• Archives of Plastic Surgery
• /
• v.39 no.6
• /
• pp.643-648
• /
• 2012

Background Aggressive treatment of sternoclavicular joint (SCJ) infection involves systemic antibiotics, surgical drainage and resection if indicated. The purpose of this paper is to describe a classification of post resectional SCJ defects and highlight our reconstructive algorithm. Defects were classified into A, where closure was possible often with the aid of topical negative pressure dressing; B, where parts of the manubrium, calvicular head, and first rib were excised; and C, where both clavicular, first ribs and most of the manubrium were resected. Methods Twelve patients (age range, 42 to 72 years) over the last 8 years underwent reconstruction after SCJ infection. There was 1 case of a type A defect, 10 type B defects, and 1 type C defect. Reconstruction was performed using the pectoralis major flap in 6 cases (50%), the latissimus dorsi flap in 4 cases (33%), secondary closure in 1 case and; the latissimus and the rectus flap in 1 case. Results All wounds healed uneventfully with no flap failure. Nine patients had good shoulder motion. Three patients with extensive clavicular resection had restricted shoulder abduction and were unable to abduct their arm past $90^{\circ}$. Internal and external rotation were not affected. Conclusions We highlight our reconstructive algorithm which is summarised as follows: for an isolated type B SCJ defect we recommend the ipsilateral pectoralis major muscle for closure. For a type C bilateral defect, we suggest the latissimum dorsi flap. In cases of extensive infection where the thoracoacromial and internal mammary vessels are thrombosed, the pectoralis major and rectus abdominus cannot be used; and the latissimus dorsi flap is chosen.

• Archives of Craniofacial Surgery
• /
• v.13 no.2
• /
• pp.139-142
• /
• 2012

Purpose: To reconstruct the midface, local flaps such as nasolabial flaps have been frequently used. These local flaps, however, have the shortcomings of requiring a secondary operation or limitations in the movement of the flap. Thus, new methods have been developed. This paper reports a case wherein the basal cell carcinoma on the cheek was resected and the skin and soft tissue defect was successfully treated using a facial artery perforator flap. Methods: A 68-year-old female consulted the authors on the basal cell carcinoma that developed on her cheek. The mass was fully resected and revealed a $2.3{\times}2.3cm$ defective region. Using a Doppler ultrasonography, the facial artery path was traced, and using a loupe magnification, the facial artery perforator flap was elevated and the defective region was covered with the flap. Results: The flap developed early venous congestion, but it disappeared without any treatment. Six months after the surgery, the patient was satisfied with the postoperative result. Conclusion: The facial artery perforator flap has a thin pedicle. It offers a big arc of the rotation that allows free movement and one-stage operation. These strengths make the method useful for the reconstruction of the midface among other procedures.

• Archives of Craniofacial Surgery
• /
• v.19 no.4
• /
• pp.260-263
• /
• 2018

Background: The alar and nasal tip are important subunits of the nose. Determining the optimal procedure for reconstructing a cutaneous defect in a nasal subunit depends on several factors including size, location, and involvement of deep underlying structures. We treated cutaneous defects after tumor ablation in the alar and nasal tip with a local flap, using an S-shaped design and a modified V-Y advancement flap with a croissant shape. Methods: We analyzed 36 patients with skin tumors who underwent flap coverage after tumor ablation. Rotation flaps were used in 26 cases and croissant-shaped V-Y advancement flaps were used in 10 cases. The primary cause of the defects was skin cancer, except for one benign tumor. Results: The mean patient age was 71 years. The size of the defects ranged from $0.49cm^2$ to $3.5cm^2$. No recurrence of skin cancer was noted and all flaps lasted until the end of follow-up. Partial desquamation of the epidermis was noted in one case. The postoperative appearance for most patients was excellent, objectively and subjectively. Conclusion: For cutaneous defects of up to about $4.0cm^2$ of the alar and nasal tip, local flaps using our methods offered a good cosmetic and therapeutic result. The main advantage of our flaps is the minimal dissection required compared to bilobed and other local flap methods. We believe our flaps are a suitable option for alar and nasal tip reconstruction.

• Research in Plant Disease
• /
• v.7 no.2
• /
• pp.69-79
• /
• 2001

Meloidogyne arenaria race 2 (59%) is widely distributed, followed by M. incognita race 1 (23%), and an unknown race of M. incognita (18 ％) in greenhouses in southern Korea. The key character to distinguish between M. arenaria and M. incognita is excretory pore in female head. When oriental melon, Cucumis melo L., grafted on Shintozoa (Cucurbit maxima x Cu. moschata) is transplanted in February in a plastic tunnel inside a greenhouse infested with M. arenaria, nematodes produced egg masses on roots at 40 days after transplanting and the soil juveniles (J2) population reach maximum in July to 3,817/100 ㎤. Juveniles are distributed relatively uniform over the 180-cm-wide row horizontally and the highest density occurs at 0-25 cm soil depth. For the control of root-knot nematodes, rice rotation, solarization, and soil addition treatments are the most effective (P=0.05); treatments reduce number of J2 over 90% and increase yield two times. Corn retation, fosthiazate, and soil drying treatment are moderately effective, while sesame and green onion rotations are not effective. The relationship between M. arenaria and yield of oriental melon is adequately described by a linear regression model. In the test with wild Cucumis genetic sources introduced from U.S.Dept. of Agriculture (USDA), one of C.heptadactylus, two of C.anguria, two of C. anguria var. longaculeatus, nine of C. metuliferus are resistant to both species of root-knot nematodes.

• Structural Engineering and Mechanics
• /
• v.29 no.1
• /
• pp.17-35
• /
• 2008

Neglecting the real joint behaviour in frame analysis may result in unrealistic predictions of the response and reliability of steel frames. The reliability of the prediction of main joint properties according to the component method (Eurocode 3-Part 1.8) still remains open to further investigation. The first step toward the solution is to compare the theoretical expressions given in EN 1993-1-8 and the experimental results. With that goal in mind six nominally the same, but really different specimens of welded beam-to-column joints subjected to static load were tested. The specimens present a combination of nominally identical structural elements produced in different European mills. This paper provides these tests, as well as their detailed evaulation and interpretation. All three joint structural properties (rotational stiffness, moment resistance and rotation capacity) have been considered. Four models for determining the plastic resistance out of experimental Mj-${\phi}$ curves have been applied. The results that have been discussed in detail, point to the fact that EN 1993-1-8 underestimates the real structural properties of the tested type of joint, as well as to the conclusion that detailed research of this problem needs to be conducted using the probabilistic reliability methods.

• International Journal of High-Rise Buildings
• /
• v.6 no.3
• /
• pp.249-259
• /
• 2017

The use of high-strength steels in construction of highrise and mega building structures can bring about many technological advantages from fabrication to erection. However, key design criteria such as local and lateral stability in current steel design specifications were developed based on tests of ordinary steels which have stress-strain characteristics very different from that of high strength steels. A series of tests on 800 MPa tensile strength steel (HSA800) members are summarized in this paper which were conducted to investigate the appropriateness of extrapolating current ordinary-steel based design criteria to high strength steels. 800 MPa I-shape beam specimens designed according to flange local buckling (FLB) criteria of the AISC Specification developed a sufficient strength for elastic design and a marginal rotation capacity for plastic design. It is shown that, without introducing distinct and significant yield plateau to the stress-strain property of high-strength steel, it is inherently difficult to achieve a high rotation capacity even if all the current stability limits are met. 800 MPa I-shape beam specimens with both low and high warping rigidity exhibited sufficient lateral torsional buckling (LTB) strength. HSA800 short-column specimens with various edge restraint exhibited sufficient local buckling strength under uniform compression and generally outperformed ordinary steel specimens. The experimental P-M strength was much higher than the AISC nominal P-M strength. The measured residual stresses indicated that the impact of residual stress on inelastic buckling of high-strength steel is less. Cyclic seismic test results showed that HSA800 members have the potential to be used as non-ductile members or members with limited ductility demand in seismic load resisting systems. Finally, recent applications of 800 MPa high strength steel to highrise and mega building structures in Korea are briefly presented.

• Journal of the Korea institute for structural maintenance and inspection
• /
• v.7 no.4
• /
• pp.91-97
• /
• 2003

The maximum moment may occur at interior supports of continuous bridges. If the bigger moment is applied on them, a local yielding at interior supports may occur. They may show plastic behaviors, and the moment will be redistributed. The strength design, L.F.D., redistributes 10% of the negative moment which is obtained from the elastic analysis. However, A.L.F.D method computes the moment which is redistributed. This moment is called automoment. The moment-rotation curve is needed to find automoment. In this paper moment-rotation curve for compact sections suggested from AASHTO Guide Specifications is used to find automoment. Based on A.L.F.D. limit states specification method, a three-span continuous bridge is designed.

• Journal of the Korean Geotechnical Society
• /
• v.36 no.9
• /
• pp.33-44
• /
• 2020

In order to analyze the shear strength characteristics of the grout with sudden gelation in the pre-hardening state, the viscosity of the mixture and the indoor vane shear test were performed. The grout was prepared according to the water-cement (w/c) ratio and the shear strength test was conducted. The plastic-state shear strength of grout was affected by the w/c ratio, so the lower the w/c ratio, the higher the initial shear strength was, and the longer the curing time was, the higher the shear strength was. The maximum shear strength occurred at the faster rotation angle as the higher shear strength was developed, and the lower shear strength occurred at the larger rotation angle. In addition, it was confirmed that the pre-hardening grout rapidly decreased in strength after the maximum shear strength was gained, and converged at a certain level after the rotation angle of the vane blade was about 70° to 90°.

• Archives of Plastic Surgery
• /
• v.35 no.5
• /
• pp.611-614
• /
• 2008

Purpose: Infection, foreign body reaction and decreased volume of implant are common complications after augmentation rhinoplasty with $Gore-tex^{(R)}$ implant. The author experienced two cases of recurrent foreign body granuloma in the patients who underwent $Gore-tex^{(R)}$ removal because of infection after augmentation rhinoplasty. and treated them with complete removal of$Gore-tex^{(R)}$. Methods: Case 1: A 49 year-old female visited our clinic for recurrent foreign body reaction on nasal dorsum and tip area. The patient underwent augmentation rhinoplasty with $Gore-tex^{(R)}$ 3 years ago and implant was removed due to infection 9 months ago. Excision of the granuloma was performed and a piece of foreign body suspicious to be a $Gore-tex^{(R)}$ implant debris was detected under the subcutaneous pocket. The implant fragments were removed and nasalis muscle rotation flap was performed to cover the lesion. The specimen was proved to be $Gore-tex^{(R)}$ in histological study. Case 2: A 31 year-old-male with recurrent foreign body granuloma on the nasal tip area visited our clinic. 10 years ago, the patient had augmentation rhinoplasty with silicone implant and then, he underwent revisional rhinoplasty five times including nasal implant removal, which was performed 9 months ago. The authors excised the granuloma and found a small sized foreign body suspicious to be a $Gore-tex^{(R)}$ implant debris under the granuloma. The foreign body was excised and identified to be $Gore-tex^{(R)}$ in histological study. Results: In both cases, the lesions were healed without any complications and there were no evidences of recurrence up to 6 months of follow-up. Conclusion: The $Gore-tex^{(R)}$ is known to be weak against mechanical force. These properties of $Gore-tex^{(R)}$ make it difficult to remove the implant completely. In the patient who have infection after augmentation rhinoplasty with $Gore-tex^{(R)}$, the operator should take care to perform the complete removal without remaining fragment of the implant.

• Archives of Plastic Surgery
• /
• v.34 no.4
• /
• pp.432-435
• /
• 2007

Purpose: The jejunal free flap has the shorter ischemic time than other flap and requires a laparotomy to harvest it. As the evaluation of the perfusion the buried flap is very important, the perfusion of the buried jejunal free flap requires monitoring for its salvage. We tried to improve the monitoring flap method in the jejunal free flap and examined its usefulness. Methods: From March 2002 to March 2006, the monitoring flap method was applied to 4 cases in 8 jejunal free flaps for the pharyngeal and cervical esophageal reconstructions. The distal part of the jejunal flap was exposed without suture fixation through cervical wound for monitoring its perfusion. The status of perfusion was judged by the color change of jejunal mucosa and mesentery. If necessary, pin prick test was performed. Doppler sonography was applied to mesenteric pedicle of the monitoring flap in case of suspicious abnormal circulation. Results: The monitoring flap shows no change in 3 cases, but the congestion happened in one case at the 12 hours after the operation. This congestion was caused by the twisting or kinking of the mesenteric pedicle of the monitoring flap. So, we fixed up the monitoring flap close to adjacent cervical skin for prevention of rotation. Finally, the main part of transferred jejunal flap was intact. Conclusion: The success of a jejunal free flap depends on close postoperative monitoring and early detection of vascular compromise. So, various monitoring methods have been tried, for instance, direct visualization using a fiberoptic pharyngoscope, through a Silastic window placed in the neck flap, or external surface monitoring with an Doppler sonography, use of a buried monitoring probe. But, all of the above have their own shortcomings of simplicity, non-invasiveness, reliability and etc. In our experience, monitoring flap can be a accurate and reliable method.