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The superior lateral genicular artery flap for reconstruction of knee and proximal leg defects

  • Low, O-Wern;Loh, Tian Fu;Lee, Hanjing;Yap, Yan Lin;Lim, Jane;Lim, Thiam Chye;Nallathamby, Vigneswaran
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.108-114
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    • 2022
  • Reconstruction of defects around the knee region requires thin and pliable skin. The superior lateral genicular artery (SLGA) flap provides an excellent alternative to muscle-based flaps. The anatomy and the surgical techniques of the SLGA flap were reviewed and the results of cases using the SLGA flap for coverage of knee and proximal leg defects were analyzed. SLGA flaps were performed in two cases and followed up for at least 6 months. Twelve articles on the use of the SLGA flap were also identified. A review of 39 cases showed that the mean diameter of the perforator supplying the skin of the flap was 1.04 mm, while the mean diameter of the SLGA at its origin was 1.78 mm. The mean length of the pedicle measured from the origin of the popliteal artery was 7.44 cm. The average dimensions of the flap were 14.8×6.6 cm with primary closure of the donor site in 61.5% of cases. Of these cases, 38.5% were due to trauma, 23.1% were post-burn complications, 12.8% were defects after resection of tumors, and 10.3% were for ulcers post-bursectomy. The most common complication was flap tip necrosis. All studies reported favorable outcomes with complete wound healing.

Change and Continuity in Traditional Timugon Rice Cultivation Beliefs and Practices

  • On, Low Kok;Pugh-Kitingan, Jacqueline;Ibrahim, Ismail
    • SUVANNABHUMI
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    • v.9 no.2
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    • pp.91-122
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    • 2017
  • Before the start of the North Borneo Company administration in North Borneo (now Sabah, Malaysia) in 1882, the Timugon Murut of today's interior Tenom District lived in longhouses, and practiced head-hunting during wars with other Murutic ethnic groups. Their economy revolved around swidden agriculture of hill rice, sago, and cassava. Wet rice cultivation and water buffaloes were introduced just before 1885. Wet rice was planted on the alluvial plains around the Pegalan and Padas Rivers, while dry rice was planted on hillside swiddens that had been cleared by slash-and-burn methods. Today, wet rice cultivation and cash-cropping on the plains are the main Timugon socioeconomic activities, while some families also plant dry rice on the hills as a back-up. The Timugon believe that the physical world is surrounded by the spiritual world, and everything was made by the creator Aki Kapuuno'. The focus of this field research paper is on the beliefs and ritual practices of the Timugon connected to their traditional rice agriculture. This study found that for generations, the Timugon believed that since animals were created by Aki Kapuuno' for the wellbeing of humans, various types of animals and birds convey omens to guide people. Thus, the older Timugon rice cultivation is strongly influenced by good and bad omens and taboos, and also involves symbolic practices and ritual offerings to guardian spirits of the rice. After the 1930s and especially since the 1960s, most Timugon became Roman Catholic Christians. Hence, this paper also examines changes in the traditional Timugon rice cultivation related beliefs and practices due to religious conversion and other factors.

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A case of venous stasis ulcer treated by subfascial endoscopic perforator ligation and split thickness skin graft (내시경적 교통정맥 결찰술과 부분층 피부이식술로 치료한 정맥성 궤양의 치험례)

  • Moon, Seong ho;Lee, Jong wook;Koh, Jang hyu;Seo, Dong kook;Choi, Jai koo;Jang, Young chul
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.336-340
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    • 2009
  • Purpose: The wound of a patient who has chronic venous insufficiency is easy to recur. Also they develop a complication even after the conservative therapy or skin graft. We have to diagnose the venous stasis ulcer correctly and remove the cause to improve the effectiveness of treatment. We operated endoscopic perforating vein ligation and splitt thickness skin graft on a patient with venous stasis ulceration on right leg. Methods: A 26 year old male patient who had a scalding burn on his right leg in July 2005 checked into our hospital in March 2008. Even though he got three operations - the split thickness skin graft - at different clinics, the wound did not heal. The size of the wound was 12 by $8cm^2$ and granulation with edema and fibrosis had been formed. We kept observation on many collateral vessels and perforating vein through venogram and doppler sonography and firmly get to know that the wound came with chronic venous insufficiency. After a debridement and an application of VAC$^{(R)}$ for two weeks, the condition of granulation got better. So we proceeded with the operation using subfascial endoscopic perforating surgery and split thickness skin graft. Results: Through the venogram after the operation, we found out that the collateral vessels had been reduced compared to the previous condition and the widened perforating vein disappeared. During a follow up of 6 months, the patient did not develop recurrent stasis ulcer and postoperative complications. Conclusion: Subfascial endoscopic perforator ligation is relatively simple technique with a low complication rate and recurrence rate. Split thickness skin graft with subfascial endoscopic perforator surgery can be valuable method for treating severe venous stasis ulcers.

Verification of MCNP/ORIGEN-2 Model and Preliminary Radiation Source Term Evaluation of Wolsung Unit 1 (월성 1호기 MCNP/ORIGEN-2 모델 검증 및 예비 선원항 계산)

  • Noh, Kyoungho;Hah, Chang Joo
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.13 no.1
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    • pp.21-34
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    • 2015
  • Source term analysis should be carried out to prepare the decommissioning of the nuclear power plant. In the planning phase of decommissioning, the classification of decommissioning wastes and the cost evaluation are performed based on the results of source term analysis. In this study, the verification of MCNP/ORIGEN-2 model is carried out for preliminary source term calculation for Wolsung Unit 1. The inventories of actinide nuclides and fission products in fuel bundles with different burn-up were obtained by the depletion calculation of MCNPX code modelling the single channel. Two factors affecting the accuracy of source terms were investigated. First, the neutron spectrum effect on neutron induced activation calculation was reflected in one-group microscopic cross-sections of relevant radio-isotopes using the results of MCNP simulation, and the activation source terms calculated by ORIGEN-2 using the neutron spectrum corrected library were compared with the results of the original ORIGEN-2 library (CANDUNAU.LIB) in ORIGEN-2 code package. Second, operation history effect on activation calculation was also investigated. The source terms on both pressure tubes and calandria tubes replaced in 2010 and calandria tank were evaluated using MCNP/ORIGEN-2 with the neutron spectrum corrected library if the decommissioning wastes can be classified as a low level waste.

Optimal flammability and thermal buckling resistance of eco-friendly abaca fiber/ polypropylene/egg shell powder/halloysite nanotubes composites

  • Saeed Kamarian;Reza Barbaz-Isfahani;Thanh Mai Nguyen Tran;Jung-Il Song
    • Advances in nano research
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    • v.16 no.2
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    • pp.127-140
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    • 2024
  • Upon direct/indirect exposure to flame or heat, composite structures may burn or thermally buckle. This issue becomes more important in the natural fiber-based composite structures with higher flammability and lower mechanical properties. The main goal of the present study was to obtain an optimal eco-friendly composite system with low flammability and high thermal buckling resistance. The studied composite consisted of polypropylene (PP) and short abaca fiber (AF) with eggshell powder (ESP) and halloysite clay nanotubes (HNTs) additives. An optimal base composite, consisting of 30 wt.% AF and 70 wt.% PP, abbreviated as OAP, was initially introduced based on burning rate (BR) and the Young's modulus determined by horizontal burning test (HBT) and tensile test, respectively. The effects of adding ESP to the base composite were then investigated with the same experimental tests. The results indicated that though the BR significantly decreased with the increase of ESP content up to 6 wt.%, it had a very destructive influence on the stiffness of the composite. To compensate for the damaging effect of ESP, small amount of HNT was used. The performance of OAP composite with 6 wt.% ESP and 3 wt.% HNT (OAPEH) was explored by conducting HBT, cone calorimeter test (CCT) and tensile test. The experimental results indicated a 9~23 % reduction in almost all flammability parameters such as heat release rate (HRR), total heat released (THR), maximum average rate of heat emission (MARHE), total smoke released (TSR), total smoke production (TSP), and mass loss (ML) during combustion. Furthermore, the combination of 6 wt.% ESP and 3 wt.% HNT reduced the stiffness of OAP to an insignificant amount by maximum 3%. Moreover, the char residue analysis revealed the distinct differences in the formation of char between AF/PP and AF/PP/ESP/HNT composites. Afterward, dilatometry test was carried out to examine the coefficient of thermal expansion (CTE) of OAP and OAPEH samples. The obtained results showed that the CTE of OAPEH composite was about 18% less than that of OAP. Finally, a theoretical model was used based on first-order shear deformation theory (FSDT) to predict the critical bucking temperatures of the OAP and OAPEH composite plates. It was shown that in the absence of mechanical load, the critical buckling temperatures of OAPEH composite plates were higher than those of OAP composites, such that the difference between the buckling temperatures increased with the increase of thickness. On the contrary, the positive effect of CTE reduction on the buckling temperature decreased by raising the axial compressive mechanical load on the composite plates which can be assigned to the reduction of stiffness after the incorporation of ESP. The results of present study generally stated that a suitable combination of AF, PP, ESP, and HNT can result in a relatively optimal and environmentally friendly composite with proper flame and thermal buckling resistance with no significant decline in the stiffness.