• Progress in Medical Physics
• /
• v.8 no.1
• /
• pp.75-82
• /
• 1997

The human physiological systems are so complex and irregular dynamics. Dynamics of peripheral blood vessel, in particular, have quite sensitive and complex. Before, the linear analytic method have been used to analyze the system. But, the method have many problems to predict the following results. In the other hand, the nonlinear analytic method, chaotic time series analysis method, is suitable for measuring complex, vary system. In this study, the scalar data of the blood flow of peripheral blood vessel of rabbits, in accordance with injection of glucose, was obtained and redefined as multi-dimensional vectors, with time-series analytic methods. This study also intended to confirm that the peripheral blood flow is chaotic dynamics and evaluate the availability of non-linear analytic method. As a result, the existing FFT, and mean could show the difference of blood flow of peripheral blood vessel by injection of glucose, but the nonlinear analytic method could show the definite difference. The hemodynamics is a chaotic phenomenon.

• Archives of Plastic Surgery
• /
• v.49 no.3
• /
• pp.444-447
• /
• 2022

Reconstruction of soft tissue defects around the knee is challenging, and the most common solution is to use various locoregional flaps or, in some difficult cases, a free flap. The distally based anterolateral thigh (dALT) flap is a commonly used flap that relies on reverse blood flow from the descending branch of the lateral circumflex femoral artery (d-LCFA). Here, we present the case of an anteromedial knee reconstruction using a dALT flap after resection of a pleomorphic undifferentiated sarcoma. The tumor resection resulted in a 14 × 7 cm defect, and a dALT flap, measuring 20 × 8 cm was elevated. During the surgery, we found a robust oblique branch of the LCFA (o-LCFA) sending off two sizable perforators to the anterolateral thigh region, whereas the d-LCFA was relatively small with no usable perforators. Therefore, we harvested a dALT flap relying on reverse flow from the o-LCFA. The patient's postoperative course was uneventful, and the flap survived without complications. This report demonstrates that reverse flow from the o-LCFA may be an alternative to nourish a dALT flap in cases where the d-LCFA is hypoplastic or suitable perforators from the d-LCFA are unavailable.

• Archives of Plastic Surgery
• /
• v.49 no.6
• /
• pp.782-784
• /
• 2022

Diabetic foot ulcers are a severe complication of diabetes, and their management requires a multidisciplinary approach for optimal management. When treating these ulcers, limb salvage remains the ultimate goal. In this article, we present the "hanging" free flap for the reconstruction of chronic lower extremity diabetic ulcers. This two-staged approach involves standard free flap harvest and inset; however, following inset the "hanging" pedicle is covered within a skin graft instead of making extraneous incisions within the undisturbed soft tissues or tunnels that can compress the vessels. After incorporation, a second-stage surgery is performed in 4 to 6 weeks which entails pedicle division, flap inset revision, and end-to-end reconstruction of the recipient vessel. Besides decreasing the number of incisions on diabetic patients, our novel technique utilizing the "hanging" pedicle simplifies flap monitoring and inset and allows reconstruction of recipient vessels to reestablish distal blood flow.

• Archives of Plastic Surgery
• /
• v.50 no.2
• /
• pp.166-170
• /
• 2023

Diaphragmatic reconstruction is required for extensive diaphragmatic defects associated with tumor resection. Methods using artificial mesh and autologous tissues, such as pedicled flaps, have been reported predominantly for diaphragmatic reconstruction. We present the case of a 61-year-old woman who presented with a 14×13×12 cm tumor in the abdominal cavity of the upper left abdomen on computed tomography. The diaphragm defect measuring 12×7 cm that occurred during excision of the malignant tumor was reconstructed using the rectus abdominis muscle and fascial flap. The flap has vertical and horizontal vascular axes; therefore, blood flow is stable. It also has the advantage of increasing the range of motion and reducing twisting of the vascular pedicles. Fascial flap does not require processing such as thinning and can be used during suture fixation. This procedure, which has rarely been reported so far, has many advantages and may be a useful option for diaphragm reconstruction.

• Journal of Chest Surgery
• /
• v.20 no.2
• /
• pp.432-437
• /
• 1987

Pulmonary atresia with intact ventricular septum is a extremely rare congenital cardiac anomaly. With the history of cyanosis and failure to thrive, this anomaly should not be excluded and emergency management is necessary. Our patient was 69 day-old male with pulmonary atresia which was confirmed by cardiac angiography. Prostaglandin E1 was used for maintenance of pulmonary blood flow preoperatively. Right ventricular outflow reconstruction with pericardial patch and concomitant pulmonary valvotomy were done on beating heart for palliation. With this method, growing of right ventricle and tricuspid annulus are highly expected.

• Archives of Reconstructive Microsurgery
• /
• v.8 no.2
• /
• pp.130-138
• /
• 1999

The lower extremity injuries are extremely increasing with the development of industrial & transportational technology. For the lower extremity injuries that result from high-energy forces, particularly those in which soft tissue and large segments of bone have been destroyed and there is some degree of vascular compromise, the problems in reconstruction are major and more complex. In such cases local muscle coverage is probably unsuccessful, because adjacent muscles are destroyed much more than one can initially expect. Reconstruction of the lower extremity has been planned by dividing the lower leg into three parts traditionally The flaps available in each of the three parts are gastrocnemius flap for proximal one third, soleus flap for middle one third and free flap transfer for lower one third. Microvascular surgery can provide the necessary soft tissue coverage from the remote donnor area by free flap transfer into the defect. Correct selection of the appropriate recipient vessels is difficult and remains the most important factor in successful free flap transfer. Vascular anastomosis to recipient vessels distal to the zone of injury has been advocated and retrograde flow flaps are well established in island flaps. Retrograde flow anastomosis could not interrupt the major blood vessels which were essential for survival of the distal limb, the compromise of fracture or wound healing might be prevented. During 5 years, from March 1993 to Feb. 1998, we have done 68 free flap transfers in 61 patients to reconstruct the lower extremity. From analysis of the cases, we concluded that for the reconstruction of the lower extremity, free flap transfer yields a more esthetic and functional results.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.13 no.11
• /
• pp.5311-5316
• /
• 2012

Single Photon Emission Computed tomography(SPECT) was performed on 13 healthy adults (average age: 39) to investigate the changes of cerebral blood flow according to brain imaging analysis algorithm. The acquired images were filtered and reconstructed through Filtered Back Projection (FBP) and Ordered Subset Expectation Maximization (OSEM). The brain distribution data of radiopharmaceuticals were compared using Statistical Parametric Mapping (SPM), and the changes of blood flow was expressed in Cluster. As a result, uptake rate was increased in Sub-gyral, Sub-Lobar, Extra-Nuclear, Limbic lobe and Cingulate Gyrus, while uptake rate was decreased in Middle frontal gyrus, Inferior Frontal Gyrus and Precentral Gyrus. The discriminable SPM was shown according to cerebral blood flows in Cluster by the reconstruction algorithm.

• Proceedings of the KSMRM Conference
• /
• 1999.04a
• /
• pp.34-42
• /
• 1999

의료영상에서 인공물(Artifacts) 이라 함은 영상이 얻어지는 신체부위와 아무런 관련이 없으나 얻어진 영상에는 마치 영상의 일부분으로 나타나는 모든 것을 가리킨다. 따라서 영상에서 이들 인공물들은 실제 조직의 해부학적인 구조를 나타내지 않으므로 영상 판독에 영향을 주어 잘못된 진단을 초래할 수도 있다. 그러나 MR 영상이 가능한 이래로 새로운 여러 종류의 MR 인공물들이 많이 발견 되었으나 다행스럽게도 거의 모든 MR 인공물들은 쉽게 설명이 가능하며, 따라서 이들 인공물들에 의한 진단 오류의 가능성은 매우 희박한 실정이다. 그러나 새로운 영상방법이나 혹은 새로운 펄스대열이 계속 고안됨에 따라 새로운 종류의 인 공물들이 생겨날 가능성은 항상 존재하고 있다. 지금까지 알려진 여러 MR 인공물들은 그 생겨난 원인에 따라 다음과 같이 크게 세 가지로 분류가 가능하다. I. Motion Artifacts 1. Voluntary motion 2. Involuntary motion 1) Bowel Peristalsis 2) Respiration 3) Cardiac and vessel pulsation 4) Swallowing 3. Fluid motion 1) Blood flow 2) Cerebrospinal fluid flow II. Reconstruction Artifacts 1. Aliasing 2. Partial volume averaging 3. Truncation (Ringing) 4. Central point III. Magnetic and RF Field Related Artifacts 1. Chemical shift 1) First kind 2) Second kind 2. Susceptibility 1) Dental 2) Metal 3. Magic angle 4. Zipper 5. Bad data point 6. RF field inhomogeneity 7. Magnetic field inhomogeneity 8. Eddy current 9. slice overlapping 10. Zebra 11. RF overflow

• Archives of Plastic Surgery
• /
• v.48 no.3
• /
• pp.254-260
• /
• 2021

Background Myelomeningocele is a frequently seen condition at tertiary care hospitals. Its treatment involves a variety of plastic reconstructive techniques. Herein, we present a series of myelomeningocele patients treated using keystone flaps. Methods We gathered information regarding soft tissue reconstruction and the use of bilateral keystone flaps to treat myelomeningocele patients. We obtained data from clinical records and recorded the demographic characteristics of mothers and children with the condition. The size, level of defect, and complications detected during the follow-up were analyzed. Results A series of seven patients who underwent bilateral keystone flaps for myelomeningocele closure was analyzed. There were no cases of midline or major dehiscence, flap loss, necrosis, surgical site infections, or cerebrospinal fluid leakage. No revision procedures were performed. Minor complications included one case with minimal seroma and three cases with areas of peripheral dehiscence that healed easily using conventional measures. Conclusions The use of keystone flaps is an adequate option for closure of dorsal midline soft tissue defects related to myelomeningocele. This technique offers predictable results with an acceptable spectrum of complications. Robust blood flow can be predicted based upon anatomical knowledge.

• Archives of Reconstructive Microsurgery
• /
• v.10 no.2
• /
• pp.163-168
• /
• 2001

The defects of the abdominal wall could be brought about either congenitally, for instances in such cases as omphalocele or gastroschisis, or by various acquired causes-trauma, excision of tumors, excision of burn scar, tissue necrosis caused by infection, hematoma after abdominal surgery, tissue necrosis after radiation therapy and so on. As for the techniques of the reconstruction of the abdominal wall defects, many authors have developed and reported diverse methods. To summarize, primary closure, skin graft, local skin flaps, various myocutaneous flaps, free flap, fascia graft, artificial mesh, tissue expansion, etc could be used in the reconstruction of the abdominal wall defects. The periumbilical perforator-based island skin flap has a many advantages such as no significant sacrifice of the rectus abdominis muscle, wide rotation arc, reliable blood flow of the perforator, short elevation time for flap, and for middle-aged, obese patients, the donor site may be the best from the cosmetic point of view. We used perforator-based island skin flap in 5 cases with reasonable result from March 1999 to May 2001. There were no significant complications and donor sites could be repaired primarily.