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ABSTRACT: Acne inverse (AI), also known as hidradenitis suppurativa, is characterized by inflammatory nodules, fistulating sinus tracts, and painful skin abscesses. The severe AI often produces disfiguring scars influenced in both the appearance and function, especially in the facial and cervical regions. There might be difficulties in the situation for surgical treatment. This report described a 26-year-old man with severe scarring contractures in the neck and mandible regions after a long-term AI treated successfully with a bilateral pedicled expanded forehead flap. With the achievement of mental cervical angle, the patient has been reconstructed well both aesthetically and functionally during the long-term follow-ups.
The Journal of craniofacial surgery 11/2012; 23(6):e615-7. · 0.81 Impact Factor
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Journal of Plastic Reconstructive & Aesthetic Surgery 08/2011; 65(2):276-7. · 1.49 Impact Factor
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ABSTRACT: The presence of an epicanthal fold is a distinctive anatomic feature of the Asian population. Epicanthoplasty can be very helpful in resolving the above problematic anatomy and may produce a more aesthetic appearance. The goal of this report is to describe a modification in the traditional operative methods related to medial epicanthoplasty, to minimise scar appearance and maximise normal appearance. An inverse triangular flap of skin is based on the semilunar skin, which is elevated and retracted within the line of the normal eyelid. The design of four key points is crucial to this epicanthoplasty. A total of 62 patients were performed with this method; 42 of this group underwent simultaneous double-eyelid plasty. Most of the patients obtained satisfactory results aesthetically followed from 6 months to 4 years postoperation. There was no recurrence of the epicanthal fold. As many as 38 patients were followed by interview and photographs were taken at the same time. The rest of the patients were followed up through telephone. No patients complained about visible scarring in the epicanthal area. As many as 60 patients obtained satisfactory results aesthetically, two patients complained about the median canthal asymmetry. The result indicates the reliability and feasibility of epicanthoplasty.
Journal of Plastic Reconstructive & Aesthetic Surgery 08/2011; 65(1):43-7. · 1.49 Impact Factor
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ABSTRACT: Five young pseudohermaphrodite girls with clitoromegaly genital abnormalities are presented. Considering the deficiency and hypogenesis of the local tissue in these young patients, the treatment was performed as a staged operation. First, the cavernosa was mostly removed, and a clitoroplasty was performed to form a clitoris with part of the glans. At 2 weeks after the surgery, the labia minora reconstruction was performed to restore female vulvae using a foreskin flap. The results showed that the transferred foreskin flaps survived well without complications. The vulvae appearance was very good and very much resembled normal female external genitals, both aesthetically and functionally. The authors' experiences have shown that the staged surgical technique could maximize tissue survival to achieve well-formed and aesthetically accurate vulvae.
Aesthetic Plastic Surgery 04/2010; 34(5):652-6. · 1.41 Impact Factor
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ABSTRACT: Dermal papillae cells are widely applied to reconstruction of tissue engineered hair follicle and skin. To investigate the difference of the biological characteristics of dermal papillae cells cultured with keratinocyte medium (KM) and normal medium (NM), and to determine whether it is feasible for the reconstruction of tissue engineered hair follicle using dermal papillae cells cultured in KM.
Scalp samples were obtained in rhytidectomy procedure. Dermal papillae were isolated by two steps digestive treatment, then cultured with KM and NM in two groups. The time of dermal papillae adherence and cell outgrowth was recorded and the rate of dermal papillae adherence was determined after 5 days. As well as, the difference of cell morphology was observed through inverted phase contrast microscope. The maximum generations were determined in two groups and the cell sheets were observed by HE staining. In third-generation cells, the number of aggregates in every dish and the proliferation by MTT were compared between two groups. Meanwhile, the expression of a-smooth muscle actin (alpha-SMA) and ALP were detected by immunofluorescence and specific staining in two groups.
Dermal papillae of KM group had a higher rate of adherence and fast outgrowth. The rates of adherence were 54.17% and 36.78% in KM group and in NM group, respectively. In KM group, cells adhered after 24 hours and outgrew after 64 hours. While, cells adhered after 48 hours and outgrew after 80 hours in NM group. The cells were bigger in NM group than in KM group. In third-generation cells, 3.06 +/- 1.12 and 9.25 +/- 1.73 aggregates formed in NM group and KM group, respectively, the difference was significant (P < 0.05). In addition, cells could form cell sheets which were muti-layers in KM group. Mostly 7 and 15 generations could been subcultured in NM group and KM group, respectively. The result of MTT indicated that cells proliferated more actively in KM group; absorbance value of KM group was significantly higher than that of NM group after 7 days (P < 0.05). The positive of alpha-SMA were detected in the third-generation cells of both groups. Occasionally a little few cells expressed ALP with (987 +/- 146) microm2 positive area in the sixth-generation cells of NM group. However, the cells still expressed ALP with (8 757 +/- 558) microm2 positive area in the fourteenth-generation cells of KM group and the difference was significant (P < 0.05).
Cells proliferate actively and aggregate obviously and could been subcultured more generations in KM. Therefore, culturing dermal papillae cells with KM is feasible for the reconstruction of tissue engineered hair follicle.
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 02/2010; 24(2):138-42.
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ABSTRACT: Perioral scar after burn usually not only results in the certain degree of functional loss of the mouth, but it also destroys the facial appearance. This study aims to restore the perioral scarring lesion after burn as a whole unit to be achieved the functional and cosmetic outcomes in this area, by using a bilateral-pedicled expanded forehead flap with minimal donor morbidity. Six patients with perioral burn scar were undergoing the treatment. The technique was carried out by first positioning a tissue expander in the forehead pocket under the frontalis of the forehead and serially inflating it in about a 6 to 8-week period. An expanded forehead flap was then designed partially from the frontal hairline by basing on the bilateral temporal scalp pedicles including in the frontal branches of the superficial temporal arteries. Thereafter, a transverse incision was also made in the flap at the planned mouth position to have the mouth open. The flap was then raised and transferred into the recipient site after the perioral scar was excised. The forehead donor site was directly closed into the frontal hairline with the remained expanded forehead tissue. The temporal donor sites were temporarily covered with the grafted scarring skin from the recipient site. About 3 to 4 weeks after the operation, the bilateral pedicles were cut off and return to the temporal sites after the lesion were prepared. With our experiences in 6 patients using the flap for full-perioral lesion repair, the flap could be formed as big as 12 x 25 cm across the midline of the forehead without flap necrosis and the problem of the forehead donor site closure. All of the patients showed esthetic and functional results in the perioral area and good donor acceptability with minimal donor morbidity. The results indicate that the above-mentioned flap can not only be a safe, ample, and color-matched flap for full-perioral reconstruction, but it could also diminish the donor morbidity to minimum.
Annals of plastic surgery 10/2009; 63(6):640-4. · 1.29 Impact Factor
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ABSTRACT: For a large lesion of the scalp (e.g., up to 50% scalp loss), restoration of the scalp with a hair-bearing scalp flap to achieve a pleasing aesthetic outcome and hair growth matched to the direction of the lesion, especially for a hemiscalp defect in children, often becomes very difficult and challenging for plastic surgeons.
Treatment was performed for 18 children with severe hemiscalp losses after burns. The technique was carried out by initially positioning a tissue expander in the subgaleal pocket of the scalp and serially inflating it with normal saline in 5- to 7-day intervals for about 3 months. Thereafter, a "flying-wings" expanded scalp flap was designed by combining advancement and rotation flap transplantation principles. This design was based on at least one nominated vascular system of the scalp used as the pedicle, with the wings often working to correct the distant part of the lesion in which the hair direction is greatly changed. After the lesion was excised, the expanded hair-bearing flap was advanced and rotated to the recipient site when the expander was removed.
For the 18 patients, the flap used for hemiscalp reconstruction could be transferred to repair the hemiscalp loss totally (for 17 patients) or mostly (for 1 patient) in a single-tissue expansion process without flap necrosis. The patient with a remaining lesion was treated completely with a secondary tissue expansion in the postauricular area. All the patients showed good aesthetic results, with the hair growth direction matching the recipient site well.
The described technique strongly indicates that tissue expansion is a simple, safe, and efficient technique for large scalp restoration. The "flying-wings" design of the expanded scalp flap can properly distribute the expanded hair-bearing scalp in the recipient site.
Aesthetic Plastic Surgery 04/2009; 33(3):361-5. · 1.41 Impact Factor
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ABSTRACT: Sampling technology has been widely deployed in measurement systems to control memory consumption and processing overhead. However, most of the existing sampling methods suffer from large estimation errors in analyzing small-size flows. To address the problem, we propose a novel adaptive non-linear sampling (ANLS) method for passive measurement. Instead of statically configuring the sampling rate, ANLS dynamically adjusts the sampling rate for a flow depending on the number of packets having been counted. We provide the generic principles guiding the selection of sampling function for sampling rate adjustment. Moreover, we derive the unbiased flow size estimation, the bound of the relative error, and the bound of required counter size for ANLS. The performance of ANLS is thoroughly studied through theoretic analysis and experiments under synthetic/real network data traces, with comparison to several related sampling methods. The results demonstrate that the proposed ANLS can significantly improve the estimation accuracy, particularly for small-size flows, while maintain a memory and processing overhead comparable to existing methods.
INFOCOM 2008. The 27th Conference on Computer Communications. IEEE; 05/2008
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Yuan-Bo Liu,
Jin-Cai Fan,
Peng Jiao,
Xin Tang,
Li-Qiang Liu,
Qian Wang, Jia Tian,
Cheng Gan,
Zeng-Jie Yang,
Zhuo-Nan Zhang,
Yu-Gang Chen
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ABSTRACT: To apply the scapular free flap extended to the upper arm for resurfacing the face and neck, as well as the upper lip in one stage.
The scapular free flap was designed with extended portion to the posterior and interior part of the upper arm. Then the free flap was transferred to resurface the face and neck with the routine portion and to resurface the upper lip with the extended portion.
6 cases with extensive upper lip, facial and cervical burn scar were treated with the extended scapular free flaps. The flap size ranged from 22 cm x 11 cm to 40 cm x 9.5 cm (36.57 cm x 10.20 cm in average) for the routine portion and from 7 cm x 4 cm to 12 cm x 4 cm (10.32 cm x 3.67 cm in average) for the extended portion. All flaps survived completely.
There are direct communicating branches ("choke vessel") between the circumflex scapular artery (CSA) and the posterior humeral circumflex artery (PHCA). When the blood supply of PHCA is cut off, the CSA can provide blood supply through the communicating branches to the upper arm skin area previously nourished by PHCA. So the blood supply of the extended portion of the scapular free flap is not only from the branches of CSA, but also from the direct communicating branches between the CSA and PHCA. The extended scapular free flap has a reliable blood supply and can be applied to construct the facial and cervical scar contraction with the extended portion to resurface the upper lip. The satisfactory result can be expected.
Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery 04/2008; 24(2):112-5.
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ABSTRACT: Sampling is increasingly utilized by passive measurement systems to save the resources consumption. However, the widely adopted static linear sampling selects packets with the same sampling rate (probability) for both large flows and small flows, which leads to intolerably high relative error for small flows. In order to bound the relative error for both small and large flows, we have proposed an adaptive nonlinear sampling method for passive measurement, which dynamically tunes the sampling rate according to the counter value. We have provided the unbiased estimation of the actual number of events n and have demonstrated that the relative error is radic[(1-1/n)a/2] for both large flows and small flows, where a is a constant parameter, and the counter size is bounded by a logarithmic function, log(1+an)/log(1+a). The theoretical and experimental results have shown that the proposed adaptive sampling method obtain a better tradeoff between relative error and memory consumption than existing sampling methods.
Global Telecommunications Conference, 2007. GLOBECOM '07. IEEE; 12/2007
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Yuan-Bo Liu,
Jin-Cai Fan,
Peng Jiao,
Xin Tang,
Li-Qiang Liu,
Qian Wang, Jia Tian,
Cheng Gan,
Zeng-Jie Yang,
Zhuo-Nan Zhang,
Yu-Gang Chen
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ABSTRACT: To provide an ideal method for flap prefabrication.
The superficial temporal fascial flap has been elevated based on the superficial temporal vessels during the first-stage procedure. A subcutaneous tissue pocket with appropriate site was formed in the retroauricular and mastoid process region. The fascial flap was transferred into the pocket and fixed properly. The tissue expander was placed under the fascial flap. When the expanding process has been finished, the expander was removed and the expanded induced prefabricated skin flap of the retroauricular and mastoid process region pedicled on the superficial temporal vascular bundle was elevated and transferred to repair the facial skin defect.
There were nine cases in the group. Facial defects after resection of the melanotic nevus was repaired in 2 cases and facial defects after resection of the facial haemangioma and scar were repaired in 2 and 5 cases respectively. Pedicle length of the superficial temporal fascial flap was ranged from 5.5 cm to 7 cm (mean length 6.2 cm). The size of the fascial flaps was ranged from 4 cm x 3 cm to 7 cm x 7 cm (mean size 5.7 cm x 4.9 cm). The size of the prefabricated skin flaps was ranged from 5 cm x 5 cm to 8.0 cm x 7.5 cm (mean size 6.4 cm x 6.1 cm). The average time of the tissue expansion process is 16.1 weeks. All flaps survived postoperatively and the donor sites of the flaps were appropriated directly in 5 cases. The split-thickness skin grafting was used to recover the donor site defects in 4 cases.
The superficial temporal fascial flap owns the following advantages: the vascular pedicle is much longer and vascular supply is plentiful, and it is convenient to transfer. Meanwhile, the skin of the retroauricular and mastoid process region is most similar to that of the face in texture, color and depth. For the patients selected strictly, the technique mentioned above is somewhat an ideal method for facial defect repair.
Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery 06/2007; 23(3):187-90.
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ABSTRACT: Sampling technology has been widely deployed in network measurement systems to control memory consump-tion and processing overhead. However, most of the existing methods suffer from large errors for the estimation of small-size flows. To address this problem, we propose an adaptive non-linear sampling (ANLS) method for flow size estimation. Instead of statically pre-configuring the sampling rate, ANLS dynamically adjusts the sampling rate for each flow according to the value of a corresponding counter. A smaller sampling rate is utilized when the counter value is large, while a larger sampling rate is employed for a smaller counter. In this paper, the unbiased flow size estimation, the relative error, and the required counter size are studied through theoretical analysis and experimental evaluations. The analysis and experiments demonstrate that ANLS can significantly improve the estimation accuracy (particularly for small-size flows), and save memory consumption, while maintaining processing overhead comparable to existing methods. Moreover, we validate the design of ANLS by implementing an FPGA-based prototype, which is capable of measuring traffic throughput up to 26.5 Gbps.
