• Title/Summary/Keyword: perforating

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The Value of Preoperative Multidetector Computed Tomography for Deep Inferior Epigastric Artery Perforator Free Flap (심하복벽동맥 천공지 유리피판에서 술전 MDCT의 유용성)

  • Heo, Chan Yeong;Hong, Ki Yong;Yoon, Chang Jin;Eun, Seok Chan;Baek, Rong Min;Minn, Kyung Won
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.140-146
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    • 2009
  • Purpose: Autologous breast reconstruction with abdominal tissue is one of the best options after mastectomy. In a free transverse rectus abdominis myocutaneous(TRAM) or deep inferior epigastric artery perforator(DIEP) flap, a preoperative evaluation of the precise location of perforating vessels and vascular run - off systems is required. The objective of this report is to demonstrate the usefulness of multidetector computed tomography(MDCT) in the preoperative planning of patients undergoing breast reconstruction with abdominal flap. Methods: From June 2006 to January 2008, 28 patients underwent MDCT evaluation before breast reconstruction. All subjects were females with an age range of 30 to 55 years. The CT scan was performed using a 64 - slice MDCT scanner(Brilliance 64; Philips Medical Systems, Best, Netherlands). Results: One perforator or two major perforators were marked on image in good relation with a hand - held Doppler examination and intraoperative findings. All vascular run - off systems were cleared before operation. Conclusion: Preoperative evaluation of perforator arteries with MDCT angiography is beneficial in patients undergoing breast reconstruction. This technique provides a noninvasive approach of the vascular anatomy of the entire anterior abdominal wall.

Subcutaneous Fascial Pedicled Lateral Supramalleolar Flap (피하 근막 혈관경을 사용한 외측 과상부 피판술)

  • Rhee, Seung-Hwan;Chung, Moon-Sang;Baek, Goo-Hyun;Lee, Young-Ho;Gong, Hyun-Sik;Lee, Sang-Ki;Kim, Ji-Yeong;Park, Jong-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.16 no.2
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    • pp.68-74
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    • 2007
  • Soft-tissue reconstruction of the foot and ankle has long been a challenge for reconstructive surgeons. Limitations in the available local tissue and donor-site morbidity restrict the options. In an effort to solve these difficult problems, the authors have begun to use a subcutaneous fascial pedicled lateral supramalleolar flap. This report presents the authors' experience with five patients treated with this flap. The patients’ ages ranged from 26 to 72 years; four of the patients were male and one was female. The cause of the soft-tissue defects involved acute trauma and malignant melanom. All flaps survived and provided satisfactory coverage of the defect. Compared with the classic lateral supramalleolar flap, when the perforating branch is interrupted in its course, it is possible to elevate this subcutaneous fascial pedicled flap. The distally based flap with a compound pedicle which is continuous with a vascular axis and a band of subcutaneous fascial pedicle has long pedicle. This procedure is valuable for remote defect of the foot. It is believed that this flap is versatile and effective and is a good addition to the available techniques used by reconstructive surgeons for coverage of the foot and ankle.

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Radiomorphometric analysis of edentulous posterior mandibular ridges in the first molar region: a cone-beam computed tomography study

  • Magat, Guldane
    • Journal of Periodontal and Implant Science
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    • v.50 no.1
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    • pp.28-37
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    • 2020
  • Purpose: The aim of our study was to determine the prevalence and degree of lingual concavities in the first molar region of the mandible to reduce the risk of perforating the lingual cortical bone during dental implant insertion. Methods: A total of 163 suitable cross-sectional cone-beam computed tomography images of edentulous mandibular first molar regions were evaluated. The mandibular morphology was classified as a U-configuration (undercut), a P-configuration (parallel), or a C-configuration (convex), depending on the shape of the alveolar ridge. The characteristics of lingual concavities, including their depth, angle, vertical location, and additional parameters, were measured. Results: Lingual undercuts had a prevalence of 32.5% in the first molar region. The mean concavity angle was 63.34°±8.26°, and the mean linear concavity depth (LCD) was 3.03±0.99 mm. The mean vertical distances of point P from the alveolar crest (Vc) and from the inferior mandibular border were 9.39±3.39 and 16.25±2.44, respectively. Men displayed a larger vertical height from the alveolar crest to 2 mm coronal to the inferior alveolar nerve (Vcb) and a wider LCD than women (P<0.05). Negative correlations were found between age and buccolingual width at 2 mm apical to the alveolar crest, between age and Vcb, between age and Vc, and between age and LCD (P<0.05). Conclusions: The prevalence of lingual concavities was 32.5% in this study. Age and gender had statistically significant effects on the lingual morphology. The risk of lingual perforation was higher in young men than in the other groups analyzed.

Characteristics of Stacked Probe-Fed Sqare-Ring Microstrip Antenna (적층구조, 프로브 급전방식, 정사각형 링형태 마이크로스트립 안테나 특성에 관한 연구)

  • 이정연;이중근;김성철
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
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    • v.12 no.1
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    • pp.143-152
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    • 2001
  • A method for miniaturization of microstrip patch antenna without degrading its radiation characteristics is investigated in this paper. It involves perforating the patch to form a microstrip square-ring antenna, and it's BW enhancement is investigated numerically and experimentally. A ring geometry introduces additional parameters to the antenna, and those are used to control impedances, resonance frequencies, and bandwidths. For a single square ring antenna, an increase of the size of perforation increases its input impedance, decreases the resonance frequency, and bandwidths. But it affects little on directivity of the antenna. To match the antenna to a transmission line and also enhance its bandwidth, the ring is stacked by a square patch or another square ring. Also numerically simulated results by the IE3D, and experimental data are compared for proof.

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A Fundamental Study of the Silla Shield through the Analysis of the Shape, Dating, and Species Identification of Wooden Shields Excavated from the Ruins of Wolseong Moat in Gyeongju (경주 월성 해자 유적 출토 목제방패의 형태, 연대 및 수종분석을 통한 신라 방패의 기초적 연구)

  • NAM, Tae-Gwang;KIM, Hun-Suk
    • Journal of the Korean Wood Science and Technology
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    • v.49 no.2
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    • pp.154-168
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    • 2021
  • Various types of wooden relics are being unearthed following the full-scale excavation in Wolseong palace site, Gyeongju in Korea. In particular, a large number of relics were found in the moat surrounding the Wolseong Fortress. This study attempted to secure basic data on the shields of the Silla era through species identification, radiocarbon dating, and shape analysis of the two wooden shields excavated from the Wolseong moat. As a result of the radiocarbon dating, it was confirmed that the shields were made of wood procured in the period between the mid-4th century and the early 5th century. The species identification confirmed that the body of the relic was made with Pinus soft pine group and the handle with Zelkova serrata. It was also confirmed that the excavated wooden shield was made by first marking a thin line on a flat grain board, then marking double concentric circles and perforating small holes. The distance between the division lines is constant at about 6cm, and spaces between them are colored in red and black. The shape analysis estimated that two artifacts were more than 50cm and 36cm in width, respectively.

Evaluation of a new method, "non-injection resection using bipolar soft coagulation mode (NIRBS)", for colonic adenomatous lesions

  • Mitsuo Tokuhara;Masaaki Shimatani;Kazunari Tominaga;Hiroko Nakahira;Takuya Ohtsu;Katsuyasu Kouda;Makoto Naganuma
    • Clinical Endoscopy
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    • v.56 no.5
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    • pp.623-632
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    • 2023
  • Background/Aims: Endoscopic resection of all colorectal adenomatous lesions with a low complication rate, simplicity, and negative residuals is challenging. Hence, we developed a new method called "non-injection resection using bipolar soft coagulation mode (NIRBS)" method, adapted for colorectal lesions. In addition, we evaluated the effectiveness of this method. Methods: We performed NIRBS throughout a 12-month period for all colorectal lesions which snare resection was acceptable without cancerous lesions infiltrating deeper than the submucosal layer. Results: A total of 746 resected lesions were included in the study, with a 4.5 mm mean size (range, 1-35 mm). The major pathological breakdowns were as follows: 64.3% (480/746) were adenomas, and 5.0% (37/746) were intraepithelial adenocarcinomas (Tis lesions). No residuals were observed in any of the 37 Tis lesions (mean size, 15.3 mm). Adverse events included bleeding (0.4%) but no perforation. Conclusions: NIRBS allowed the resection of multiple lesions with simplicity because of the non-injection and without perforating due to the minimal burn effect of the bipolar snare set in the soft coagulation mode. Therefore, NIRBS can be used to resect adenomatous lesions easily, including Tis lesions, from small to large lesions without leaving residuals.

'Studies on diagnosis and Treatment of tumor.abscess.ulcer in intestinal carbuncle' (장옹(腸癰)에 있어서 종양(腫瘍).농양(膿瘍).궤양(潰瘍)의 진단(診斷)과 치료(治療)에 관(關)한 고찰(考察))

  • Han, Gyu-Eon;Ryu, Bong-Ha;Park, Dong-Won;Ryu, Gi-Won;Jang, In-Gyu
    • The Journal of Internal Korean Medicine
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    • v.11 no.1
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    • pp.93-107
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    • 1990
  • Studies on diagnosis and treatment of tumor . abscess . ulcer in intestinal carbuncle were carried out. The result of studies were summerized as follows: 1. By Nai-Gyung carbuncle-tumor arose from disharmony between nutrient and defensive because of cold, abscess arose from fever victory between cold and fever, ulcer arose from decreasing function of Bi-Kam year. By latter literature Bi-Kam year could be interpreted that spleen stomach was invaded evil influence from unattainable vital force of the earth. 2. Sites of intestinal carbuncle were large intestine, small intestine, intestinal inside or outside between large and small intestine, Intestinal carbuncle was common name of a disease about large intestinal carbuncle, small intestinal carbuncle, pelvic intestinal carbuncle, shrink leg intestinal carbuncle etc.. Pain appeared Chunchu-Hyul in large intestinal carbuncle, and Gwanweon-Hyul in small intestinal carbuncle. 3. On abdominal diagnosis tumor had indistinct pain of Gwanweon Chunchu, edema and heary feeling in low abdomen, no excessive pain by hand press and intestinal boiling sound. In abscess pain descended from right side of low abdomen to huckle, and there was rejection against press, feeling about fever,water sound with flank movement. In ulcer hand approach was difficult since excessive pain diffuse to whole abdomen, and perforating ulcer sometimes caused a serious symptom of umbilical pus. 4. On fecal and urinary diagnosis in tumor urine was yellowish red pollakiuria like gonorrhoea and occasional constipation. In abscess uncomfortable rough pain short red early urine like gonorrhoea appeared during urination, and constipation with stinging pain appeared during defecation. In ulcer red rough pyuria appeared, and stinging and pain with puruloid blood appeared during defecation. 5. On treatment in tumor Daiwhang-Tang Daisenggi-Tang Dangui-Jun by dissipation method, calming down method, interior reliance maturation method, in abscess Mokdan-San Euiiin-Tang Jeokduiin-Tang by the method of water repelling pus discharge, acute breaking, in ulcer Takridanggui-Tang Paljin-Tang Bojungikki-Tang were each used by the method of interior reliance, virulence astriction, supplement vital force and blood, supplement spleen stomach. 6. On treatment patient may have to be careful of excessive moving and suprising anxiety. Abuse of acupuncture and moxibustion made patient worse, misuse of analgesics purgative intestinal irrigation etc. could provoke difficult diagnosis and perforation. So you must treat after exact diagnosis. 7. Prognosis of ease tumor ease abscess ease ulcer and ease astriction was good. If the intestinal carbuncle were not to promote to abscess and ulcer for a long time, its prognosis was bad and it could metastasize to cancer because of dark purple with hardness. So tumor abscess ulcer in intestinal carbuncle may be significant of precancerous lesion.

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Lateral Supramalleolar Fasciocutaneous Island Flap for Reconstruction of the Foot and Ankle Soft Tissue Defect (외측 복사뼈 상부 근막-피부 섬피판을 이용한 발 및 발목관절 연부조직 결손의 재건)

  • Choi, Jae Hoon;Kim, Nam Gyun;Choi, Tae Hyun;Lee, Kyung Suk;Kim, Joon Sik
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.784-788
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    • 2006
  • Purpose: For the reconstruction of the ankle joint as well as the soft tissue defect in the distal lower leg, a free flap or a local flap has been used, and because of the condition of patients, if a complex microvascular surgery under general anesthesia could not be performed, it could be reconstructed by using the distally based lateral supramalleolar fascio-cutaneous island flap using the perforating branch of the peroneal artery in the ankle area. Methods: The study subjects were 4 male patients between 53 years and 73 years of age. 2 cases were tissue defect in the medial malleolus area due to systemic diseases such as gouty arthritis accompanied traffic accident, diabetes mellitus foot, atherosclerotic obliterans, etc., 1 case was the defect in the pretibia area, and 1 case was the defect underneath the lateral malleolus, which was reconstructed by the distally based lateral supramalleolar fascio-cutaneous island flap. The donor area was the skin harvested from the groin, and the full thickness skin graft was performed. The size of the flap varied from $4{\times}3cm$ to $9{\times}6cm$. As the flap border, the medial side was to the tibialis anterior tendon, the lateral side was to the fibula crest, and the proximal area was less than the fibula size. Results: The consequence is that, in total 4 cases, the congestion in the flap began from 12 hours after the surgery, and the progression of congestion was ceased on the 5th day after the surgery, and finally epidermal bulla and sloughing, partial necrosis was developed. After the end of necrosis, the defect area was reconstructed successfully by the second full thickness skin graft. Conclusions: Although the distally based lateral supramalleolar fascio-cutaneous island flap has the shortcoming of requiring the second skin graft, it has the advantages that it does not require a long complex microsurgery, the flap itself is thin, it is similar to the color of the skin in the recipient area, and it does not leave a big scar in the donor area. Therefore, it is thought that for the cases who could not undergo a long complex surgery due to systemic diseases or the cases of patients whose condition of the recipient area is not suitable for microsurgery, the lateral supramalleolar fascio-cutaneous island flap is very useful for the reconstruction of the distal lower leg and the ankle joint area.

THE EFFECT OF CANAL OBTURATION ACCORDING TO THE DEPTH OF THE SYSTEM B PLUGGER TIP IN THE TYPE IV CANAL (제 IV 형 근관에서 System B Plugger tip의 깊이에 따른 근관 충전 효과)

  • Choi, Hee-Won;Kim, Soo-Mee;Hwang, Ho-Keel
    • Restorative Dentistry and Endodontics
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    • v.33 no.6
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    • pp.518-525
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    • 2008
  • The purpose of this study was to evaluate the effect of the apical sealing according to the depth of the System B Plugger tip when root canal was filled with gutta-percha and sealer by Continuous Wave of Condensation technique in the Type IV canal. 50 simulated resin blocks with J-shaped curvature canals were instrumented by ProTaper (Dentsply Maillefer, Ballagiues, Switzerland) Ni-Ti files using the crown-down technique. Type IV canals were made using a broken ProTaper F3 Ni-Ti file for making a ledge at 3mm short from the working length. And ProTaper F1 Ni-Ti file was used for perforating resin block. The prepared Type IV canals were randomly divided into three experimental groups of 15 each according to the depth of System B Plugger tip. All of experimental groups were obturated with Continuous Wave of Condensation technique. The length of gutta-percha and sealer in lingual of the Type IV canals was measured with a measuring digital calliper under magnifying glass (${\times}2.3$). The results are as follows : 1. In control group, there was no gutta-percha and sealer in lingual canal. 2. 3 mm group showed relatively more gutta-percha than 5mm or 7 mm group (p<0.05). 3. 7 mm group did not showed gutta-percha and relatively more void were observed than 3mm or 5 mm group. (p<0.05) In conclusion, within the limits of the results of this experiment, the 3 mm depth of System B Plugger tip was acceptable for obturating the Type IV canal.

Comparison of Endovenous Treatment Using a 980 nm Diode Laser versus Conventional Stripping for Truncal Saphenous Vein Incompetence: Mid-term Results by VCSS Score and Recurrence (복재정맥 부전에 대한 980-nm 다이오드 레이저를 이용한 치료와 전통적인 발거술 간의 비교: VCSS 점수와 재발에 의한 중기 임상 결과)

  • Choi, Jae-Sung;Kim, Eung-Joong;Lee, Jeong-Sang
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.387-393
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    • 2010
  • Background: The aims of the present study were to assess and compare mid-term clinical outcomes including recurrences between endovenous laser therapy (EVLT) and stripping. Material and Method: Between January 2007 and February 2010, 318 limbs in 237 patients with saphenous truncal varicosities were treated by laser energy using a 980 nm diode or were treated with conventional stripping. At the initial visit and at 1, 2, 6, 12, 18, 24, and 36 months postoperatively, clinical examination and questioning for Venous Clinical Severity Score (VCSS) as well as duplex ultrasonography were done. In order to compare clinical outcomes between the two treatment groups, EVLT versus stripping, all data were processed and analyzed. Result: There were no significant differences between the two treatment groups in the extent of the reflux and the number of insufficient perforating veins. The in EVLT and the stripping group at 12 months were $90.3{\pm}4.5%$ and $93.9{\pm}4.2%$, respectively (p>0.05). Total recurrence rates were 4.4% in the EVLT group and 1.5% in the stripping group (p>0.05). In both groups, the VCSS scores were significantly reduced at week 1, 1 month, and 2 months after EVLT or stripping (p<0.001). Conclusion: Efficiency in eliminating truncal saphenous vein incompetence and reducing venous clinical severity were equal in the two treatment groups.