• Archives of Reconstructive Microsurgery
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• v.8 no.1
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• pp.50-55
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• 1999

Avascular necrosis is a significant late complication of talar neck fracture. However, treatment for early stage avascular necrosis has been not established. Two patients with post-traumatic avascular necrosis of talus treated with vascular pedicle graft using lateral tarsal artery were reviewed to determine the efficacy of procedure. The procedure involved grafting the lateral tarsal artery and vein into a hole made in the talus through a anterolateral approach. Follow-up was 12 and 24 months respectively. Two patients had significant pain relief, improved function, no worsening of their radiologic staging. The results are promising enough to recommend consideration of this procedure in early stages of avascular necrosis.

• Journal of Korean Foot and Ankle Society
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• v.4 no.2
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• pp.83-86
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• 2000

A vascular necrosis of the talus has frequently been reported following trauma because talus has no muscle insertions, sixty percent of the surface of the talus is covered by hyaline cartilage, takes only a small area for entrance of a blood supply. Osteonecrosis is also associated with a variety of nontraumatic disorders. There are many indications for steroid usage, patient with rheumatoid arthritis, systemic lupus erythematosus, chronic obstructive pulmonary disease, and status- post renal or cardiac transplantation may be on long- term steroid usage, osteonecrosis may develop. A vascular necrosis of the talus secondary to chronic steroid usage is an unusual case. Delay in detection of osteonecrosis may lead to fragmentation and collapse of the talar body. When pain on range of motion is present and conservative treatment have been exhausted, surgical treatment is indicated, that is, fusion of the ankle joint. However it is important that conservative treatment may prevent its various sequelae with early diagnosis because steroid - treated patients have a more operative risk and increased risk for postoperative infection. We report a rare case of corticosteroid induced avascular necrosis of talus after cardiac transplantation.

• Toxicological Research
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• v.11 no.2
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• pp.169-173
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• 1995

The effects of tumor necrosis factor alpha $(TNF-{\alpha})$ on growth and tubular formation of bovine aortic endothelial cells were examined using an in vitro angiogenesis model system. The growth of endothelial cells was enhanced in a dose-dependent manner when the cells were cultured with $TNF-{\alpha}$ for 3 days, but $TNF-{\alpha}$, at the concentration of 1 nM or higher, produced a growth inhibition of endothelial cells when the cells were cultured for 8 days. The endothelial cells incubated with $TNF-{\alpha}$ for 48-h exhibited a typical morphologic change. Then, they showed a fibroblastoid organization of overlapping, elongated, and spindle-shaped cells. $TNF-{\alpha}$, at the concentration of O. 1 nM or higher, inhibited the tubular formation of vascular endothelial cells in an in vitro anglogenesis model using a 3-dimensional culture system.

• Korean Journal of Head & Neck Oncology
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• v.28 no.1
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• pp.50-53
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• 2012

Advanced cancer of the oral cavity has been treated with wide excision in conjunction with mandibulectomy and neck dissection. This has resulted in significant mandibulofacial defects with functional and cosmetic significance. Therefore, proper mandibular reconstruction is very important for physiologic and esthetic restoration. The risk factors of free flap reconstruction have been reported including obesity, age, smoking, previous irradiation, and systemic vascular disease. We recently experienced a case of donor site necrosis after fibular osteocutaneous free flap in oral cavity cancer.

• Archives of Plastic Surgery
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• v.50 no.3
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• pp.311-314
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• 2023

In lower extremity reconstruction, the recipient vessel often requires long-range mechanical dilation because of extensive vasospasm or plaque formation induced by concomitant atherosclerosis. While a forceps dilator can be used to manipulate and dilate vessels approximately 1 cm from their end, a DeBakey vascular dilator can dilate long-range vessels. The authors successfully performed free flap reconstruction of the lower extremity using the DeBakey vascular dilator. Of the two patients who underwent lower extremity reconstruction, one had extensive vasospasm, and the other had plaques in the recipient arteries. Irrigation with 4% lidocaine and dilation of the lumen with a forceps dilator were insufficient to restore the normal arterial blood flow. Instead, a DeBakey vascular dilator with a 1-mm diameter tip was gently inserted into the lumen. Then, to overcome vessel resistance, the dilator gently advanced approximately 10 cm to dilate the recipient artery. Normal arterial blood flow was gushed out after dilating the vessel lumen using a DeBakey vascular dilator. The vascular anastomosis was performed, and intravenous heparin 5000 IU was administered immediately after anastomosis. Prophylactic low-molecular-weight-heparin (Clexane, 1 mg/kg) was administered subcutaneously to both patients for 14 days. The reconstructed flap survived without necrosis in either patient.

• Journal of Chest Surgery
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• v.33 no.1
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• pp.1-6
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• 2000

Background: TNF-$\alpha$ plays a major role in producing left ventricular dysfunction cardio-myopathy pulmonary edema and inhibits the compensatory mechanism of congestive heart failure. IL-6 is an acute reactant of immune reaction and also known to control immune reaction but its function in the myocyte was not clearly investigated. Author's performed this experiment to investigate the contents of TNF-$\alpha$ and IL-6 on the assumption that TNF-$\alpha$ and IL-6 may reside in nonfailing heart that has gone cardiac surgery and play some role in cardiac function. Material and Method : Right auricular tissues were sampled from 12 patients who had undergone total corrective surgery for both congenital and acquired heart diseases from January 1998 to June 1998 in Kosin Universcfy Gospel hospital. The quantitive analysis of TNF-$\alpha$ and IL-6 were assessed by ELISA method in right auricular tissue. Hemodynamic values about the pressure of ventricle atrium aorta pulmonary artery and cardiac index pulmonary and systemic vascular resistance and cardiac output were measured by echocardiography and cardiac catheterization and biochemical analyses of LDH & AST were done before operation. statistical analysis was by Paired Student t-test. Patients were divided into children(under 15 years olds) and adults groups and the data was compared beween two groups. Conclusion: Mild pulmonary hypertension and increased pulmonary vascular resistance were existed in both group. The contents of tissue TNF-$\alpha$ IL-6 in each group were independent of each data.

• Journal of Plant Biology
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• v.3 no.2
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• pp.29-34
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• 1960

From the view point of phytopathological anatomy, the author has tried to study the effect of the shoot cluster disease virus on the internal structure of vascular tissues of chinese date tree (Ziziphus jujuba var. inermis Rehd.) comparing healthy checks and diseased plants. The materials were collected at the several sites, Kumgock-Ri, Masuc-Ri, Kyungi-Do, and near the campus of Korea University and around the area of Chongam-Dong, Seoul City, from August 15th to September 5th 1959. The leaf materials of healthy and diseased plants are fixed and aspirated in two kinds of killing solutions, formalin-acetic acid alcohol solution and Craf III solution. Sections were cut at 5-10$\mu$ thickness and stained with the double staining reagents of safranin and fast green. In this experiment the author has observed that there are marked structural changes in the infected plants in contrast of healthy checks. As figures 3-7 show that the following characteric changes have taken place on infected plants: 1) the arrangement of irregularly developed sieve elements in phloem, 2) the degeneration of phloem elements, 3) the irregular arrangement of epidermis in mid-vein, 4) more necrosis is observed among the parenchymatous cells, 5) abundant accumulatin of starch grains in parenchymatous cells, . In contrast to the above irregularities caused by the virus disease, the healthy checks appear normal structures as shown in figures 1 and 2. In adding to the all features noted above, the author could also observe an interesting feature that the xylem elements in mid-vein vascular bundle tissues are considerably disorganized to show the unspecialized vessel elements, the irregularly arranged xylem elements. However, this kind of irregularities which occur in xylem under the virus infection has not been reported previously. The features noted on the internal structure of vascular bundle under the condition of infection by the shoot cluster disease on chinese date trees appear to be more or less closely similar to the symptoms of the bunchy-top of banana and the yellow dwarf disease of barley in respect to the fact that whether phloem necrosis takes place as a primary symptom or a secondary symptom. In all these disease, primary histological changes of hypoplasia and hypertrophy are preceeded by the necrosis of phloem.

• Archives of Craniofacial Surgery
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• v.19 no.1
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• pp.64-67
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• 2018

Varying degrees of complications can occur after hyaluronic acid filler injections. Tissue necrosis due to interruption of the vascular supply is an early complication that can be severe. If the site of tissue necrosis due to the filler injection is the forehead, successfully reconstructing the region without distorting the key landmarks is challenging. We describe the case of a 50-year-old man who experienced widespread forehead skin necrosis after hyaluronic acid filler injection in the glabellar area. We successfully covered the forehead area with a $3{\times}4-cm^2$ midline necrotic tissue using the modified double-opposing rotation-advancement flap method. Although modified double-opposing rotation-advancement flap closure has the disadvantage of leaving a longer scar compared to conventional double-opposing rotation-advancement flap closure, the additional incision line made along the superior border of the eyebrow aids in camouflaging the scar and decreases eyebrow distortion. Therefore, it is believed that the modified double-opposing rotation-advancement flap technique is an excellent tool for providing adequate soft tissue coverage and minimal free margin distortion when reconstructing widespread skin necrosis in the central mid-lower forehead that can occur after filler injection in the glabellar area.

• Journal of Haehwa Medicine
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• v.27 no.2
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• pp.11-20
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• 2018

Objectives : Coronary and cerebrovascular disease with high mortality is a major factor in arteriosclerosis. Pro-inflammatory cytokines damage vascular endothelial cells, leading to vascular inflammation. These vascular inflammation can build up cholesterol and thrombus to cause atherosclerosis. Methods : In this study, we researched the effect of ChungHyul-Plus for vascular inflammation in human umbilical vein endothelial cells (HUVECs) stimulated with tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$). Change in mRNA expression of inflammatory cytokines (CCL5, CXCL8, CX3CL1, and MCP-1), cell adhesion molecules (VCAM-1 and ICAM-1), and anti-inflammation modulators (KLF2 and eNOS) were quantified by qRT-PCR. Results : ChungHyul-Plus decreased expression of inflammatory cytokines and cell adhesion molecules and increased anti-inflammation modulators expression in $TNF-{\alpha}$ stimulated HUVECs. Conclusions : These results suggest that ChungHyul-Plus can be used in the treatment and prevention of vascular inflammation and arteriosclerosis.

• Archives of Plastic Surgery
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• v.48 no.4
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• pp.457-461
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• 2021

Background Pedicled perforator flaps can present postoperative complications similar to those encountered in free flap surgery. Beyond a clinical evaluation, there is still no reliable technical aid for the early prediction of vascular issues. The aim of this study was to assess the support of near-infrared spectroscopy technology as an intraoperative tool to anticipate postsurgical flap ischemia. Methods We prospectively enrolled 13 consecutive patients who were referred to our hospital from March 2017 to July 2018 and required a reconstructive procedure with a pedicled fasciocutaneous perforator flap. We measured flap peripheral capillary oxygen saturation (SpO₂) in each patient with a Somanetics INVOS 5100C Cerebral/Somatic Oximeter (Medtronic), both before and after transposition. Patient demographics, operative data, and complications were then recorded during the following 6 months. We analyzed the data using the Wilcoxon signed-rank test and linear regression. Results The mean flap SpO₂ before and after transposition was 92%±3% and 78%±19%, respectively. The mean change in SpO₂ was 14%±17%, with a range of 0% to 55%. The change in saturation and mean saturation ratio were significantly different between patients with and without postoperative flap necrosis. Conclusions An immediate quantitative analysis of flap peripheral capillary SpO₂ after transposition has never before been described. In our experience, an intraoperative drop in SpO₂ equal to or greater than 15%-20% predicted vascular complications in pedicled perforator flaps. Conversely, flap size and rotation angle were not correlated with the risk of flap necrosis.