• Archives of Plastic Surgery
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• 제43권4호
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• pp.311-315
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• 2016

In Korea, lateral canthoplasty, along with medial epicanthoplasty, has become popular over the past years to widen the horizontal length of the palpebral fissure. However, the effect of the surgery differs greatly depending on the shape and structure of the eyes. If over-widened, complications such as eversion, scarring, and conjunctival exposure may occur. Thus, the author of this study suggests a more effective and safe method for lateral canthal lengthening that causes minimal complications. A total of 236 patients underwent lateral canthoplasty between July 2007 and December 2015. For each patient, a triangular flap 4-5 mm away from the lateral canthus was elevated and rotated 45 degrees laterally while the continuity of the lower eyelid gray line was maintained. A new lateral canthus was created by fixating the rotation flap to the lateral orbital rim with minimal skin trimming and tension-free sutures, preventing relapse and maintaining a triangular shape. In more than 95% of cases, effective and satisfactory extension was achieved. On average, a 3 mm extension of the lateral canthus was achieved. There were minor complications such as wound dehiscence, webbing, and scarring, which were easily corrected. The author not only extended the lateral canthus 3-4 mm laterally but also maintained the continuity of the gray line on the lower lid as a more natural-looking triangular shape, while minimizing complications such as webbing and conjunctival exposure.

• Steel and Composite Structures
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• 제1권1호
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• pp.145-158
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• 2001

An experimental study was conducted to evaluate the effects of loading sequence and lateral bracing on the behavior of reduced beam section (RBS) steel moment frame connections. Four full-scale moment connections were cyclically tested-two with a standard loading history and the other two with a near-fault loading history. All specimens reached at least 0.03 radian of plastic rotation without brittle fracture of the beam flange groove welds. Two specimens tested with the nearfault loading protocol reached at least 0.05 radian of plastic rotation, and both experienced smaller buckling amplitudes at comparable drift levels. Energy dissipation capacities were insensitive to the types of loading protocol used. Adding a lateral bracing near the RBS region produced a higher plastic rotation; the strength degradation and buckling amplitude were reduced. A non-linear finite element analysis of a one-and-a-half-bay beam-column subassembly was also conducted to study the system restraint effect. The study showed that the axial restraint of the beam could significantly reduce the strength degradation and buckling amplitude at higher deformation levels.

• Archives of Plastic Surgery
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• 제48권1호
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• pp.69-74
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• 2021

Background In inferomedially rotated zygomatic fractures sticking in the maxillary sinus, it is often difficult to achieve complete reduction only by conventional intraoral reduction. We present a new intraoral reduction technique using a Kirschner wire and its clinical outcome. Methods Among 39 inferomedially impacted zygomatic fractures incompletely reduced by a simple intraoral reduction trial with a bone elevator, a Kirschner wire (1.5 mm) was vertically inserted from the zygomatic body to the lateral orbital rim in 17 inferior-dominant rotation fractures and horizontally inserted to the zygomatic arch in nine medial-dominant and 13 bidirectional rotation fractures. A Kirschner wire was held with a wire holder and lifted in the superolateral or anterolateral direction for reduction. Following reduction of the zygomaticomaxillary fracture, internal fixation was performed. Results Fractures were completely reduced using only an intraoral approach with Kirschner wire reduction in 33 cases and through an additional lower lid or transconjunctival incision in six cases. There were no surgical complications except in one patient with undercorrection. Postoperative 6-month computed tomography scans showed complete bone union and excellent bone alignment. Four patients experienced difficulty with upper lip elevation; however, these problems spontaneously resolved after manual tissue lump massage and intralesional steroid (Triamcinolone) injection. Conclusions We completely reduced infraorbital rim fractures, zygomaticomaxillary buttresses, and zygomaticofrontal suture fractures in 84% of patients through an intraoral approach alone. Intraoral Kirschner wire reduction may be a useful option by which to obtain effective and powerful reduction motion of an inferomedially rotated zygomatic body.

• Earthquakes and Structures
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• 제16권6호
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• pp.691-704
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• 2019

This study simulates the responses of large-scale bridge piers under pseudo-dynamic tests to investigate the performance of four types of numerical models that consider the nonlinear behavior of the pier and the rocking behavior of the footing. In the models, beam-column elements with plastic hinges are used for the pier, two types of foundation models (rotational spring and distributed spring models) are adopted for the footing behavior, and two types of viscous damping models (Rayleigh and dashpot models) are applied for energy dissipation. Results show that the nonlinear pier model combined with the distributed spring-dashpot foundation model can reasonably capture the behavior of the piers in the tests. Although the commonly used rotational spring foundation model adopts a nonlinear moment-rotation property that reflects the effect of footing uplift, it cannot suitably simulate the hysteretic moment-rotation response of the footing in the dynamic analysis once the footing uplifts. In addition, the piers are susceptible to cracking damage under strong seismic loading and the induced plastic response can provide contribution to earthquake energy dissipation.

• Steel and Composite Structures
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• 제22권1호
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• pp.141-159
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• 2016

Commonly in steel frames, steel beam and concrete slab are connected together by shear keys to work as a unit member which is called composite beam. When a composite beam is subjected to positive bending, flexural strength and stiffness of the beam can be increased due to "composite action". At the same time despite these advantages, composite action increases the strain at the beam bottom flange and it might affect beam plastic rotation capacity. This paper presents results of study on the rotation capacity of composite beam connected to Rectangular Hollow Section (RHS) column in the steel moment resisting frame buildings. Due to out-of-plane deformation of column flange, moment transfer efficiency of web connection is reduced and this results in reduction of beam plastic rotation capacity. In order to investigate the effects of width-to-thickness ratio (B/t) of RHS column on the rotation capacity of composite beam, cyclic loading tests were conducted on three full scale beam-to-column subassemblies. Detailed study on the different steel beam damages and concrete slab damages are presented. Experimental data showed the importance of this parameter of RHS column on the seismic behavior of composite beams. It is found that occurrence of severe concrete bearing crush at the face of RHS column of specimen with smaller width-to-thickness ratio resulted in considerable reduction on the rate of strain increase in the bottom flange. This behavior resulted in considerable improvement of rotation capacity of this specimen compared with composite and even bare steel beam connected to the RHS column with larger width-to-thickness ratio.

• Archives of Plastic Surgery
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• 제36권1호
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• pp.38-45
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• 2009

Purpose: The congenital muscular torticollis is a neck deformity involving shortening of the sternocleidomastoid muscle, which is detected at birth or shortly after birth. This childhood disease is the third most common congenital musculoskeletal anomaly. The indication for surgery is a persistent head tilt with dificit of passive rotation and lateral bending of the neck and a tight band or tumor in the sternocleidomastoid muscle even after physical therapy. The purpose of this article is to report surgical outcomes with patients who had no or little response to physical therapy. Methods: Surgery was performed on 29 patients and their average age was 4.1 years (from 6 months to 20.1 years). The unipolar open release and partial myectomy were done in 28 cases and the muscle lengthening was done in 1 case. Physical therapy was started from postoperative seventh day. Follow - up period was ranged from 2 months to 5.4 years(mean follow - up, 20.4 months). Result: There were neither rotation nor lateral bending deficit after surgical treatment. Mild head tilt was noticed in 3 cases and residual bend was observed in 4 cases. The subjective assessments of surgical results by parents were excellent. Conclusion: Our surgical outcome encourages the surgical treatment of congenital muscular torticollis for patients who failed to respond to physical therapy.

• Steel and Composite Structures
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• 제52권1호
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• pp.31-43
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• 2024

A very widely used analytical method (mathematical model), mentioned in Eurocode 3, to examine the connections' bending behavior is the component-based method that has certain weak points shown in the plastic behavior part of the moment-rotation curves. In the component method available in Eurocode 3, for simplicity, the effect of strain hardening is omitted, and the bending behavior of the connection is modeled with the help of a two-line diagram. To make the component method more efficient and reliable, this research proposed its advanced version, wherein the plastic part of the diagram was developed beyond the guidelines of the mentioned Regulation, implemented to connect the end plate, and verified with the moment-rotation curves found from the laboratory model and the finite element method in ABAQUS. The findings indicated that the advanced component method (the method developed in this research) could predict the plastic part of the moment-rotation curve as well as the conventional component-based method in Eurocode 3. The comparison between the laboratory model and the outputs of the conventional and advanced component methods, as well as the outputs of the finite elements approach using ABAQUS, revealed a different percentage in the ultimate moment for bolt-extended end-plate connections. Specifically, the difference percentages were -31.56%, 2.46%, and 9.84%, respectively. Another aim of this research was to determine the optimal dimensions of the end plate joint to reduce costs without letting the mechanical constraints related to the bending moment and the resulting initial stiffness, are not compromised as well as the safety and integrity of the connection. In this research, the thickness and dimensions of the end plate and the location and diameter of the bolts were the design variables, which were optimized using Particle Swarm Optimization (PSO), Snake Optimization (SO), and Teaching Learning-Based Optimization (TLBO) to minimization the connection cost of the end plate connection. According to the results, the TLBO method yielded better solutions than others, reducing the connection costs from 43.97 to 17.45€ (60.3%), which shows the method's proper efficiency.

• 한국지진공학회논문집
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• 제13권5호
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• pp.51-60
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• 2009

안전한 내진설계를 위해서는 각 부재에 요구되는 소성변형 요구량을 정확히 예측하여야 한다. 본 연구에서는 등가정적내진설계에 쉽게 활용할 수 있도록, 복잡한 비선형해석 없이 탄성해석을 사용하여 모멘트골조 부재의 소성변형을 평가하는 방법을 개발하였다. 각 부재의 소성변형은 부재 강성과 탄성해석 결과로부터 직접 결정되는 층간변위비 요구량 및 모멘트 재분배 등의 설계 변수로부터 결정된다. 제안된 방법을 8층 2경간의 모멘트골조에 적용하고, 비선형해석을 통하여 제안된 방법의 정확성을 검증하였다. 검증결과, 제안된 방법은 비선형거동에 의한 층간변위비 요구량과 각 부재의 소성변형 요구량을 정확히 평가하였다. 제안된 방법은 부재연성설계와 같은 신축건물의 내진설계에 활용할 수 있을 뿐만 아니라 기존건물의 내진성능평가에도 활용될 수 있을 것으로 기대된다.

• Archives of Plastic Surgery
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• 제46권4호
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• pp.330-335
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• 2019

Background The use of anatomic implants has improved the aesthetic results of breast surgery; however, implant malrotation is an uncommon, but serious complication of these procedures. Nevertheless, little research has explored implant adhesion. In this study, we investigated adhesion between the expander and the capsule. Methods Seventy-nine cases of immediate breast reconstruction via two-stage implant-based reconstruction performed between September 2016 and November 2017 were evaluated. Mentor CPX4 expanders were used in 14 breasts, and Natrelle expanders in 65. We analyzed areas of adhesion on the surfaces of the tissue expanders when they were exchanged with permanent implants. We investigated whether adhesions occurred on the cephalic, caudal, anterior, and/or posterior surfaces of the expanders. Results Total adhesion occurred in 18 cases, non-adhesion in 15 cases, and partial adhesion in 46 cases. Of the non-adhesion cases, 80% (n=12) were with Mentor CPX4 expanders, while 94.4% (n=17) of the total adhesion cases were with Natrelle expanders. Of the partial adhesion cases, 90.7% involved the anterior-cephalic surface. The type of tissue expander showed a statistically significant relationship with the number of attachments in both univariate and multivariate logistic regression analyses (P<0.001) and with total drainage only in the univariate analysis (P=0.015). Conclusions We sought to identify the location(s) of adhesion after tissue expander insertion. The texture of the implant was a significant predictor of the success of adhesion, and partial adhesion was common. The anterior-cephalic surface showed the highest adhesion rate. Nevertheless, partial adhesion suffices to prevent unwanted rotation of the expander.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.798-802
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• 2011

Purpose: A wart is caused by epidermal infection with the human papilloma virus. Although wart naturally disappears in some cases, it require treatment because of pain, aesthetic problem, and the possibility of malignant change. Conventional non-surgical treatment cannot be a fundamental solution for the pain and has such disadvantages as frequent recurrence and difficulties in achieving a satisfactory outcome. A surgical procedure was performed on patients with wart and the procedure had a good outcome. Methods: We investigated the gender, age, lesion site, mean treatment duration, and presence or absence of recurrence in 21 patients with a wart within the period of January 2007 to July 2011. For local lesions, primary closure, including subcuticular suture after the excision, was performed. If the defect size was too big to do primary closure, we performed rotation flap. For wide multiple lesions, a split thickness skin graft was performed. Results: Among the 21 patients, 12 patients were male and 9 patients were female, and their mean age was 42 years (SD=17.38, range: 11~75 years). The lesion site was the foot in 10 patients, the hand in 8 patients, the face in 2 patients, and the scalp in 1 patient. The mean treatment duration was 13.5 days (SD=4.36, range: 6~15 days) for the primary closure or rotation flap, and 18.5 days (SD=2.12, range: 17~20 days) for the skin graft. 20 patients were cured without recurrence. No recurrence was observed in the patients who underwent primary closure or rotation flap. One of the two patients who underwent a skin graft of their wart that had covered their entire palm had local recurrence in part of her finger tips. Conclusion: We performed surgical procedure on recalcitrant wart. As a results, we can treat it with short treatment duration, low recurrence rate and less scarring and get high patient satisfaction.