• 한방비만학회지
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• 제8권2호
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• pp.25-35
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• 2008

Objectives This study was performed to find out the characters about distribution of abdominal fat(especially superficial and deep subcutaneous fat) in obese premenopausal Korean women. Methods 39 obese premenopausal women were recruited in 2008. Anthropometry and body impedance analysis have been done and abdominal fat distribution had been assessed by computed tomography scan at the level of L4-5. Blood test and questionnaires about depression, eating attitude and physical activity were underwent. Result Abdominal total fat area, subcutaneous fat area including superficial and deep were significantly correlated with anthropometry and BIA result while visceral fat was correlated only with age and waist circumference. In blood profile, only visceral fat area was correlated with HDL cholesterol and triglyceride. And there were no correlation among questionnaires and abdominal fat. There were no difference between superficial and deep subcutaneous fat. Conclusion Abdominal subcutaneous fat including superficial and deep did not have any correlation with heart risk factor. superficial and deep subcutaneous fat had no differences with each other and they did not show any correlation with visceral fat in obese perimenopausal Korean women.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.535-546
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• 2010

Purpose: The subcutaneous fat tissue is separated into 2 layers by the subcutaneous fascia: the superficial and deep fat layers. The two fat layers have different structures according to the body regions. The purpose of this study is to evaluate the distribution and pattern of the two fat layers in the human body by computed tomography (CT) and histological analysis according to age, sex, anatomical region, and body mass index (BMI). Methods: This study included 200 males and 200 females who underwent 64-channel dynamic CT in our hospital. The patients were divided into 5 groups according to 10 years of their ages separately in either male or female gender. The thickness of the superficial and deep fat layers was measured in the abdominal, pelvic, and femoral regions, and we analyzed the values. Statistical analyses were performed using SPSS software. The $3{\times}3$-cm whole fat layers were harvested from the same sites of 3 cadavers for histological examination, and one cadaver was dissected for gross evaluation. Results: The total thickness of subcutaneous fat tissue was greater in females than in males, and the ratio of the superficial fat layer to the whole fat layer was higher in females. The superficial fat layer became thinner with increasing age in males. As BMI increased, the total fat layer became thicker, and the superficial fat layer became thicker than the deep fat layer. On histological examination, the superficial fat layer had small adipose lobules and showed a densely distributed pattern in the abdominal region, whereas in the femoral region, it had large adipose lobules and showed a sparsely distributed pattern. There were no significant differences in the histological findings of the deep fat layer between the 3 body regions. Conclusion: Significant differences in histological findings of the two fat layers were found in relation to age, sex, anatomical region, and BMI. The superficial fat layer became thinner with increasing age in males, but it was constant in females. As BMI increased, the total thickness of subcutaneous fat tissue became greater, and the superficial fat layer became thicker than the deep fat layer. Our measurements can be used to understand the characteristics of the fat layers in relation to age, sex, anatomical region, and BMI.

• 한방비만학회지
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• 제7권2호
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• pp.15-25
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• 2007

Objectives In clinical studies, the visceral fat obesity has been emphasized because of its correlation with the metabolic syndrome. But the subcutaneous adipose tissue also would correlate with the risk factor of metabolic syndrome. Especially deep tissue, which is a subdivision of the subcutaneous adipose tissue would be more related. This study is to investigate the relationship between subcutaneous adipose tissue and various diseases. Methods We searched for papers which had subcutaneous adipose tissue, deep subcutaneous adipose tissue and obesity for subjects in the Pubmed site. Results : 24 papers were found. Subcutaneous adipose tissue, deep subcutaneous adipose tissue especially, was related with the insulin resistance, metabolic syndrome, sex hormones and other diseases. Conclusions Subcutaneous adipose tissue is a risk factor of insulin resistance but not lipoprotein. But deep subcutaneous adipose tissue was related with lipoprotein. So deep tissue, which is a subdivision of the subcutaneous adipose tissue is a more important risk factor of the metabolic syndrome.

• Archives of Plastic Surgery
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• 제45권3호
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• pp.214-221
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• 2018

Clarification is needed regarding the definitions and classification of groove and hollowness of the infraorbital region depending on the cause, anatomical characteristics, and appearance. Grooves in the infraorbital region can be classified as nasojugal grooves (or folds), tear trough deformities, and palpebromalar grooves; these can be differentiated based on anatomical characteristics. They are caused by the herniation of intraorbital fat, atrophy of the skin and subcutaneous fat, contraction of the orbital part of the orbicularis oculi muscle or squinting, and malar bone resorption. Safe and successful treatment requires an optimal choice of filler and treatment method. The choice between a cannula and needle depends on various factors; a needle is better for injections into a subdermal area in a relatively safe plane, while a cannula is recommended for avoiding vascular compromise when injecting filler into a deep fat layer and releasing fibrotic ligamentous structures. The injection of a soft-tissue filler into the subcutaneous fat tissue is recommended for treating mild indentations around the orbital rim and nasojugal region. Reducing the tethering effect of ligamentous structures by undermining using a cannula prior to the filler injection is recommended for treating relatively deep and fine indentations. The treatment of mild prolapse of the intraorbital septal fat or broad flattening of the infraorbital region can be improved by restoring the volume deficiency using a relatively firm filler.

• Korean Journal of Radiology
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• 제21권1호
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• pp.88-100
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• 2020

Objective: We aimed to develop and validate a deep learning system for fully automated segmentation of abdominal muscle and fat areas on computed tomography (CT) images. Materials and Methods: A fully convolutional network-based segmentation system was developed using a training dataset of 883 CT scans from 467 subjects. Axial CT images obtained at the inferior endplate level of the 3rd lumbar vertebra were used for the analysis. Manually drawn segmentation maps of the skeletal muscle, visceral fat, and subcutaneous fat were created to serve as ground truth data. The performance of the fully convolutional network-based segmentation system was evaluated using the Dice similarity coefficient and cross-sectional area error, for both a separate internal validation dataset (426 CT scans from 308 subjects) and an external validation dataset (171 CT scans from 171 subjects from two outside hospitals). Results: The mean Dice similarity coefficients for muscle, subcutaneous fat, and visceral fat were high for both the internal (0.96, 0.97, and 0.97, respectively) and external (0.97, 0.97, and 0.97, respectively) validation datasets, while the mean cross-sectional area errors for muscle, subcutaneous fat, and visceral fat were low for both internal (2.1%, 3.8%, and 1.8%, respectively) and external (2.7%, 4.6%, and 2.3%, respectively) validation datasets. Conclusion: The fully convolutional network-based segmentation system exhibited high performance and accuracy in the automatic segmentation of abdominal muscle and fat on CT images.

• 대한수의학회지
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• 제42권4호
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• pp.537-543
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• 2002

The purpose of the present study was to investigate structural stability of extensive laminectomy and the effect of subcutaneous fat autograft on restricting formation of postlaminectomy membrane (fibrous tissue). Eighteen healthy dogs of both sexes and of mixed breeding were divided into 6 groups : (1) unilateral hemilaminectomy (group H) on 3rd, 4th and 7th vertebrae ; (2) modified dorsal laminectomy (group D) on 3rd, 4th and 7th vertebrae. Hemilaminectomies were carried out incontinuously at 16 sites in 4 dogs, then subcutaneous fat autografts (group F) were applied to 8 laminectomy sites and no treatment (group C) was assigned to 8 laminectomy sites, too. Operating time of group H ($30.9{\pm}10.4$ minutes) was significantly shorter (p<0.05) than that of group D ($43.1{\pm}12.2$ minutes), but surgical hemorrhage of group H is severer than that of group D. General states, such as standing, gait, defecation and urination, were normal. Upper motor neuron/lower motor neuron signs were not found and superficial/deep pain, proprioception and anal sphincter tone were normal. Gross postmortem findings were similar in all groups. The laminectomy sites of groups H and D were filled with fibous connective tissue at 4 months after operation and histopathological abnormalities of spinal cord were not found. One of eight laminectomy sites in group F was filled with fibrous tissue at 2 months after operation, but all operating sites of group C were covered with fibrous tissue. The present study indicated that extensive laminectomy on 7 vertebrae, using unilateral hemilaminectomy and modified dorsal laminectomy technique, maintained structural stability and subcutaneous fat autograft was effective on reducing the formation of fibrous membrane in laminectomy sites.

• Archives of Plastic Surgery
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• 제41권6호
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• pp.693-701
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• 2014

Background A thin perforator flap is one of the best methods for covering defects. This study aimed to revisit and further test the rapidly advancing field of flap thinning techniques. Methods We performed two cadaveric studies to test the known flap thinning methods, and then applied these methods to a clinical series. In the first study, five cadavers were used to observe the anatomical relation of the perforator with the subdermal plexuses and the subcutaneous fat layer by injecting a colored latex solution. The second study was done on four cadavers independently from the first study. Last, a clinical series was performed on 15 patients. Results The areolar fat lobules of 10 anterolateral thigh perforator (ALT), seven deep inferior epigastric artery perforator (DIEAP), and six thoracodorsal artery perforator (TAP) flaps were dissected to reduce the flap thickness guided by the colored vascular pattern. On average, the ALT, DIEAP, and TAP flaps were reduced to $32.76%{\pm}9.76%$, $37.01%{\pm}9.21%$, and $35.42%{\pm}9.41%$, respectively. In the second study, the areolar fat lobules were directly dissected in six ALT, six TAP, and four MSAP flaps, and an average reduction in flap thickness of $53.41%{\pm}5.64%$, $52.30%{\pm}2.88%$, and $47.87%{\pm}6.41%$, respectively, was found. In the clinical series, 13 out of the 15 cases yielded satisfactory outcomes with an average thickness reduction of $37.91%{\pm}7.15%$. Conclusions These multiple studies showed that the deep fat layer could be safely removed to obtain a thin yet viable perforator flap. This evidence suggests that the macroscopic flap thinning technique can achieve thin flaps. Surgeons should consider this technique before embracing the latest technique of supermicrosurgery.

• 한방재활의학과학회지
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• 제19권2호
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• pp.261-273
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• 2009

Objectives : This study was performed to figure out the effects of herbal mesotherapy on abdominal fat in obese women. Methods : Forty obese women those who were diagnosed abdominal obesity had been recruited during February, 2008. They were randomly assigned experimental or control group under block-randomization. Experimental group were treated with Sobi-eum(Xiaofei-yin) injection during 6 weeks (2 times a week) and placebo group were treated with normal saline injection under same procedures. Anthropometry, body impedance analysis, fat computed tomography, blood test, and questionnaires had been administered before and after the treatment. Results : Four subjects were dropped out (voluntary give up), so 18 in experimental group and 18 in placebo group were evaluated. There were significant changes after treatments in both groups. Although no significant differences have been found in the result of anthropometry, body impedance analysis and fat computed tomography between two groups, in the experimental group, the changes of total fat area had a highly significant relationship with all part of abdominal fat. While the placebo group had highly significant relationships with subcutaneous fat area, superficial and deep subcutaneous fat area but not with visceral fat area. Conclusions : Compaired with saline group, herbal mesotheraphy Sobi-eum(Xiaofei-yin) is effective in reduction of visceral fat after adjusting TFA.

• Archives of Reconstructive Microsurgery
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• 제25권1호
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• pp.15-18
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• 2016

Any types of burn injury that involve more than deep dermis often require reconstructive treatment. In gluteal region, V-Y fasciocutaneous advancement flap is frequently used to cover the defect. However, in case of large burn wounds, this kind of flap cannot provide adequate coverage because of the lack of normal surrounding tissues. We suggest V-Y adipofascial flap using the surrounding superficially damaged tissue. We present the case of a patient who was referred for full-thickness burn on gluteal region. We performed serial debridement and applied vacuum-assisted closure device to defective area as wound preparation for coverage. When healthy granulation tissue grew adequately, we covered the defect with surrounding V-Y adipofascial flap and the raw surface of the flap was then covered with split-thickness skin graft. We think the use of subcutaneous fat as an adipofascial flap to cover the deeper defect adjacent to the flap is an excellent alternative especially in huge defect with uneven depth varying from subcutaneous fat to bone exposure in terms of minimal donor site morbidity and reliability of the flap. Even if the flap was not intact, it was reuse of the adjacent tissue of the injured area, so it is relatively safe and applicable.

• Archives of Plastic Surgery
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• 제39권1호
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• pp.3-10
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• 2012

The free muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) and deep inferior epigastric perforator (DIEP) flaps involve transferring skin and subcutaneous tissue from the lower abdominal area and have many features that make them well suited for breast reconstruction. The robust blood supply of the free flap reduces the risk of fat necrosis and also enables aggressive shaping of the flap for breast reconstruction to optimize the aesthetic outcome. In addition, the free MS-TRAM flap and DIEP flap require minimal donor-site sacrifice in most cases. With proper patient selection and safe surgical technique, the free MS-TRAM flap and DIEP flap can transfer the lower abdominal skin and subcutaneous tissue to provide an aesthetically pleasing breast reconstruction with minimal donor-site morbidity.