RESUMO
The rubbing of a polymer layer, a commonly applied process, leads to an anisotropic surface morphology, aligning liquid crystal molecules. Scanning force microscopy can be used to intentionally create areas with a similar anisotropy by operating the instrument at loads in the range of 10(-7) to 10(-5) newtons. These areas have an orientation effect on liquid crystals indistinguishable from the rubbing process, which allows a systematic investigation of the orientation properties of an alignment layer as a function of its nanometer-scale morphology. Refractive index patterns can be tailored with this method by scratching a suitable area, as demonstrated by fabrication of an optical waveguide 6 micrometers wide and 5 millimeters long.
RESUMO
The latissimus dorsi myocutaneous flap has proved valuable in breast reconstruction after radical mastectomy. The procedure has been used often and successfully at the Breast Reconstruction Center of Memorial Sloan-Kettering Cancer Center. Since the axis of the mastectomy scar often varies, we have found that adjusting the orientation and location of the skin islands is necessary to achieve maximal coverage on the chest wall and to place the transposed skin without tension precisely where it is most needed. These different skin island designs may necessitate a scar on the back that is not covered by a brassiere. This paper discusses and illustrates with clinical examples modifications that produce superior reconstructive results.
Assuntos
Mama/cirurgia , Cirurgia Plástica , Retalhos Cirúrgicos , Adulto , Feminino , Humanos , Mastectomia , Pessoa de Meia-Idade , Complicações Pós-OperatóriasRESUMO
To use the entire muscle for breast reconstruction with the latissimus dorsi musculocutaneous flap, the location of the skin ellipse on the back is planned with a cloth pattern. The technique as used in two patients is described and illustrated.
Assuntos
Mama/cirurgia , Mastectomia , Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Adulto , Dorso , Neoplasias da Mama/cirurgia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Breast reconstruction after mastectomy is discussed with emphasis on present surgical techniques and results achieved. The deformity is defined and the goals outlined. Contra-indications, indications, evaluation of the patient and proper choice of reconstructive procedures and implantable materials are reviewed as well as complications and restrictions. Selective illustrations demonstrate some of the clinical experience of patients treated at Memorial-Sloan Kettering Cancer Center.
