Background:Reconstruction of large scalp defects after tumor resection is common and challenging.Free skin grafting or free flap transfer is always performed.However,these techniques can result in poor functional and ...Background:Reconstruction of large scalp defects after tumor resection is common and challenging.Free skin grafting or free flap transfer is always performed.However,these techniques can result in poor functional and cosmetic outcomes.Methods:In the Second Affiliated Hospital of Soochow University and the Second Affiliated Hospital of Chengdu Medical College,35 patients underwent jigsaw puzzle flap procedures based on a free-style perforator to repair large scalp defects after tumor resection from May 2013 to November 2022.The key to this procedure was to divide a large defect into several smaller parts that correspond to adjacent free-style perforators around the scalp defect.The free-style perforator flaps were designed in different ways,such as propeller flaps,rotation flaps,and V-Y advancement flaps,which were pedicled with free-style perforators.All of the small flaps were then mobilized to the defect and sutured to each other to create a new,large jigsaw puzzle-like flap to cover the large scalp defect.Finally,all the donor sites were closed directly.Results:Overall,35 patients were treated.The average defect size was 72 cm^(2)(range,25-91 cm^(2)).All flaps had a satisfactory appearance after follow-up periods of 6 months-10 years.Local tumor recurrence occurred in one case.Conclusion:The application of a jigsaw puzzle flap based on a free-style perforator is a suitable option for the reconstruction of large scalp defects after resection,yielding satisfactory functional and cosmetic results.展开更多
BACKGROUND Microcystic adnexal carcinoma(MAC)is a rare malignant tumor of the skin that is commonly found on the face.It grows slowly and has a low mortality rate.However,for various reasons,including strong histologi...BACKGROUND Microcystic adnexal carcinoma(MAC)is a rare malignant tumor of the skin that is commonly found on the face.It grows slowly and has a low mortality rate.However,for various reasons,including strong histological invasiveness,clinical inexperience and inadequate procedure design,immediate or permanent facial deformity may occur after surgical operations.CASE SUMMARY This article describes a middle-aged female artist who was diagnosed with MAC on the left upper lip.She declined the recommended treatment plan,which included two-stage reconstruction,skin grafting,or surgery that could have resulted in obvious facial dysfunction or esthetic deformity.We accurately designed a personalized procedure involving a“jigsaw puzzle advancement flap”for the patient based on the lesion location and the estimated area of skin loss.The procedure was successful;both pathological R0 resection and immediate and long-term esthetic reconstruction effects were achieved.CONCLUSION This study suggests that when treating facial MAC or other skin malignancies,a surgical team should have sufficient plastic surgery-related knowledge and skills.An optimal surgical plan for an individual is needed to achieve good facial esthetics and functional recovery and shorten the treatment course.展开更多
Current image steganography methods are working by assigning an image as a cover file then embed the payload within it by modifying its pixels,creating the stego image.However,the left traces that are caused by these ...Current image steganography methods are working by assigning an image as a cover file then embed the payload within it by modifying its pixels,creating the stego image.However,the left traces that are caused by these modifications will make steganalysis algorithms easily detect the hidden payload.A coverless data hiding concept is proposed to solve this issue.Coverless does not mean that cover is not required,or the payload can be transmitted without a cover.Instead,the payload is embedded by cover generation or a secret message mapping between the cover file and the payload.In this paper,a new coverless image steganography method has been proposed based on the jigsaw puzzle image generation driven by a secret message.Firstly,the image is divided into equal rows then further divided into equal columns,creating blocks(i.e.,sub-images).Then,according to secret message bits and a proposed mapping function,each block will have tabs/blanks to get the shape of a puzzle piece creating a fully shaped jigsaw puzzle stego-image.After that,the generated jigsaw puzzle image is sent to the receiver.Experimental results and analysis show a good performance in the hiding capacity,security,and robustness compared with existing coverless image steganography methods.展开更多
基金supported by the National Natural Science Foundation of China(grant nos.32071238,82073477,and 82103773)Natural Science Project of Chengdu Medical College(grant nos.CYZZD20-01 and CYZ19-31)+3 种基金Science and Technology Project of Health Commission of Sichuan Province(grant no.21PJ158)Scientific Research Fund Project of China Baoyuan Investment Co.,Ltd.(grant no.CBYI202104)Nuclear Medical Science and Technology Innovation Project of China National Nuclear Corporation Medical Industry Management Co.,Ltd.(grant no.ZHYLTD2021002)Young Talent Project of China National Nuclear Corporation.
文摘Background:Reconstruction of large scalp defects after tumor resection is common and challenging.Free skin grafting or free flap transfer is always performed.However,these techniques can result in poor functional and cosmetic outcomes.Methods:In the Second Affiliated Hospital of Soochow University and the Second Affiliated Hospital of Chengdu Medical College,35 patients underwent jigsaw puzzle flap procedures based on a free-style perforator to repair large scalp defects after tumor resection from May 2013 to November 2022.The key to this procedure was to divide a large defect into several smaller parts that correspond to adjacent free-style perforators around the scalp defect.The free-style perforator flaps were designed in different ways,such as propeller flaps,rotation flaps,and V-Y advancement flaps,which were pedicled with free-style perforators.All of the small flaps were then mobilized to the defect and sutured to each other to create a new,large jigsaw puzzle-like flap to cover the large scalp defect.Finally,all the donor sites were closed directly.Results:Overall,35 patients were treated.The average defect size was 72 cm^(2)(range,25-91 cm^(2)).All flaps had a satisfactory appearance after follow-up periods of 6 months-10 years.Local tumor recurrence occurred in one case.Conclusion:The application of a jigsaw puzzle flap based on a free-style perforator is a suitable option for the reconstruction of large scalp defects after resection,yielding satisfactory functional and cosmetic results.
文摘BACKGROUND Microcystic adnexal carcinoma(MAC)is a rare malignant tumor of the skin that is commonly found on the face.It grows slowly and has a low mortality rate.However,for various reasons,including strong histological invasiveness,clinical inexperience and inadequate procedure design,immediate or permanent facial deformity may occur after surgical operations.CASE SUMMARY This article describes a middle-aged female artist who was diagnosed with MAC on the left upper lip.She declined the recommended treatment plan,which included two-stage reconstruction,skin grafting,or surgery that could have resulted in obvious facial dysfunction or esthetic deformity.We accurately designed a personalized procedure involving a“jigsaw puzzle advancement flap”for the patient based on the lesion location and the estimated area of skin loss.The procedure was successful;both pathological R0 resection and immediate and long-term esthetic reconstruction effects were achieved.CONCLUSION This study suggests that when treating facial MAC or other skin malignancies,a surgical team should have sufficient plastic surgery-related knowledge and skills.An optimal surgical plan for an individual is needed to achieve good facial esthetics and functional recovery and shorten the treatment course.
基金funded by“Taif University Researchers Supporting Project No.(TURSP-2020/160),Taif University,Taif,Saudi Arabia.”。
文摘Current image steganography methods are working by assigning an image as a cover file then embed the payload within it by modifying its pixels,creating the stego image.However,the left traces that are caused by these modifications will make steganalysis algorithms easily detect the hidden payload.A coverless data hiding concept is proposed to solve this issue.Coverless does not mean that cover is not required,or the payload can be transmitted without a cover.Instead,the payload is embedded by cover generation or a secret message mapping between the cover file and the payload.In this paper,a new coverless image steganography method has been proposed based on the jigsaw puzzle image generation driven by a secret message.Firstly,the image is divided into equal rows then further divided into equal columns,creating blocks(i.e.,sub-images).Then,according to secret message bits and a proposed mapping function,each block will have tabs/blanks to get the shape of a puzzle piece creating a fully shaped jigsaw puzzle stego-image.After that,the generated jigsaw puzzle image is sent to the receiver.Experimental results and analysis show a good performance in the hiding capacity,security,and robustness compared with existing coverless image steganography methods.
