• Title/Summary/Keyword: Non-plastic

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Comprehensive Evaluation of the Current Knowledge on Breast Implant Associated-Anaplastic Large Cell Lymphoma

  • Yoo, Hyokyung;Park, Ji-Ung;Chang, Hak
    • Archives of Plastic Surgery
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    • v.49 no.2
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    • pp.141-149
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    • 2022
  • Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a recently spotlighted T-cell origin non-Hodgkin's lymphoma with an increasing incidence of over 800 cases and 33 deaths reported worldwide. Development of BIA-ALCL is likely a complex process involving many factors, such as the textured implant surface, bacterial biofilm growth, immune response, and patient genetics. As the incidence of BIA-ALCL is expected to increase, it is important for all surgeons and physicians to be aware of this disease entity and acquire thorough knowledge of current evidence-based guidelines and recommendations. Early detection, accurate diagnosis, and appropriate treatment are the foundations of current care.

A Simple Strategy in Avulsion Flap Injury: Prediction of Flap Viability Using Wood's Lamp Illumination and Resurfacing with a Full-thickness Skin Graft

  • Lim, Hyoseob;Han, Dae Hee;Lee, Il Jae;Park, Myong Chul
    • Archives of Plastic Surgery
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    • v.41 no.2
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    • pp.126-132
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    • 2014
  • Background Extensive degloving injuries of the extremities usually result in necrosis of the flap, necessitating comprehensive skin grafting. Provided there is a sufficient tool to evaluate flap viability, full-thickness skin can be used from a nonviable avulsed flap. We used a Wood's lamp to determine the viability of avulsed flaps in the operation field after intravenous injection of fluorescein dye. Methods We experienced 13 cases during 16 months. Fifteen minutes after the intravenous injection of fluorescein dye, the avulsed skin flaps were examined and non-fluorescent areas were marked under Wood's lamp illumination. The marked area was defatted for full-thickness skin grafting. The fluorescent areas were sutured directly without tension. The non-fluorescent areas were covered by defatted skin. Several days later, there was soft tissue necrosis within the flap area. We measured necrotic area and revised the flap. Results Among all the cases, necrotic area was 21.3% of the total avulsed area. However, if we exclude three cases, one of a carelessly managed patient and two cases of the flaps were inappropriately applied, good results were obtained, with a necrotic area of only 8.4%. Eight patients needed split-thickness skin grafts, and heel pad reconstruction was performed with free flap. Conclusions A full-thickness skin graft from an avulsed flap is a good method for addressing aesthetic concerns without producing donor site morbidity. Fluorescein dye is a useful, simple, and cost-effective tool for evaluating flap viability. Avulsed flap injuries can be managed well with Wood's lamp illumination and a full-thickness skin graft.

Schwannoma of the Foot: A Case Report (족부 신경초종의 치험례)

  • Song, Woo-Jin;Kim, Chul-Han;Kang, Sang-Gue;Tark, Min-Seong;Choi, In-Ho
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.890-893
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    • 2011
  • Purpose: Schwannoma is a slow-growing, encapsulated benign peripheral nerve tumor that originates from the Schwann cell of the nerve sheath. Schwannoma most frequently involves the major nerve. Schwannoma of the foot is rare. This is a report of our experience with a small, deep-seated, and non-palpable schwannoma occurring in the foot. Methods: A 42-year-old woman presented with the plantar pain of the right foot during 2 years. Physical examination did not identified a palpable mass. She made a clinical diagnosis of plantar fasciitis and was conservatively treated 2 years ago. Since her plantar foot pain was aggravated, she was recently visited again. For the evaluation of her plantar foot pain, sonographic examination of the whole right foot was performed, and it revealed a small hypoechoic hetergenous, deep-seated mass beneath the plantar aponeurosis. At operation, a $0.7{\times}0.6{\times}0.4$ cm sized, ovoid, yellowish grey mass was removed. Results: Histology was confirmed that the mass was a benign schwannoma. There were no postoperative complications. Conclusion: Unsusual case of a schwannoma with the plantar foot pain during 2 years is presented. It should be recognized a small, deep-seated, non-palpable

Characteristics of Phosphorus Adsorption of Acidic, Calcareous, and Plastic Film House Soils

  • Kim, Myung-Sook;Park, Seong-Jin;Lee, Chang-Hoon;Yun, Sun-Gang;Ko, Byong-Gu;Yang, Jae E.
    • Korean Journal of Soil Science and Fertilizer
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    • v.49 no.6
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    • pp.789-794
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    • 2016
  • Continuous excessive application of phosphorus (P) fertilizer and manure in plastic film house soils can lead to an accumulation of P in soils. The understanding of P sorption by soils is important for fertilizer management. In this study, 9 samples were collected for acidic and calcareous soils as non-cultivated soil and plastic film house soils as cultivated soil Phosphorus sorption data of acidic soils fit the Langmuir equations, Freundlich equations in calcareous and plastic film house soils. In calcareous and plastic film house soils, the slope of isotherm adsorption changed abruptly, which could be caused P precipitation with $CaCO_3$. The calculated Langmuir adsorption maximum ($S_{max}$) varied from 217 to 1,250, 139 to 1,429, and $714mg\;kg^{-1}$ for acidic soils, calcareous soils, and plastic film house soils with low available phosphate concentration, respectively. From this result, maximum P adsorption by the Langmuir equation could be regarded as threshold of P concentration to induce the phosphate precipitation in soil. Phosphate-sorption values estimated from one-point isotherm for acidic and calcareous soils as non-cultivated soils were comparable with the $S_{max}$ values calculated from the Langmuir isotherm.

Concordant Surgical Treatment: Non-melanocytic Skin Cancer of the Head and Neck

  • Ryu, Wan Cheol;Koh, In Chang;Lee, Yong Hae;Cha, Jong Hyun;Kim, Sang Il;Kim, Chang Gyun
    • Archives of Craniofacial Surgery
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    • v.18 no.1
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    • pp.37-43
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    • 2017
  • Background: Skin cancer is the most common type of cancer. Of the 4 million skin lesions excised annually worldwide, approximately 2 million are considered cancerous. In this study, we aimed to describe a regional experience with skin cancers treated by a single senior surgeon and to provide a treatment algorithm. Methods: The medical records of 176 patients with head and neck non-melanocytic skin cancer (NMSC) who were treated by a single surgeon at our institution between January 2010 and May 2016 were retrospectively reviewed, and their data (age, sex, pathological type, tumor location/size, treatment modality) were analyzed. Patients with cutaneous squamous cell carcinoma (cSCC) who were classified as a high-risk group for nodal metastasis underwent sentinel node mapping according to the National Comprehensive Cancer Network guidelines. Results: Among the patients with NMSC who were treated during this period, basal cell carcinoma (BCC; n=102, 57.9%) was the most common pathological type, followed by cSCC (n=66, 37.5%). Most lesions were treated by complete excision, with tumor-free surgical margins determined via frozen section pathology. Thirty-one patients with high-metastasis-risk cSCC underwent sentinel node mapping, and 17 (54.8%) exhibited radiologically positive sentinel nodes. Although these nodes were pathologically negative for metastasis, 2 patients (6.5%) later developed lymph node metastases. Conclusion: In our experience, BCC treatment should comprise wide excision with tumor-free surgical margins and proper reconstruction. In contrast, patients with cSCC should undergo lymphoscintigraphy, as nodal metastases are a possibility. Proper diagnosis and treatment could reduce the undesirably high morbidity and mortality rates.

The Development of a Non-Linear Finite Element Model for Ductile Fracture Analysis - For Mini-Computer - (연성파괴 해석을 위한 비선형 유한요소 모델의 개발 -소형 컴퓨터를 위한 -)

  • 정세희;조규종
    • Transactions of the Korean Society of Mechanical Engineers
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    • v.10 no.1
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    • pp.25-33
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    • 1986
  • In this paper, the frontal method based elastic-plastic F.E.M. program for mini-computer was developed. Since, the executable source program size was restricted by the system core memory size on the mini-computer, the active variables were memorized by the element base and the nonactive varables were memorized to the external disc file. The active variables of the finally developed program were reduced enough to execute about 1,000 freedom finite element on the mini-computer on which available variables were restricted as 32,767 integers. A modified CT fracture test specimen was examined to test the developed program. The calculated results were compared with experimental results concerning on the crack tip plastic deformation zone. Recrystallization technique was adopted to visualize the intensive plastic deformation regions. The Von-Mises criterion based calculation results were well agreed with the experimental results in the intensive plastic region which was over than 2% offset strain. The F.E.M. results using the developed program were well agreed with the theoritical plastic boundary which was calculated by the stress intensity factor as r$_{p}$=(K$_{1}$$^{2}$/2.pi..sigma.$_{y}$$^{2}$).f(.theta.).).).

The Efficacy and Safety of Ablative Fractional Resurfacing Using a 2,940-Nm Er:YAG Laser for Traumatic Scars in the Early Posttraumatic Period

  • Kim, Sun-Goo;Kim, Eun-Yeon;Kim, Yu-Jin;Lee, Se-Il
    • Archives of Plastic Surgery
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    • v.39 no.3
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    • pp.232-237
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    • 2012
  • Background : Skin injuries, such as lacerations due to trauma, are relatively common, and patients are very concerned about the resulting scars. Recently, the use of ablative and non-ablative lasers based on the fractional approach has been used to treat scars. In this study, the authors demonstrated the efficacy and safety of ablative fractional resurfacing (AFR) for traumatic scars using a 2,940-nm erbium: yttrium-aluminum-garnet (Er:YAG) laser for traumatic scars after primary repair during the early posttraumatic period. Methods : Twelve patients with fifteen scars were enrolled. All had a history of facial laceration and primary repair by suturing on the day of trauma. Laser therapy was initiated at least 4 weeks after the primary repair. Each patient was treated four times at 1-month intervals with a fractional ablative 2,940-nm Er:YAG laser using the same parameters. Posttreatment evaluations were performed 1 month after the fourth treatment session. Results : All 12 patients completed the study. After ablative fractional laser treatment, all treated portions of the scars showed improvements, as demonstrated by the Vancouver Scar Scale and the overall cosmetic scale as evaluated by 10 independent physicians, 10 independent non-physicians, and the patients themselves. Conclusions : This study shows that ablative fractional Er:YAG laser treatment of scars reduces scars fairly according to both objective results and patient satisfaction rates. The authors suggest that early scar treatment using AFR can be one adjuvant scar management method for improving the quality of life of patients with traumatic scars.

Effect of lidocaine on pain caused by nasal pack removal after closed reduction of nasal bone fractures

  • Sung, Ji Yoon;Kang, Kyung Dong;Kim, Min Wook;Kim, Joo Hyoung
    • Archives of Plastic Surgery
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    • v.47 no.1
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    • pp.15-19
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    • 2020
  • Background Pain caused by nasal pack removal after closed reduction of nasal bone fractures is a common problem. This study investigated the effect of infiltrating lidocaine into nasal packs on the pain caused by pack removal after closed reduction of nasal bone fractures. Methods Seventy-five patients who underwent closed reduction of nasal bone fractures between March 2016 and March 2018 were enrolled in this prospective, randomized, single-blind study. Merocel (hydroxylated polyvinyl acetate) packs were applied bilaterally and retained for 5 days. Twenty minutes before removal, both packs were rehydrated with 6 mL of 2% lidocaine in 26 patients and with 6 mL of saline in 24 patients; the packs were not rehydrated in 25 patients. Visual analog scale (VAS) scores for pain on removal were recorded. Results The mean VAS score was 5.3±2.0 in all patients, 3.8±1.5 in the lidocaine group, 5.8±1.4 in the saline group, and 6.3±2.1 in the non-rehydrated group. There was a significant difference in the pain score between the lidocaine and saline groups (P<0.001) but not between the saline and non-rehydrated groups (P=0.186). Conclusions Infiltration of lidocaine into Merocel packs reduced the pain caused by pack removal after closed reduction of nasal bone fractures.

Accuracy and robustness of hysteresis loop analysis in the identification and monitoring of plastic stiffness for highly nonlinear pinching structures

  • Hamish Tomlinson;Geoffrey W. Rodgers;Chao Xu;Virginie Avot;Cong Zhou;J. Geoffrey Chase
    • Smart Structures and Systems
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    • v.31 no.2
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    • pp.101-111
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    • 2023
  • Structural health monitoring (SHM) covers a range of damage detection strategies for buildings. In real-time, SHM provides a basis for rapid decision making to optimise the speed and economic efficiency of post-event response. Previous work introduced an SHM method based on identifying structural nonlinear hysteretic parameters and their evolution from structural force-deformation hysteresis loops in real-time. This research extends and generalises this method to investigate the impact of a wide range of flag-shaped or pinching shape nonlinear hysteretic response and its impact on the SHM accuracy. A particular focus is plastic stiffness (Kp), where accurate identification of this parameter enables accurate identification of net and total plastic deformation and plastic energy dissipated, all of which are directly related to damage and infrequently assessed in SHM. A sensitivity study using a realistic seismic case study with known ground truth values investigates the impact of hysteresis loop shape, as well as added noise, on SHM accuracy using a suite of 20 ground motions from the PEER database. Monte Carlo analysis over 22,000 simulations with different hysteresis loops and added noise resulted in absolute percentage identification error (median, (IQR)) in Kp of 1.88% (0.79, 4.94)%. Errors were larger where five events (Earthquakes #1, 6, 9, 14) have very large errors over 100% for resulted Kp as an almost entirely linear response yielded only negligible plastic response, increasing identification error. The sensitivity analysis shows accuracy is reduces to within 3% when plastic drift is induced. This method shows clear potential to provide accurate, real-time metrics of non-linear stiffness and deformation to assist rapid damage assessment and decision making, utilising algorithms significantly simpler than previous non-linear structural model-based parameter identification SHM methods.

Open Reduction and Non-fixation Method for the Zygoma Body Fracture (비고정 방법을 사용한 관골 체부 골절 정복술)

  • Park, Bo Young;Kim, Yang Woo;Kang, So Ra
    • Archives of Craniofacial Surgery
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    • v.10 no.2
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    • pp.76-80
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    • 2009
  • Purpose: Zygoma is a major portion of the midfacial skeleton, forms the malar prominence and the three adjacent bony articulations. Zygoma fracture is a very common in facial trauma. Open reduction and rigid fixation of displaced zygoma fractures are necessary to avoid immediate and delayed facial asymmetry and depression. However, it is possible to happen the complications related to the plates and screws. So, we planned to treat the 24 patients of Group II, III, IV zygoma fractures with precise reduction and non-fixation method via intraoral approach. Methods: From August, 2006, to August, 2009, we treated 24 cases of zygoma fracture with reduction and non-fixation methods. Before the surgery, we choose the patients who could be treated with this method among the Group II, III, IV patients. Results: No patients in this study had postoperative complications such as displacement of bony fragments, facial depression and asymmetry, malocclusion, hypoesthesia. Satisfactory aesthetic and functional results can be obtained. Conclusion: In the treatment of the zygoma fracture, it is possible to treat with precise reduction and non-fixation method. The greatest advantage is to decrease the operative time, no need to wide dissection, no complications related to the plates and screws. For the using of this method, it is necessary to choose the adequate patients through the preoperative planning.