• Title/Summary/Keyword: Functional reconstruction

Search Result 577, Processing Time 0.034 seconds

A Case of Reconstruction of Hypopharyngeal Stricture with Radial Forearm Free Flap (요전박유리피판을 이용한 하인두협착 재건)

  • 김민식;선동일;이동희;조승호
    • Korean Journal of Bronchoesophagology
    • /
    • v.3 no.2
    • /
    • pp.307-312
    • /
    • 1997
  • Reconstruction of the pharyngoesophagus is one of the most difficult challenges in head and neck surgery. The goals of pharyngoesophageal reconstruction include restoration of a person's ability to swallow and to speak with minimal morbidity, but no current reconstruction modality is clearly best. Following its first introduction as fasciocutaneous flap by Yang in 1981, the forearm flap based on radial artery has become recognized as a very reliable and relatively easy one to use. The forearm flap has thin, pliable and predominantly hairless skin and scant subcutaneous layer In addition, its vascular pedicle is long and of large caliber, which greatly increases the chance of successful revascularization. The forearm flap shows the potentiality for better functional rehabilitation in swallowing and speech as well as the possibility of three dimensional reconstruction. We experienced a case of radial forearm free flap for the reconstruction in a patient with the hypopharyngeal stricture. The early return of oral feeding was possible and successfully enough to return to the normal daily activity.

  • PDF

Sole Reconstruction Using Anterolateral Thigh Perforator Free Flaps (전외측 대퇴부 천공지 유리피판을 이용한 발바닥 재건)

  • Kim, Eun Key;Hong, Joon Pio
    • Archives of Plastic Surgery
    • /
    • v.32 no.4
    • /
    • pp.441-446
    • /
    • 2005
  • Sole reconstruction should consider both functional and aesthetic aspects; durable weight bearing surface, adequate contour for normal footwear, protective sensation and solid anchoring to deep tissue to resist shearing. The anterolateral thigh perforator free flap has such favorable characteristics as long pedicle, reliable perforators and minimal donor site morbidity. This flap can be safely thinned to 3-4 mm. It can also be elevated with sufficient bulk with muscles like vastus lateralis for complex defect. Between June 2002 and December 2004, 48 cases of sole reconstruction were performed with anterolateral thigh perforator free flaps. Follow up period ranged from 4 to 34 months with a mean of 14.7 months and with exception of one case, all flaps survived. One case of total flap loss was noted due to infection in a patient who was administered lifetime immunosuppressant. Partial necroses developed in three cases but were treated conservatively. Satisfactory aesthetic and functional results were achieved and acceptable gait recovery was noted. Seventy-eight percent of the patients regained protective sensation by 6 months and earlier sensory recovery was noted in sensate flap group. The authors also present a standardized protocol for preoperative patient evaluation and postoperative management and rehabilitation.

REVIEW OF RECONSTRUCTION OF ORAL AND MAXILLOFACIAL DEFECT WITH FLAP (피판을 이용한 구강악안면 결손부의 재건)

  • Lee, Dong-Keun;Chung, Ho-Yong;Lee, Jae-Eun
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.16 no.4
    • /
    • pp.359-370
    • /
    • 1994
  • The reconstruction of major head and neck defects must be an integral part of the overall cancer treatment plan. The priorities of surgical treatment of head and neck tumor are 1) local tumor control, 2) relief of pain, 3) avoidance of difficult dressing, 4) provision of oral continence, and 5) ability to swallow and manage saliva. The recent advances in reconstructive surgery including the development of musculocutaneous flaps and microvascular free tissue transfer have allowed the surgical restoration of head and neck tumor defects that previously were not possible. These techniques have provided the opportunity to undertake larger, more aggressive resection while at the same time permitting functional rehabilitation. The timing of reconstruction demands on the nature of the resection, the ability of the ablative and reconstructive teams to coordinate efforts, the overall health of the patients, the patient's needs and wishes. So, we report to emphasize current methods for restoring major head and neck tumor defects after tumor ablation, reviewing for the reconstructive operations, postoperative complications, and postoperative sequelae etc, of patients from Jan, 1990 to Dec, 1993.

  • PDF

A new flap combination for reconstruction of lower nasal dorsum and supra-tip skin defects

  • Guesnier, Melanie;Claveleau, Xavier;Longeac, Marielle;Barthelemy, Isabelle;Dang, Nathalie Pham;Depeyre, Arnaud
    • Archives of Plastic Surgery
    • /
    • v.46 no.5
    • /
    • pp.480-483
    • /
    • 2019
  • Repairing surgical defects of the nose is still challenging due to its tridimensional shape and its aesthetic concern. Difficulty in reconstructing nasal subunits lies in their contour, skin texture and limited availability of adjacent skin. For lower nasal dorsum and supra-tip regions, we design a new combined local flap as existing local flaps may give disappointing results. This combination flap was performed on two patients for reconstruction of the lower nasal dorsum area after basal cell carcinoma excision. Size of the excision ranged from 20 to 25 mm diameter and safe margins were obtained. The defects were reconstructed with a local flap that combined a rotation nasal flank flap and a V-Y advancement nasolabial flap. Excision and reconstruction were performed in a one-stage surgery under intravenous sedation and local anesthesia. There were no postoperative complications and no flap loss occurred. Aesthetic and functional results after 6 months postoperatively were satisfying without modification of nasal shape. This flap is reliable and offers interesting functional and aesthetic outcomes. It can be considered as a new reconstruction alternative for supra-tip and lower nasal dorsum skin defects performed in a one-stage procedure under local anesthesia.

Finding Needles in a Haystack with Light: Resolving the Microcircuitry of the Brain with Fluorescence Microscopy

  • Rah, Jong-Cheol;Choi, Joon Ho
    • Molecules and Cells
    • /
    • v.45 no.2
    • /
    • pp.84-92
    • /
    • 2022
  • To understand the microcircuitry of the brain, the anatomical and functional connectivity among neurons must be resolved. One of the technical hurdles to achieving this goal is that the anatomical connections, or synapses, are often smaller than the diffraction limit of light and thus are difficult to resolve by conventional microscopy, while the microcircuitry of the brain is on the scale of 1 mm or larger. To date, the gold standard method for microcircuit reconstruction has been electron microscopy (EM). However, despite its rapid development, EM has clear shortcomings as a method for microcircuit reconstruction. The greatest weakness of this method is arguably its incompatibility with functional and molecular analysis. Fluorescence microscopy, on the other hand, is readily compatible with numerous physiological and molecular analyses. We believe that recent advances in various fluorescence microscopy techniques offer a new possibility for reliable synapse detection in large volumes of neural circuits. In this minireview, we summarize recent advances in fluorescence-based microcircuit reconstruction. In the same vein as these studies, we introduce our recent efforts to analyze the long-range connectivity among brain areas and the subcellular distribution of synapses of interest in relatively large volumes of cortical tissue with array tomography and superresolution microscopy.

Utility of Gait Analysis and Functional Assessment of Prosthetic Reconstruction in Bone Tumor around the Knee (슬관절 주위에 발생한 골종양 환자에서 종양 대치물을 이용한 재건술 후 기능적 평가 및 보행 분석의 유용성)

  • Lee, Jin-Ho;Seol, Young-Jun;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.18 no.2
    • /
    • pp.51-58
    • /
    • 2012
  • Purpose: This study attempts to know functional results and gait analysis usefulness in patients with bone tumor around knee joint tumors who underwent prosthesis knee joint reconstruction. Materials and Methods: Retrospective study was conducted with 7 patients out of 30 patients who underwent prosthesis knee joint reconstruction after wide marginal excision for bone tumor around knee in orthopedics of this hospital from 2001 to 2010. Functional assessment and gait analysis were perforemed. Results: For the SF-36 score, while 'role physical' and 'role emotional' items showed 100% (100 points) high scores individually, general health, physical function, vitality, and social function showed low scores. The mean score of MSTS was 88.1% (23.8 points [17-27]), indicating a relatively high score. For the gait analysis, mean gait velocity was 97.2 m/s, mean cadence was 105.6 step/min, mean stride length was 111.3 m, mean step length was 61.5 cm, swing phase was 39.8%cycle, stance phase was 60.1%cycle, mean single limb support was 37.1%cycle, mean double limb support was 13.0%cycle, and mean push off was 60.7%cycle. Conclusion: It is expected that prosthesis reconstruction after wide marginal excision for bone tumor around knee has relatively good functional results. Gait analysis was considered one of method which showed gait phase and assessed functional ability objectively by quantitative assessment post operative patient condition. It might help treatment and post operative rehabilitation planning with the functional assessment.

Functional Evaluation after Arthroscopic Reconstruction in Isolated and Combined Injury of Posterior Cruciate Ligament (후방십자인대의 단독 및 동반 손상에서 관절경적 재건술 후 기능적 평가)

  • Lee Kwang-Won;Lee Seung-Hun;Park Jae-Guk;Kim Ha-Yong;Kim Byung-Sung;Choy Won-Sik
    • Journal of the Korean Arthroscopy Society
    • /
    • v.6 no.2
    • /
    • pp.115-120
    • /
    • 2002
  • Purpose : To compare the functional evaluation with the posterior translation after arthroscopic PCL reconstruction in isolated and combined PCL-deficient knees. Materials and Methods : We retrospectively evaluated 45 patients with PCL-deficient knees who were treated by arthroscopic PCL reconstruction using Achilles tendon allograft from June 1994 to June 2000. The differences of posterior translation were measured with posterior stress lateral radiographs and KT-2000 arthrometer. The functional results were evaluated using the Lysholm knee score and IKDC evaluation form. Results : Preoperative mean side to side differences of the posterior translation were 11.83 mm in isolated PCL-deficient knees and 12.7 mm in combined PCL-deficient knees respectively. At the last follow-up in isolated and combined PCL-deficient knees, the mean radiographic side to side differences of the posterior translation were 6.38 mm and 6.7 mm, the average corrected 20 Ib posterior displacements using KT-2000 arthrometer were 3.5 mm and 4.1 mm, the mean Lysholm score were 87.4 and 81.2, the grade A and B of IKDC evaluation form were 16 cases $(88.9\%)$ and 23 cases $(85.2\%)$, respectively. Conclusion : The functional results had no relationship with the degree of posterior translation after arthroscopic PCL reconstruction. Tendency of posterior translation may be influenced by associated injury of the knee.

  • PDF

A Study on Medical Discourse of Oriental Medicine and Health Functional Foods - Focusing on the Consumption Discourse Analysis of Homegrown Agricultural Products - (한약과 건강기능식품의 의료담론 분석 - 농촌생산물의 소비담론을 중심으로 -)

  • Lee, Seong-O
    • Journal of Agricultural Extension & Community Development
    • /
    • v.22 no.4
    • /
    • pp.465-479
    • /
    • 2015
  • The purpose of this study is to explains consumers' medical discourse embedded in the consumption of oriental medicine and health functional foods. Despite the fact that both of oriental medicine and western medicine is legally accepted, people tend to recognize that accurate diagnosis is possible only in the latter. As the discourse that oriental medicine, compared with western medicine, has an auxiliary position is widely spreaded, the rivalry between herbal medicine and health functional foods come to be formed. And it led to a close correlation between the decrease of herbal medicine consumption and the growth of health supplement market. Herbal medicine is compared to red ginseng, one of the representative health supplement. Negative notion such as using an Asian herb from China and side effect of hepatotoxicity influences herbal medicine consumption. This study argues two conclusion. First, the correlation between the consumption of herbal medicine and that of health functional foods results from the discourse of scientific reconstruction, standardization, and commercialization all of which come from globalization discourse. Second, medical discourse embedded in these commodity, in the end, has impact on agricultural production.

Modified Brostrom Operation for Revision Lateral Ankle Ligament Reconstruction (실패한 만성 족근관절 외측 재건술에서의 변형 Brostrom 술식의 결과)

  • Lee, Kyung-Tai;Young, Ki-Won;Kim, J-Young;Kim, Eung-Soo;Cha, Seung-Do;Park, Shin-Yi
    • Journal of Korean Foot and Ankle Society
    • /
    • v.8 no.2
    • /
    • pp.149-152
    • /
    • 2004
  • Purpose: We assessed the clinical results of modified Brostrom procedure as a revision method after failure of a primary reconstruction. Materials and Methods: This is a retrospective study of seven patients treated with Modified Brostrom procedure after failed lateral ankle ligament reconstruction between 1996 and 2002. Instability symptom developed average 4.7 month after the initial reconstruction surgery at other clinics. All patients had significant functional impairment before surgery and not responded to conservative protocols. Modified Brostrom procedure was applied to all patients. Results: The average follow up was 51 months (18 to 84). Seven of eight patients had clinical stability following revision reconstruction, six patients (75%) returned to their previous functional level. American Orthopaedic Foot and Ankle Society ankle-hindfoot scores averaged 87.5. There is no difference in active or passive range of motion of plantar flexion or dorsiflexion when compared to the contralateral ankle. However, three patients were noted to have lost some degree of inversion when compated to contralateral ankle. Two patients had osteochondral lesion and multiple spurs and had pain around the ankle that prevented their full recovery. One patient complained of persistent pain which was considered complex regional pain syndrome. Conclusion: Though the outcome of the Modified Brostrom procedure as a method of revision surgery was less satisfactory compared to the results of primary ankle reconstruction, it would be an appropriate option when concomitant abnormalities were not accompanying.

  • PDF

Aesthetic Microsurgical Reconstruction of Extremities (사지의 미용적 미세수술적 재건)

  • Yeo, Hyeon-Jung;Son, Dae-Gu;Kim, Jun-Hyung;Han, Ki-Hwan
    • Archives of Reconstructive Microsurgery
    • /
    • v.20 no.1
    • /
    • pp.1-7
    • /
    • 2011
  • The aim of extremity reconstruction has focused on early wound coverage and functional recovery but rarely aesthetics. As the quality of life improves, however, the request for aesthetics has been growing. The authors has conducted retrospective reviews on the 86 cases that had extremity reconstruction using free flap, considering the characteristics of parts that had been assessed in primary operation between May 1996 and December 2010. Aesthetic grading was performed in four categories; color, texture, contour and marginal scar. Recipient sites were 42 hands, 19 feet, 14 lower extremities excluding feet and 10 upper extremities apart from the hand. Types of free flap were 16 latissimus dorsi free flaps, 13 anterolateral thigh free flaps, 12 dorsalis pedis free flaps, 8 transvers rectus abdominis free flaps, 7 gracillis free flaps, and 5 superficial temporal fascia free flaps. Total flap necrosis was seen in 8 cases(9.3%) and partial necrosis in 5 cases(5.8%). Secondary revision was done in 24 cases(27.9%) and the most common revision, debulking was done in 14 cases(16.3%). The authors has considered cosmetic aspects along with wound coverage and functional recovery in primary reconstruction. The results of aesthetic grading was 16.2 out of 20, and the secondary revision rate was reduced.

  • PDF