• Title/Summary/Keyword: Soft-Tip

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Alar Base Augmentation by Various Methods in Secondary Lip Nasal Deformity (다양한 방법을 이용한 이차성 구순열 비변형의 비익기저 증대술)

  • Kwon, Ino;Kim, Yong Bae;Park, Eun Soo;Jung, Sung Kyun
    • Archives of Plastic Surgery
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    • v.32 no.3
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    • pp.287-292
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    • 2005
  • The definitive correction of secondary lip nasal deformities is a great challenge for plastic surgeons. To rectify the secondary lip nasal deformities, various procedures and its modifications have been reported in many centers. However, no universal agreement exist to correct the various components of secondary nasal deformities. The secondary nasal deformity of the unilateral cleft lip has its own characteristic abnormalities including the retroplaced dome of the ipsilateral nasal tip, hooding of the alar rim, a secondary alar-columellar web, short columella, depressed alar base and so forth. Among these components of secondary nasal deformity, maxillary hypoplasia, especially in the area of piriform aperture, and alveolar bone defect can make the alar base depressed, which in turn, leads to wide and flat nasal profile, obtuse nasolabial angle coupled with subnormal nasal tip projection in aspect of aesthetic consideration. Moreover, the maxillary hypoplasia contributes to reduced size of the nasal airway in combination with other component of external nasal deformity and therefore the nasal obstruction may be developed functionally. Therefore, the current authors have performed corrective rhinoplasty with the augmentation of alar base with various methods which include rearrangement of soft tissue, vertical scar tissue flap and use of allogenic or autologous materials in 42 patients between 1998 and 2003. The symmetric alar base could be achieved, which provides the more accurate evaluation and more appropriate management of the various component of any coexisting secondary nasal deformity. In conclusion, the augmentation of alar base, as a single procedure, is a basic and essential to correct the secondary lip nasal deformities.

The Etiology and Treatment of the Softened Phallus after the Radial Forearm Osteocutaneous Free Flap Phalloplasty

  • Kim, Seok-Kwun;Kim, Tae-Heon;Yang, Jin-Il;Kim, Myung-Hoon;Kim, Min-Soo;Lee, Keun-Cheol
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.390-396
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    • 2012
  • Background The radial forearm osteocutaneous free flap is considered to be the standard technique for penile construction. One year after their operation, most patients experience a softened phallus, so that they suffer from difficulties in sexual intercourse. In this report, we present our experience with phalloplasty by radial forearm osteocutaneous free flap, as well as an evaluation of the etiology and treatment of the softened phallus. Methods Between March 2005 and February 2010, 58 patients underwent phalloplasty by radial forearm osteocutaneous free flap. Most of their neophallus had been softened subjectively and among them, 12 patients who wanted correction were investigated. We performed repetitive fat injection, artificial dermis grafting, silicone rod insertion, and rib bone with cartilaginous tip graft. Physical examination, plain radiograph, computed tomography, bone scintigraphy, and satisfaction scores were investigated. Results Most of the participants' penises have been softened after phalloplasty, and the skin elasticity had been also decreased. On plain radiograph, the distal end of the bone was self-rounded; however, the bone shape of the neophallus had no significant interval changes or resorption. Computed tomography showed equivocal density of cortical bone. On bone scintigraphy, the bone metabolism was active at 3 months postoperatively, and remained active 9 years postoperatively. Conclusions The use of a rib bone with cartilaginous tip graft could be an option for improvement of the softened phallus. Silicon rod insertion is also worth considering for rigidity of the softened phallus. Decreased rigidity due to soft tissue atrophy could be alleviated with repeated fat injection and artificial dermis grafting.

Influence of Lithiation on Nanomechanical Properties of Silicon Nanowires Probed with Atomic Force Microscopy

  • Lee, Hyun-Soo;Shin, Weon-Ho;Kwon, Sang-Ku;Choi, Jang-Wook;Park, Jeong-Young
    • Proceedings of the Korean Vacuum Society Conference
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    • 2011.08a
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    • pp.110-110
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    • 2011
  • The nanomechanical properties of fully lithiated and unlithiated silicon nanowire deposited on silicon substrate have been studied with atomic force microscopy. Silicon nanowires were synthesized using the vapor-liquid-solid process on stainless steel substrates using Au catalyst. Fully lithiated silicon nanowires were obtained by using the electrochemical method, followed by drop-casting on the silicon substrate. The roughness, derived from a line profile of the surface measured in contact mode atomic force microscopy, has a smaller value for lithiated silicon nanowire and a higher value for unlithiated silicon nanowire. Force spectroscopy was utilitzed to study the influence of lithiation on the tip-surface adhesion force. Lithiated silicon nanowire revealed a smaller value than that of the Si nanowire substrate by a factor of two, while the adhesion force of the silicon nanowire is similar to that of the silicon substrate. The Young's modulus obtained from the force-distance curve, also shows that the unlithiated silicon nanowire has a relatively higher value than lithiated silicon nanowire due to the elastically soft amorphous structures. The frictional forces acting on the tip sliding on the surface of lithiated and unlithiated silicon nanowire were obtained within the range of 0.5-4.0 Hz and 0.01-200 nN for velocity and load dependency, respectively. We explain the trend of adhesion and modulus in light of the materials properties of silicon and lithiated silicon. The results suggest a useful method for chemical identification of the lithiated region during the charging and discharging process.

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Versatility of Modified Nasolabial Flap in Oral and Maxillofacial Surgery

  • Mitra, Geeti Vajdi;Bajaj, Sarwpriya Sharma;Rajmohan, Sushmitha;Motiwale, Tejas
    • Archives of Craniofacial Surgery
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    • v.18 no.4
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    • pp.243-248
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    • 2017
  • Background: To evaluate the versatility and reach of modified nasolabial flap used in reconstruction of defects created in and around the oral cavity. Methods: A total number of 20 cases were selected. Out of which 13 were males and 7 females. The age of these patients ranged from 24-63 years. 29 modified nasolabial flaps were raised in twenty patients. Based on clinical and histopathological examination, out of 20 patients, 14 patients were diagnosed with oral submucous fibrosis, 3 with verrucous carcinoma, 1 with squamous papilloma, 1 with oro-antral fistula and 1 with traumatic loss of lower lip. Results: Minimum preoperative interincisal distance (IID) was 0 mm and maximum was 15 mm with mean of $6.00{\pm}4.76mm$ in patients with oral submucous fibrosis and 12 months postoperatively minimum IID was 16 mm and maximum was 41 mm with mean of $28.00{\pm}8.96mm$. In one case, dehiscence (3.4%) was noted on the anterior tip for which tip revision was done. Bulky appearance of the flap intraorally was observed in 2 cases (6.9%). Five (17.2%) among the 29 flaps had visible scar at the donor site postoperatively up to 3 months. Conclusion: Numerous reconstructive techniques have been employed in the reconstruction of small to intermediate sized defects of oral cavity. Modified nasolabial flap is a versatile flap which has robust vascularity and can be successfully used with minimal complications. It can be rotated intraorally to extend from the soft palate to the lip. Thus, it can be used efficiently to treat the small defects of the oral cavity as well as recreating lost lip structure.

Karyotype Analysis in Twelve Species of Pinus Genus (소나무속(屬) 12수종(樹種)의 염색체(染色體) 핵형분석(核型分析)에 관(關)한 연구(硏究))

  • Kim, Su In
    • Journal of Korean Society of Forest Science
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    • v.77 no.1
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    • pp.53-64
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    • 1988
  • The idiogram of pine chromosomes was obtained from the length, the ratio of the long and short arm, and the position of the secondary constriction. The descending order of the long arm was found by analyzing the idiogram for 6 species of hard pines and 5 species of soft pines growing in Korea. The basic chromosome number of the genus Pinus was n=12, of which the ten chromosomes were the M-type showing similar S/L ratio, and the other two short chromosomes were the heterobrachial SM-type and the sub-median centric SM-type. The interspecific identification was able to made by comparing the number and the position of the secondary constriction, and the pattern of descending order of the long arm. The intraspecific variation was also able to be identified by comparing the long arms Descending order among the provenaces. Some differences were found in the chromosomal structures between the hard- and the soft-pines. However, the differences were not apparent as much as those in the morphological characteristics. The results might not be exactly reproducible because of the variable responses of chromosomes depending on concentration of the chemicals, the temperatures and time of the treatments, and the analytical errors during the preparateur preparation.

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The Evaluation of Soft and Hard Tissue Change for Retraction of Lower Anterior Tooth in Bimaxillary Protrusion Patients according to Two Different Therapeutic Methods: Mandibular Anterior Segmental Osteotomy and Orthodontic Treatment with Teeth Extraction (양악전돌증 환자에서 하악 6전치 후방 이동 시 치료 방법에 따른 하악 경조직과 연조직의 변화: 하악 전방분절골절단술과 발치 교정 치료)

  • Kim, Young-Joo;Kim, Kyung-A;Yu, Yong-Jae;Ryu, Kyung-Sun;Ryu, Jeong-Min;Ohe, Joo-Young;Kim, Su-Jung;Kim, Seoung-Hun;Lee, Baek-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.4
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    • pp.246-251
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    • 2012
  • Purpose: The purpose of the study is to evaluate the effectiveness of anterior segmental osteotomy (ASO) in bimaxillary protrusion (BP) patients by comparison between the mandibular soft and hard tissue changes from orthodontic treatment and ASO. Methods: All 44 patients were diagnosed with BP in Kyung-Hee Medical Center. Orthodontic treatment with teeth extractions were underwent by 23 patients (Group A) and 21 patients underwent ASO (Group B). Mandibular soft and hard tissue changes were measured and evaluated, which were based on the vertical and horizontal reference line in lateral cephalometric radiographs. Statistical significance between the changes and correlation between each measurement were analyzed. Results: The amount of B point movement was lesser than that of the lower incisal tip (LIT) retraction, and LIT was tilted lingually in group A. The posterior movement discrepancy between LIT and B point was insignificant, and the inclination of lower incisor was not changed in group B. The soft tissues, including the lower lip, showed a posterior movement and reduction in the depth of mento-labial groove. According to the correlation analysis, the movement of the lower incisor was significantly related to the movement of the lower lip in group A, and the movement of the lower incisor was significantly related to that of the movement of lower lip, B point and Pog in group B. Conclusion: The orthodontic treatment in BP patients results in posterior tilting movement of the lower incisor, but ASO results in the bodily movement of the lower incisor. Consequently, ASO is more effective in BP cases because it ensures the controlled movement of the lower incisors.

Development and Application of Penetration Type Field Shear Wave Apparatus (관입형 현장 전단파 측정장치의 개발 및 적용)

  • Lee, Jong-Sub;Lee, Chang-Ho;Yoon, Hyung-Koo;Lee, Woo-Jin;Kim, Hyung-Sub
    • Journal of the Korean Geotechnical Society
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    • v.22 no.12
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    • pp.67-76
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    • 2006
  • The reasonable assessment of the shear stiffness of a dredged soft ground and soft clay is difficult due to the soil disturbance. This study addresses the development and application of a new in-situ shear wave measuring apparatus (field velocity probe: FVP), which overcomes several of the limitations of conventional methods. Design concerns of this new apparatus include the disturbance of soils, cross-talking between transducers, electromagnetic coupling between cables, self acoustic insulation, the constant travel distance of S-wave, the rotation of the transducer, directly transmitted wave through a frame from transducer to transducer, and protection of the transducer and the cable. These concerns are effectively eliminated by continuous improvements through performing field and laboratory tests. The shear wave velocity of the FVP is simply calculated, without any inversion process, by using the travel distance and the first arrival time. The developed FVP Is tested in soil up to 30m in depth. The experimental results show that the FVP can produce every detailed shear wave velocity profiles in sand and clay layers. In addition, the shear wave velocity at the tested site correlates well with the cone tip resistance. This study suggests that the FVP may be an effective technique for measuring the shear wave velocity in the field to assess dynamic soil properties in soft ground.

Arterialized Venous Free Flap at the Insufficient Vascular Recipient Bed in Finger Reconstruction (수지 재건시 불충분한 혈행상태의 수혜부에 시행한 동맥화 정맥 유리 피판술)

  • Lee, Young-Keun;Park, Ki-Tae;Lee, Jun-Mo;Park, Hyuk
    • Archives of Reconstructive Microsurgery
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    • v.21 no.2
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    • pp.131-136
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    • 2012
  • Purpose: Arterialized venous flap is useful for reconstruction of the traumatic soft tissue defect in fingers, but insufficient circulation of the traumatic fingers makes surgeons annoying to use the flap. We have grafted flaps in 7 fingers with insufficient vascular bed hoping to expanded the category of the flap. Materials and Methods: Arterialized venous flap have transplanted in 7 fingers from March 2008 through February 2010 and followed up for 4 to 16 months(average 7.2 months). They were all male with a mean age at the time of surgery was 33. The main injury was crushing in 4 degloving, contact burn and saw injury was I respectively. Time interval from injury to flap transplantation was average 3.1. weeks(3 days to 6 weeks). Designed flap size ranges from $8cm{\times}3.5cm$to $4cm{\times}3cm$. Vessel type of flap was one artery with two veins were 5 cases and one artey with one vein 2. Flap type was cutaneous in 3, tendocutaneous 2, neurotendocutaneous 1 and neurocutaneous 1. The circulation state of recipient site was avascular in 2 cases, insufficiency 3 and tip avascular 2. Results: Arterialized venous flap was complete survived in 2 cases, partial necrosis(less than 10%) 3 and failed in 2. Conclusion: An arterialized venous free flap could be a useful procedure for reconstruction in soft tissue or combined defect of the finger despite an avascular or insufficient vascular beds if the recipient beds were free from infection.

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Performance of laterally loaded piles considering soil and interface parameters

  • Fatahi, Behzad;Basack, Sudip;Ryan, Patrick;Zhou, Wan-Huan;Khabbaz, Hadi
    • Geomechanics and Engineering
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    • v.7 no.5
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    • pp.495-524
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    • 2014
  • To investigate the soil-pile interactive performance under lateral loads, a set of laboratory model tests was conducted on remoulded test bed of soft clay and medium dense sand. Then, a simplified boundary element analysis had been carried out assuming floating pile. In case of soft clay, it has been observed that lateral loads on piles can initiate the formation of a gap, soil heave and the tension crack in the vicinity of the soil surface and the interface, whereas in medium dense sand, a semi-elliptical depression zone can develop. Comparison of test and boundary element results indicates the accuracy of the solution developed. However, in the boundary element analysis, the possible shear stresses likely to be developed at the interface are ignored in order to simplify the existing complex equations. Moreover, it is unable to capture the influence of base restraint in case of a socketed pile. To bridge up this gap and to study the influence of the initial stress state and interface parameters, a field based case-study of laterally-loaded pile in layered soil with socketed tip is explored and modelled using the finite element method. The results of the model have been verified against known field measurements from a case-study. Parametric studies have been conducted to investigate the influence of the coefficient of lateral earth pressure and the interface strength reduction factor on the results of the model.

Cross-Leg Achilles Tendon Reconstruction Using a Composite Flap of Dorsalis Pedis and Tendon Strips of the Extensor Digitorum Longus in a Vascular Compromised Wound (족지 신건이 포함된 족배부 도서형 교차하지 피판을 이용한 혈행장애 하지부의 일단계 아킬레스건 재건 -증례보고-)

  • Lee, June Bok;Lee, Sung Jun;Kim, In Gue;Kim, Sug Won
    • Archives of Plastic Surgery
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    • v.32 no.4
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    • pp.539-542
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    • 2005
  • Reconstructions of soft tissue defect of the posterior ankle including Achilles the tendon should take into account not only coverage but functional outcome. Various methods of tendon transfer and tendon graft have been reported as a single-stage procedure. With advances and refinements in microsurgical techniques, several free composite flaps including tendon, fascia, or nerve have been used in single-stage reconstructions of large defects in this area minimizing further damage to the traumatized leg. However, when free flap is not feasible for some reasons, this cannot be accomplished successfully. Here we present a patient with Achilles tendon and circumferential large soft tissue defect. Because of circulatory compromise of the lower extremity, free flap reconstruction could not be applied. Instead, cross-leg composite flap of the dorsalis pedis flap including the extensor hallucis brevis musle and tendon, and tendon strips of the Second, third and fourth extensor digitorum logus were employed, Functional reconstruction of the tendon and resurfacing were obtained at the same time. The flap was detached 3 weeks postoperatively, and the transplanted flap has survived without any complications. By 3 months after surgery, full weight bearing, tip-toe standing and even walking without crutch assistance was possible. When functional reconstruction with the free flap is unattainable in the large defect of the posterior ankle including the Achilles tendon, cross-leg composite island flap of dorsalis pedis flap and tendon strips of the extensor digitorum longus tendon is a viable alternative.