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Pilonidal sinus disease is a cystic lesion or draining sinus tract involving the sacrococcygeal area. A long-standing sinus tract can lead to squamous cell carcinoma in the tract and overlying skin. We present the case of a 56-year-old female patient who had undergone pilonidal cyst excision whose postoperative pathologic report indicated squamous cell carcinoma. The sinus tract did not heal for 3 months, and the patient was then transferred to our clinic. Our team conducted a thorough resection of the cystic lesion and the overlying skin, followed by the relocation of two flaps to restore the skin and soft tissue defect. The patient recovered after a 1-month wound healing period. Postoperative fluid collection or discharge did not occur, and the patient achieved the ability to perform daily activities such as walking and eating meals in the sitting position. Adequate resection of cystic lesions is necessary when treating pilonidal sinus disease. A benign cyst can turn into a malignant lesion, and additional wide excision followed by tissue restoration is a therapeutic option for curative treatment.

Necrotizing fasciitis of the upper extremities is a severe, life-threatening condition, potentially resulting in amputation or death in the absence of prompt and aggressive surgical treatment. Reconstruction is eventually required after adequate surgical debridement, and patients are often referred to a plastic surgeon for this purpose. Herein, we present the case of a patient with extensive soft tissue defects on the upper extremity after fasciotomy for necrotizing fasciitis. We successfully performed a pedicled latissimus dorsi myocutaneous island flap, full-thickness skin graft, and split-thickness skin graft for this patient. After 2 months, the patient did not have any wound problems and could carry out adequate upper extremity motion.

Naso-orbito-ethmoidal (NOE) fractures are complicated fractures of the mid-face. The treatment of NOE fractures is challenging and a comprehensive treatment strategy is required. We introduce a case of NOE fracture treated with open reduction and suspension sutures. A 28-year-old woman presented with a unilateral NOE fracture. To reduce the frontal process of the maxilla, a suspension suture was made by pulling the fragment using a double arm suture via a transcaruncular incision. The suture thread was placed in the horizontal plane. Another suspension suture on the inferior orbital rim assisted reduction procedure, and they passed through the overlying skin. The reduction alignment could be finely adjusted by tightening the transcutaneous suture threads while checking the degree of bone alignment through the subciliary incision. The two suture threads were suspended using a thermoplastic nasal splint. An additional skin incision on the medial canthal area, which would have resulted in a scar, could be avoided. Four months postoperatively, computed tomography showed an accurate and stable reduction. The patient was satisfied with her aesthetic appearance, and functional deficits were not present.

Benign cartilaginous tumors, known as chondrogenic tumors, show cartilage components in the microscopic diagnosis. We present two clinical cases with cartilaginous tumors of the toes showing distinctive clinical manifestations. Two juvenile patients visited our outpatient clinic due to tumors with toenail deformities. A 10-year-old girl presented with a palpable mass with a nail deformity on the left third toe. The initial pathology report was soft tissue chondroma until complete resection. Another 15-year-old male patient visited the dermatology department with a toenail deformity and underwent a punch biopsy. The pathology report was fibrosis with myxoid degeneration. Excisional biopsies were performed for both patients. In the operative field, we observed exophytic tumors connected to the distal phalangeal bones. The final pathology reports were subungual osteochondroma on both patients. The specimen exhibited mature bone trabeculae with a focal cartilaginous cap. Benign cartilaginous tumors have a slow, progressive course and do not show significant symptoms. However, tumors in subungual areas are accompanied by toenail deformities and they can cause pain. Their clinical characteristics lead to a delayed diagnosis. Surgeons can be confused between soft tissue and chondrogenic tumors. When they conduct physical examinations, these categories should be considered in the differential diagnosis.

South Korea is seeing a steady increase in its aging population. One in five people in the Republic of Korea will be at least 65 years old by 2025, putting more pressure on healthcare and social spending. Various geriatric diseases such as cancer, arthritis, and stroke are major contributors to disabilities in aging populations. Compounded with an increase in diabetes mellitus, the number of patients with pressure ulcers and diabetic foot ulcers is growing. Therefore, considerations for treating chronic wounds such as pressure ulcers and diabetic wounds are emerging as an urgent public health need in South Korea. The treatment of chronic wounds increases medical expenses, placing a significant social, economic, and practical burden on individuals. When complications related to chronic wounds occur, the patient’s quality of life deteriorates, threatening public health. Therefore, strategies for managing chronic wounds are clinically important; South Korea should begin to recognize the importance of chronic wound care. Social attention and government support with the establishment of proper medical insurance policies, as well as efficient medical expense budget execution, are essential for the management of chronic wounds. Silver has been known to inhibit infections for many centuries and is widely used around the world. Previous studies reported the clinical and cost-effectiveness of silver-impregnated dressings. The majority of randomized controlled studies found the positive effects of silver-impregnated dressings on chronic wound healing. A number of studies found that silver-impregnated dressings reduced wound healing time, dressing change frequency, the need for pain medication during dressing changes, and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia resulting from MRSA-infected wounds, thereby shortening hospital stays. Despite evidence of the positive effects of silver-impregnated dressings on chronic wound healing, medical insurance policies and government support fall far short of expectations. This is because government officials, who often lack the required knowledge and understanding of chronic wound care, impose impossibly strict regulations on the use of silver-impregnated dressings. The regulations that enable use of silver-impregnated dressings only on major burns prohibitively limit the use of silver-impregnated dressings to a few indications and low-volume uses. Currently, silver-impregnated dressings cannot be used for chronic wounds such as pressure ulcers, diabetic wounds, venous ulcers, and cancerous wounds, even though patients are willing to bear the full costs without any government subsidies. As South Korea has one of the fastest rates of population aging in the world, a continued rise in the economic, clinical, and social impacts of chronic wounds warrants a more structured approach and proportionate investment in chronic wound care. Medical expense budget providers should be encouraged to think broadly about the potential for wider cost savings in terms of reducing wound healing time, hospital stays, and nursing time by using appropriate dressings. Therefore, there is an urgent need for better communication and mutual understanding among wound specialists, policy makers, and working-level public servants on insured dressings for chronic wound care. This white paper is a policy proposal composed by senior members of the Board of Directors of the Korean Wound Management Society for chronic wound care using silver-impregnated dressings and will hopefully contribute to a better understanding of silver-impregnated dressings for chronic wound care.

Upper blepharoplasty is 1 of the most popular cosmetic procedures in Asia. As people become older, they develop soft tissue atrophy and multiple folds due to a sunken upper eyelid. Furthermore, people with thin upper eyelid skin are more likely to develop multiple folds, even at a young age. The authors investigated the effectiveness of a transverse mattress suture technique to prevent recurrence during upper blepharoplasty in patients with primary multiple folds.Data on 656 patients with primary multiple folds who underwent upper blepharoplasty from March 2017 to January 2020 were retrospectively reviewed. The authors compared the operative time, patients' satisfaction, panel assessment, and complications according to whether the suture technique was used.Among 656 patients, 228 were lost to follow-up or had incomplete data; therefore, the files of 428 patients were analyzed. In total, 199 patients did not undergo the suture technique, whereas 229 patients did. Statistically significant differences were found between the 2 groups in patients' satisfaction, aesthetic results, and recurrence. However, between-group difference was not significant in terms of symmetry or complications such as hematoma and swelling.People with thin upper eyelid skin or slightly protruding eyes are more likely to develop multiple folds at a young age, even in their teens or 20s. The authors performed a skin suture during upper blepharoplasty, and then performed a transverse mattress suture on the spots where multiple folds are expected. Patients who underwent the suture technique showed better aesthetic results and a significantly lower recurrence rate.

The scalp is the thickest skin in the body and protects the intracranial structures. The coverage of a large scalp defect is a difficult surgical procedure, the full details of which must be considered prior to the procedure, such as defect size and depth, and various factors related to the patient’s general condition. Although a free flap is the recommended surgical procedure to cover large scalp defects, it is a high-risk operation that is not appropriate for all patients. As such, other surgical options must be explored. We present the case of a patient with an ulcer on the scalp after wide excision and split-thickness skin graft for squamous cell cancer. We successfully performed a reverse temporalis muscle flap for this patient.

Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder is a rare disease characterized by a single mass on the face or upper part of the trunk. It usually presents an asymptomatic and favorable progression, and its histopathologic findings include small and medium-sized lymphoid cells. The authors report a case of primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder on the forehead. A 51-year-old man presented with a protruding mass on his forehead that the patient had noted 1 month previously. Surgical excision and a permanent biopsy were performed under local anesthesia. Based on the biopsy results, the mass was diagnosed as a primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder. There was no evidence of recurrence at a 15-month follow-up visit.

Severe burns may lead to a series of pathophysiological processes that result in death. Machine learning models that demonstrate prognostic performance can be used to build analytical models to predict postoperative mortality. This study aimed to identify machine learning models with the best diagnostic performance for predicting mortality in critically ill burn patients after burn surgery, and then compare them. Clinically important features for predicting mortality in patients after burn surgery were selected using a random forest (RF) regressor. The area under the receiver operating characteristic curve (AUC) and classifier accuracy were evaluated to compare the predictive accuracy of different machine learning algorithms, including RF, adaptive boosting, decision tree, linear support vector machine, and logistic regression. A total of 731 patients met the inclusion and exclusion criteria. The 90-day mortality of the critically ill burn patients after burn surgery was 27.1% (198/731). RF showed the highest AUC (0.922, 95% confidence interval = 0.902–0.942) among the models, with sensitivity and specificity of 66.2% and 93.8%, respectively. The most significant predictors for mortality after burn surgery as per machine learning models were total body surface area burned, red cell distribution width, and age. The RF algorithm showed the best performance for predicting mortality.

In this report, one-step 3D structuring of protein-based microneedles is proposed using digital light processing (DLP) 3D printing. Such a technique is advantageous in direct 3D construction of molecules dissolved in aqueous solution at relatively low concentration. The DLP printing of silk fibroin (SF) as a safe protein-based microneedle is challenging, and use of riboflavin, an enzyme that acts as a photoinitiator, reduces the toxicity in biomedical applications. An anti-aliasing process produces SF microneedles with oblique features, while dehydration of the printed hydrogel enhances the sharpness of printed features. The flexibility of an SF microneedle array pad is investigated, and the delivery of molecules to the skin is verified using rhodamine B fluorescence dye.

Background: Many wound assessment systems including the Wagner classification and University of Texas (UT) grading system have been previously described. The authors of this study applied the DIRECT (Debridement of necrosis, Infection control, Revascularization, Exudate control, Chronicity, and Top surface) wound coding system for initial assessment of diabetic foot ulcers (DFUs) to predict limb salvage and prognosis.Methods: From January 2016 to February 2020, a total of 169 first-time DFU patients were retrospectively evaluated using the DIRECT wound coding assessment system. DFUs were followed up for at least 6 months, and scores in each component of the coding system according to final limb status were statistically evaluated. The coding assessment’s ability to predict major amputation was compared to those of the Wagner classification and the UT grading system.Results: Subjects were divided into complete healing (n=80, 47.3%), not healed (n=71, 42%), and amputation (n=18, 10.7%) groups. The mean values of each component of DIRECT assessment for the complete healing/amputation groups were D 0.86/1.56 (PConclusion: The DIRECT coding system shows a greater association with prediction of amputation or complete healing, compared with the Wagner and UT wound classification systems. This more accurate wound assessment system will be helpful in predicting prognosis and planning treatments.

Dermatomyositis (DM) is an autoimmune inflammatory myopathy with some cutaneous manifestations. We present the case of a patient with a bone-depth skin ulceration on the elbow that was well healed with a transposition flap using a dorsal interosseous artery perforator. A 56-year-old man reported difficulties when climbing stairs and diffuse pain of unclear origin throughout his body that started 2 months previously. The patient was diagnosed with DM, and the department of plastic and reconstructive surgery was consulted for the management of an ulcerative skin lesion on the left elbow. The dorsal interosseous artery was first detected by vascular Doppler ultrasonography, and a transposition flap was designed including the pedicle. The flap was transposed to cover the bone exposure over the olecranon. At 4 weeks postoperatively, complete healing of the wound was observed without complications, and the patient had full range of motion of the elbow without pain. Despite major developments in the medical treatment of DM, ulcerative cutaneous lesions remain difficult to treat. Our experience suggests that the use of a transposition flap including the dorsal interosseous artery is suitable for the treatment of ulcerative lesions around the elbow in DM patients.

This work describes development of a silk fibroin (SF)-based ink material for digital light processing 3D printing. Riboflavin initiates the crosslinking of SF molecules under irradiation with visible light to form an SF hydrogel through dityrosine bonding. Rapid formation of a β-sheet structure induces shrinkage of SF hydrogels in phosphate-buffered saline solution at 37 °C. Such shrinkage of SF hydrogel is effectively prevented by addition of gelatin to SF ink. As the ratio of gelatin in the composite ink is increased, the density of β-sheet structures is reduced, and structural deformation of the 3D SF/gelatin hydrogel is inhibited. Printability is critical in fabrication of 3D SF/gelatin composite hydrogel structures. For evaluation of printing performance, the actual width of the hydrogel formed by 3D printing is compared with the designed width. The 3D printing of SF is performed by irradiating a series of features with different shapes or sizes in a vertical manner.

Venous ulcers, ischemic wounds and skin lesions from autoimmune diseases are some examples of unhealing wounds. Practitioners treating such wounds should consider the possibility of skin metastasis of neoplasms, especially in patients with cancer. Treatment of cutaneous metastasis in cancer must include both surgical resection and chemotherapy. Here we present a patient who had lung cancer with skin metastasis. Though incidence of metastasis from lung cancer is known to be as low as 1% to 12%, its prognosis is poor. Also, the clinical features of these skin lesions tend to vary, often resulting in them being misdiagnosed as benign lesions. The diagnosis of malignancy for this particular case was delayed. After the metastatic lesion was diagnosed as such, surgical resection was performed and the defect caused by wide excision was covered by a superior gluteal artery perforator flap. Though the patient was administered an anticancer drug, the wound healed well after the operation.

LiNixCoyMnzO2 cathode materials are technologically important for high-energy-density Li-ion batteries. However, poor electronic conductivity limits their practical use compared to conventional LiC...

Background Keloids are benign fibro-proliferative lesion, related to excessive inflammatory reactions in certain anatomical areas, including the auricles. Their specific etiology remains unclear; nonetheless they exhibit tumor-like characteristics of significant recurrence and cause emotional distress, even with various treatment strategies. We applied intermittent magnetic pressure therapy on ear keloids in combination with surgical excision, and present its effectiveness herein. Methods Ear keloid patients were treated with surgical excision followed by magnetic pressure therapy. The keloid tissues underwent excision and keloid marginal flaps were utilized for wound closure. Intermittent magnetic pressure therapy was applied 2 weeks after the surgical procedure. The pressure therapy consisted of a 3-hour application and 2-hour resting protocol (9 hr/day), and lasted for 6 months. The results were analyzed 6 months after the therapeutic procedures, using the scar assessment scale. Results Twenty-two ear keloids from 20 patients were finally reviewed. Among the keloids that completed the therapeutic course, 20 ear keloids out of 22 in total (90.9%) were successfully eradicated. Two patients (2 keloids) exhibited slight under-correction. Postoperative complications such as wound dehiscence or surgical site infection were not noted. The scar assessment scale demonstrated a significant improvement in each index. The intermittent pressure therapy led to patient compliance, and avoided pressure-related pain and discomfort. Conclusion Excision followed by intermittent pressure application using a magnet successfully reduced the burden of fibro-proliferative keloids, and had good patient compliance. The role of intermittent pressure application and resting should be studied with regard to keloid tissue remodeling.

Burn injuries can cause significant malnutrition, leading to cardiovascular impairments. The prognostic nutritional index (PNI) predicts postoperative complications. We evaluated the impact of preoperative PNI on major adverse cardiac events (MACE) after burn surgery. PNI was calculated using the equation, 10×(serum albumin level)+0.005×(total lymphocyte count). Multivariable logistic regression analysis was conducted to evaluate the predictors for MACE at 6 months after burn surgery. Receiver operating characteristic curve and propensity score matching analyses were conducted. Additionally, Kaplan–Meier analysis was conducted to compare postoperative 1-year mortality between MACE and non-MACE groups. MACE after burn surgery occurred in 184 (17.5%) of 1049 patients. PNI, age, American Society of Anesthesiologists physical status, and TBSA burned were significantly related to MACE. The area under the receiver operating characteristic curve of PNI was 0.729 (optimal cutoff value = 35). After propensity score matching, the incidence of MACE in the PNI

Here, we composite an artificial leaf comprising a transparent hydrogel sheet, vein structures, and a photosynthetic system using cellulose nanofibers (CNFs) which can be produced from a biomass. A simple imprinting using a 3D printed stamp enabled the formation of fluidic channels in the hydrogel, embedding living cells without toxic chemistry or a drying process. Microalgae in the hydrogel grows and proliferates under ambient condition for a long period because of the continuous supply of nutrient from the channels, which is more effective for metabolic bioactivity than a flat sheet cultured in a bulk solution. This mimicry of the plant leaf provides a potential for a whole artificial plant. In addition, the simple fabrication of fluidic channels in the hydrogel can be applied to diverse living organisms, including bacteria, animal, and plant cells.

Swelling behavior of the graphite electrode hinders the increase in volumetric density of Li ion batteries as the free space in the cell is necessary to ensure battery safety by accommodating the volume change of the anode associated with Li ions. Here, we report a simple electrode microstructural engineering strategy to control swelling behavior of the anode by employing a two-step pressing process. Two-step pressing enables the uniform distribution of the pores throughout the electrode without cracking or pulverization of the active material. The anode prepared by a two-step pressing process under an optimized condition exhibits superior swelling behavior (4.47% swelling after 25 cycles) compared to that of the anode prepared with a one-step pressing process (5.00% swelling after 25 cycles). The electrochemical properties could be also further improved due to a uniform pore distribution and enhanced adhesion strength.

Electrode materials with high specific capacities such as metal sulfides always experience conversion and/or alloying reactions, which cause large volume changes during cycling. These repetitive volume changes eventually pulverize the active material and electrically isolate it from the current collector, consequently diminishing cycle stability. Here, we develop a self-buffering electrode constructed by ultra-large Fe7S8 nanoplates (S-Fe7S8) for sodium-ion batteries (SIBs). This hierarchical structure has a self-buffering effect on the large volume changes during cycling, which greatly enhances the cycling stability. In addition, the nano-micro hybrid structure as a whole does not show any apparent volume changes during cycling. Therefore, it is safe to conclude that the self-buffering structure is expected to be effective in accommodating volume changes in real batteries. Moreover, the combination of pseudocapacitance and redox reactions in the sodiation and desodiation processes provides the S-Fe7S8 electrode an exceptional rate capability.

An electrosurgery unit (ESU) is the mainstay of bleeding control in blepharoplasty. There are two different types of ESUs: monopolar (m-ESU) and bipolar (b-ESU).We used m- and b-ESUs in upper, lower, and combined blepharoplasty and compared their outcomes.In this retrospective file review of 292 blepharoplasty patients, we excluded 14 who were lost to follow-up or had missing data; among the 278 enrolled patients, we recorded operative time, a surgeon panel's score for edema and ecchymosis on the third postoperative day, patients' scores of their satisfaction and inconvenience, and postoperative complications.One hundred thirty-nine patients were included in the m-ESU and b-ESU group. Overall, 105 patients underwent upper blepharoplasty, 77 underwent lower blepharoplasty, and 96 underwent combined blepharoplasty. The total mean operative time in the m-ESU and b-ESU was 67.94 and 62.82 minutes, respectively. This difference was not significant (P .05). The panel's edema and patient satisfaction and inconvenience scores were significantly better in the b-ESU group (P .05). There were no significant differences in the panel's ecchymosis score and frequency as well as nature of complications between the m-ESU and b-ESU group (P .05).In this cohort of blepharoplasty patients, minimally invasive b-ESUs were efficient in obtaining reliable surgical results with higher satisfaction and lower inconvenience rates of patients than m-ESUs. We would like to recommend the use of b-ESUs in blepharoplasty, especially for plastic surgeons inexperienced in periorbital esthetic surgery.

BACKGROUND Alveolar clefts give rise to many aesthetic and functional problems among affected patients. Therefore, surgical adjustments of the bony defective anomalies are important. The authors performed secondary bone grafts and analyzed the effects particularly on the nasal septum and maxillary area (midface). METHODS The patients who had alveolar bone grafts were retrospectively reviewed with pre/postoperative 3-dimensional computed tomography; the measurements included distances between the anterior nasal spine (ANS) and the vertical midline, angles between the nasal septum and the transverse line, and angles between the floor of the pyriform aperture and the transverse line. RESULTS A total number of 23 patients were finally included in the study. The mean age of the patients was 9.7 ± 1.95 years (range, 7-14 years). The mean distance between the ANS and the vertical midline was 5.3 ± 4.70 mm/4.9 ± 4.15 mm pre/postoperatively, showing the mean paired difference of 0.4 ± 0.89 mm (P

Copper sulfide (CuS) thin films were deposited on a glass substrate at room temperature using the radio-frequency (RF) magnetron-sputtering method at RF powers in the range of 40−100 W, and the structural and optical properties of the CuS thin film were investigated. The CuS thin films fabricated at varying deposition powers all exhibited hexagonal crystalline structures and preferred growth orientation of the (110) plane. Raman spectra revealed a primary sharp and intense peak at the 474 cm−1 frequency, and a relatively wide peak was found at 265 cm−1 frequency. In the CuS thin film deposited at an RF power of 40 W, relatively small dense particles with small void spacing formed a smooth thin-film surface. As the power increased, it was observed that grain size and grain-boundary spacing increased in order. The binding energy peaks of Cu 2p3/2 and Cu 2p1/2 were observed at 932.1 and 952.0 eV, respectively. Regardless of deposition power, the difference in the Cu2+ state binding energies for all the CuS thin films was equivalent at 19.9 eV. We observed the binding energy peaks of S 2p3/2 and S 2p1/2 corresponding to the S2− state at 162.2 and 163.2 eV, respectively. The transmittance and band-gap energy in the visible spectral range showed decreasing trends as deposition power increased. For the CuS/tin sulfide (SnS) absorber-layer-based solar cell (glass/Mo/absorber(CuS/SnS)/cadmium sulfide (CdS)/intrinsic zinc oxide (i-ZnO)/indium tin oxide (ITO)/aluminum (Al)) with a stacked structure of SnS thin films on top of the CuS layer deposited at 100 W RF power, an open-circuit voltage (Voc) of 115 mA, short circuit current density (Jsc) of 9.81 mA/cm2, fill factor (FF) of 35%, and highest power conversion efficiency (PCE) of 0.39% were recorded.

Background This study was conducted to determine the effect of the distributional relationship between dental roots and the mandibular bone on single mandibular bone fractures, which are common craniofacial fractures. Methods This was a retrospective, single-center study in Seoul, Korea. Patients with single mandibular fractures in the symphysis, parasymphysis, body, and angle area, with tooth structure involvement were included. The control group included patients with simple, bone-level lacerations without fractures. In total, 94 patients (72 males and 22 females) were included in the treatment group, and 125 (71 males and 54 females) were included in the control group. The height of the mandibular bone and the dental root were measured with panoramic radiography. The central incisor represented the symphysis area, the canine represented the parasymphysis area, the first molar represented the body area, and the second molar represented the angle area. Results In the treatment group, symphysis fractures occurred in 16 patients (17%), parasymphysis fractures in 36 patients (38%), body fractures in 17 patients (18%), and angle fractures in 25 patients (27%). The ratios of the dental roots to the total height of the mandibular bone in the treatment group were 30.35%, 39.75%, 39.53%, and 36.27% for symphysis, parasymphysis, body, and angle areas, respectively, whereas in the control group, they were 27.73%, 39.70%, 36.76%, and 35.48%. The ratios of the treatment group were significantly higher than those of the control group. Conclusion The results show that the higher ratio of the dental root to the height of the mandibular bone increases the fracture risk.

Diabetic foot ulcers (DFUs) are slow to heal because of poor tissue vascularity and regenerative capacity, among various factors.In this study, the authors evaluate the efficacy of applying a paste formulation of acellular dermal matrix (ADM) to DFUs.Patients with Wagner grade 2 or 3 DFUs (N = 49) received either ADM paste (treatment group; n = 23) or conventional foam dressing (control group; n = 26). All chronic wounds were debrided and irrigated in an attempt to control infection. After paste application, mild compaction was undergone to fill ulcer cavities, and foam dressings were used to cover the surface to absorb any discharge. All DFUs were analyzed with regard to ulcer area, depth, progression, healing rate, and duration to complete healing.At the 60-day primary outcome mark, 56.52% (13/23) of the DFUs in the treatment group were healed, compared with 23.08% (6/26) of DFUs in the control group. Mean rates of wound area resolution in the treatment and control groups were 74.17% ± 30.84% and 51.87% ± 32.81%, respectively (P ⟨ .05), with mean times to heal (within 60 days) of 13.54 ± 9.18 days and 21.5 ± 11.98 days, respectively (P ⟨ .05). There were no serious adverse events in either group, and no complications related to ADM paste application.The ADM paste effectively enhanced tissue regeneration, shortening ulcer duration and preventing associated complications, while eliminating the need for supplemental ulcer management procedures. The paste formulation of ADM provides a matrix for tissue ingrowth, promoting the healing of DFUs.

본 연구에서는 폴리아미드6(PA6)/유리섬유(GF) 복합소재의 사출 시 흐름성을 개선하기 위한 저분자량의 아미드계 활제를 합성하였다. 저분자량의 아미드계 활제(N,N"-bis(2,2,6,6,-tetramethylpiperidin-4-yl)-1,3-dicarboxamide)를 두가지 방법으로 합성하여 PA6/GF 복합소재의 흐름성을 향상시켰다. 아미드계 활제는 상온 축합반응과 가온 축합 반응으로 진행하였으며, 합성 조건에 따른 성능 분석을 실시하였다. 폴리아미드 수지 내 혼합된 활제는 이축 스크류 배합기의 축력을 순수 폴리아미드 수지 대비 50% 수준 감소시켰다. 가온 축합반응으로 합성된 활제를 적용한 PA6/GF35% 복합소재의 물성은 일반 PA6/GF35% 복합소재 대비 흐름성 72%, 인장강도 10% 상승하는 것을 확인하였다. 이는 아미드계 활제가 소재 내에서 분자 사슬간의 결합력을 감소시켜서 가소제 역할을 하여 분자 사슬의 유동성을 증가시킨 것으로 판단된다.

Tear trough deformity has been an area that has received much attention in terms of esthetic improvements. Fat transposition has been commonly used for the treatment of tear trough deformity. As some patients have had minimal improvement by that method, we propose the use of fat grafting combined with open blepharoplasty to complement the sunken area, including some of anterior maxilla region, and evaluate and precisely remove the excessive tissue.Lower blepharoplasty was performed by separating the skin and muscle flap. The excessive or laxed tissue was evaluated during the procedure and resected in each flap. Fat grafting was performed after completing a lower blepharoplasty, to ensure accurate placement on the spot where the surgeon originally intended. Overcorrection is not recommended.No serious complications were reported during a period of 10 years. Only 4 patients required a secondary fat injection.Patients who require structural correction of the lower eyelid area (eg, aggressive herniated fat, excessive skin laxity, or bulky orbicularis oculi muscle) and who need complementary material to fill the lower lid area (eg, deep, wide sunken area or relative exophthalmos) are good candidates for blepharoplasty with a fat grafting procedure.