / Si / Goon administrative districts. Here, we suggest a mixture model of binomial distributions, assuming heterogeneous populations. The estimation of the location parameters, weights and correlation coefficient of the mixture model is conducted by the EM algorithm, and the heterogeneity of the regions is expressed as a picture using ArcView GIS.

Evaluating Scapular Notching after Reverse Total Shoulder Arthroplasty

  • Kim, Young-Kyu;Won, Jun-Sung;Park, Chang-Kyu;Kim, Jong-Geun
    • Clinics in Shoulder and Elbow
    • /
    • v.18 no.4
    • /
    • pp.248-253
    • /
    • 2015
  • Background: Scapular notching can happen at diverse location depending on implant design or operative technique, therefore, it is easily misdiagnosed. Thus, this study purposed to suggest a method helpful to assess scapular notching. Methods: The subjects were 73 cases of reverse shoulder arthroplasty (RSA) for cuff tear arthropathy during the period from May 2009 to April 2014 and followed-up for over a year. There was medialized RSA in 22 cases, bone increased offset RSA (BIO-RSA) in 36 cases, and metal increased offset RSA (metal-RSA) in 15 cases. Scapular notching was not determined by bone defect at the inferior of glenosphere as Sirveaux's classification, but scapular notching at the site where the rotational route of the polyethylene of humeral implant met the scapular neck were examined. The results were compared with conventional method. Results: By conventional method, scapular notching was observed in 10 cases (45.5%) in medialized RSA, 12 cases (33.3%) in BIO-RSA, and none in metal-RSA. By new method, it was observed in 9 cases (40.9%) in medialized RSA, 10 cases (27.8%) in BIO-RSA, and none of metal-RSA. The site of scapular notching was apart from glenoshpere in 18 cases, and at inferior of glenosphere in 1 case. Absorption of bone graft was observed in 4 (11.1%) out of 36 cases of BIO-RSA. Conclusions: It is hard to distinguish scapular notching from absorption of bone graft in BIO-RSA, and bone absorption at the lateral lower end of glenoid in medialized RSA. Thus, it is considered useful to assess scapular notching at the site where the rotational route of the polyethylene insert meets scapular neck.

Analysis of Sewer Pipe Defect and Ground Subsidence Risk by Using CCTV and GPR Monitering Results (CCTV 및 GPR을 이용한 하수관로 결함 및 지반함몰 위험성 평가)

  • Lee, Dae-Young
    • Journal of the Korean Geosynthetics Society
    • /
    • v.17 no.3
    • /
    • pp.47-55
    • /
    • 2018
  • Recently, increasing number of urban ground subsidence occurrences has been identified. This situation is mainly due to the increased number of underground cavities. This study is intended to develop the method that prevents ground settlement caused by deteriorated or damaged sewers, which are the main cause of land subsidence. To that end, GPR exploration was conducted using CCTV monitoring of deteriorated sewer at the location with high settlement potential. Through such CCTV monitoring and GPR investigation, abnormal ground behavior was monitored at the site where sewer was damaged, joint was cracked and soil was deposited. According to site investigation in this study, evaluation method using correlation analysis of CCTV monitoring and GPR investigation results is expected to prevent ground settlement attributable to damaged sewer.

Analysis of Ankle Bony Abnormality in the Patients with Chronic Ankle Sprain and Marked Ankle Instability (저명한 불안정성을 가진 만성 족관절 염좌 환자의 족관절 골성 병변에 대한 분석)

  • Jung, Chul-Yong;Eun, Il-Soo;Kim, Byung-Cheol;Choi, Sung-Jong;Yoo, Chong-Il;Kim, Jong-Kyun;Choi, Hyun-Soo
    • Journal of Korean Foot and Ankle Society
    • /
    • v.10 no.1
    • /
    • pp.7-10
    • /
    • 2006
  • Purpose: We analyzed the ankle bony abnormality of patients with marked ankle instability who had chronic ankle sprain more than 3 years. Materials and Methods: We evaluated the chronic ankle sprain (more than 3 years) patients with marked ankle instability tested by varus stress test and anterior draw test from March 2000 to December 2005. Eighty-nine patients (104 ankle) were evaluated and there were 38 males and 51 females. The mean age of patient at the time of diagnosis was 34.5 (range, 18 to 56 years). The average duration of morbidity was 7 years and 3 months (range, 3 years and 3 months to 21 years). The patients who had history of dislocation, fracture, malalignment, operated patients, and rheumatoid ones were excluded. Plain radiographs of AP, lateral, oblique and mortise view were checked. Results: Radilologic abnormalities were found at 74 ankles (71%) among 104 ankles. Frequent sequences of location were anterior talotibial osteophyte, medial malleolar osteophyte, Os subfibulare, lateral malleolar osteophyte. Posteior osteophyte, ankle arthritis, talar articular defect were rarely found. Conclusion: Seventy-one percent among patients with chronic ankle sprain and marked ankle instability showed more than one radiologic abnormalities. Thus, more exclusive and accurate ankle examination should be performed in these patients.

  • PDF

Congenital hernia of the lung through the azygoesophageal recess (Azygoesophageal recess를 통한 선천 폐탈장)

  • Choi, Young Seok;Son, Young Jun;Bae, Si Young;Min, Kyung Sun;Cho, Young Kuk;Choi, Woo Yeon;Choi, Young Youn;Ma, Jae Sook;Hwang, Tai Ju
    • Clinical and Experimental Pediatrics
    • /
    • v.51 no.10
    • /
    • pp.1123-1126
    • /
    • 2008
  • A lung hernia, defined as the protrusion of pulmonary tissue and pleural membranes through a defect in the thoracic wall, is a rare event. It can be congenital or acquired, and cervical, thoracic, or diaphragmatic in location. We report the rare occurrence of a congenital atraumatic lung herniation through the azygoesophageal recess. An 8-month-old male infant, who was born at 35 weeks gestation, had a chronic cough. Chest radiography showed haziness at the right lower lobe of the lung (RLL). Chest computed tomography (CT) revealed herniation of the RLL through the azygoesophageal recess. If persistent unilateral haziness is observed on chest radiography, the possibility of lung herniation should be considered.

Comparison of Sequelae According to the Types of Implants in Blow-Out Fracture (안와 파열 골절 치료 시 삽입물 종류에 따른 후유증 비교)

  • Kim, Tae-Gon;Im, Jong-Hyo;Lee, Jun-Ho;Kim, Yong-Ha
    • Archives of Craniofacial Surgery
    • /
    • v.10 no.1
    • /
    • pp.23-28
    • /
    • 2009
  • Purpose: Blow out fracture can present tenderness, swelling, enophthalmos, extraoccular muscle limitation, paresthesia, diplopia according to severity of injury, so reconstruction of blow out fracture is important. Orbital soft tissue should be in orbit and defected orbital wall should be corrected by autologus tissue or alloplastic implants. Every implants have their merits and faults, every implants are used various. This study was designed to compare the sequelae of blow-out fracture repair using the alloplastic implants: micro-titanium mesh(Micro Dynamic titanium $mesh^{(R)}$, Leibinger, Germany), porous polyethylene ($Medpor^{(R)}$, Porex, USA), absorbable mesh plate(Biosorb $FX^{(R)}$ . Bionx Implants Ltd, Finland). Methods: Between January 2006 and April 2008, 52 patients were included in a retrospective study analysing the outcome of corrected inferior orbital wall fracture with various kind of implants. Implants were inserted through subciliary incision. Twenty patients were operated with micro-titanium mesh, fourteen patients with porous polyethylene and eighteen patients with absorbable mesh plate. In comparative category, enophthalmos, diplopia, range of motion of extraoccular muscle, inferior orbital nerve injury were more on frequently statistically in patients. Results: Fourteen of 18 patients underwent surgical repair to improve diplopia, 11 of 17 patients to improve parasthesia, 11 of 15 patients to improve enophthalmos, 8 of 9 patients to improve extraoccular muscle limitation. Duration of follow-up time ranged from 6 months to 12 months(mean, 7.4 months). There was no statistic difference of sequelae between micro titanium mesh and porous polyethylene and absorbable mesh plate in blowout fracture, inferior wall. Conclusion: There is no difference of sequelae between micro-titanium mesh, porous polyethylene and absorbable mesh plate in blow-out fracture, inferior wall. The other factors such as defect size, location, surgeon's technique, may influence the outcome of blow-out fracture repair.

Double Hill-Sachs Lesion in a Recurrent Anterior Shoulder Dislocation Patient -A Case Report - (견관절 전방 재발성 탈구 환자에서 발생한 이중 Hill-Sachs 병변 - 증례 보고 -)

  • Kim, Yong-Min;Park, Kyoung-Jin;Kim, Dong-Soo;Choi, Eui-Sung;Shon, Hyun-Chul;Cho, Byung-Ki;Hong, Kyung-Ho
    • Journal of the Korean Arthroscopy Society
    • /
    • v.15 no.2
    • /
    • pp.121-124
    • /
    • 2011
  • Hill-Sachs lesion is the most common lesion in shoulder dislocation patient and it represented by postero-lateral bony defect of humerus. The lesion could be found in patients who dislocate shoulder joint first time, and it is reported that Hill-Sachs lesion proportionally increases as dislocation does. The location and presence of Hill-Sachs lesion play significant roles in shoulder instability. Authors experienced a double Hill-Sachs lesion in a recurrent anterior shoulder dislocation patient, and thereby report the case with a review of the literature.

  • PDF