• Title/Summary/Keyword: Hand reconstruction

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Anastomotic Complications after Esophageal Reconstruction (식도재건술후 문합부 합병증)

  • Lee, Chul-Burm;Hahm, Shee-Young;Kim, Hyuk;Jung, Won-Sang;Kim, Young-Hak;Kang, Jung-Ho;Baik, Hong-Kyu
    • Korean Journal of Bronchoesophagology
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    • v.6 no.1
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    • pp.62-71
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    • 2000
  • Background: For the purpose of reducing operating time and rate of anastomotic leakage, we have performed esophagovisceral anastomosis with an EEA stapler using the largest size possible. If any difficulty in the approach of the EEA stapler was encountered one-layer interrupted hand-sewn anastomosis. Because the rate of postoperative benign anastomotic stricture was higher than expected, a retrospective study was done on all patients who underwent esophageal reconstruction. Material and Method: Over a period of 3 years from January 1996 to December 1998, we performed esophageal reconstructions on 30 patients. Patients were divided into two groups ; EEA stapler group(Group Ⅰ) comprised of 21 patients and hand-sewn group(Group Ⅱ) comprised of 9 patients.Result:The hospital mortality was 6.67 %(2/30) and the anastomotic leakage rate was 3.33 %(1/30). Among the discharged patients, the rate of recurrent anastomotic tumor was 3.57 %(1/28) and the rate of benign anastomotic stricture stricture rate was 35 %(7/20) in Group Ⅰ and 12.5 %(1/8) in Group Ⅱ, which was not significant. Conclusion: Although nontumor benign stricture was significantly higher in Group Ⅱ than in Group Ⅰ(p=0.0492), the incidence of anastomotic complications did not differ between the two groups. The one-layer interrupted hand-sewn esophagovisceral anastomosis by maintaining a wide lumen and close approximation of mucosa to mucosal layers with evenly spaced sutures could be one of the preferred surgical method to reduce benign anastomotic strictures.

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Intra-Motion Compensation Using CSRS method in MRI

  • Ro, Y.M.;Yi, J.H.;Cho, Z.H.
    • Journal of Biomedical Engineering Research
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    • v.15 no.4
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    • pp.377-382
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    • 1994
  • In the conventional Fourier imaging method in MRI (Magnetic Resonance Imaging), intramotion such as pulsatile flow makes zipper-like artifact along the phase encoding direction. On the other hand, line-integral projection reconstruction (LPR) method has advantages such as imaging of short T2, object and reduction of the flow artifact by elimination of the flow-induced phase fluctuation. The LPR, however, necessarily requires time consuming filtering and back-projection processes, so that the reconstruction takes long time. To overcome the long reconstruction time of the LPR and to obtain the flow artifact reduction effect, we adopted phase corrected concentric square raster sampling (CSRS) method and improved its imaging performance. The CSRS is a fast reconstruction method which has the same properties with the LPR. In this paper, we proposed a new method of flow artifact reduction using the CSRS method. Through computer simulations and experiments, we verified that the proposed method can eliminate phase fluctuations, thereby reducing the flow artifact and re- markably shorten the reconstruction time which required long time in the LPR.

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Reconstruction of a Circumferential Penile Shaft Defect Using Bilateral Superficial External Pudendal Artery Perforator Flaps (양측 천외음부동맥 천공지 피판을 이용한 음경둘레 연조직 결손의 재건)

  • Park, Jongohk;Shin, Donghyeok;Choi, Hyungon;Kim, Jeenam;Lee, Myungchul
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.296-300
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    • 2018
  • Penile shaft reconstruction requires adequate soft tissue characteristics as well as constant vascular pedicles when considering a perforator flap. The free flap technique using various donor sites and regional conventional and perforator flaps have been utilized for penile shaft reconstruction. Still, the free flap techniques include challenging surgical procedures in addition to postoperative management. The regional flap can be applied to limited defects due to the size and shape. We performed the bilateral superficial external pudendal artery (SEPA) perforator flaps in order to reconstruct a circumferential penile shaft defect. The circumferential wound has noted necrotic tissue involving superficial (Dartos) fascia. We underwent debridement, preserving deep (Buck's) fascia and corpus spongiosum. Thereafter, the soft tissue defect was covered with bilateral SEPA perforator flaps. The patient has been observed for 27 months, showing penile resilience without deformity or wound-related problems.

Deep Learning-Based Motion Reconstruction Using Tracker Sensors (트래커를 활용한 딥러닝 기반 실시간 전신 동작 복원 )

  • Hyunseok Kim;Kyungwon Kang;Gangrae Park;Taesoo Kwon
    • Journal of the Korea Computer Graphics Society
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    • v.29 no.5
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    • pp.11-20
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    • 2023
  • In this paper, we propose a novel deep learning-based motion reconstruction approach that facilitates the generation of full-body motions, including finger motions, while also enabling the online adjustment of motion generation delays. The proposed method combines the Vive Tracker with a deep learning method to achieve more accurate motion reconstruction while effectively mitigating foot skating issues through the use of an Inverse Kinematics (IK) solver. The proposed method utilizes a trained AutoEncoder to reconstruct character body motions using tracker data in real-time while offering the flexibility to adjust motion generation delays as needed. To generate hand motions suitable for the reconstructed body motion, we employ a Fully Connected Network (FCN). By combining the reconstructed body motion from the AutoEncoder with the hand motions generated by the FCN, we can generate full-body motions of characters that include hand movements. In order to alleviate foot skating issues in motions generated by deep learning-based methods, we use an IK solver. By setting the trackers located near the character's feet as end-effectors for the IK solver, our method precisely controls and corrects the character's foot movements, thereby enhancing the overall accuracy of the generated motions. Through experiments, we validate the accuracy of motion generation in the proposed deep learning-based motion reconstruction scheme, as well as the ability to adjust latency based on user input. Additionally, we assess the correction performance by comparing motions with the IK solver applied to those without it, focusing particularly on how it addresses the foot skating issue in the generated full-body motions.

Reconstruction of hand using anterolateral thigh fascial free flap (전외측대퇴근막 유리피판술을 이용한 수부의 재건)

  • Kim, Ki Wan;Kim, Jin Soo;Lee, Dong Chul;Ki, Sae Hwi;Roh, Si Young;Yang, Jae Won
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.571-577
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    • 2009
  • Purpose: The Provision of thin and pliable tissue and the adequate coverage of tendon - gliding surface is necessary for a soft tissue defect of the hand with exposure of bone, tendon and muscle. This report will discuss our experience with anterolateral thigh fascial free flap for the reconstruction of the soft tissue defect of the hand. Methods: Between February 2004 and August 2008, seven patients with full - thickness soft tissue defects of the hand were reconstructed by means of a composite anterolateral thigh fascial free flap. There were soft tissue defects associated with trauma (n=5), scar contracture (n=1) and necrosis due to ischemia (n=1). Flaps were harvested from the anterolateral thigh as adipofascial flaps with only a small sheet of fascia and fatty tissue above it. The fascia and the skin of the donor site was closed directly and delayed split - thickness skin graft was performed. Result: All flaps survived completely. The size of the transferred flap ranged from $2{\times}4cm$ to $5{\times}8cm$. Thin flap coverage was possible without secondary debulking operations. It left minimal donor site morbidity with a linear scar. In one case, the thigh muscle herniation in the donor site was developed. Conclusion: The anterolateral thigh fascial free flap provided thin and pliable tissue which can establish a tendon - gliding mechanism, minimal bulk, minimal donor site morbidity. The disadvantages of this technique were the need for a skin graft and the muscle herniation of donor site.

Efficacy of Roux-en-Y Reconstruction Using Two Circular Staplers after Subtotal Gastrectomy: Results from a Pilot Study Comparing with Billroth-I Reconstruction

  • Kim, Tae-Gyun;Hur, Hoon;Ahn, Chang-Wook;Xuan, Yi;Cho, Yong-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.11 no.4
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    • pp.219-224
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    • 2011
  • Purpose: The Roux en Y method has rarely been performed due to longer operation time and high risk of complication, despite several merits including prevention of bile reflux. We conducted a retrospective review of the result of Roux en Y reconstruction using two circular staplers after subtotal gastrectomy. Materials and Methods: From December 2008 to May 2009, a total of 26 patients underwent Roux en Y reconstruction using two circular staplers after subtotal gastrectomy, and seventy-two patients underwent Billroth-I reconstruction. Roux en Y anastomosis was performed using two circular staplers without hand sewing anastomosis. We compared clinicopathologic features and surgical outcomes between the two groups. All patients underwent gastrofiberscopy between six and twelve months after surgery to compare the bile reflux. Results: No significant differences in clinicopathologic findings were observed between the two groups, except for the rate of minimal invasive surgery (P=0.004) and cancer stage (P=0.002). No differences in the rate of morbidity (P=0.353) and admission duration (P=0.391) were observed between the two groups. Gastrofiberscopic findings showed a significant reduction of bile reflux in the remnant stomach in the Roux en Y group (P=0.019). Conclusions: When compared with Billroth-I reconstruction, Roux en Y reconstruction using the double stapler technique was found to reduce bile reflux in the remnant stomach without increasing postoperative morbidity. Based on these results, we planned to begin a randomized controlled clinical trial for comparison of Roux en Y reconstruction using this method with Billroth-I anastomosis.

A Novel Roux-en-Y Reconstruction Involving the Use of Two Circular Staplers after Distal Subtotal Gastrectomy for Gastric Cancer

  • Hur, Hoon;Ahn, Chang Wook;Byun, Cheul Su;Shin, Ho Jung;Kim, Young Bae;Son, Sang-Yong;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.17 no.3
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    • pp.255-266
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    • 2017
  • Purpose: Although Roux-en-Y (R-Y) reconstruction after distal gastrectomy has several advantages, such as prevention of bile reflux into the remnant stomach, it is rarely used because of the technical difficulty. This prospective randomized clinical trial aimed to show the efficacy of a novel method of R-Y reconstruction involving the use of 2 circular staplers by comparing this novel method to Billroth-I (B-I) reconstruction. Materials and Methods: A total of 118 patients were randomly allocated into the R-Y (59 patients) and B-I reconstruction (59 patients) groups. R-Y anastomosis was performed using two circular staplers and no hand sewing. The primary end-point of this clinical trial was the reflux of bile into the remnant stomach evaluated using endoscopic and histological findings at 6 months after surgery. Results: No significant differences in clinicopathological findings were observed between the 2 groups. Although anastomosis time was significantly longer for the patients of the R-Y group (P<0.001), no difference was detected between the 2 groups in terms of the total surgery duration (P=0.112). Endoscopic findings showed a significant reduction of bile reflux in the remnant stomach in the R-Y group (P<0.001), and the histological findings showed that reflux gastritis was more significant in the B-I group than in the R-Y group (P=0.026). Conclusions: The results of this randomized controlled clinical trial showed that compared with B-I reconstruction, R-Y reconstruction using circular staplers is a safe and feasible procedure. This clinical trial study was registered at www.ClinicalTrials.gov (registration No. NCT01142271).

Soft Tissue Reconstruction Using Anterolateral Thigh Flap with Fascia Lata Component (대퇴 근막이 포함된 전외측대퇴피판을 이용한 다양한 연부조직 결손의 재건)

  • Lee, Sin-Chul;Eun, Seok-Chan;Baek, Rong-Min
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.655-662
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    • 2011
  • Purpose: The anterolateral thigh flap is versatile flap for soft-tissue reconstruction for defects located at various sites of the body. This useful flap offers a thick and vascular fascia lata component with large amounts that can be soft tissue coverage for different reconstructive purposes. We present our clinical experience with the use of vascular fascia lata, combined with anterolateral thigh flap for various reconstructive goals. Methods: From April 2008 to February 2011, we transferred anterolateral thigh flaps with fascia lata component to reconstruct soft-tissue defects for different purposes in 11 patients. The fascia lata component of the flap was used for tendon gliding surface in hand/forearm reconstruction in 4 patients, for reconstruction medial and lateral patellar synovial membrane and retinaculum in 2 patients, for reconstruction of plantar aponeurosis in the foot in 2 patients, for reconstruction of fascial and peritoneal defect in the abdominal wall in 2 patient, and for dural defect reconstruction in the scalp in the remaining one. Results: Complete loss of the flap was not seen in all cases. Partial flap necrosis occurred in 2 patients. These complications were treated successfully with minimal surgical debridement and dressing. Infection occurred in 1 patient. In this case, intravenous antibiotics treatment was effective. Conclusion: Anterolateral thigh flap has thick vascular fascia with large amounts. This fascial component of the flap is useful for different reconstructive aims, such as for tendon, ligament, aponeurosis defects, abdominal wall or dura reconstruction. It should be considerated as an important advantage of the flap, together with other well-known advantages.

Transformer-based dense 3D reconstruction from RGB images (RGB 이미지에서 트랜스포머 기반 고밀도 3D 재구성)

  • Xu, Jiajia;Gao, Rui;Wen, Mingyun;Cho, Kyungeun
    • Proceedings of the Korea Information Processing Society Conference
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    • 2022.11a
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    • pp.646-647
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    • 2022
  • Multiview stereo (MVS) 3D reconstruction of a scene from images is a fundamental computer vision problem that has been thoroughly researched in recent times. Traditionally, MVS approaches create dense correspondences by constructing regularizations and hand-crafted similarity metrics. Although these techniques have achieved excellent results in the best Lambertian conditions, traditional MVS algorithms still contain a lot of artifacts. Therefore, in this study, we suggest using a transformer network to accelerate the MVS reconstruction. The network is based on a transformer model and can extract dense features with 3D consistency and global context, which are necessary to provide accurate matching for MVS.

An Anatomic Study and Clinical Application of Medial Plantar Septo-cutaneous Flap (내족저변 격막 피판의 해부학적 고찰 및 임상적 적용)

  • Yoon, Eul-Sik;Kim, Jung-Bae;Kae, Min-Seok;Dhong, Eun-Sang;Han, Seung-Kyu;Lee, Byung-Il;Koo, Sang-Hwan;Park, Seung-Ha;Kim, Woo-Kyung
    • Archives of Reconstructive Microsurgery
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    • v.11 no.1
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    • pp.53-62
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    • 2002
  • Several investigators have reported clinical experience of medial plantar septo-cutaneous flap for reconstruction for soft tissue defect of the hand and digits. Jayme and Hamilton first described the anatomy of superficial branch of medial division of the medial plantar artery used in this flap through cadavaric study in 1997. But, they had a few cases for this flap and there was no anatomic study in Korean. We experienced the reliability of medial plantar septo-cutaneous flap for reconstruction for soft tissue defect of hand and digits through an anatomic study (20 fresh specimens dissected) and clinical application (17 patients). An anatomic study revealed that there were differences in diameter and length of the vessels between Korean and Caucasian. The diameter of vessels in Korean is larger than Caucasian one in each area. Based on this anatomic knowledge, we could harvest this flap safely, and have performed reconstruction on 17 patients with soft tissue defects of hand and digits using a thin, flexible medial plantar septo-cutaneous flap similar to the volar aspect of the hand and digits in anatomical characteristics of the skin and subcutaneous tissue covering. The vessels used for this flap were superficial branches of medial division of the medial plantar artery and vena comitants, or the subcutaneous veins. The mean size of the flap was $2.82cm{\times}4.15cm$. All the flaps survived without significant complications. A medial plantar septo-cutaneous flap possesses several advantages : (1) It is very thin in comparison with other standard free flap; (2) it has two draining venous pathways; (3) it provides a good color and texture match for hand and finger; (4) a good recovery of protective sensation is achievable.

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