• Archives of Plastic Surgery
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• v.49 no.1
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• pp.80-85
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• 2022

The instep flap and medialis pedis flap are both originate based on the medial plantar artery. The medialis pedis flap is based from the deep branch and the instep flap is based from the superficial branch. To increase the axial rotation, it is acceptable to ligate the lateral plantar artery. However, this can partially affect the blood supply of the plantar metatarsal arch. We restored the blood flow with a vein graft between the posterior tibial artery and the ligated stump. From 2012 to 2020, 12 cases of heel reconstruction, including seven instep flaps and five medialis pedis flaps, were performed with ligation of the lateral plantar artery. The stump of the lateral plantar artery was restored with a vein graft and between the posterior tibial artery and the ligated stump. Patients were followed for 18 months. Long-term results showed the vascular restoration of the lateral plantar artery remained patent demonstrated by doppler ultrasonography. Restoring blood flow to the lateral plantar artery maintains good blood supply to the toes. If the patient in the future develops a chronic degenerative disease, with microvascular complications, bypass surgery can still be performed because of the patency of both branches.

• Journal of Korean Society of Steel Construction
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• v.12 no.1 s.44
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• pp.65-73
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• 2000

The behavior of double angle connections is analyzed by 3D finite element method using ABAQUS(ver 5.8). Moment-rotation curves for the connections are generated, as well as stress distribution for angle and bolt. Double angle connections have various angle thickness, gage distance and number of bolt. Parameters, such as initial stiffness, plastic tiffness, reference load and curve shape parameter were obtained by regression method using Richard's formula. These parameter lead to predict nonlinear behavior of double angle connection. Design curves giving the parameters of the moment-rotation curves are generated. These parameters are primarily a function of the angle thickness, gage distance and the number of bolts in the connection. Using these parameters, connection moment and its ratio to the full plastic moment capacity Mp of the beam are calculated.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.1
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• pp.23-27
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• 2010

The purpose of this study was to evaluate the reliability of 6-axis model surgery simulator (6AMSS) for orthognathic surgery. A rectangular parallelepiped plastic block was assembled to model-mounting plate of 6AMSS. Left-right (X), anterior-posterior (Y), up-down (Z) translation and pitching (${\phi}X$), rolling (${\phi}Y$) and yawing (${\phi}Z$) rotation was planned and performed using 6AMSS. The actual translation and rotation were measured with dial gauge and precisional protractor, respectively. Comparison between the planned and actual movements of plastic block for each variable were made using paired t- test. Statistical analysis for X, Y, Z, ${\phi}X$, ${\phi}Y$ and ${\phi}Z$ movement have shown no significant differences between planned and actual movement (P > 0.05). This indicate that model surgery performed with the aid of the 6AMSS is accurate in 3D translation and rotation. The 6AMSS is practically useful for accurate fabrication of surgical splint for orthognathic surgery.

• Geomechanics and Engineering
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• v.37 no.4
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• pp.383-393
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• 2024

Monopile foundations of offshore wind turbines embedded in soft clay are subjected to the long-term cyclic lateral loads induced by winds, currents, and waves, the vibration of monopile leads to the accumulation of pore pressure and cyclic strains in the soil in its vicinity, which poses a threat to the safety operation of monopile. The researchers mainly focused on the hysteretic stress-strain relationship of soft clay and kinds of stiffness degradation models have been adopted, which may consume considerable computing resources and is not applicable for the long-term bearing performance analysis of monopile. In this study, a modified cyclic stiffness degradation model considering the effect of plastic strain and pore pressure change has been proposed and validated by comparing with the triaxial test results. Subsequently, the effects of cyclic load ratio, pile aspect ratio, number of load cycles, and length to embedded depth ratio on the accumulated rotation angle and pore pressure are presented. The results indicate the number of load cycles can significantly affect the accumulated rotation angle of monopile, whereas the accumulated pore pressure distribution along the pile merely changes with pile diameter, embedded length, and the number of load cycles, the stiffness of monopile can be significantly weakened by decreasing the embedded depth ratio L/H of monopile. The stiffness degradation of soil is more significant in the passive earth pressure zone, in which soil liquefaction is likely to occur. Furthermore, the suitability of the "accumulated rotation angle" and "accumulated pore pressure" design criteria for determining the required cyclic load ratio are discussed.

• Archives of Plastic Surgery
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• v.48 no.1
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• pp.107-113
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• 2021

Background Applicants to integrated plastic and reconstructive surgery (PRS) residency in the United States spend exorbitant amounts of time and money throughout the interview process. Outside of first-hand experience through a visiting rotation, applicants utilize various resources in learning about a program. Today's applicants are "Millennials," the demographic cohort raised during the information age and proficient with digital technology. The authors evaluated whether programs have a presence on social media, and whether applicants are following these accounts. Methods An online survey was sent to applicants to a single integrated plastic surgery program evaluating basic demographics, social media utilization, and sources of information accessed throughout the residency application process. A manual search of popular social media platforms (Instagram, Facebook, and Twitter) was performed in October 2019. Accounts affiliated with integrated PRS programs were identified and analyzed. Results Eighty-four of 222 applicants (37.8%) completed the survey. Ninety-six percent of applicants were within the Millennial demographic. Ninety-six percent of applicants had some form of social media presence, with Facebook (90%) and Instagram (87%) being the most popular platforms. Seventy-three percent of applicants reported following a PRS residency social media account. As of October 2019, 59 integrated residency programs (73%) have active Instagram accounts. Conclusions Applicants still rely on the program website when researching potential residencies, but social media is being rapidly adopted by programs. Program social media accounts should be used as a dynamic form of communication to better inform applicants of program strengths and weaknesses.

• Journal of the Earthquake Engineering Society of Korea
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• v.13 no.2
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• pp.59-68
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• 2009

For safe and economical design to provide strong earthquake resistance, the moment redistribution and plastic rotation of structures and their members needs to be evaluated. To achieve this, an earthquake design method was developed using secant stiffness analysis. To address the variation of member stiffness due to plastic rotation and moment redistribution, a structure was modeled with a beam-column element with non-rigid end connections (NREC element). Secant stiffness for the NREC element was determined based on the ductility demands of the structure and members. By performing a conventional linear analysis for the secant stiffness model, redistributed moments and plastic rotations of the members were computed. The proposed method was applied to a moment frame and two dual systems. The design results were verified using detailed nonlinear analyses.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.36.1-36.7
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• 2015

Background: This study was performed to evaluate three-dimensional positional change of the condyle using three-dimensional computed tomography (3D-CT) following unilateral sagittal split ramus osteotomy (USSRO) in patients with mandibular prognathism. Methods: This study examined two patients exhibiting skeletal class III malocclusion with facial asymmetry who underwent USSRO for a mandibular setback. 3D-CT was performed before surgery, immediately after surgery, and 6 months postoperatively. After creating 3D-CT images by using the In-vivo $5^{TM}$ program, the axial plane, coronal plane, and sagittal plane were configured. Three-dimensional positional changes from each plane to the condyle, axial condylar head axis angle (AHA), axial condylar head position (AHP), frontal condylar head axis angle (FHA), frontal condylar head position (FHP), sagittal condylar head axis angle (SHA), and sagittal condylar head position (SHP) of the two patients were measured before surgery, immediately after surgery, and 6 months postoperatively. Results: In the first patient, medial rotation of the operated condyle in AHA and anterior rotation in SHA were observed. There were no significant changes after surgery in AHP, FHP, and SHP after surgery. In the second patient, medial rotation of the operated condyle in AHA and lateral rotation of the operated condyle in FHA were observed. There were no significant changes in AHP, FHP, and SHP postoperatively. This indicates that in USSRO, postoperative movement of the condylar head is insignificant; however, medial rotation of the condylar head is possible. Although three-dimensional changes were observed, these were not clinically significant. Conclusions: The results of this study suggest that although three-dimensional changes in condylar head position are observed in patients post SSRO, there are no significant changes that would clinically affect the patient.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.546-551
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• 2006

Purpose: The reconstruction of oropharyngeal defect after cancer surgery is very difficult because of their complicated structure and the functional importance to prevent velopharyngeal incompetence. In this article we investigated affecting factors of velopharyngeal function after reconstruction and a fundamental rule of reconstruction for saving their functions such as swallowing, speeching and breathing. Methods: We classified 18 patients into three group under Kimata's grouping. Type I defect(6 patients) was healed by primary closure or secondary intention. In Type II or III defect, two operation methods were used - the folded flap(8 patients) and modified Gehanno method(4 patients), which include a lateral-posterior pharyngeal rotation-advancement flap. We evaluated wound dehiscence between the flap and the soft palate, speech intelligibility using Hirose's method, regurgitation during oral feeding, and hypernasality. Results: Most of type I or II defects patients recovered satisfactory velopharyngeal function. But, in patients with type III defects we found wound dehiscence, worse speech function, and common velopharyngeal incompetence. Conclusion: The large defect size and presence of wound dehiscence are major factors of postoperative velopharyngeal function. We conclude that folded flap or modified Gehanno method is a good reconstructive operation method for broad contact between the flap and defect site, preventing wound problem.

• Archives of Plastic Surgery
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• v.33 no.4
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• pp.474-479
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• 2006

Purpose: To report of a series of successful reconstruction of soft tissue defect on distal leg with extensor digitorum brevis myo-cutaneous flap. Methods: Between April 2002 to December 2004, 7 patients with soft tissue defect on distal leg were operated with Extensor Digiotorum Brevis myocutaneous flap. 6 of these patients had osteomyelitis. Results: Extensor Digiotorum Brevis myocutaneous flap were used in 6 patients and reverse flow flap was used in one patient. Average follow up was 19 months. All flap were survived 100% without any complication and osteomyelitis were controled in all cases. Aesthetic and functional out come were excellent on both recipient and donor sites. Conclusion: The advantages of this flap are effectively control of local wound infection, constant and reliable anatomical structures, adequately thin flap. Technical easiness for raising flap and wide arch of rotation. Extensor Digitorum Brevis myo-cutaneous flap is one of ideal option for the reconstruction of distal leg and foot defects.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.465-468
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• 2010

Purpose: Soft tissue deformity and skin defect after tumor resection in the periorbital area can cause trouble in the function of eyelid as well as in the aspect of external appearance. Therefore, as cosidering reconstruction in periorbital area, detailed assessment of both functional and aesthetic property are required. thus, the purpose of this study is to examine an appropriate reconstruction through clinical cases. Methods: A 14-year-old girl with congenital giant hairy nevus on right periorbital area was selected. Her first visit to our plastic surgery outpatient clinic was on July 2006. Since then, she has undergone staged removal of lesions and reconstruction by various flap technique such as pedicled island flap, forehead galeal flap, paramedian forehead flap, cheek rotation & advancement flap. Results: In the case of this girl, most lesions were removed and replaced by normal skins. Although there was the difference of skin color after skin graft, such difference was not noticeable and section scar by skin flaps was slight. There was no obvious dysfunction in the eyelids and the girl and her parents were satisfied with results after the surgery. Conclusions: In the reconstruction of soft tissue defect or soft tissue deformity and contracture, it is required to choose appropriate reconstruction method, considering aesthetic and functional aspects depending on aesthetic unit sufficiently.