• Archives of Plastic Surgery
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• 제38권6호
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• pp.803-807
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• 2011

Purpose: The safety of radiation therapy after breast reconstruction using transverse rectus abdominis myocutaneous (TRAM) flap is still being debated, and few studies exist on the outcome of irradiation after immediate TRAM breast reconstruction. Some authors presented satisfactory outcomes after adjuvant radiation therapy on reconstructed breast with pedicled TRAM flap, while others reported significant post radiation changes of the flap. Effect of radiation therapy on TRAM flap was evaluated to see whether adjuvant radiation therapy was tolerable. Methods: 1000 immediate TRAM breast reconstruction was done by a single surgeon from July, 2001 to December, 2009. Among them 105 patients required adjuvant radiation therapy because of advanced disease or locoregional recurrence. Fat necrosis, radiation fibrosis, mastectomy skin flap necrosis, need for secondary touch up procedures, patient satisfaction were evaluated. Results: The incidence of fat necrosis was 10.5% and significant radiation fibrosis occurred in only one patient. Delayed wound problem did not occur during or after irradiation. Secondary touch-up procedures were performed in 12.3%, the most common being fat graft (8.6%). Average patient satisfaction score was 8.62/10, which was not significantly different from the authors' previous report involving all the TRAM patients (8.50). Conclusion: Radiation therapy did not increase the complication rate significantly. Aesthetic result was affected but was tolerated in most cases. The fear of adjuvant radiation is not a negative factor in selecting immediate breast reconstruction with TRAM flap.

• BMB Reports
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• 제33권3호
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• pp.213-220
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• 2000

A fulminant hepatitis is associated with massive liver cell necrosis and a high mortality rate. But survivors regenerate a normal liver and do not have chronic liver disease. This clinical course suggests that the acutely injured livers release a factor that allows a recovery from chronic hepatitis or cirrhosis. The objective of this study was to isolate and characterize an anti-fibrotic factor from acutely damaged rat livers. The liver cell necrosis was prepared from rat by warm ischemical perfusion and the perfusates were assessed against the growth inhibition of fat-storing cells (FSC). A liver-derived growth inhibitory factor (LDGIF) was purified from ischemically damaged rat livers by chromatographies on Sephacryl S-300, CM Sepharose, hydroxyapatite, and Superose 12. The LDGIF was isolated with an overall purification of 194-fold and 40% recovery. Although LDGIF was identified as the rat liver arginase by Nterminal sequence analysis, LDGIF exists as a monomer and the purified native arginase has a trimer form. Furthermore, LDGIF has a lower enzyme activity on the hydrolysis of L-arginine and a higher inhibitory effect on proliferation of FSC than the normal rat liver arginase. The catalytic activity of LDGIF is ascribed to the monomeric characteristics of the LDGIF. Therefore, the inhibitory action of LDGIF might not be due to the arginine depletion by the catalytic activity of arginase. In conclusion, the presence of the LDGIF could interpret the clinical course that serious fibrosis is not found in the liver of patients recovering from severe hepatic necrosis due to fulminant hepatitis, suggesting that this LDGIF may provide a novel target for the prevention and treatment of hepatic fibrosis.

• 한국동물위생학회지
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• 제36권2호
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• pp.121-125
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• 2013

The survey was conducted to investigate the relation between slaughter inspection results and the quality of cattle carcasses by inquiring animal products grading service results of Korea Institute for Animal Products Quality Evaluation (KAPE) about partial-disposed cattle carcasses after dismantling inspection. Of the 13,586 slaughtered cattle, 1,343 (9.9%) cattle heads were partially disposed from January to August, 2012 at slaughterhouses in Gwangju area, Korea. Of the 1,343 partial disposed cattle, 613 (45.6%) cattle carcasses were graded into above "Grade 1". Among partially disposed 1,171 Hanwoo heads, 613 (52.3%) cattle carcasses were graded into above "Grade 1". However, none of dairy and beef cattle carcasses were graded into above "Grade 1" out of 163 and 9 partial disposals, respectively. Of the 221 partial disposals by enteric fat necrosis, 139 carcasses were graded into above "Grade 1", and the ratio; 62.9% (P=0.001), was higher than that (50.3%) of total cattle carcass grade which is above "Grade 1". From these results, it is suggested that quality of cattle carcasses which is mainly determined by marbling might be related to the fatty lesions such as fatty liver and enteric fat necrosis.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.324-331
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• 2022

Prior abdominal liposuction can be viewed as a relative or absolute contraindication to abdominally based autologous breast reconstruction given concerns for damaged perforators and scarring complicating intraoperative dissection. This systematic review aims to explore the outcomes of abdominally based breast reconstruction in patients with a history of abdominal liposuction. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided literature search was conducted using PubMed, Scopus, and Web of Science from the earliest available date through June 2020. Deep inferior epigastric perforator, muscle-sparing transverse rectus abdominis musculocutaneous (TRAM), superficial inferior epigastric artery, and pedicled TRAM flaps were included for evaluation. Complications included total or partial flap loss, fat necrosis, seroma, delayed wound healing, and donor site complications. After inclusion criteria were applied, 336 non-duplicate articles were screened, yielding 11 for final review, representing 55 flaps in 43 patients. There was no instance of total flap loss, eight (14.5%) flaps developed partial loss or fat necrosis, three (5.4%) flaps had delayed wound healing, and two (4.6%) patients had donor site complications. Most authors (8/11) utilized some type of preoperative imaging. Doppler ultrasonography was the most used modality, and these patients had the lowest rate of partial flap loss or flap fat necrosis (8%), followed by those without any preoperative imaging (10%). In conclusion, this review supports that patients undergoing abdominally based autologous breast reconstruction with a history of abdominal liposuction are not at an increased risk of flap or donor site complications. Although preoperative imaging was common, it did not reliably decrease complications. Further prospective studies are needed to address the role of imaging in improving outcomes.

• Journal of Yeungnam Medical Science
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• 제9권2호
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• pp.224-238
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• 1992

간 섬유화에서 fat-storing cell의 변화를 미세 구조학적 측면에서 관찰하고자, 사염화탄소를 mineral oil에 녹여 1 : 1로 회석한 후 Kg당 0.5 ml의 용량을 주 2회씩 12주간 흰쥐에 복강 주입하였다. 실험기간 동안 1주 간격으로 도살하고, 적출된 간조직을 광학현미경과 연역조직화학적 검사 및 전자현미경으로 관찰하여 다음과 같은 결과를 얻었다. 광학현미경적 소견상 소엽 중심주의 염증 반응 및 세포 침윤 현상은 사염화탄소 투여 후 1주부터 나타나서 4주 째 가장 심하였으며, 이시기에 desmin염색 반응 양성세포의 수도 증가되었다. 괴사 및 섬유화는 2주부터 나타나기 시작하여 6주부터 결절이 형성되기 시작하였고 괴사성 병변은 8주까지 지속되었다. 그러나 세포 침윤 정도는 감소되면서 desmin에 대한 반응성도 낮아졌고, 경변성 변화는 10주 이후부터 나타났다. 전자현미경적 소견상 fat-storing cell의 숫적 증가는 1주부터 관찰되었으며 지방적이 감소하고 rER이 팽창된 이행세포는 2주째 출현하여 4주에 가장 현저히 증가되었다. 섬유아세포는 3주부터 나타나기 시작하였는데, rER이 확장되었으며 지방적은 없거나 1-2개의 소적이 세포돌기에서 관찰되었다. 섬유화가 진행됨에 따라 이행세포 및 fat-storing cell은 감소하고 섬유아세포는 증가된 상태를 유지하였다. 이상의 결과로 보아 fat-storing cell은 간섬유화 과정에서 활성화되고 증식하여 형태학적으로 이행세포 및 섬유아세포로 전환함으로써, 정지상태에 있는 섬유아세포의 전구체로서 간섬유화에 중요한 역할을 하는 것으로 사료된다.

• 대한의생명과학회지
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• 제18권3호
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• pp.237-243
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• 2012

This study was undertaken to know the effect of fat diet (for eight weeks) on changes of inflammatory markers [tumor necrosis factor (TNF-${\alpha}$) and prostaglandin $E_2$ ($PGE_2$)] and blood coagulation system [platelet aggregation function (PAF), prothrombin time (PT), activated partial thromboplastin time (aPTT)] in rats. Serum TNF-${\alpha}$, $PGE_2$, biochemical markers, PAF, PT, aPTT, and body weight were measured and compared between the control (normal diet-rats) and the fat group (fat diet-rats). The weights in the fat group were higher than those of the control group. TNF-${\alpha}$, $PGE_2$, glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and creatinine levels were greater in the fat group compared with the control group. The degree of platelet aggregation was lower, whereas PT and aPTT levels were longer in the fat group than in the control group. These findings have shown that fat diet may cause inflammatory response, diabetes, liver and renal dysfunction, and disturbances of fibrinolysis and coagulation system.

• 대한수의학회지
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• 제23권1호
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• pp.57-67
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• 1983

The present study was carried out to observe the histopathological changes in the mammary gland of lactating rats and rabbits injected with dexamethasone. White rats were intramuscularly injected with 0.25mg, 0.5mg or 1.0mg of dexamethasone sodium phosphate (containing $9{\alpha}$-fluoro-$16{\alpha}$-methylprednisolone, 5.0mg/ml) daily for 3 to 10 days on the 3rd day after parturition and white rabbits were intramammary infused with 4mg or 20mg of dexamethasone daily for 4 days on 7th day after parturition. The histopathological changes of the mammary glands, ovaries and adrenal glands of rats and rabbits were observed with light microscope. In the mammary glands of rats, the microscopic findings encountered were decrease of the milk in the alveolar lumina, necrosis and desquamation of epithelial cells, atrophy of alveoli, proliferation of fibroblasts and thickness of alveolar walls, destruction of alveoli, presence of fat droplets within the glandular epithelial cells, infiltration of mononuclear cells and proliferation of adipose tissue, which were relative to the dose and duration of injection. Especially, in the cases of the administration of large doses or long duration, there were severe fibrosis and focal necrosis of glandular tissue. In the mammary glands of rabbits, the morphological changes were similar to those findings in the rats. The milk in the alveolar lumina was decreased gradually according to the dose and duration of injection, while milk fat concentration regarded to increase. In the histological findings of ovaries, necrosis of granulosa cellos, vacuolization and necrosis of luteal cells, atrophy and necrotic foci in the corpora lutes were observed. In the adrenal glands, hyperemia, hemorrhage, vacuolization of adrenal cortical cells, necrotic foci and atrophy of adrenal cortex were observed.

• The Korean Journal of Pain
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• 제5권1호
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• pp.117-120
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• 1992

본 통증치료실에서 요통 및 하지 방사통을 호소하는 30세된 남자환자를 보통 시행하는 횟수 보다 많은 경막외강내 스테로이드 주입중에 발생한 양측 무혈성 골두괴사를 경험하였다. 물론 이 환자는 약국이나 한약방 등에서 약명미상의 약물을 경구투여받고 있었으므로 그것(혹시 스테로이드)으로 인한 원인인지 혹은 단순히 경막외강으로 주입된 스테로이드로 인한것인지는 분명하지 않다. 그러나 최근 피부과 질환으로 인한 스테로이드의 장기복용 및 도포로 무혈성 대퇴골두괴사가 종종 보고되고 있으므로 그 원인일수도 있다는 가정하에 통증치료실에 근무하는 종사자들의 주의를 요하는 뜻에서 이 증례를 보고하는 바이다.

• 대한의생명과학회지
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• 제10권4호
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• pp.447-452
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• 2004

This study was designed to investigate the effect of Codonopsis lanceolata extracts on carbon tetrachloride (CCl₄)­induced hepatotoxicity in rats fed high, medium or low fat diet. The liver weight was increased not by the level of fat in diet but by administration of CCl₄. Activities of serum aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were significantly increased by CCl₄, the activities of AST and alanine aminotransferase (ALT) were significantly decreased in case of CCl₄ treatment with C. lanceolata extracts. In high fat diet with CCl₄ administration, the content of total lipid in liver was significantly increased, which was significantly decreased by the administration of C. lanceolata extracts. Administration of C. lanceolata water extracts remarkably prevented the tissue injury such as lipid degeneration, infiltration of inflanunatory cells and necrosis caused by CCl₄, but those methanol extracts did not affect histopathological changes of the liver as water extract. The data suggest that intake of C. lanceolata extracts would prevent lipid accumulation and hepatotoxicity induced by high fat diet and CCl₄ abministratim, and the water extract of C. lanceolata is supposed to be more effective than those methanol extract.

• Archives of Plastic Surgery
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• 제33권3호
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• pp.298-302
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• 2006

Various method of insetting the transverse rectus abdominis myocutaneous flap for breast reconstruction has been reported in literature. The Bostwick's principle is commonly applied, which utilizes contralateral pedicle in a vertical or oblique flap inset position and ipsilateral pedicle in the transverse position. But it is relatively a complex and difficult technique, thus requires a more simplified strategy. We have formulated a new insetting method, in which the contralateral pedicled TRAM flap with an oblique($0^{\circ}-90^{\circ}$) flap inset was carried out. We used this method in 100 cases from July 2001 to June 2003. This maneuver places Hartrampf's zones I and III with good vascularity in the medial side, and zone II in lateral side of breast. Fat necrosis was observed in 14 patients(14%) and of these, only three cases needed surgical excision. This simplified method is easy to learn. Specifically, fat necrosis removal is easy with more tolerable aesthetic results, especially in Asian patients with smaller breasts.