• Archives of Plastic Surgery
• /
• 제48권5호
• /
• pp.483-493
• /
• 2021

Background Direct-to-implant (DTI) breast reconstruction after nipple-sparing mastectomy (NSM) with the use of acellular dermal matrix (ADM) provides reliable outcomes; however, the use of ADM is associated with a higher risk of complications. We analyzed our experiences of post-NSM DTI without ADM and identified the predictive factors of adverse surgical outcomes. Methods Patients who underwent NSM and immediate DTI or two-stage tissue expander (TE) breast reconstruction from 2009 to 2020 were enrolled. Predictors of adverse endpoints were analyzed. Results There were 100 DTI and 29 TE reconstructions. The TE group had a higher rate of postmastectomy radiotherapy (31% vs. 11%; P=0.009), larger specimens (317.37±176.42 g vs. 272.08±126.33 g; P=0.047), larger implants (360.84±85.19 g vs. 298.83±81.13 g; P=0.004) and a higher implant/TE exposure ratio (10.3% vs. 1%; P=0.035). In DTI reconstruction, age over 50 years (odds ratio [OR], 5.43; 95% confidence interval [CI], 1.50-19.74; P=0.010) and a larger mastectomy weight (OR, 1.65; 95% CI, 1.08-2.51; P=0.021) were associated with a higher risk of acute complications. Intraoperative radiotherapy for the nipple-areolar complex increased the risk of acute complications (OR, 4.05; 95% CI, 1.07-15.27; P=0.039) and the likelihood of revision surgery (OR, 5.57; 95% CI, 1.25-24.93; P=0.025). Conclusions Immediate DTI breast reconstruction following NSM is feasible in Asian patients with smaller breasts.

• Nuclear Engineering and Technology
• /
• 제54권4호
• /
• pp.1421-1430
• /
• 2022

The computation of the solid angle and the detector efficiency is considering to be one of the most important factors during the measuring process for the radioactivity, especially the cylindrical γ-ray NaI(Tl) detectors nowadays have applications in several fields such as industry, hazardous for health, the gamma-ray radiation detectors grow to be the main essential instruments in radiation protection sector. In the present work, a generic numerical simulation method (NSM) for calculating the efficiency of the γ-ray spectrometry setup is established. The formulas are suitable for any type of source-to-detector shape and can be valuable to determine the full-energy peak and the total efficiencies and P/T ratio of cylindrical γ-ray NaI(Tl) detector setup concerning the truncated conical radioactive source. This methodology is based on estimate the path length of γ-ray radiation inside the detector active medium, inside the source itself, and the self-attenuation correction factors, which typically use to correct the sample attenuation of the original geometry source. The calculations can be completed in general by using extra reasonable and complicate analytical and numerical techniques than the standard models; especially the effective solid angle, and the detector efficiency have to be calculated in case of the truncated conical radioactive source studied condition. Moreover, the (NSM) can be used for the straight calculations of the γ-ray detector efficiency after the computation of improvement that need in the case of γ-γ coincidence summing (CS). The (NSM) confirmation of the development created by the efficiency transfer method has been achieved by comparing the results of the measuring truncated conical radioactive source with certified nuclide activities with the γ-ray NaI(Tl) detector, and a good agreement was obtained after corrections of (CS). The methodology can be unlimited to find the theoretical efficiencies and modifications equivalent to any geometry by essential sufficiently the physical selective considered situation.

• Advances in concrete construction
• /
• 제16권4호
• /
• pp.205-216
• /
• 2023

Concrete structures may become vulnerable during their lifetime due to several reasons such as degradation of their material properties; design or construction errors; and environmental damage due to earthquake. These structures should be repaired or strengthened to ensure proper performance for the current service load demands. Several methods have been investigated and applied for the strengthening of reinforced concrete (RC) structures using various materials. Fiber reinforced polymer (FRP) reinforcement is one of the most recent type of material for the strengthening purpose of RC structures. The main objective of the present research is to identify the behavior of reinforced concrete slabs strengthened with FRP bars by using near surface mounted (NSM) technique. Validation study is conducted based on the experimental test available in the literature to investigate the accuracy of finite element models using LS-DYNA to present the behavior of the models. A parametric analysis is conducted on the effect of FRP bar diameters, number of grooves, groove intervals as well as width and height of the grooves on the flexural behavior of strengthened reinforced slabs. Performance of strengthening RC slabs with NSM FRP bars was confirmed by comparing the results of strengthening reinforced slabs with control slab. The numerical results of mid-span deflection and stress time histories were reported. According to the numerical analysis results, the model with three grooves, FRP bar diameter of 10 mm and grooves distances of 100 mm is the most ideal and desirable model in this research. The results demonstrated that strengthening of reinforced concrete slabs using FRP by NSM method will have a significant effect on the performance of the slabs.

• 근관절건강학회지
• /
• 제20권3호
• /
• pp.189-196
• /
• 2013

Purpose: The purpose of this study was to investigate electromyographic (EMG) activity of deep and superficial trunk muscles during trunk stabilization exercises with and without stabilization maneuvers. Methods: The relative muscle activity ratios and local muscle activities of 25 healthy males were measured using the 8 channel surface EMG system (Myosystem 1400A, Noraxon Inc., U.S.A). The surface EMG activities were tested during performing abdominal hollowing maneuver (AHM), abdominal bracing maneuver (ABM) and no stabilization maneuver (NSM) in random order. Data were analyzed using $1{\times}3$ repeated measures ANOVA. Results: During bridging exercises, the EMG activity ratio of transverse abdominis/internal oblique abdominis relative to rectus abdominis was significantly lower in NSM than in AHM and ABM. During bridging and kneeling exercises, the EMG activity ratio of multifidus relative to erector spinae was significantly higher in AHM than in NSM. Conclusion: The AHM can be clinically used by the physical therapist to activate selectively the trunk muscles when designing selective training programs for patients.

• 콘크리트학회논문집
• /
• 제26권1호
• /
• pp.79-86
• /
• 2014

이 연구는 표면매입 보강된 FRP 판과 콘크리트사이의 응력전달기구를 이론적으로 연구한 것으로서 이선형 부착모델을 이용하여 부착거동을 묘사하고 이를 실험 결과와 비교하여 신뢰성있는 해석방법을 제시하였다. 연구로부터, 표면매입된 FRP 판과 콘크리트사이의 계면특성을 고려한 미분방정식에 이선형 부착-미끄러짐 관계곡선을 사용하여 해석할 경우, 모델의 임계값인 최대전단강도와 미끄러짐 변위, 그리고 박락에 의한 연화거동이 시작될 때의 변위값 선정과정이 제시되었다. 또한 제안된 모델을 사용하여 부착길이가 다르게 보강된 표면매입 FRP 판의 미끄러짐 거동을 해석한 결과 실제 거동을 매우 근사하게 묘사할 수 있는 것으로 나타났다.

• Archives of Plastic Surgery
• /
• 제42권3호
• /
• pp.302-308
• /
• 2015

Background In the literature on nipple-sparing mastectomy (NSM) with one-stage immediate implant reconstruction, contralateral symmetrisation has drawn little attention, with many surgeons still performing standard cosmetic mammaplasty procedures. However, standard implant-based mammaplasty usually does not result in proper symmetry with the mastectomy side, especially regarding breast projection, overall shape, and volume distribution. Methods We retrospectively reviewed 19 consecutive patients undergoing unilateral NSM with immediate prosthetic reconstruction and contralateral simultaneous symmetrisation by using the tailored reduction/augmentation mammaplasty technique between June 2012 and August 2013. Results The average follow-up time was 13 months (range, 10-24 months). No major complications, such as infection, haematoma, and nipple-areola complex necrosis, were experienced. Conclusions Our experience suggests that simultaneous contralateral symmetrisation with tailored reduction/augmentation mammaplasty after unilateral immediate implant reconstruction after NSM facilitates durable and pleasant symmetric outcomes.

• Nuclear Engineering and Technology
• /
• 제53권10호
• /
• pp.3421-3430
• /
• 2021

Spherical NaI(Tl) detectors are used in gamma-ray spectrometry, where the gamma emissions come from the nuclei with energies in the range from a few keV up to 10 MeV. A spherical detector is aimed to give a good response to photons, which depends on their direction of travel concerning the detector center. Some distortions in the response of a gamma-ray detector with a different geometry can occur because of the non-uniform position of the source from the detector surface. The present work describes the calibration of a NaI(Tl) spherical detector using both an experimental technique and a numerical simulation method (NSM). The NSM is based on an efficiency transfer method (ETM, calculating the effective solid angle, the total efficiency, and the full-energy peak efficiency). Besides, there is a high probability for a source-to-detector distance less than 15 cm to have pulse coincidence summing (CS), which may occur when two successive photons of different energies from the same source are detected within a very short response time. Therefore, γ-γ ray CS factors are calculated numerically for a ¹⁵²Eu radioactive cylindrical source. The CS factors obtained are applied to correct the measured efficiency values for the radioactive volumetric source at different energies. The results show a good agreement between the NSM and the experimental values (after correction with the CS factors).

• International Journal of Concrete Structures and Materials
• /
• 제5권1호
• /
• pp.43-48
• /
• 2011

This paper presents the performance of anchor systems for reinforced concrete beams retrofitted with carbon fiber reinforced polymer (CFRP) strips. Nine simply-supported beams are tested with various anchor systems such as steel hooks, steel plates with anchor bolts, CFRP anchor plates, and near-surface mounted (NSM) CFRP strip. The effects of these anchors on the behavior of the retrofitted beams are discussed, including load-carrying capacity, failure modes, and ductility characteristics. Test results indicate that end-anchorage is an important parameter when a CFRP-retrofit design is conducted. Mechanical bolts and NSM CRFP anchors are recommended.

• 한국정보통신학회논문지
• /
• 제13권11호
• /
• pp.2260-2266
• /
• 2009

본 논문에서는 플랜지된 평행평판도파관으로 급전된 슬릿과 이에 평행하고 근접하는 도체 스트립과의 전자기적인 결합문제를 단순화된 근접주사현미 경의 관점에서 연구하였다. 슬릿의 등가어드미턴스, 슬릿근처 도파관 내부 및 외부의 무효전력, TEM파 전압반사계수의 크기 및 위상 등의 변화결과로부터 플랜지된 평행평판도파관의 특성을 조사하였다. 제안된 구조의 근접주사현미경으로서의 성능을 다양한 구조적인 파라미터들(도파관 높이, 슬릿의 폭, 스트립의 폭, 슬릿과 스트립 간격, 슬릿 폭과 도파관 높이의 비)이 TEM파 전압반사계수의 크기와 위상에 미치는 영향을 관찰하여 점검하였다. 슬릿으로부터 스트립의 변위에 따른 전압반사계수의 변화결과로부터 도파관의 높이가 작을 때 보다 높은 주사해상도를 얻을 수 있음과 반사계수의 크기 변화에 비해 위상변화가 훨씬 민감함을 확인하였다.

• Archives of Plastic Surgery
• /
• 제39권3호
• /
• pp.216-221
• /
• 2012

Background : Nipple-sparing mastectomy (NSM) is gaining popularity due to its superior aesthetic results. When reconstructing the breast with free abdominal tissue transfer, we must readdress the recipient vessel, because NSM can cause difficulty in access to the chest vessel. Methods : Between June 2006 and March 2011, a total of 92 women underwent NSM with free abdominal tissue transfer. A lateral oblique incision was used for the nipple-sparing mastectomy. For recipient vessels, the internal mammary vessels were chosen if the mastectomy flap did not block access to the vessels. If it did, the thoracodorsal vessels were used. Age, degree of breast ptosis, weight of the mastectomy specimen, and related complications of the internal mammary vessel group and the thoracodorsal vessel group were compared. Results : Thoracodorsal vessels were used as recipient vessels in 59 cases, and internal mammary vessels in 33 cases including 4 cases with perforators of the internal mammary vessels. Breast reconstruction was successful in all cases except one case involving a total flap failure, which was replaced by a silicone gel implant. The internal mammary group and the thoracodorsal group were similar in terms of age, height, breast weight, and degree of ptosis. The flap related complications such as flap loss and take-back operation rates were not significantly different between the two groups. The rate of nipple necrosis was higher in the internal mammary group. Conclusions : The thoracodorsal vessels could produce comparable outcomes in breast reconstruction after nipple-sparing mastectomies. If access to internal mammary vessels is difficult, the thoracodorsal vessel can be a better choice.