• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.2
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• pp.220-224
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• 1999

The acrofacial dysostosis(AFD) is a rare heterogenous disorders combining varying severities of mandibulofacial dysostosis(MFD) with pre and/or post axial limb abnormalities. The Nager syndrome is characterized by preaxial limb defects whereas Miller syndrome is characterized by post axial limb defects. Our AFD case is a 14-year old female. She showed malar hypoplasia, cleft lip & palate(Rt, Lt side), wide nasal bridge, telecanthus. Her right thumb was abscent and middle phalanx, radius, carpal bones of right hand were hypoplastic, and metatarsus varus was present. She showed normal stature and intelligence.

• Archives of Craniofacial Surgery
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• v.24 no.6
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• pp.260-265
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• 2023

Background: The traditional nasolabial V-Y advancement flap is widely used for midface reconstruction, particularly for the lower third of the nose and upper lip, as its color and texture are similar to these areas. However, it provides insufficient tissue to cover large defects and cannot restore the nasal convexity, nasal ala, and adjacent tissues. The purpose of this study is to investigate the modified nasolabial V-Y advancement flap with extension limbs the along alar crease for the reconstruction of complex midface defects. Methods: A retrospective analysis of 18 patients, who underwent reconstruction with the modified nasolabial V-Y advancement flap, was performed between September 2014 and December 2022. An extension limb was added along the alar crease, adjacent to the defect area, and was hinged down as a transposition flap at the end of the advancement flap. Results: The extension limb along the alar crease successfully covered large and complicated defects, including those of the ala, the alar rim, the alar base, the nostrils, and the upper lip, with minor complications. Conclusion: The alar crease is a good donor site for the reconstruction of large and complex nasal and upper lip defects.

• Toxicological Research
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• v.19 no.3
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• pp.181-187
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• 2003

Effects of repeated treatment with butylated hydroxyanisole (BHA) on the induction of glutathione S-transferases (GSTs) and teratogenicity of cyclophosphamide were investigated in rats. Pregnant rats were orally treated with BHA (50 mg/kg) for 7 days, from days 6 to 12 of gestation, and intraperitoneally challenged with cyclophosphamide (15 mg/kg) 2 hr after the final treatment. On day 20 of gestation, the maternal and fetal abnormalities were examined. Separately, a part of rats was sacrificed for the assay of hepatic and placental GSTs activities on day 12 of gestation following 7-day treatment with BHA. Cyclophosphamide, administered on day 12 of gestation, induced 43.2% of fetal death and resorption, and 100% of malformations in live fetuses, in contrast to low fetal resorption (8.7%) and malformations (8%) in control group. The malformations include cranial defect and exencephaly (100%), micrognathia and tongue extrusion (100%), limb defects (40%), renal pelvic dilatation (39%), and cleft palate (15%). Interestingly, BHA induced GSTs activities by 62% and 46% over the control in liver and placenta, respectively, and remarkably reduced the fetal resorption (13.9%) and malformations, resulting in 62% of cranial defect and exencephaly, 68% of micrognathia and tongue extrusion, 29% of limb defects, and 14% of renal pelvic dilatation. Taken together, it is suggested that a long-term pretreatment with BHA could substantially prevent fetuses from abortion and malformations following intrauterine exposure to teratogens including cyclophosphamide by inducing phase II antioxidant enzymes such as GSTs.

• Journal of the Korean Society of Clothing and Textiles
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• v.42 no.2
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• pp.298-310
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• 2018

This study examines how to improve clothes according to types of disability and classify related studies. The study method used a literature review along with studies conducted after 2000. According to the results, the types of disability causing difficulty in terms of clothing habits are limb disorders and sensory defects among the types of physical disability. The results of the quantitative measurement on studies indicated that the number of studies increased almost twice as much before 2000. Particularly with the development of new technology and fashion trends, the number of studies on design increased. The topics of studies are found in design development, construction for disabled, and understanding clothing life. The design development topic is about suggesting functional designs that can protect the human body or aid in the use of rehabilitation devices. The construction topic for the disabled is to improve the inconvenience of wearing clothes, particularly for those with limb disorders. Lastly, the topic of examining clothing life is about using new technology to provide individuals with sensory defects with information about clothing life or the current status of the clothing market for the disabled.

• Archives of Plastic Surgery
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• v.44 no.2
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• pp.124-135
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• 2017

Background In cases of total knee arthroplasty (TKA) threatened by potential hardware exposure, flap-based reconstruction is indicated to provide durable coverage. Historically, muscle flaps were favored as they provide vascular tissue to an infected wound bed. However, data comparing the performance of muscle versus fasciocutaneous flaps are limited and reflect a lack of consensus regarding the optimal management of these wounds. The aim of this study was to compare the outcomes of muscle versus fasciocutaneous flaps following the salvage of compromised TKA. Methods A systematic search and meta-analysis were performed to identify patients with TKA who underwent either pedicled muscle or fasciocutaneous flap coverage of periprosthetic knee defects. Studies evaluating implant/limb salvage rates, ambulatory function, complications, and donor-site morbidity were included in the comparative analysis. Results A total of 18 articles, corresponding to 172 flaps (119 muscle flaps and 53 fasciocutaneous flaps) were reviewed. Rates of implant salvage (88.8% vs. 90.1%, P=0.05) and limb salvage (89.8% vs. 100%, P=0.14) were comparable in each cohort. While overall complication rates were similar (47.3% vs. 44%, P=0.78), the rates of persistent infection (16.4% vs. 0%, P=0.14) and recurrent infection (9.1% vs. 4%, P=0.94) tended to be higher in the muscle flap cohort. Notably, functional outcomes and ambulation rates were sparingly reported. Conclusions Rates of limb and prosthetic salvage were comparable following muscle or fasciocutaneous flap coverage of compromised TKA. The functional morbidity associated with muscle flap harvest, however, may support the use of fasciocutaneous flaps for coverage of these defects, particularly in young patients and/or high-performance athletes.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.597-604
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• 2009

Purpose: Compound tissue defects remain a challenge to reconstructive surgeons. The objective of this study was to introduce examples of successful reconstruction of compound defects of the head and neck and upper and lower limbs, using chimeric flaps based on the subscapular vascular system. Methods: We report 19 reconstruction cases using chimeric flaps based on the subscapular vascular system. The scapular flap, scapular fascia, scapular bone, parascapular flap, latissimus dorsi, latissimus dorsi perforator flap, latissimus dorsi myocutaneous perforator flap, serratus anterior, serratus anterior fascia, and rib bone were used as components for chimeric flaps. 12 cases had defects of the upper limb, three in the lower limb, three in the head and neck area, and one case had a defect of the thoracoabdominal wall. Results: Defect sizes ranged from $6{\times}8cm$ to $20{\times}22cm$. The component used most often for skin coverage was the latissimus dorsi perforator flap; for soft tissue bulk, the latissimus dorsi; for fascia coverage, the serratus anterior fascia flap; and for bone reconstruction, the scapular bone flap respectively. All cases were successfully reconstructed without additional operative procedures or flap necrosis. Conclusion: Because it is fairly easy to employ vascular pedicles of sufficient length and diameter, enabling the use of diverse types of tissue with various shapes and sizes, the use of chimeric flaps based on the subscapular vascular system allows one - stage reconstruction tailored to the characteristics of the defect area.

• Archives of Reconstructive Microsurgery
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• v.6 no.1
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• pp.56-62
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• 1997

Latissimus dorsi(LD) muscle is the largest transplantable block of vascularized tissue. Since LD free flap was introduced in 1970's, this flap has been widely used for the reconstruction of large soft tissue defect of the limb. From 1981 to 1996, we had experienced 37 cases of LD free flap. Serratus anterior muscle was combined with LD in three of them whose defects were very large. The average age of the patients was 31 years(range : 4-74 years), and thirty one patients were male. Trauma was cause of the defect in every case. For the recipient sites, the foot and ankle was the most common(22 cases); and the knee and lower leg(11 cases), the elbow and forearm(2 cases), the hand(2 cases) were the next. The duration of follow-up was averaged as 16 months(range: 6 months-12 years). Thirty one cases(84%) out of 37 were successful transplantations. In one case the failure of the flap was due to heart attack and subsequent death of the patient. One failure was caused by sudden violent seizure of the patient who had organic brain damage. Immediate reexploration of the flap was performed in 4 patients, and the flap survived in three of them. There was one necrosis of the grafted split-thickness skin on the survived LD flap. LD free flap was considered as one of the good methods, for the reconstruction of the large soft tissue defect of the limb.

• Archives of Reconstructive Microsurgery
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• v.4 no.1
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• pp.9-15
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• 1995

Free vascularized composite tissue transfer is more frequently underwent for reconstruction of complicated tissue defects with the recent advance of microsurgery. But postoperative result was not satifactory because of donor site morbidity, flap bulkiness and cosmetic problem. So would no longer be a problem if we can obtain the exact donor tissue required for the recipient site as allotransplantation and designing the flap. Allotransplantation has been resolved with the recent development of immunosuppressive agents, while reconstruction has made great progress with the refinement of microsurgical techniques in the last 20 years. The final sucess or failure of the operative procedure in transplantation is so utterly dependent no the availability of strategies that can control the immune system effectively, selectively, safely to allow allotransplantation of a nonvital body part. 1 used 2 strains of rats, BUF and LEW, for the limb allotransplantation as a composite tissue transfer. The primary goal of this program is to improve results in clinical transplantation by accelerating the transformation of new immunological knowledge into useful medicine. Two of the most promising new immunosuppressive compounds are FK-t06(FK) and rapamycin(RPM). Both drugs are antibiotic macrolide fungal fermentation products that presumably suppress the immune system in ways similar to cyclosporin(CyA). This study shows that two new immunosuppressive drugs compare the immunosuppressive activity and effectiveness of FK-506 and RPM for prevention of the limb allograft rejection in the rat. Additional experiments investigate the dose, route of administration and histologic findings. These data demonstrates that rapamycin is far more potent and effective than FK-506 when both compounds are administered by the intraperitoneal route, as well as prolonged graft survival significantly in a dose-route dependent manner. These results lead to the view that vascularized allograft composite tissue transfer can become a reality with the expectation of possible future application in reconstructive surgery of humans.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.273-277
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• 2002

Syndrome of 4q deletion is characterized by an abnormal shape of the skull, craniofacial dysmorphism, cardiovascular malformations, genitourinary defects, limb and digital anomalies, and developmental delay. We experienced a case of 4q interstitial deletion in a 2 day-old female neonate who showed short extremities, partial agenesis of corpus callosum and congenital heart defects. We report the case with a brief review of the literature.

• Neonatal Medicine
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• v.16 no.1
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• pp.85-88
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• 2009

The amniotic band syndrome is an uncommon congenital fetal abnormality, presumably due to fetal entanglement in strands of ruptured amniotic sac. The defects caused by this syndrome vary from simple limb defects to major visceral and craniofacial defects. We cared for a newborn infant with this syndrome, who showed constriction rings of the right leg and right axilla, right club foot, thoracic scoliosis, polydactyly, absence of the right thumb and aplasia cutis of the scalp. We report this case with a brief review of the literature.