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Open Reduction and Internal Fixation (ORIF) of Trapdoor Orbital Floor Blowout Fracture with Absorbable Mesh Plate (뚜껑문 안와저 골절에 있어서 망상 흡수성 판을 이용한 관혈적 정복술 및 내고정술)

  • Kwon, Yu-Jin;Kim, Ji-Hoon;Hwang, Jae-Ha;Kim, Kwang-Seog;Lee, Sam-Yong
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.619-625
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    • 2010
  • Purpose: Trapdoor orbital blowout fracture is most common in orbital blowout fracture. Various materials have been used to reconstruct orbital floor blowout fracture. Absorbable alloplastic implants are needed because of disadvantages of nonabsorbable alloplastic materials and donor morbidity of autogenous tissue. The aim of the study is to evaluate usefulness of absorbable mesh plate as a reconstructive material for orbital blowout fractures. Methods: From December 2008 to October 2009, 18 trapdoor orbital floor blowout fracture patients were treated using elevator fixation, depressor fixation, or elevatordepressor fixation techniques with absorbable mesh plates and screw, depending on degree of orbital floor reduction, because absorbable mesh plates are less rigid than titanium plates and other artificial substitutes. Results: Among 18 patients, 5 elevator fixation, 4 depressor fixation, and 9 elevator and depressor fixation technique were performed. In all patients, postoperative computed tomographic (CT) scan showed complete reduction of orbital contents and orbital floor, and no displacement of bony fragment and mesh plate. Mean follow-up was 10 months. There were no significant intraoperative or postoperative complications. Conclusion: Three different techniques depending on the degree of orbital floor reduction are useful for open reduction and internal fixation of trapdoor orbital floor blowout fracture with absorbable mesh plates.

The Development of Digital Art Archives Using CollectiveAccess for Local Arts Organization : A Case of J Art Association (CollectiveAccess를 활용한 지역예술단체 디지털 아트 아카이브 구축 - J미술협회를 중심으로 -)

  • Park, Jun-Hyeong;Park, Ji-Won;Han, Hui-Lyeong;Jeong, Ji-Na;Kim, Yong
    • Journal of Korean Library and Information Science Society
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    • v.48 no.3
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    • pp.303-331
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    • 2017
  • Local Arts Organization has performed various events in the provinces such as performances, exhibitions, competitions, and festivals, has been a place where local artists share information of arts, and has contributed greately to the development of art culture in the provinces for a long time. Records of Local Arts Organization are historical records showing the level and value of past and present local cultural arts, so systematic management and preservation is necessary. Also, since the records of Local Arts Organization are high in interest and demand of users, exhibition services are needed to show them effectively. Therefore, this study shows how to construct a Local Arts Organization based on CollectiveAccess, which is open software, to manage Local Arts Organization and provide exhibition services.

A Technique for Assist in Positioning the Proximal Segment during Open Reduction of a Fractured Mandibular Condyle (하악 과두 골절의 개방 정복 시 근위 골편의 수복법)

  • Kim, Myung Good
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.792-796
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    • 2006
  • Purpose: After exposure of fracture site, the proximal segment must be reduced to their preinjury position for open reduction of fractured mandibular condyle. We examined the use of inter-maxillary fixation screws or titanium screws tied with stainless steel wire to assist in positioning of proximal segment. Since it enables to make a relatively small preauricular incision by not disturbing the operative field like Moule pin, we can reduce the danger of injury to the facial nerve. Methods: A preauricular approach was used for exposure, reduction, and rigid fixation in 4 cases of mandibular condylar fractures. Inter-maxillary fixation screws or titanium screws tied with stainless steel wire were used to assist in aligning proximal segment. The joints were submitted to functional exercises and postoperative radiologic and clinical follow-ups were performed. Results: No facial nerve lesions were found in all 4 cases. Radiologic follow-up showed correct reduction and fixation in all 4 cases. Clinical follow-up showed an initial limitation, but normal morbility of the condyle was achieved within 4 months after the operation, with a maximum mouth opening of $34.1{\pm}5.2mm$ after 12 months. There found no occlusal disturbances, no trismus, no lateral deviations of the mandible. Conclusion: By using Inter-maxillary fixation screws tied with stainless steel wire, it was shown that reducing the proximal segment to their preinjury position is easy to perform and it enables us to make a minimal dissection below preauricular skin incision to avoid facial nerve injury.

Implementing the Management Model of the Institutional Repositories for the Efficient Distribution Infrastructure of National Knowledge Focusing on the dCollection System (국가지식정보의 효율적인 유통체제 구축을 위한 대학 리포지토리의 운영 모형 개발 : dCollection을 중심으로)

  • Kim, Hyun-Hee;Ahn, Tae-Kyoung;Chang, Woo-Kwon;Kwak, Byeong-Heui
    • Journal of the Korean Society for information Management
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    • v.22 no.3 s.57
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    • pp.103-127
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    • 2005
  • The purpose of the study is to implement the management model of the institutional repositories for the efficient distribution infrastructure of national knowledge focusing on the dCollection system which is operated by KERIS (service provider). In order to build the management model, the two steps were utilized. The first step is to investigate the checklists of repositories that are important factors for the successful repository implementation through literature review. On the other hand, the second one is to survey the current status of the sixteen domestic and foreign institutional repositories through interviews, surveys and email as well as the repository home pages and literature reviews. Through the two steps, the management model including six components such as content and librarian role was proposed. The proposed management model will be utilized to supply guides both to the universities which plan to build their institutional repositories and to the universities which try to promote the activities of their repositories.

Open Reduction of Proximal Interphalangeal Fracture-Dislocation through a Midlateral Incision Using Absorbable Suture Materials

  • Lee, Jae Jun;Park, Hyoung Joon;Choi, Hyun Gon;Shin, Dong Hyeok;Uhm, Ki Il
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.397-402
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    • 2013
  • Background Fracture-dislocation of the proximal interphalangeal (PIP) joint is a relatively common injury. Various treatments for fracture-dislocation of the PIP joint have been reported. In the present study, we performed open reduction through a midlateral incision using absorbable sutures to reduce the small bone fragments and performed volar plate repair. Methods We treated nine patients with fracture-dislocation of the PIP joint with small fractured bone fragments too small for pinning or screw fixation. Patients with volar plate injury were treated with open reduction and volar plate repair at the periosteum of the middle phalangeal bone base by the modified Kessler method using absorbable sutures. All patients were placed in a dorsal aluminum extension block splint, which maintained the PIP joint in approximately 30 degrees of flexion to avoid excessive tension on the sutured volar plate. Results At a mean final follow-up of postoperative 9 months, all patients were evaluated radiographically and had adequate alignment of the PIP joint and reduction of the displaced bone fragments. Range of motion was improved and there were no complications. Conclusions This technique is an excellent alternative to the current method of treating patients with fracture-dislocations that include small fragments that are too small for pinning or screw fixation. It is a less invasive surgical method and enables stable reduction and early exercise without noticeable complications.

The usefulness of intermolar traction wiring for restoration of maxillary & mandibular dental arch in facial bone fracture (안면골 골절에서 상하악 치열궁 복원을 위한 양측 대구치간 철사견인술의 유용성)

  • Jeong, Jae Ho;Shin, Seung Kyu;Lee, Jun Ho;Kim, Yong Ha
    • Archives of Plastic Surgery
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    • v.36 no.1
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    • pp.56-60
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    • 2009
  • Purpose: Palatal fracture and mandible fracture result in instability of dental arch. Because they divide the maxillary and mandibular alveolus sagittally and / or transversely and comminute the dentition, they permit rotation of dental alveolar segments and significantly increase the potential for fracture malalignment, complicating fracture treatment. Previous treatment of palatal fracture consisted of palatal splint application and rigid palatal vault stabilization. This procedure result in patient's oral discomfort and removal of palate and screw. Mandible fracture often results in malocclusion due to widening of posterior aspect of dental arch. So we introduce more simple method using intermolar traction wiring, which can protect the widening of dental arch and rotation of dental alveolar segment. Methods: Arch bar and intermolar traction wiring with wire 1 - 0, or 2 - 0 was applied. After exposure of fracture line, neutrooclusion was maintained with intermaxillary fixation. And then open reduction & internal fixation on maxillary fracture line, commonly maxillary buttress, alveolar ridge, pyriform aperture except palatal vault or mandibular fracture line. After 1 week, intermolar traction wiring was removed. We checked occlusion and postoperative radiologic finding. Results: From June of 2007 to October of 2007, 10 patient, who have maxillary fracture with palatal fracture and mandible fracture, underwent open reduction & internal fixation with intermolar traction wiring. All have satisfactory occlusion and there were no complication, like gingiva disease, mouth opening impairment and nonunion. Conclusion: The intermolar traction wiring accompany open reduction and internal fixation can be alternative method for restoration of dental arch in facial bone fracture.

Enhancing Dermal Matrix Regeneration and Biomechanical Properties of $2^{nd}$ Degree-Burn Wounds by EGF-Impregnated Collagen Sponge Dressing

  • Cho Lee Ae-Ri
    • Archives of Pharmacal Research
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    • v.28 no.11
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    • pp.1311-1316
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    • 2005
  • To better define the relationship between dermal regeneration and wound contraction and scar formation, the effects of epidermal growth factor (EGF) loaded in collagen sponge matrix on the fibroblast cell proliferation rate and the dermal mechanical strength were investigated. Collagen sponges with acid-soluble fraction of pig skin were prepared and incorporated with EGF at 0, 4, and 8 $\mu$g/1.7 $cm^{2}$. Dermal fibroblasts were cultured to 80$\%$ confluence using DMEM, treated with the samples submerged, and the cell viability was estimated using MTT assay. A deep, $2^{nd}$ degree- burn of diameter 1 cm was prepared on the rabbit ear and the tested dressings were applied twice during the 15-day, post burn period. The processes of re-epithelialization and dermal regeneration were investigated until the complete wound closure day and histological analysis was performed with H-E staining. EGF increased the fibroblast cell proliferation rate. The histology showed well developed, weave-like collagen bundles and fibroblasts in EGF-treated wounds while open wounds showed irregular collagen bundles and impaired fibroblast growth. The breaking strength (944.1 $\pm$ 35.6 vs. 411.5 $\pm$ 57.0 Fmax, $gmm^{-2}$) and skin resilience (11.3 $\pm$ 1.4 vs. 6.5 $\pm$ 0.6 mJ/$mm^{2}$) were significantly increased with EGF­treated wounds as compared with open wounds, suggesting that EGF enhanced the dermal matrix formation and improved the wound mechanical strength. In conclusion, EGF-improved dermal matrix formation is related with a lower wound contraction rate. The impaired dermal regeneration observed in the open wounds could contribute to the formation of wound contraction and scar tissue development. An extraneous supply of EGF in the collagen dressing on deep, $2^{nd}$ degree-burns enhanced the dermal matrix formation.

Effectiveness of mini-open carpal tunnel release: An outcome study

  • van den Broeke, Lieselotte R.;Theuvenet, Willem.J.;van Wingerden, Jan.J.
    • Archives of Plastic Surgery
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    • v.46 no.4
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    • pp.350-358
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    • 2019
  • Background Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy with a high morbidity and healthcare-related costs. Currently there is no consensus about the best treatment option. The purpose of this prospective cohort study conducted at a single institution was to evaluate the clinical outcomes and patient satisfaction following a mini-open carpal tunnel release for idiopathic CTS. Methods A total of 72 patients (53 female and 19 male patients; mean age, $57.8{\pm}15.3$ years; range, 24-94 years) had a mini-open carpal tunnel release performed by a single senior surgeon between June 2015 and June 2016. The patients were evaluated preoperatively, and at 3 and 12 months post-intervention. At every follow-up, the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) and visual analogue scale (VAS) scores for pain and satisfaction were completed. Digital sensibility (using Semmes-Weinstein monofilaments) was assessed and pinch and grip strengths were measured. Results Statistically significant and clinically relevant improvement was found in terms of digital sensibility, grip and pinch strength (except for 2-point pinch), BCTSQ scores and pain scores. The complication rate was minimal, and no major complications occurred. Two patients experienced recurrence. The availability of follow-up records (including patient-reported outcomes, BCTSQ and VAS scores, and the complication rate) at 1-year post-intervention varied between 69% and 74% (50-53 patients) depending on which parameter was assessed. Patient satisfaction was high (mean, $80.9{\pm}26.0$; range, 0-100). Conclusions This study demonstrates that mini-incision carpal tunnel release is clinically effective in the short and long term.

Evaluation of pedicled flaps for type IIIB open fractures of the tibia at a tertiary care center

  • Vathulya, Madhubari;Dhingra, Mohit;Nongdamba, Hawaibam;Chattopadhyay, Debarati;Kapoor, Akshay;Dhingra, Vandana Kumar;Mago, Vishal;Kandwal, Pankaj
    • Archives of Plastic Surgery
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    • v.48 no.4
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    • pp.417-426
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    • 2021
  • Background Soft tissue coverage plays a vital role in replacing the vascularity of the underlying bone in Gustilo type IIIB fractures. The aim of this article was to evaluate the feasibility of local pedicled flaps in type IIIB fractures at a tertiary care center. Methods We included all cases of open Gustilo-Anderson type IIIB fractures of the tibia treated with local flap coverage from January 2017 to February 2019. We carried out a retrospective analysis to investigate the relationships of complications, hospital stay, and cost-effectiveness with the choice of flap, infective foci, site and size of the defect, and type of fixation. Results Out of 138 Gustilo type IIIB fractures analyzed in our study, 27 cases had complications, of which 19 (13.76%) involved flap necrosis, four (2.89%) were infections, three (2.17%) involved partial necrosis, and one (0.72%) was related to bone spur development. Flap complications showed a statistically significant association with the perforator flap category (propeller flaps in particular) (P=0.001). Flap necrosis showed a significant positive correlation with cases treated within 3 weeks after trauma (P=0.046). A significant positive correlation was also found between defect size and the duration of hospital stay (P=0.03). Conclusions Although local flaps are harvested from the same leg that underwent trauma, their success rate is at least as high as microvascular flaps as reported from other centers. Amidst the local flaps, complications were predominantly associated with perforator flaps.

Discussion: Use of the Fix and Flap Approach to Complex Open Elbow Injury: The Role of the Free Anterolateral Thigh Flap

  • Zhang, Yixin
    • Archives of Plastic Surgery
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    • v.39 no.2
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    • pp.137-137
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    • 2012
  • Fast improvements in microsurgery have opened new strategies in the field of reconstructive trauma surgery that can be applied to severe elbow trauma management. The disadvantages of pedicle flaps can be overcome in the hand of an experienced trauma surgeon by using free flaps based on the perforators. This provides the patient with the best possible wound cover within the optimal time frame and the treatment of underlying additional structural damage. Although the authors presented only a small number of cases, the results of this study are promising and encourage the use of the ALT flap for the treatment of severe elbow trauma.