• 제목/요약/키워드: Extended defect

검색결과 119건 처리시간 0.02초

The Oblique Extended Reverse First Dorsal Metacarpal Artery Perforator Flap for Coverage of the Radial-Volar Defect of the Proximal Interphalangeal Joint in the Index Finger: A Case Report

  • Jeeyoon Kim;Bommie Florence Seo;Junho Lee;Sung No Jung
    • Archives of Plastic Surgery
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    • 제49권6호
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    • pp.760-763
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    • 2022
  • The dorsal metacarpal artery perforator flap is a flap that rises from the hand dorsum. Owing to its reliability and versatility, this flap is used as a workhorse for finger defect. However, to cover the radial-volar defect of the proximal interphalangeal joint (PIPJ) of the index finger, a longer flap is required than before. Here, we introduce the oblique extended reverse first dorsal metacarpal artery (FDMA) perforator flap to cover the radial-volar aspect defect of the index finger. A 45-year-old man got injured to the radial-volar defect of PIPJ of the left index finger caused by thermal press machine. The wound was 2 × 1 cm in size, and the joint and bone were exposed. We used FDMA perforator from anastomosis with palmar metacarpal artery at metacarpal neck. Since the defect was extended to the volar side, the flap was elevated by oblique extension to the fourth metacarpal base level. The fascia was included to the flap, and the flap was rotated counterclockwise. Finally, PIPJ was fully covered by the flap. Donor site was primarily closed. After 12 months of operation, the flap was stable without complication and limitation of range of motion. The oblique extended reverse FDMA perforator flap is a reliable method for covering the radial-volar defect of the PIPJ of the index finger. This flap, which also has an aesthetic advantage, will be a good choice for hand surgeons who want to cover the PIPJ defect of the index finger using a nonmicrosurgical option.

Use of Heparin Cream for Venous Congestion in the Extended Reverse Metacarpal Artery Flap: A Case Report

  • Tatar, Burak Erguun;Sabanciogullarindan, Fahri;Gelbal, Caner;Bozkurt, Mehmet
    • Archives of Plastic Surgery
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    • 제49권5호
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    • pp.663-667
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    • 2022
  • Finger dorsum defects are a challenging situation. Many reconstruction methods are used in these defects. Extended reverse dorsal metacarpal artery (RDMA) flap is used in dorsal finger reconstruction. Venous congestion in this flap is most important cause of flap failure. In this case, we presented a case in which we used heparin cream due to development of venous congestion in our patient who underwent an extended RDMA flap. A 24-year-old female patient presented to the emergency department with a defect of dorsal of left-hand fourth finger. Defect was covered with an extended RDMA flap. On postoperative first day, venous congestion was observed, and heparin cream was applied three times a day on flap. The signs of venous congestion were regressed. Tissue healed as a result of superficial epidermolysis and skin grafting. No functional limitation was observed in sixth-month postoperative control. Venous congestion is the most important cause of flap failure of extended RDMA flaps. Generally, subcutaneous heparin administration and leech therapy are used. In our case, heparin was applied as a cream instead of subcutaneously, and flap healing was observed as a result of superficial epidermolysis. Heparin cream application can also be used as a treatment option in flaps with venous congestion.

Nb를 첨가한 $TiO_2$ 의 전기적 성질 및 결함형태 (Electrical Properties and Defect Types of Nb-doped $TiO_2$)

  • 이순일;백승봉;김명호
    • 한국세라믹학회지
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    • 제36권12호
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    • pp.1335-1341
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    • 1999
  • The electrical conductivity ($\sigma$) of TiO2 doped with 0.05-4.0mol% Nb2O5 was measured in the oxygen partial pressure range of 10-17 to 100 atm and temperature range of 1100 to 130$0^{\circ}C$ to investigate the electrical properties and defect types. The oxygen partial pressure dependence of the electrical conductivity (log$\sigma$/logPo2) above 110$0^{\circ}C$ was divided into the four regions. From these experimental results the following defect regions were proposed ; 1) Magneli phase(extended defect) 2) reduced rutile region where intrinsic defect predominates 3) nearly stoichiometric region which is independent on the oxygen partical pressure and 4) overstoichiometric region which is not observed in pure TiO2 The electrical conductivity of Nb-doped TiO2 depended on the doping content the oxygen partial pressure and the measuring tem-perature.

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협부 연부조직을 직접 침습한 상악동 아스페르길루스증 (Direct Aspergillosis Invasion to the Anterior Wall of the Maxillary Sinus: A Case Report)

  • 이중호;이소영;오득영;김상화;이종원;안상태
    • Archives of Plastic Surgery
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    • 제38권5호
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    • pp.691-694
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    • 2011
  • Purpose: With an increase in the population of immunocompromised patients, the incidence of maxillary sinus aspergillus infection has also escalated. Maxillary sinus aspergillosis is generally extended to the sinus antrum, base or thin orbital wall and ethmoid air cell region. We experienced a case of maxillary sinus aspergillosis which was extended directly to the soft tissue of the cheek. Methods: A 46-year-old man with acute myelogenous leukemia was consulted for the defect of the anterior wall of the maxillary sinus, and cheek. Radiologic and histologic findings were consistent with invasive maxillary sinus aspergillosis. The otolaryngology department performed debridement via endoscopic sinus surgery first. Coverage of the resulting defect in the anterior wall of the maxillary sinus and its inner layer was undergone by the plastic and reconstructive surgery department, using a pedicled superficial temporal fascia flap and a split thickness skin graft. The remaining skin defect of the cheek was covered with a local skin flap. Results: The patient went through an uneventful recovery. There was no recurrence during 6 months of follow-up. Conclusion: Maxillary sinus aspergillosis usually involves the orbit or the gingiva but in some cases it may directly invade soft tissues of the cheek. Such an atypical infection extending into the cheek may lead to a large soft tissue defect requiring coverage. Thus, any undiagnosed soft tissue defect involving the cheek or maxillofacial area, especially in immunocompromised patients, should be evaluated for aspergillosis. We present this rare case, with a review of the related literature.

Thermal Properties of Diamond Films Deposited by Chemical Vapor Depositon

  • Chae, Hee-Baik;Baik, Young-Joon
    • The Korean Journal of Ceramics
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    • 제3권1호
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    • pp.29-33
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    • 1997
  • Four diamond films were deposited by the microwave plasma assisted chemical vapor deposition method varying CH4 concentration from 2.5 to 10% in the feeding gases. Thermal conductivity was measured on these free standing films by the steady state method from 80 K to 400K. They showed higher thermal conductivity as the film deposited with lower methane concentration. One exception, 7.79% methane concentration deposited film, was observed to be the highest thermal conductivity. Phonon scattering processes were considered to analyze the thermal conductivity with the full Callaway model. The grain size and the concentration of the extended and the point defects were used as the fitting parameters. Microstructure of diamond films was investigated with the scanning electron microscopy and Raman spectroscopy.

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하수관로 결함 점수 및 상태 등급 판정 방법 제안 (Suggestion of the defect score and condition grading protocol about sewer pipe)

  • 김정률;이재현;오재일
    • 상하수도학회지
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    • 제31권1호
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    • pp.21-28
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    • 2017
  • This study was performed to propose the sewer defect scoring, and grading protocols for sewer condition assessment. For this, sewer defect scoring methods were comparatively analyzed and reviewed for four international condition assessment protocols, which are established based on WRc manual. As a result, we proposed a new protocol for sewer condition assessment, in which characteristics of sewer pipes are considered by segment. In reference to the PIM-3, the extent of ground subsidence was adopted to be of importance, and renewal scores increased in accordance with weighting of defects causing structural backfill materials. Also, defect grades of 'Hole' were extended to 5 levels of the grading, and 'Surface Damage' was excluded in defect assessment. The addition of 'Buckling' resulted in reduction of weights in 'Surface Damage' and 'Lining Defects'.

Subpulmonary VSD 를 동반한 활로 4증: 수술 치험 1례 보고 (Tetralogy of Fallot with Subpulmonary Ventricular Septal Defect: A Case Report)

  • 우종수
    • Journal of Chest Surgery
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    • 제11권2호
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    • pp.175-180
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    • 1978
  • A rare form of tetralogy of Fallot, in which large ventricular septal defect was located at subpulmonary position rather than beneath a well developed crista supraventricularis was operated in this Department. This case satisfied the criteria for the diagnosis of tetralogy of Fallot, having large ventricular septal defect beneath the aortic valve with overriding of aorta, pulmonary stenosis and right ventricular hypeFtrophy. The operation was done through a median sternotomy using cardiopulmonary bypass. A vertical right ventriculotomy was extended to the pulmonary valve ring. Pulmonary and aortic valve were adjacent to each other, in contrast to the situation of classic tetralogy of Fallot. Pulmonary valvulotomy was done and ventricular septal defect was closed. with Teflon, and right ventricular outflow tract was reconstructed with woven Dacron covered by pericardial patch after minimal resection of septal band. The post-operatiove courses was uneventful except wound infection. The patient was discharged 15 days after open heart surgery.

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ON THE DEFECTS OF HOLOMORPHIC CURVES

  • Yang, Liu;Zhu, Ting
    • 대한수학회보
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    • 제57권5호
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    • pp.1195-1204
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    • 2020
  • In this paper we consider the holomorphic curves (or derived holomorphic curves introduced by Toda in [15]) with maximal defect sum in the complex plane. Some well-known theorems on meromorphic functions of finite order with maximal sum of defects are extended to holomorphic curves in projective space.

대동맥중격결손증[수술치험 1예] (Aorticopulmonary Window: one case report)

  • 최영호
    • 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.

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전이형 외측 상완 피판술을 이용한 주관절 연부조직 결손의 피복 (Transposition Lateral Arm Flap for Coverage of the Elbow Defects)

  • 송주현;이윤민;이주엽
    • Archives of Reconstructive Microsurgery
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    • 제17권2호
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    • pp.82-86
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    • 2008
  • Purpose: Soft tissue defect can occur on the posterior aspect of the elbow after trauma or fracture fixation. To cover the defect and maintain elbow functions, various flap surgeries including latissimus dorsi muscle flap, lateral arm flap and radial forearm flap can be performed. We present the clinical results of transposition lateral arm flap for coverage of the elbow defect and discuss the cause of posterior soft tissue necrosis after fracture fixation. Materials and Methods: Two patients who had posterior soft tissue defect of the elbow after open reduction of the fractures around the elbow were treated with transposition lateral arm flap. The mean size of skin defect was 20 $cm^2$. The flap was elevated with posterior radial collateral artery pedicle and transposed to the defect area. Donor defect was covered with split thickness skin graft. The elbow was immobilized for 1 week in extended position and active range of motion was permitted. Results: All two cases of transposition lateral arm flap survived without marginal necrosis. The average range of motion of the elbow was 10~115 degrees. Mayo elbow performance score was 72 and Korean DASH score was 23. Conclusion: When elbow fractures are fixed with three simultaneous plates and screws, skin necrosis can occur on the posterior aspect of the elbow around olecranon area. If the size of skin defect is relatively small, transposition lateral arm flap is very useful option for orthopaedic surgeons without microsurgical technique.

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