• Archives of Plastic Surgery
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• v.36 no.5
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• pp.591-596
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• 2009

Purpose: To reconstruct soft tissue defect on lower extremity especially combined with osteomyelitis, free flap with enough blood supplies is required. There are some instance when patients have inadequate recipient vessels for microanastomosis. Anastomosis with harvested vein graft can solve the problem. It may be more problematic or even increase recipient site complication. Cross leg free flaps using contra - lateral vessel can be a solution. Methods: From 2005 to 2008, 12 cases of cross leg free flap were done for 12 patients(male = 9, female = 3). External fixators used in all cases. Free flaps used were laissmus dorsi muscle flap(n=5), anterolateral thigh flap(n=4), gracilis muscle flap(n=2) and medial plantar artery fasciotaneous flap(n=1). In all cases, contralateral posterior tibial artery and vein were used as recipient pedicle. Results: All flaps survived without additional operative procedures. There were no complications such as hematoma or Infection. Sometimes patients needs further therapeutic exercise for fast movement recovery. Conclusion: Although cross leg free flaps require long period of bed resting and rehabilitation after pedicle cutting, It can be practical alternative for soft tissue defect on lower distal extremity with inadequate recipient vessels for free flap on affected leg.

• Journal of Veterinary Clinics
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• v.24 no.2
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• pp.276-279
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• 2007

A 2-year-old male, 3 kg body weight Japanese Chin was injured in the automobile accident three months ago. The dog became antebrachiocarpal joint instability, and performed pancarpal arthrodesis using 3 K-wires in localanimal hospital. But, the result was failure. Therefore the dog was referred to Chonbuk Animal Medical Center, Chonbuk National University. In physical examination, right carpal joint instability, knuckling sign and pain were evident. In radiography, sclerosis was observed on the 4th carpal bone. Complete blood count (CBC), serum chemistry and urinalysis finding were within reference ranges. Pancarpal arthrodesis was re-performed using 7-hole plate. However, mild skin and muscle defects was appeared by skin tension of extremity. We expected that granulation would fill the defect, but inflammation was continued on the lesions for 3 days. So, operation which is filling it was done by using the muscle flap and tubed skin flap. The donor muscles were flexor carpi radialis and superficial digital flexor muscles. After 7 days, the muscle flap was survived, but tubed skin flap was necrosed. After 20 days, the skin defect was substituted with granulation tissues. The flexor carpi radialis muscle and superficial digital flexor muscle transposition can be a useful procedure for reconstructing soft tissue defects in the carpal and metacarpal areas.

• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.68-72
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• 1998

With the advent of microvascular free-tissue transfer, this single stage resurfacing method for large scar and soft tissue defects around the wrist in the patients of electrical burn has distinctive advantage over the conventional multistage pedicle-flap transfer. Between 1992 and 1996, we treated 9 cases of 8 patients who had large scar around the wrist due to old electrical burn with free flaps as a preparation of staged tendon graft. Mean age was 30.3 years and average scar area was $6{\times}11cm$. The length of time the injury and free flaps was 9 months on an average. Prior to the free flap, we performed the angiography to all patients in order to evaluate the circulation of the forearm and hand and to choose the recipient vessel. In all cases, proximal ulnar arteries in the forearm remained intact and all radial arteries remained intact in 8 of 9 cases on angiogram. The interosseous arteries were well visualized in all cases. We used the ulnar arteries as a recipient artery. The types of flaps used were f scapular cutaneous flaps, 2 dorsalis pedis flaps and a radial forearm flap. Flap survial was 100 percents with satisfactory functional and cosmetic results. Free flaps using ulnar artery as a recipient artery is one of the useful reconstruction methods for the resurfacing of large scar around the wrist in the patients of old electrical burn.

• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.28-34
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• 1998

The traditionally useful coverage methods of the wrist and hand soft tissue defect are the chinese forearm flap, the ulnar forearm flap. But, this flaps are inevitably sacrifice major vessel to the hand. Advantages of the posterior interosseous artery island flap(PIA Flap) is no need to sacrifice blood supply to the hand and supply relatively large thin, good quality flap and more cosmetic than other forearm flaps. But, it is difficult to dissect and raise because of deep seat, close relation with the posterior interosseous nerve and anatomic variation. Authors evaluated 8 cases of 7 patients in the department of orthopaedic surgery, college of medicine, Hallym University from January, 1993 to December, 1995. The results are as follows: 1. The satisfactory coverage was achieved 7 cases and 1 case failed because of anatomic variation. 2 The pedicle length is average 9cm and the flap size is variable from 3cm by 4cm to 5cm by 8cm. 3. The donor site defect was repaired by direct closure in 5 cases, remained 3 cases combined with skin graft. From our experience we conclude that the PIA flap is one of the useful coverage methods of the wrist and hand soft tissue defect.

• Journal of the Korean Orthopaedic Association
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• v.54 no.6
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• pp.490-497
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• 2019

Owing to the recent advances in biological knowledge on stem cells, many efforts are being made to apply them to clinical practice. Although mesenchymal stem cells were first found in bone marrow aspirates, they are understood to be multipotent stromal cells that can be extracted from a variety of tissues, such as adipose, dermal, skeletal muscle, and umbilical-cord tissues. The osteogenicity of mesenchymal stem cells has been verified through various experiments and animal studies. Some successful bone regenerations have also been reported in difficult clinical situations, such as large bone defects, osteonecrosis, and nonunion. On the other hand, there are no standardized indications or application methods for each clinical situation, and convincing evidence of its efficacy and safety is still lacking. Bone regeneration therapies using mesenchymal stem cells are likely to expand further in the future, but there are some issues that need to be addressed in order for them be recognized as standard treatments.

• Pediatric Infection and Vaccine
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• v.30 no.3
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• pp.159-164
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• 2023

A brain abscess is a potentially life-threatening infection of the brain that can be challenging to diagnose, especially in children. In this report, we describe a case of a central nervous system infection caused by rare pathogens in an immunocompetent child. A 10-year-old female presented with a severe headache lasting 10 days, along with flashing lights, nausea, and vomiting. The patient was diagnosed with secundum atrial septal defect 7 years ago and underwent dental work for cavities one month prior to admission. Brain magnetic resonance imaging (MRI) showed a 4.2 cm sized brain abscess in the right parietal lobe, causing left inferior quadrantanopia. A craniotomy and abscess aspiration surgery were performed, and cultures from the aspirated pus and tissue revealed Aggregatibacter aphrophilus. Additionally, Actinomyces georgiae was identified through 16S rRNA sequencing. After 8 weeks of antimicrobial therapy with ampicillin-sulbactam, the patient was discharged without any complications. A follow-up brain MRI showed complete resolution of the abscess and edema.

• Journal of Life Science
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• v.25 no.10
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• pp.1091-1097
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• 2015

We have isolated and characterized an ascorbate peroxidase (APx) gene, OsAPx1 from rice. Northern and Western blot analyses indicated that at young seedling stage, OsAPx1 mRNA was expressed highly in root, shoot apical meristem (SAM) and leaf sheath than leaf. In mature plant, OsAPx1 gene expressed highly in root, stem and flower but weakly in leaf. OsAPx1 gene and protein expression level was induced in leaves inoculated with Magnaporthe oryzae (M. oryzae) and Xanthomonas oryzae pv. oryzae (Xoo). Phytohormones treatment showed that OsAPx1 was up-regulated by jasmonic acid (JA), but was down regulated by ABA and SA co-treatments with JA, resulting that they have antagonistic effect on pathogen responsive OsAPx1 expression. Phylogenetic analysis illustrated that Arabidopsis AtAPx1 has a close relationship with OsAPx1. In AtAPx1 knock out lines, the accumulation of O₂^- and H₂O₂ are all highly detected than wild type, revealing that the high concentration of exogenous H₂O₂ cause the intercellular superoxide anion and hydrogen peroxide accumulation in AtAPx1 knockout plant. These results suggested that OsAPx1 gene may be associated with the pathogen defense cascades as the mediator for balancing redox state by acting ROS scavenger and is associated with response to the pathogen defense via Jasmonic acid signaling pathway.

• The Korean Journal of Nuclear Medicine
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• v.30 no.4
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• pp.524-531
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• 1996

Purpose : To evaluate the pattern- of skeletal metastases and to classify the pattern of renal uptakes on bone scans in renal cell carcinoma. Materials and Methods : We reviewed the bone scans of 158 patients with RCC established pathologically. In order to identify individual scan lesion as a bone metastasis, we reviewed all available correlative radiological studies, follow-up bone scans, and biopsies for each lesion. The metastatic bone lesions were divided into seven anatomic regions; skull, spine, shoulder girdle, sternum, ribs, pelvis, and long bones of extremities. The individual scan lesions were divided into two groups as the pattern of uptakes, hot and cold lesion. In addition, the contours and uptakes of kidneys with RCC were classified into 6 groups ; normal uptake, photon-deficient lesion, faint up-take with enlargement, uneven uptake with enlargement, lateralization with crescentic shape, and increased uptake. Results : Twenty out of 158(12.7%) patients with RCC at varying stages showed 71 metastatic bone lesions at presentation and on follow- up bone scans. Nearly 80% of all metastatic lesions were in the axial skeleton with predominantly increased uptake of the radioactivity However a considerable number(22.5%) showed cold lesions on bone scan. A half of bone scans revealed abnormal uptake of involved kidney and much more(82.4%) in case of bone metastases. Two common patterns of abnormal renal uptake were photon-deficient lesion (50%) and faint uptake with enlargement(24.3%). In four patients with bone pain or pathologic fracture, bone scans were useful for the serendipitious localization of previously unrecognized primary lesion of RCC as well as for the detection of bone metastases from RCC. Conclusion : The understanding of the pat-terns of skeletal metastases and renal uptakes on bone scans in RCC is important for the useful information about primary lesion(RCC) as well as detection of bone metastases.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1979.05a
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• pp.4.4-5
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• 1979

The degree of hearing impairment of chronic otitis media will indicate the nature and severity of middle ear pathology especially condition of ossicular chain, size of ear drum perforation and location of granulation tissue in the middle ear cavity. The subjects were 189 ears of tympanoplasty for chronic otitis media and divided into four groups as follows: Normal ossicular chain with only ear drum perforation (group I), normal ossicular chain with granulation tissue only around the ossicles regardless of any other region (group II), ossicular ankylosis or fixation of handle of malleus to promontory with or without granulation tissue around the ossicle (group III) and ossicular interruption by partial or complete destruction(groupf IV). The results were concluded as follows: 1) The average hearing threshold of chronic otitis media was 44.6 dB and hearing threshold was closely related to the condition of ossicular chain. Hearing threshold became greater in order of normal ossicular chain, ankylosis and interruption. 2) The average hearing threshold of ossicular interrupted group was 49.1 dB and it was greater in the cases of total destruction than that of partial destruction. 3) The hearing loss in the cases of normal ossicular chain with only tympanic membrane perforation was within 45 dB and this level was presumed to represent normal ossicular function. The degree of hearing loss was in proportion to the size of ear drum perforation and when over 45 dB, other middle ear pathology was suggested. 4) In the cases of small ear drum perforation with normal ossicular function, the hearing threshold was within 30 dB. 5) In the type of audiogram, flat type was 30.2% and ascending type 35.4%. Descending type was more frequent in the cases of normal ossicular mobility with granulation tissue around the ossicle and flat type was observed frequently in the cases of ossicular ankylosis. 6) Carhart's notch was seen in 14 cases (7.4%) and observed mainly in ossicular ankylosis. 7) There was no relation between hearing threshold and histopathological type of granulation tissue in chronic otitis media. However the degree of hearing impairment was related to the location of granulation tissue in the middle ear cavity. 8) Authors recognized the granulation tissue compensated the function of interrupted ossicular chain.

• Journal of Periodontal and Implant Science
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• v.37 no.3
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• pp.465-478
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• 2007

Various periodontal barrier membranes used in many clinical and experimental fields, and many recent studies of membranes have reported good results. To improve clinical results, selection of barrier membranes is an important factor. So, we need not only to evaluate various barrier mem-branes, but also to understand the property of barrier membranes appropriate to defect characteristics. For this purpose, this study reviewed available literature, evaluated comparable experimental models, and compared various barrier membranes. From above mentioned methods, the following conclusions are deduced. 1. In i-wall periodontal defect models, new bone formation showed a consistent result, almost 30% of the defect size. New cementum formations measured mostly 40% of the defect size, but showed more variations than new bone formations. This seems to be resulted form difference in experimental methods, so standardization in experimental methods is needed for future studies. 2. Application PLGA barrier membrane to periodontal defect demonstrated improved healing in new bone and new cementum. 3. There was a minimal periodontal regeneration with calcium sulfate barrier membrane only. But, there was better healing pattern in combination of calcium sulfate membrane with bone graft material, such as DFDBA, 4. There was no significant difference between the experimental group that used chitosan mem-brane only and the control group. But, in combination with bone graft material for space maintanence, periodontal regeneration was improved. Overall, Space maintenance is a critical factor for Guided tissue regeneration using barrier membranes. Also, a barrier membrane itself that has difficulty in maintaining space, achieved better result when used with graft material.