• Title/Summary/Keyword: Perforating

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Vascular Anatomy of Peroneal Perforator Flap (비골 동맥 천공지 피판의 혈관 해부학)

  • Chung, Duke Whan;Han, Chung Soo;Hwang, Joon Sung
    • Archives of Reconstructive Microsurgery
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    • v.13 no.1
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    • pp.36-42
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    • 2004
  • Materials and Methods: We studied 50 cases of peroneal perforating branch about branching pattern, course, length of vascular pedicle, and perforating level of the perforating cutaneous branches from Oct. 1985 to November 2003 by doppler flow meter and intraoperative findings. Results: 1) The perforating cutaneous branches were classified into four types, the Straight Branch (27cases), the Proximal Oblique Branch (11cases), the Branch from Muscular Artery (10cases), the Distal Oblique Branch(2 cases) respectively. The most common patten was Straight Branch, that was 54%. 2) There were 3 pathways of these branches, the most common one passed between the Soleus and Peroneus muscles(34 cases, 68%) 3) The length of vascular pedicle in Buoy Flap was variable from from 3 cm to 15 cm, but 32 cases(64%) were distributed between 5 cm and 6 cm. 4) The perforating level of branches were 5.9 cm in average from fibular neck to subcutaneous perforator artery 5) Peroneal Buoy Flap in possible to reconstruct both seperated bone and skin defect in some distance by One-Stage Operation and we can harvest maximal $8{\times}16cm$ sized flap in one perforating artery. If we include more two perforating artery, we get more wide flap which can cover large defect.

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Pharmacoacupuncture Treatment of Coccygodynia Caused by Perforating Cutaneous Nerve Entrapment Syndrome: Two Cases Report (관통피부신경 포착으로 발생한 꼬리뼈 통증 환자 약침치료 치험 2예)

  • Moon, Sori;An, Sunjoo;Choi, Seonghwan;Park, Seohyun;Keum, Dongho
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.3
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    • pp.149-156
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    • 2019
  • This study was performed to evaluate the effectiveness of pharmacoacupuncture treatment of coccygodynia caused by perforating cutaneous nerve entrapment syndrome. Two patients were diagnosed as coccygodynia caused by perforating cutaneous nerve entrapment syndrome which pain was within the anatomical field of the nerve, worsened by pressure-inducing posture, no objective sensory loss and in presence of pin-point tenderness. They were treated by pharmacoacupuncture at perforating cutaneous nerve region penertrating the sacrotuberous ligament and local tenderness point of coccyx. The evaluation of clinical outcome was done by pain intensity numerical rating scale (PI-NRS), pressure pain threshold (PPT) and EuroQol five dimensions questionnaire (EQ-5D) index. After treatment, their PI-NRS was decreased, PPT and EQ-5D index were increased. The pharmacoacupuncture therapy at entrapment point of perforating cutaneous nerve could be an effective way to treat coccygodynia caused by perforating cutaneous nerve entrapment syndrome.

A Study on the Perforating Process of the Muffer Tube using FEM

  • Han Kyu-Taek
    • Journal of Advanced Marine Engineering and Technology
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    • v.29 no.3
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    • pp.275-280
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    • 2005
  • Recently there has been a growing interest in the design and manufacturing of the muffler tube due to the strict environment regulations, A muffler is an important part used to reduce noise and to purify exhaust gas in cars and heavy equipment. The shape of the muffler tube and the number of the tube hole has been made variously according to the weight and function of the car. The perforating technique of the muffler tube has a great influence on the manufacturing cost. In this study, metal forming analysis has been carried out to investigate the perforating process for the muffler tube and predict an optimal forming conditions of the muffler tube, Also its simulation results by the finite element method were reflected to the die design and the manufacturing system for the muffler tube. The perforating process is performed in the longitudinal direction of the tube. According to the simulation results, when the shear angle of punch was similar to the tube curvature, the optimal shape was obtained. Also when the clearance of die was 0.2mm, the burr was minimized and optimal shear section was obtained.

The Regional Anatomy of Perforating artery and Pedicle for the Anterolateral Thigh Free Flap in the Korean (한국사람의 앞가쪽넙다리유리피판술에서의 관통동맥과 피판줄기에 대한 국소 해부)

  • Song, Hyun Suk;Park, Myong Chul
    • Archives of Plastic Surgery
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    • v.35 no.1
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    • pp.20-27
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    • 2008
  • Purpose: The anterolateral thigh flap has many advantages over other conventional free flaps. But the anterolateral thigh flap has yet to enter widespread use because perforating arteries exhibit a wide range of anatomic variations and are difficult to dissect when small. The aim of this study is to identify the vascular variability of perforating arteries and pedicle in the anterolateral thigh free flap. Methods: We studied 12 cadavers and dissected 23 thighs. An anterolateral thigh flap ($12{\times}12cm$) was designed and centered at the midpoint of the line drawn from anterior superior iliac spine to the superolateral border of the patella. After we identifed the perforating arteries we dissected up to their origin from lateral circumflex femoral artery along descending branch of lateral circumflex femoral artery. We then investigated the number and the position of perforating arteries, length and diameter of vascular pedicle and pattern of lateral circumflex femoral arterial system. Results: On average $2.3{\pm}1.1$ perforating arteries per thigh were identified. The musculocutaneous perforators were 63.1%. In those perforators five perforators were arose from transverse branch of lateral circumflex femoral artery and two were arose from rectus femoral artery. Most of the perforators were near the intermuscular septum between rectus femoris muscle and vastus lateralis muscle. The length and diameter of pedicle were $11.9{\pm}3.5cm$ and $3.1{\pm}0.8mm$ on average. Conclusion: This study will be helpful for the success in anterolateral thigh free flap.

High-Resolution Intracranial Vessel Wall MRI Findings Among Different Middle Cerebral Artery Territory Infarction Types

  • So Yeon Won;Jihoon Cha;Hyun Seok Choi;Young Dae Kim;Hyo Suk Nam;Ji Hoe Heo;Seung-Koo Lee
    • Korean Journal of Radiology
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    • v.23 no.3
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    • pp.333-342
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    • 2022
  • Objective: Intracranial atherosclerotic stroke occurs through various mechanisms, mainly by artery-to-artery embolism (AA) or branch occlusive disease (BOD). This study evaluated the spatial relationship between middle cerebral artery (MCA) plaques and perforating arteries among different MCA territory infarction types using vessel wall magnetic resonance imaging (VW-MRI). Materials and Methods: We retrospectively enrolled patients with acute MCA infarction who underwent VW-MRI. Thirty-four patients were divided into three groups according to infarction pattern: 1) BOD, 2) both BOD and AA (BOD-AA), and 3) AA. To determine the factors related to BOD, the BOD and BOD-AA groups were combined into one group (with striatocapsular infarction [BOD+]) and compared with the AA group. To determine the factors related to AA, the BOD-AA and AA groups were combined into another group (with cortical infarction [AA+]) and compared with the BOD group. Plaque morphology and the spatial relationship between the perforating artery orifice and plaque were evaluated both quantitatively and qualitatively. Results: The plaque margin in the BOD+ group was closer to the perforating artery orifice than that in the AA group (p = 0.011), with less enhancing plaque (p = 0.030). In the BOD group, plaques were mainly located on the dorsal (41.2%) and superior (41.2%) sides where the perforating arteries mainly arose. No patient in the AA group had overlapping plaques with perforating arteries at the cross-section where the perforator arose. Perforating arteries associated with culprit plaques were most frequently located in the middle two-thirds of the M1 segment (41.4%). The AA+ group had more stenosis (%) than the BOD group (39.73 ± 24.52 vs. 14.42 ± 20.96; p = 0.003). Conclusion: The spatial relationship between the perforating artery orifice and plaque varied among different types of MCA territory infarctions. In patients with BOD, the plaque margin was closer and blocked the perforating artery orifice, and stenosis degree and enhancement were less than those in patients with AA.

Visible Perforating Lateral Osteotomy: Internal Perforating Technique with Wide Periosteal Dissection

  • Rho, Bong Il;Lee, In Ho;Park, Eun Soo
    • Archives of Plastic Surgery
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    • v.43 no.1
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    • pp.88-92
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    • 2016
  • There are two general categories of lateral osteotomy techniques-the external perforating method and the internal continuous method. Regardless of which technique is used, procedural effectiveness is hampered by limited visualization in the surgical field. Considering this point, we devised a new technique that involves using a wide subperiosteal dissection and internal perforation under direct visualization. Using an intranasal approach, whereby the visibility of the intended fracture line was maintained, enabled a greater degree of control, and in turn, results that were more precise, and thus predictable and reproducible. Traditionally, it has been taken as dogma that the periosteum must be preserved, considering the potential for dead space and bony instability; however, under sufficient visualization of the surgical field with an internal perforating method, complete osteotomy with fully preserved intranasal mucosa could be conducted exactly as intended. This intact mucosal lining compensates for the elevated periosteum. Compressive dressing and drainage through a Silastic angio-needle catheter enabled the elimination of dead space. Therefore, precise, reproducible, and predictable osteotomy minimizing the potential for associated complications such as ecchymosis, that is, bruising owing to hemorrhage, could be performed. In this article, we introduce a novel technique for lateral osteotomy with improved visualization.

Significance of Perianal Lesion in Pediatric Crohn Disease

  • Jin, Won Seok;Park, Ji Hyoung;Lim, Kyung In;Tchah, Hann;Ryoo, Eell
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.3
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    • pp.184-188
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    • 2018
  • Purpose: Despite the increasing incidence of pediatric Crohn disease (CD) in Korea, data on the characteristics of perianal lesions are scarce. Therefore, we aimed to investigate the characteristics of pediatric CD with accompanying perianal lesions in Korea. Methods: We retrospectively reviewed the medical records of children (age ${\leq}18$ years) with confirmed CD at Gachon University Gil Medical Center between 2000 and 2014. Patients were classified into two groups based on the presence or absence of any perianal lesions including skin tags. Additional analysis was performed according to the presence or absence of perianal perforating lesions. Results: Among the 69 CD children (mean age, 15.4 years) include in the analysis, 54 (78.3%) had a perianal lesion and 29 (42.0%) had a perianal perforating lesion. The median duration of chief complaints was longer in pediatric CD with any accompanying perianal lesions (5.40 months vs. 1.89 months, p=0.02), while there was no difference between pediatric CD with and without perianal perforating lesions (5.48 months vs. 4.02 months, p=0.18). Perianal symptoms preceded gastrointestinal symptoms in 13 of 29 (44.8%) patients with perianal perforating lesions. Conclusions: CD should be suspected in children with perianal lesions, even in circumstances when gastrointestinal symptoms are absent.

Peroneal Perforator Flap (비골 동맥 천공지 피판)

  • Chung, Duke Whan;Hwang, Joon Sung
    • Archives of Reconstructive Microsurgery
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    • v.13 no.1
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    • pp.29-35
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    • 2004
  • Materials and Methods: Total number of peroneal perforator flap is 14 cases, which 10 cases were man, 4 cases were woman. The range of age was 12 years old minimally and until 63 years old. The trauma was most common etiology, which was like traffic accidents, 9 cases. We confirmed tibialis anterior artery patency by doppler flow meter, angiography as preoperative evaluation. Results: 1. The success rate was 91%, that in 14 cases, 13 cases were succeded. 2. To obtain successful result of peroneal flap, one must have the anatomic concept for vascular pattern, 8 cases were between peroneus muscle and soleus muscle branch type but, 3 cases were through soleus muscle branch type, so we treated these cases by using soleus muscle including peroneal perforating branch not to injury perforating artery directly. 3. The pedicle size was between minimally $2{\times}2.5cm$ and maximally $6.5{\times}8.5cm$ so we could treat large recipient site. 4. The pedicle length was between minimally 3.2 cm and maximally 11.5cm, average 7.5 cm. 5. The diameter of perforating artery was estimated by inspection, that was about 0.2-0.5 cm Conclusion: The peroneal perforating artery flap has merits that we can approach in avascular zone and has wide movable range from foot to distal femur and little donor site mobidity and can harvest osteocutaneous flap. The weak point was the irregular anatomy of nutrient artery and not to contain sensory nerve.

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Development of Perforating Die for Manufacturing Fine Multi-perforated type Nail Files (미세 다수공 타입의 네일파일 제조용 퍼퍼레이팅 금형 개발)

  • Kim Sei-Hwan
    • Proceedings of the KAIS Fall Conference
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    • 2004.06a
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    • pp.42-46
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    • 2004
  • 0.5mm thick steel is used to manufacture nail files. The first process is blanking the blank and then make about 300 holes of 0.8$\~$1.0mm in diameter. This process depends mainly on etching which takes $33\%$ of manufacturing cost and it can make manufacturing cost rise. The residual etching reagent is not environmentally friendly and the steel material is apt to rust as well. The key accomplishments of this research are to change the material from steel to stainless and develop a progressive perforating die in place of etching process.

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Study on Residual Velocity of Steel Sphere Perforating Light Weight Thin Plate (경량 박판을 관통하는 강구의 잔류속도 연구)

  • Song, Min-Cheol
    • Journal of the Korea Institute of Military Science and Technology
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    • v.8 no.3 s.22
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    • pp.101-110
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    • 2005
  • In this paper, the experiments have been conducted to measure the residual velocity for 3.5g steel ball perforating light weight metal plates of aluminum alloy and magnesium alloy. Non-contact electro-magnetic sensors were used to measure the velocity of steel ball before/after perforating plates. The thicknesses of specimens used were about 2.8mm and 4.8mm. The impact velocities of steel ball were from 662m/s to 3594m/s. With same conditions, numerical analysis using Autodyn 2D has been conducted. The results of numerical analysis corresponded with those of experiments. Also, It is suggested that the difference between the residual velocity of experiment or numerical analysis and that of THOR experimental equation of BRL grew smaller as the impact velocity were increased.