• 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 Veterinary Clinics
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• v.41 no.1
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• pp.24-29
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• 2024

A 6-year-old spayed female French Bulldog presented with a left-sided chest wall tumor. Physical examination revealed that the tumor was firmly adhered to the chest wall. A preoperative punch biopsy of the tumor revealed a grade 2 soft tissue sarcoma (STS). On computed tomography, the tumor's dimensions were assessed as 6.5 × 5.7 × 3.5 cm, and it exhibited invasiveness near the tissue surrounding the ninth rib. The tumor size was large in comparison to the dog's chest wall area. Hence, if the traditional wide-margin resection surgery were to be performed, primary wound closure seemed impractical and could potentially result in respiratory function complications. Therefore, considering the extent of tumor invasion and grade, deep margins were established to include the removal of the eighth to tenth ribs, and a 1-cm lateral margin was designated to enable primary wound closure. To reconstruct the chest wall, polypropylene mesh was attached to the adjacent ribs and the remaining muscles were sutured and covered over the mesh. The dog exhibited a rapid recovery beginning the day after the operation. Postoperative biopsy confirmed that the tumor was a grade 2 STS, and the surgical margins were evaluated as incomplete. The owner chose to pursue follow-up observation instead of chemotherapy. In this study, the surgical approach was chosen based on the importance of functional recovery after surgery. Recent research indicates that the tumor grade is more critical for postoperative prognosis than the extent of surgical margins when removing an STS.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.37 no.9
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• pp.807-814
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• 2013

A fundamental study on laser-tissue interaction was conducted with the aim of developing a therapeutic medical device that can remove lesions on the intestinal wall by irradiating a high-power 808-nm infrared laser light incorporated in an endoscopic system. The perforation depth was linearly increased in the range of 1~4 mm in proportional to laser output (3~12 W) and irradiation time (5~20 s). We demonstrated that the perforation depth during laser irradiation was varied according to the tissue property of each extracted porcine organ. The measurement of the temperature distribution suggests that the energy is localized in the irradiation spot and transferred to deep tissue, which protects the surrounding tissue from thermal injury. These results can be used to set the driving parameters for a laser incision technique as an alternative to conventional surgical interventions.

• Archives of Plastic Surgery
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• v.41 no.2
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• pp.171-173
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• 2014

Preoperative perforator marking for deep inferior epigastric artery perforator flaps is vital to the success of the procedure in breast reconstruction. Advances in imaging have facilitated accurate identification and preselection of potentially useful perforators. However, the reported imaging accuracy may be lost when preoperatively marking the patient, due to 'mapping errors', as this relies on the use of 2 reported vectors from a landmark such as the umbilicus. Observation errors have been encountered where inaccurate perforator vector measurements have been reported in relation to the umbilicus. Transcription errors have been noted where confusing and wordy reports have been typed or where incorrect units have been given (millimetres vs. centimetres). Interpretation errors have also occurred when using the report for preoperative marking. Furthermore, the marking process may be unnecessarily time-consuming. We describe a bespoke template, created using an individual computed tomography angiography image, that increases the efficiency and accuracy of preoperative marking. The template is created to scale, is individually tailored to the patient, and is particularly useful in cases where multiple potential suitable perforators exist.

• Archives of Craniofacial Surgery
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• v.16 no.2
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• pp.80-83
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• 2015

We present reconstruction of a complicated scalp-dura defect using acellular human dermis and latissimus dorsi myocutaneous free flap. A 62-year-old female had previously undergone decompressive craniectomy for intracranial hemorrhage. The cranial bone flap was cryopreserved and restored to the original location subsequently, but necessitated removal for a methicillin-resistant Staphylococcal infection. However, the infectious nidus remained in a dermal substitute that was left over the cerebrum. Upon re-exploration, this material was removed, and frank pus was observed in the deep space just over the arachnoid layer. This was carefully irrigated, and the dural defect was closed with acellular dermal matrix in a watertight manner. The remaining scalp defect was covered using a free latissimus dorsi flap with anastomosis between the thoracodorsal and deep temporal arteries. The wound healed well without complications, and the scalp remained intact without any evidence of cerebrospinal fluid leak or continued infection.

• Restorative Dentistry and Endodontics
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• v.8 no.1
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• pp.133-137
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• 1982

Radiography is one of the important tool adopted in daily dental practice and medical diagnosis. To visualize soft tissuechange various contrast media has Been introduced. Any cavity or space can be easily determined by increasing the X-ray absorption of the cavity using the radiopaque contrast media which widely employed in medical radiography to show much of the digestive, cardiovascular, pulmonary, and renal system. The essential part of any radiopaque medium is a heavy element that can absoarb most of the X-ray beam. The element must be noninjurious and easily eliminated. Both aqueous and oil suspensions of iodine containing compounds' are available to the dental profession, for example Lipiodol and Dionosil. The study was designed to determine toxic effect of Lipiodol to the vital pulp and to confirm visualization ioprovement in pulp canal. 1. Thin mixture of Calcium hydroxide and Lipiodol was applied to 19 deep vital cavities for 24 hours. Only one case complained slight pain for short time. 2. Cotton pellet over-saturated in Lipiodol was inserted in coronal chamber of which 6 were non vital and 5 were vital. The transference of Lipiodol was not noticed in every case after 24 hours. 5 cases with vital pulp tissue in the canals showed no clinical symptome. 3. Extracted 20 teeth were routinely prepared for endodontic treatment and applied Lipiodol in conjunction with cotton fiber as deep as midportion of the roots. After 24, hours the medicament reached to nearly the end of apex, but there were no evidence of penetration in dentine layer and migrate into ramified canal.

• Journal of Trauma and Injury
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• v.32 no.3
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• pp.168-171
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• 2019

The treatment outcome remains poor of severe facial injuries because of the high risk of compromised airway or massive bleeding. We experienced two successful treatment cases of severe facial injury by the chainsaw. A 52-year-male had his face injured by the chainsaw during his work. He was transferred to the Level I trauma center using the Doctor-Helicopter. During his flight, bleeding control was tried and the information was given to the trauma surgeons before his arrival. His consciousness was alert and the vital signs were stable. The crushing wound, mandible open fracture, deep laceration of tongue, lip, neck and arterial bleeding were noted around his mandible. Nasotracheal intubation was performed under the bronchoscope-guided. Emergency operation (open reduction & internal fixation, primary repair with neurorrhaphy) was performed. At 30 hospital days, he was discharged with facial palsy on left mandibular area. A 30-year-male had his face injured by the chainsaw. He was transferred to our Level I trauma center from the local hospital. The deep-mutiple lacerations on right upper eyelid and forehead with the bony exposure were noted. The vital signs were stable and emergency operation was performed. He was discharged at 20 hospital days. Bone loss or tissue loss were not devastating than we expected even though the injury was occurred by the chainsaw. Aggressive treatment including airway manipulation or bleeding control and maximal opportunity of therapy are absolutely needed.

• Journal of the Korean Burn Society
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• v.22 no.2
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• pp.58-65
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• 2019

Wound caused by high-tension electrical burns is difficult to manage because the wound is deep and complex. The wound is progressively necrotic due to microvascular injury resulting in deep tissue exposure. So, coverage of the wound at the entry point and the exit point is cumbersome, often requiring flap coverage. We experienced a case of one patient for peroneal artery perforator free flap coverage on the palm of the right hand of the entry point of electrical burn. The left foot wound of electrical exit point was covered by full thickness skin graft. Also a small wound was on the left side of the lower back was the exit point of electrical burn. The lower back wound was healed and recurred repeatedly after burn. On postburn day 6 month, through the radiologic exam, metal shadow was identified in the left gluteus muscle forming chronic sinus. We explored the wound of sinus and a foreign body was identified in the sac as multi braid wires thin as hair. According to the patient's past history, we suspected that the back wound was caused by electrical burn injury through the wires.

• Journal of Veterinary Science
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• v.24 no.6
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• pp.79.1-79.16
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• 2023

Background: The need for a storage method capable of preserving the intrinsic properties of bones without using toxic substances has always been raised. Supercooling is a relatively recently introduced preservation method that meets this need. Supercooling refers to the phenomenon of liquid in which the temperature drops below its freezing point without solidifying or crystallizing. Objectives: The purpose of this study was to identify the preservation efficiency and applicability of the supercooling technique as a cortical bone allograft storage modality. Methods: The biomechanical effects of various storage methods, including deep freezing, cryopreservation, lyophilization, glycerol preservation, and supercooling, were evaluated with the three-point banding test, axial compression test, and electron microscopy. Additionally, cortical bone allografts were applied to the radial bone defect in New Zealand White rabbits to determine the biological effects. The degree of bone union was assessed with postoperative clinical signs, radiography, micro-computed tomography, and biomechanical analysis. Results: The biomechanical properties of cortical bone grafts preserved using glycerol and supercooling method were found to be comparable to those of normal bone while also significantly stronger than deep-frozen, cryopreserved, and lyophilized bone grafts. Preclinical research performed in rabbit radial defect models revealed that supercooled and glycerol-preserved bone allografts exhibited significantly better bone union than other groups. Conclusions: Considering the biomechanical and biological superiority, the supercooling technique could be one of the optimal preservation methods for cortical bone allografts. This study will form the basis for a novel application of supercooling as a bone material preservation technique.

• Archives of Reconstructive Microsurgery
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• v.19 no.2
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• pp.97-100
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• 2010

Purpose: Epidermolysis bullosa is a rare genetic disease, characterized by the presence of extremely fragile skin and formation of recurrent blister resulting from even a minor mechanical injury. Squamous cell carcinoma (SCC) is recognized as a complication of the chronic scarring associated with dystrophic epidermolysis bullosa (DEB). When a soft tissue defect happens in a patient with epidermolysis bullosa, it is difficult to cover it with a skin graft or a flap. We describe the successful use of a pedicled deep inferior epigastric perforator flap for the reconstruction of SCC associated with DEB in the groin. Methods: A 29-year-old man diagnosed with DEB at birth sustained an ulcer increasing in the right groin for the last 7 months. Under general anesthesia, the mass lesion and lymph nodes were removed and the resulting defect was covered with a pedicled deep inferior epigastric perforator flap. Results: The flap survived completely and his postoperative course was uneventful. Histopathological examination revealed a SCC in the right groin and malignant tumor cells in the removed lymph nodes as well. Additional positron emission tomogram showed a malignant lesion in the ileocecal area with regional lymph node metastasis. The patient was referred to an oncologist for chemotheraphy, but the patient refused to take it. During a 4-month follow-up period, there was no recurrence in the right groin. Conclusion: We suggest that perforator flaps can be considered as a reliable alternative for the reconstruction of soft tissue defects in a patient with DEB.