• 제목/요약/키워드: Distal end

검색결과 283건 처리시간 0.025초

원위기저 도서형 천비복동맥 근막피판으로 하지 재건 시 과급정맥문합의 이용 (Reconstruction of the Soft Tissue Defect of the Lower Leg by Distally Based Superficial Sural Artery Fasciocutaneous Island Flap Using Supercharged Vein)

  • 하영인;최환준;최창용;김용배
    • Archives of Plastic Surgery
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    • 제35권2호
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    • pp.208-213
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    • 2008
  • Purpose: Distally based superficial sural artery island flap has some disadvantages such as postoperative flap edema, congestion, and partial necrosis of the flap margin. Venous congestion is an area of considerable concern in distally based superficial sural artery fasciocutaneous flap and is one of the main reasons for failure, particularly when a large flap is needed. However, we could decrease these disadvantages by means of venous superdrainage. Methods: From June of 2006 to June of 2007, a total of two patients with soft tissue defects of lower one third of the leg underwent venous supercharging distally based superficial sural artery island flap transfer. The distal pivot point of this flap was designed at septocutaneous perforator from the peroneal artery of the posterolateral septum, which was 5 cm above the tip of the lateral malleolus. Briefly, this technique is performed by anastomosing the proximal end of the lesser saphenous vein and collateral vein to any vein in the area of the recipient defect site. Results: No venous congestion was noted in any of the two cases. No other recipient or donor-site complications were observed, except for minor wound dehiscence in one case. In 3 to 6 months follow-up, patients had minor complaints about lack of sensation in the lateral dorsal foot. Conclusion: The peroneal artery perforator is predictable and reliable for the design of a distally based superficial sural artery island flap. Elevation of the venous supercharging flap is safe, easy, and less time consuming. In conclusion, the venous supercharging distally based superficial sural artery island flap offers an alterative to free tissue transfer for reconstruction of the lower extremity.

The Etiology and Treatment of the Softened Phallus after the Radial Forearm Osteocutaneous Free Flap Phalloplasty

  • Kim, Seok-Kwun;Kim, Tae-Heon;Yang, Jin-Il;Kim, Myung-Hoon;Kim, Min-Soo;Lee, Keun-Cheol
    • Archives of Plastic Surgery
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    • 제39권4호
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    • pp.390-396
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    • 2012
  • Background The radial forearm osteocutaneous free flap is considered to be the standard technique for penile construction. One year after their operation, most patients experience a softened phallus, so that they suffer from difficulties in sexual intercourse. In this report, we present our experience with phalloplasty by radial forearm osteocutaneous free flap, as well as an evaluation of the etiology and treatment of the softened phallus. Methods Between March 2005 and February 2010, 58 patients underwent phalloplasty by radial forearm osteocutaneous free flap. Most of their neophallus had been softened subjectively and among them, 12 patients who wanted correction were investigated. We performed repetitive fat injection, artificial dermis grafting, silicone rod insertion, and rib bone with cartilaginous tip graft. Physical examination, plain radiograph, computed tomography, bone scintigraphy, and satisfaction scores were investigated. Results Most of the participants' penises have been softened after phalloplasty, and the skin elasticity had been also decreased. On plain radiograph, the distal end of the bone was self-rounded; however, the bone shape of the neophallus had no significant interval changes or resorption. Computed tomography showed equivocal density of cortical bone. On bone scintigraphy, the bone metabolism was active at 3 months postoperatively, and remained active 9 years postoperatively. Conclusions The use of a rib bone with cartilaginous tip graft could be an option for improvement of the softened phallus. Silicon rod insertion is also worth considering for rigidity of the softened phallus. Decreased rigidity due to soft tissue atrophy could be alleviated with repeated fat injection and artificial dermis grafting.

감마선 분포 측정을 위한 섬광필름 기반의 감마 영상 검출기 제작 및 성능평가 (Fabrication and Performance Evaluation of a Scintillating Film-based Gamma Imaging Detector to Measure Gamma-ray Distribution)

  • 신상훈;유욱재;장경원;조승현;이봉수
    • 센서학회지
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    • 제24권3호
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    • pp.202-207
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    • 2015
  • As a feasibility study on development of a gamma imaging probe, we developed a scintillating film-based gamma imaging detector that can obtain scintillation images with information of gamma-ray distribution. The scintillating film-based gamma imaging detector was composed of a sensing probe, an image intensifier, and a beam profiler. To detect and transmit scintillation image, the sensing probe was fabricated by coupling a scintillating film, a fiber-optic image conduit, and a fiber-optic taper, consecutively. First, the optical images of USAF 1951 resolution target were obtained and then, modulation transfer function values were calculated to test the image quality of the sensing probe. Second, we measured the scintillation images according to the activity of the 137Cs and the distance between the surface of 137Cs and the distal-end of sensing probe. Finally, the intensities of scintillating light as functions of the activity and the distance were evaluated from the region of interest in the scintillation image. From the results of this study, it is expected that a fiber-optic gamma imaging detector can be developed to detect gamma-rays emitted from radiopharmaceuticals during radioimmunoguided surgery.

유리 피판술과 동측 혈관 부착 비골 전위술을 이용한 경골 결손의 재건 (Reconstruction of Tibia Defect with Free Flap Followed by Ipsilateral Vascularized Fibular Transposition)

  • 황정철;정덕환;한정수;이재훈;고택수;박양우;박진성
    • Archives of Reconstructive Microsurgery
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    • 제17권2호
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    • pp.68-74
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    • 2008
  • Segmental defects of the tibia after open fractures, sepsis and a tumor surgery are among the most difficult and challenging clinical problems. Tibia defects in these situations are complicated with infection and are resistant to conventional bone grafting techniques. The aim of this study is to report the results and discuss the role of free flap followed by ipsilateral vascularized fibular transposition (IVFT) for reconstruction of tibia defects. Ten patients had free flap followed by IVFT in the period 1989~2007. Mean age was 25.3 years. The patients were followed for an average of 3.4 years. All flaps were survived including 1 case with venous thrombosis requiring additional surgery. The average time to union of proximal and distal end was 5.2 months, 8.2 months, each other. All transposed fibula were viable at last follow-up. IVFT offers the advantages of a vascularized graft. In patients with large bone and soft tissue defects combined with infection, free flap followed by IVFT is an useful and reliable method without microvascular anastomosis.

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Selenium이 adriamycin에 의해서 유발되는 랫드 신장병변에 미치는 영향 (The effect of selenium on renal lesions induced by adriamycin in rats)

  • 박은성;이준섭
    • 대한수의학회지
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    • 제37권1호
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    • pp.41-57
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    • 1997
  • This study was carried out to investigate the effect of selenium on the adriamycininduced renal lesions in male Sprague Dawley rats. A total of 60 Sprague-Dawley male rats were divided into 2 control groups(C1: saline, C2: selenium) and 2 treatment groups(T1: adriamycin, T2: adriamycin+selenium). The rats of the C1 and T1 groups were given normal saline(0.15ml/rat), the rats of the C2 and T2 groups were given sodium selenite(0.5mg/kg) intraperitoneally three days a week for 4 weeks. The treatment groups were dosed intraperitoneally with adriamycin(2mg/kg/day) five days at the second week. Animals were sacrificed at the 1st week, 2nd week and 3rd week after dosing with adriamycin. The morphologic abnormalities of the glomeruli and tubules in the kidney of male rats were examined histopathologically and electron microscopically.The results obtained were as follows : The mean body weight of adriamycin dosed group was significantly decreased as compared with that of control group at 4th week(p<0.05). In adriamycin and selenium dosed group, the mean body weight was decreased until the end of 2nd week but gradually increased from 3rd to 4th week. The histopathological findings of the renal corpuscle in adriamycin dosed group were parietal epithelial cell proliferation, vacuolization of glomerulus, and thickened basement membrane of the parietal epithelium. Proximal convoluted tubules were significantly dilated and the lumens were filled with renal cast. These lesions were generally not very significant in the rats given adriamycin and selenium. The electron microscopical findings of the renal glomerulus in the adriamycin dosed group were focal loss and fusion of the pedicels of the podocyte, and some vacuoles in the cytoplasm of the podocytes. There were numerous cytoplasmic vacuoles in the proximal and distal convoluted tubular cells. However, these ultrastructural changes were not significantly observed in the renal tubules of the rats of adriamycin and selenium dosed group. These results suggest that selenium may act as an inhibitor of the renal lesions induced by adriamycin in male rats.

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흰쥐의 위궤양 발생에 미치는 대상회전 제거 및 미주신경 절단의 영향 (Influence of cingulate cortical ablation and vagotomy upon gastric ulceration in rats)

  • 박형진;강숙희;조양혁;김철
    • The Korean Journal of Physiology
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    • 제11권1호
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    • pp.45-50
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    • 1977
  • This study was undertaken to investigate the effect of cingulate cortical ablation upon gastric ulceration, and the pathway through which cingulate cortex exerts the effect. 56 female rats were divided equally into cingulate (cingulate cortical ablation), cingulate-vagal (cingulate cortical ablation and vagotomy), normal control and vagal (vagotomy) groups. Cingulate cortex was ablated through a slit-shaped opening (1 mm in width, 13 mm in length) which was made symmetrically on both sides of, and parallel to, the sagittal suture by removing a bone flap from parietal and frontal bones on each side. Vagus nerves on both sides were transected around the distal end of the esophagus. In the normal control animals, surgical intervention ended with scalp incision. All rats were kept without restraint or food deprivation for 3 weeks after surgery. The stomach of each rat was inflated with 7 ml of physiological saline and then removed under deep anesthesia. The mucosal surface was examined under dissecting microscope for the location, shape and number of ulcers, and then enlarged photograph $(4{\times})$was taken. The incidence of ulcer in each group was counted and the number of ulceration as well as the total area of glandular mucosa were measured on the photograph. Results obtained were as follows: 1. The mean number of ulcer per stomach and the total area of ulcer exprssed as permillage of the total area of glandular mucosa were significantly higher in the cingulate group than the cingulate-vagal, the normal control and the vagal groups. There was no difference among the latter three groups. 2. The incidence of ulcer in the cingulate group was significantly higher than that in the .normal control group and was also higher, though not significantly, than those in the cingulate-vagal and the vagal groups. There was no difference among the normal control, the cingulate-vagal and the vagal groups. It is inferred from the above results that the cingulate cortex exerts an inhibitory influence upon gastric ulceration and that this influence is mediated by controlling the vagal activity.

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중엽증후군과 폐렴을 유발한 기관지의 성장을 보이는 기관지 지방종 1예 (A Case of Bronchial Lipoma with Extrabronchial Growth Causing Middle Lobe Syndrome and Pneumonia)

  • 박세종;장경순;김도민;권재성;이성근;김명선;강종렬;김응수;이병두
    • Tuberculosis and Respiratory Diseases
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    • 제47권4호
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    • pp.549-556
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    • 1999
  • Benign pulmonary tumors are rare entities, and among them bronchial lipomas are the most uncommon. Up to date, about 80 cases have been reported in the English literature. But, the bronchial lipoma with extrabronchial growth causing middle lobe syndrome and pneumonia is extremely rare. Bronchial lipomas, mainly arising from normal fatty tissue of the proximal portion of the lobar or segmental bronchi, are histologically benign. But if diagnosis and treatments are delayed, they can produce extensive pulmonary parenchymal damage and irreversible brochiectasis distally. So whenever possible, the treatment of choice is resection by means of bronchoscopy via early diagnosis. But if endoscopic removal is not possible because the distal end of the tumor could not be visualized by fiberoptic bronchoscopy or if the nature of the tumor is unclear, surgery is necessary, with lobectomy or pneumonectomy being required in most cases due to the extensively damaged pulmonary parenchyma. We present a case of bronchial lipoma with extrabronchial growth, with a review of the literature and report of an unusual case.

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편측 후방 치아 잔존시 의치 설계에 따른 지대치지지 조직과 잔존 치조제의 응력 분석에 관한 연구 (STRESS ANALYSIS AT SUPPORTING TISSUE OF ABUTMENT TEETH AND RESIDUAL RIDGE ACCORDING TO DENTURE DESIGN WITH REMAINING UNILATERAL POSTERIOR TEETH)

  • 안광호;정영완;진태호
    • 대한치과보철학회지
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    • 제37권2호
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    • pp.185-199
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    • 1999
  • This study was peformed to investigate the distribution and magnitude of stress at supporting tissue of abutment teeth and residual ridge tissue with remaining unilateral posterior teeth. Four types of removable partial dentures that included clasp retained removable partial denture, attachment retained removable partial denture, telescopic removable partial denture, and swing-lock partial denture were designed, and strain gauge was used for stress analysis. Each prosthesis was subjected to simulated vertical and oblique load. The following conclusions were drawn from this study. 1. The clasp retained removable partial denture generally distributed simulated vertical force more evenly to the supporting structure. 2. The stress at buccal side of 1st premolar was the lowest in swing-lock partial denture and that was highest in attchment retained removable partial denture. The stress at lingual side of 1st premolar was the lowest in telescopic partial denture. 3. In clasp retained removable partial denture, stress was lower at load site and ridge crest at mid-line, but it was higher at 1st premolar area on vertical load. 4. In attachment removable partial denture, stresses at buccal side of 1st premolar. lingual side of 1st premolar on vertical load, and ridge crest at midline on oblique load were higher. 5. In telescopic removable partial denture, stress at lingual side of 1st premolar was the least in all removable partial dentures, but the stress at load site was higher. 6. In swing-lock removable partial denture, stress at buccal side of 1st premolar was the lowest, and stresses at load site and distal end of residual ridge crest were higher.

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토끼 실험적 골 결손부에 이식한 이종 이식골편의 처리방법에 따른 신생골 형성능력 비교 (Comparison of Efficacy of New Bone Formation According to Implant Treatment in Xenograft Transplanted for Experimental Bone Defects of Rabbits)

  • 송하나;이종일
    • 한국임상수의학회지
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    • 제24권3호
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    • pp.350-357
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    • 2007
  • Bone graft had been widely investigated for reconstruction of bone defects or acceleration of bone healing in orthopedics, neurosurgery and dental surgery. Autograft is the golden standard of bone graft but it is associated with donor site morbidity and is restricted in quantity. Xenograft has been researched an alternative method for autograft. The purpose of this study was to investigate the efficacy of new bone formation according to three different preparations of implants on rabbit xenograft. Cortical bone xenografts which made from bovine femoral cortical bone were treated by freezing, freeze-drying or defat-freezing implant preparations. They were transplanted into proximal diaphyseal shaft of bifibulae of 15 rabbits which were divided into three groups according to their implant preparation method. The fibulae transplantations were evaluated radiographically and examined osteoblast activity by bone alkaline phosphatase (BALP) biweekly for 16 weeks to observe new bone formation and union of the experimental defected region. New bone formation was observed in 7 cases in freeze-drying and defat-freezing group, respectively. Union of proximal and distal end of defected region, which was considered as success of bone graft, was observed in 4 cases (40%; 4 of 10 cases), respectively. In freezing group, new bone formation was observed in 6 cases but, there is no union observed. BALP value was increased over twice after two weeks of graft procedure in all union cases of freeze-drying and defat-freezing group (two of five animals, respectively) then gradually decreased to 16th week. In non-union cases, there is no significant variation in BALP value. Defat-freezing or freeze-drying preparations of implants are more efficacious in new bone formation than freezing method on rabbit xenograft. While it is difficult to propose which is superior between defat-freezing and freeze-drying, defatting of implants may enhance new bone formation in xenograft.

임상적인 적용에 기반한 후구치삼각융기 형태와 분류의 포괄적인 이해 (Comprehensive understandings in the shape of retromolar pad and its classification based on clinical application)

  • 박찬진;고경호;허윤혁;조리라
    • 구강회복응용과학지
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    • 제35권2호
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    • pp.64-71
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    • 2019
  • 무치악 환자의 교합평면 수준을 결정할 때 후구치삼각융기는 흔하게 이용하는 해부학적 지표 중 하나로 연조직 덩어리이며 의치의 의해 피개 되어야 한다. 후구치삼각융기의 형태는 다양성을 보이며 이는 최후방 치아 발거에 따른 치유과정을 통해 형성되는 변화는 필연적이기 때문이다. 본 문헌고찰은 후구치삼각융기의 형태에 있어서 해부학적 관계와 임상적인 가치를 고려하고 형태적인 분류에 관해 고찰하고자 하였다.