Purpose: Industrial punch accidents involving fingers cause segmental injuries to tendons and neurovascular bundles. Although multiple-level segmental amputations are not replanted to regain function, most patients with an amputated finger want to undergo replantation for cosmetic as much as functional reason. The authors describe four cases of digital amputation by an industrial punch that involved the reinstatement of the amputated finger involving a joint and neurovascular bundle. Amputated segments were replanted to restore amputated surfaces and distal segments. Methods: A single institution retrospective review was performed. Inclusion criteria of punch injuries requiring replantation were applied to patients of all demographic background. Injury extent (size, tissue involvement), operative intervention, pre- and postoperative hand function were recorded. Result: Four cases of amputations were treated at our institute from 2004 to 2008 from industrial punch machine injury. Average patient age was 32.5 years (25~39 years) and there were three males and one female. Sizes of amputated segments ranged from $1.0{\times}1.0{\times}1.2\;cm^3$ to $3{\times}1.5{\times}1.6\;cm^3$. Tenorrhaphy was conducted after fixing fractured bone of the amputated segments with K-wire. Proximal and distal arteries and veins were repaired using the through & through method. The average follow-up period was thirteen months (2~26 months), and all replanted cases survived. Osteomyelitis occurred in one case, skin grafting after debridement was performed in two cases. Because joints were damaged in all four cases, active ranges of motion were much limited. However, a secondary tendon graft enhanced digit function in two cases. The two-point discrimination test showed normal values for both static and dynamic tests for three cases and 9 mm and 15 mm by dynamic and static testing, respectively, in one case. Conclusion: Though amputations from industrial punch machines are technically challenging to replant, our experience has shown it to be a valid therapy. In cases involving punch machine injury, if an amputated segment is available, the authors recommend that replantation be considered for preservation of finger length, joint mobility, and overall functional recovery of the hand.
Purpose: Pedicled transverse rectus abdominis myocutaneous(TRAM) flap has been a gold standard for breast reconstruction and one of surgical techniques preferred by many surgeons. The authors examined the course of deep epigastric artery focusing on distance from margins of rectus abdominis to pedicle and location of choke vessels to get minimal muscles during pedicled TRAM flap operation. Methods: Eleven rectus abdominis muscle from nine cadavers were used in this study. Rectus abdominis was separated from the cadavers, deep inferior and superior epigastric artery were isolated and then 8 anatomical landmarks in medial and lateral margins of rectus abdominis were designated. Distance to a pedicle meeting first horizontally was measured and vertical location from umbilicus to choke vessel was determined. In addition, 32 rectus abdominis images of 16 women(average age: 37.2 years old) from 64 channel abdomen dynamic computerized tomography were also examined with the same anatomical landmarks with those of cadavers. Results: Average distance from four landmarks on lateral margin of rectus abdominis to pedicle was 1.9 - 3.4cm and 1.8 - 3.8 cm on medial margin. Choke vessel was located between middle and inferior tendinous intersection in all cases and average distance between two tendinous intersection was 6.7 - 7.0 cm on medial margin and 6.2 cm on lateral margin. Location of inferior tendinous intersection was on umbilicus or superior of it in all cases and its average distance from umbilicus was 1.8 - 5.6 cm on medial margin and 2.7 - 6.2 cm on lateral margin. Conclusion: Distance from medial and lateral margins of rectus abdominis muscle to pedicle was the shortest in inferior tendinous intersection and that was averagely 1.8 cm on medial margin and 1.9 cm in average on lateral margin. All choke vessels were located between middle and inferior tendinous intersection.
Purpose: Reconstruction of chest wall has always been a challenging problem. Muscle flaps for chest wall reconstruction have been helpful in controling infection, filling dead space and covering the prosthetic material in this challenge. However, when we use muscle flaps, functional and cosmetic donor site morbidities could occur. The authors applied and revised various partial muscle flaps and combination use of them to cover the prosthetic material for the chest wall reconstruction and evaluated the usefulness of partial muscle flaps. Methods: This study included 7 patients who underwent chest wall reconstruction using partial muscle flap to cover prosthetic material from 2004 to 2008. The pectoralis major muscle was used in anterior 2/3 parts of it leaving lateral 1/3 parts of it. The anterior 2/3 parts of the pectoralis major muscle were used while lateral 1/3 parts were left. In case of the rectus abdominis muscle flap, we used upper half of it, or we dissected it around its origin and then advanced to cover the site. The latissimus dorsi muscle flap was elevated with lateral portion of it along the descending branch of the thoracodorsal artery. If single partial muscle flap could not cover whole prosthetic material, it would be covered with combination of various partial muscle flaps adjacent to the coverage site. Results: Flap coverage of the prosthetic material and chest wall reconstructions were successfully done. There occurred no immediate and delayed post operative complications such as surgical site infection, seroma, deformity of donor site and functional impairment. Conclusion: When we use the muscle flaps to cover prosthetic material for chest wall reconstruction, use of the partial muscle flaps could be a good way to reduce donor site morbidity. Combination of multiple partial flaps could be a valuable and good alternative way to overcome the disadvantages of partial muscle flaps such as limitation of volume and size as well as flap mobility.
Proceedings of the Korean Society of Plant Biotechnology Conference
/
2002.04b
/
pp.49-58
/
2002
Oxidative stress derived from reactive oxygen species (ROS) is one of the major damaging factors in plants exposed to environmental stress. In order to develop the platform technology to solve the global food and environmental problems in the 21st century, we focus on the understanding of the antioxidative mechanism in plant cells, the development of oxidative stress-inducible antioxidant genes, and the development of transgenic plants with enhanced tolerance to stress. In this report, we describe our recent results on industrial transgenic plants by the gene manipulation of antioxidant enzymes. Transgenic tobacco plants expressing both superoxide dismutase (SOD) and ascorbate peroxidase (APX) in chloroplasts were developed and were evaluated their protection effects against stresses, suggesting that simultaneous overexpression of both SOD and APX in chloroplasts has synergistic effects to overcome the oxidative stress under unfavorable environments. Transgenic tobacco plants expressing a human dehydroascorbate reductase gene in chloroplasts were showed the protection against the oxidative stress in plants. Transgenic cucumber plants expressing high level of SOD in fruits were successfully generated to use the functional cosmetic purpose as a plant bioreactor. In addition, we developed a strong oxidative stress-inducible peroxidase promoter, SWPA2 from sweetpotato (Ipomoea batatas). We anticipate that SWPA2 promoter will be biotechnologically useful for the development of transgenic plants with enhanced tolerance to environmental stress and particularly transgenic cell lines engineered to produce key pharmaceutical proteins.
Silicone (polydimethylsiloxane) has widely been used in breast augmentation and other cosmetic procedures. Despite the stability of its chemical nature, local and systemic adverse reactions associated with silicone have been reported. There were several patients who suffered from pulmonary embolism associated with injection of silicone. Silicone-induced pneumonitis and sudden death after subcutaneous injection of silicone has been also described. However, there is no case in the literature of clinically diagnosed silicone-induced pulmonary embolism in Korea. We experienced 2 women who developed respiratory symptoms after illicit subcutaneous injection of silicone for the purpose of colporrhaphy. One patient was admitted because of dyspnea, chest pain, hemoptysis and bilateral pulmonary infiltration after repeated injection of silicone. Pulmonary function test initially showed severe restrictive pattern and transbronchial lung biopsy disclosed numerous oil-like material filling the alveolar septal capillaries and macrophages. High resolution C. T., bronchoalveolar lavage, transbronchial lung biopsy and pulmonary angiogram disclosed abnormalities compatible with silicone fluid-induced pulmonary embolism. The other patient expired shortly after arrival in the emergency room. It is suggested that illicit injecion of silicone fluid carries serious respiratory problems and can induce pulmonary embolism followed by acute respiratory failure.
This study's purpose is to find the ancient costume of the folk song's words on Dunhuang manuscripts in the background wass-carvings sculptures and several art works. Dunhuang had played the part of major route between ancient China and Europe. It is located on kam-suksong the west of China. 1. In the aspect of costume arrangement hair Styling is represented by Naegagyo, Wangyesa, Kyongburak, Bonkwyun, Pogurak, Chonsonja, Namgaja, Tongson-ga, Ojesa, Chanboja in Dunhuang manuscripts. tugue is sim-ilar to Sabyokkwanja in Naegagyo as of that time these kinds of Kwan-ja was very popular. It was told that emperor's wife concubine and maid of honor would wear kwnaja favorably. And the kinds of Tugeu is PuyongKwyunkye, Aangunkye, Chunkye from Kyuwanjon except Sangunkye, Ounkye in Dunhuangsa. 2. Jangdaegy is guoted from Kyuw-anjon -A series of the chinese history book-tells us about women's make-up . The narmes of make-up are Hongjang Unjan--g, Yiljang chwejang, Tam-ajang Murgjang, Sanagjang, Light-make up are referred in Naegagyo is included as packjang Besides we can find other make-up skills Huphwaro and Rujang from the Kaewonch onbon-wisa which was Yangkwibi's episodes. We can find the a corpus of song's words about cosmetic custom in Kor-ea. Which is 'Haecho' folk song in the souther-en costal regions 'Jinggum' folk song in Kim-hae regions and so on.... It's words is similar to Dunhuangsa in China. 3. Bichun inherited to China with India Bud-dism art in the middle of Dunhuang wall-pain-tings is one of the important Buddist saint. Sometimes it is painted with Giakchun Its arms of fly-dnacing in heaven with colored belt on body has almost the form of play on the musical instrument, We can see seasily the form in the painting of Buddist ser-mon. It was progressed and changed with the background of chinese traditional culture. When Dang's period came the color was chan-ged lighting dark blue has rhythmical and viv-id power of life. 4. Among the corpus of song's words which express the singers' system and rites of their tradition or habits. Dunhuang manuscripts des-cribes on behalf of the folk song's words in tra-ditional costume. This is following: (1) Naegagyo o sabyokwanja o Chyrasam o Rashang (2) Wangyesa o Sokryugun o Costume for fisher man (3) Bungajang of the chanboja o Ajang (4) Pongkwyun o Chongui (5) Tongsongs o Junofore (6) Namgaja o thin-Rasam (7) Yuchungnang o Hongsam o Sokryugun : The color of red costume (8) Kyongburak o Hongrasam o Sokryugun : Costume for charming woman Therefore traditional costume could be extracted according to the Dunhuang folk song's words out of culture such as learning rit-es three-obedience four-virtues and in-struction. As the same time it reflects ancient China's characteristics directly. I would endeavor to development for the history of the costume furher creative design and participat-ed in research activity with concerns forward continuously.
Extraoral maxillofacial prostheses are essential for restoring facial structures that are lost as a result of congenital missing, injuries from accidents, surgical treatments of head and neck cancer. Recently, silicone is the most useful material for this purpose and is more advantageous than other maxillofacial prosthetic materials. However, there are some problems for long-term usage of silicone prostheses due to tear and color change. These are major contributing environmental factors to those problems that are such as ultraviolet light, cleansing agents, changes in humidity and successive adhesion and removal. The aim of this study is to evaluate the physical properties and color changes of maxillofacial prosthetic silicone material by those environmental factors using A-2186 silicone material (Factor II, USA) and two pigments, cadmium yellow medium and cosmetic red. Aluminium molds were fabricated according to the ASTM No. D412 & D624 specifications and resulted specimens from molds were fabicated and treated as follows. Control group and experimental I group were fabricated with 0.1% wt. pigment mixing in silicone elastomer and II-1 group, II-2 group of experimental II group were fabricated with 0.2%, 0.3% wt. pigment mixing in silicone elastomer, respectively. Control group was kept in darkroom at room temperature, I-1 group was kept under natural sunlight during 1week, I-2 group was soaked in 20% soap water during 1wk. I-3 group was successively adhered and removed 200 times on inner region of arm using Daro adhesive-33. Experimental II groups were kept in darkroom at room temperature. Instron universal testing machine was used to measure the % elongation, tensile strength, tear strength of control, experimental I, II groups and reflectance spectrophotometer(COLOR EYE-3000, Macbeth, USA) was used to measure the color differences between control group and experimental I group. The results were as follows : 1. When compared with control group, natural weathering group and 20% soap-water soaking group had no significant differences in % elongation(p>0.05). 2. 200 times successive adhesion and removal group, 0.2% wt. pigment group and 0.3% wt. pigment group had significant decreases in % elongation(p<0.05). 3. Natural weathering group, 20% soap-water soaking group and 200 times successive adhesion and removal group had no significant differences in tensile strength (p>0.05). 4. 0.2%, 0.3% wt. pigment groups had significant decreases in tensile strength(p<0.05). 5. Values of all experimental groups were decreased in tear strength. and 200 times successive adhesion and removal group had significant decrease in tear strength(p<0.05). 6. Natural weathering group and 20% soap-water soaking group had significant color differences(${\Delta}E$) and it could be detectable to naked eye(p<0.05). 7. Color differences between control group and 200 times adhesion and removal group were not detectable to the naked eye (${\Delta}E<1.0$).
Kim, Ji Hoon;Burm, Jin Sik;Kim, Yang Woo;Kang, So Ra;Kim, Hyoung Kyoung
Archives of Plastic Surgery
/
v.36
no.4
/
pp.512-515
/
2009
Purpose: Neurofibromatosis(NF) is an autosomal - dominant systemic disease. Up to fifty percent of patients with NF are reported to have concomitant vascular abnormalities. In the resection of a larger NF, the risk of uncontrolled hemorrhage is much higher due to the difficulty of hemostasis of large vessels within the tumor. We ligated the base of the giant NF with a simple loop - shaped ligation before removal of the giant NF in both buttocks. And then we could successfully reduce the amount of hemorrhage during the operation. Methods: A 46 - year - old female patient presented for giant masses of both gluteal area, which has been growing slowly for the last ten years. Each mass was about $30{\times}20cm$ in size. After designing the elliptical resection margin, we tightened the tumor base by using continuous loop - shaped suture ligation(weaving the thread up and down in a loop - shaped pattern, leaving a space of 2 cm between each loop) with a straight needle and prolene 2 - 0. After skin incision, we proceeded the dissection toward the central and inferior side of the mass obliquely while we avoided breaking large vascular sinuses. We resected the tumor in a wedged - shape. Subcutaneous tissue was sutured layer by layer and skin was closed by vertical mattress and interrupted suture. The loop - shaped ligation of the base was removed and compressive dressing was done with gauzes and elastic bandages. Results: Postoperative complications such as infection, hemorrhage, hematoma, and dehiscense did not occur. Perioperatively the patient was sufficiently transfused with five units of blood and two units of fresh frozen plasma. During the subsequent 1 year follow - up, the functional and cosmetic result was excellent. Conclusion: A continuous loop - shaped suture ligation procedure along the base of the giant NF effectively reduced the amount of hemorrhage during the operation, made dissection and ligation of vessels easily and quickly, and shorten the operating time and postoperative recovery time.
Oxidative stress derived from reactive oxygen species (ROS) is one of the major damaging factors in plants exposed to environmental stress. In order to develop the platform technology to solve the global food and environmental problems in the 21st century, we focus on the understanding of the antioxidative mechanism in plant cells, the development of oxidative stress-inducible antioxidant genes, and the development of transgenic plants with enhanced tolerance to stress. In this report, we describe our recent results on industrial transgenic plants by the gene manipulation of antioxidant enzymes. Transgenic tobacco plants expressing both superoxide dismutase (SOD) and ascorbate peroxidase (APX) in chloroplasts were developed and were evaluated their protection effects against stresses, suggesting that simultaneous overexpression of both SOD and APX in chloroplasts has synergistic effects to overcome the oxidative stress under unfavorable environments. Transgenic tobacco plants expressing a human dehydroascorbate reductase gene in chloroplasts were showed the protection against the oxidative stress in plants. Transgenic cucumber plants expressing high level of SOD in fruits were successfully generated to use the functional cosmetic purpose as a plant bioreactor. In addition, we developed a strong oxidative stress-inducible peroxidase promoter, SWPA2 from sweetpotato (lpomoea batatas). We anticipate that SWPA2 promoter will be biotechnologically useful for the development of transgenic plants with enhanced tolerance to environmental stress and particularly transgenic cell lines engineered to produce key pharmaceutical proteins.
Kim, Sun Heum;Lee, Soo Hyang;Choi, Hyun Gon;Shin, Dong Hyeok;Uhm, Ki Il;Song, Wu Chul
Archives of Plastic Surgery
/
v.35
no.1
/
pp.110-115
/
2008
Purpose: The objective of this study is to propose an effective management of unstable zygomatic arch fracture. The reduction methods of arch fracture were relatively simple but the maintenance of reduction state is very troublesome. On this, authors introduce an effective management method of unstable zygomatic arch fracture. Methods: Authors experienced 23 cases of unstable segmental zygomatic arch fractures and used Thermo-splint in all cases. All the arch fractures were reduced through Gillies' approach under the general anesthesia. After the reduction, the most effective suspension points were marked on the covering skin of the fractured arch. A needle of heavy nonabsorbable suture material was inserted toward the marking site under the reduced zygomatic arch. And then Therm-splint was dipped in the hot water, and we got the splint pattern of patient face. Reshaped Thermo-splint was trimmed and fixated with previous suspension suture materials. More additive suspension was done if necessary. The splint was applied for in two to three weeks postoperatively. Results: In all the cases, good cosmetic and functional results were observed without severe complications. There were 4 cases of incomplete reductions but they also had no specific problems. There were no facial nerve symptom and scar(stitch mark). Postoperative slight tenderness and trismus were completely subsided after removal of the splint. Conclusion: The Thermo-splint safely protect and maintain the postoperative reduction state. The application, maintenance and removal were easy and simple. It could be reformed to any contour of face and had enough rigidity for supporting. Above all these things, effective prevention of displacement and easy manipulation were significant merit. Authors experienced good results with Thermo-splint, and would introduce it for another method of management of zygomatic arch fracture.
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