Ahn, Deok Ki;Lew, Dae Hyun;Roh, Tai Suk;Lee, Won Jai
Archives of Plastic Surgery
/
v.42
no.5
/
pp.619-625
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2015
Background The reconstruction of ankle and heel defects remains a significant problem for plastic surgeons. The following options exist for reconstructing such defects: local random flaps, reverse flow island flaps, and free flaps. However, each of these methods has certain drawbacks. Peroneal artery perforators have many advantages; in particular, they are predictable and reliable for ankle and heel reconstructions. In this study, we report our clinical experience with peroneal artery perforator-based pedicled flaps in ankle and heel reconstructions. Methods From July 2005 to October 2012, 12 patients underwent the reconstruction of soft tissue defects in the ankle and heel using a peroneal artery perforator-based pedicled flap. These 12 cases were classified according to the anatomical area involved. The cause of the wound, comorbidities, flap size, operative results, and complications were analyzed through retrospective chart review. Results The mean age of the patients was 52.4 years. The size of the flaps ranged from $5{\times}4$ to $20{\times}8cm^2$. The defects were classified into two groups based on whether they occurred in the Achilles tendon (n=9) or heel pad (n=3). In all 12 patients, complete flap survival was achieved without significant complications; however, two patients experienced minor wound dehiscence. Nevertheless, these wounds healed in response to subsequent debridement and conservative management. No patient had any functional deficits of the lower extremities. Conclusions Peroneal artery perforator-based pedicled flaps were found to be a useful option for the reconstruction of soft tissue defects of the ankle and heel.
Background Xeroderma pigmentosum (XP) is an autosomal recessive disorder characterized by xerosis, ultraviolet light sensitivity, and cutaneous dyspigmentation. Due to defects in their DNA repair mechanism, genetic mutations and carcinogenesis inevitably occurs in almost all patients. In these patients, reconstruction of cutaneous malignancies in the head and neck area is associated with some challenges such as likelihood of recurrence and an aggressive clinical course. The aim of this study is to discuss the therapeutic options and challenges commonly seen during the course of treatment. Methods Between 2005 and 2015, 11 XP patients with head and neck cutaneous malignancies were included in this study. Demographic data and treatment options of the patients were evaluated. Results The mean age of the patients was 32 years (range, 10-43) (4 males, 7 females). The most common tumor type and location were squamous cell carcinoma (6 patients) and the orbital region (4 patients), respectively. Free tissue transfer was the most commonly performed surgical intervention (4 patients). The average number of surgical procedures was 5.5 (range, 1-25). Six patients were siblings with each other, 5 patients had local recurrences, and one patient was lost to follow-up. Conclusions Although genetic components of the disease have been elucidated, there is no definitive treatment algorithm. Early surgical intervention and close follow-up are the gold standard modalities due to the tendency toward rapid tumor growth and possible recurrence. Treatment must be individualized for each patient. In addition, the psychological aspect of the disease is an important issue for both patients and families.
Kang, Min Jo;Chung, Chul Hoon;Chang, Yong Joon;Kim, Kyul Hee
Archives of Plastic Surgery
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v.40
no.5
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pp.575-583
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2013
Background The aim of lower-extremity reconstruction has focused on wound coverage and functional recovery. However, there are limitations in the use of a local flap in cases of extensive defects of the lower-extremities. Therefore, free flap is a useful option in lower-extremity reconstruction. Methods We performed a retrospective review of 49 patients (52 cases) who underwent lower-extremity reconstruction at our institution during a 10-year period. In these patients, we evaluated causes and sites of defects, types of flaps, recipient vessels, types of anastomosis, survival rate, and complications. Results There were 42 men and 10 women with a mean age of 32.7 years (range, 3-72 years). The sites of defects included the dorsum of the foot (19), pretibial area (17), ankle (7), heel (5) and other sites (4). The types of free flap included latissimus dorsi muscle flap (10), scapular fascial flap (6), anterolateral thigh flap (6), and other flaps (30). There were four cases of vascular complications, out of which two flaps survived after intervention. The overall survival of the flaps was 96.2% (50/52). There were 19 cases of other complications at recipient sites such as partial graft loss (8), partial flap necrosis (6) and infection (5). However, these complications were not notable and were resolved with skin grafts. Conclusions The free flap is an effective method of lower-extremity reconstruction. Good outcomes can be achieved with complete debridement and the selection of appropriate recipient vessels and flaps according to the recipient site.
Jae, Seol A;Ahn, Kun No;Kim, Ji Young;Seo, Je Hoon;Kim, Hyong Kyu;Goo, Yong Sook
The Korean Journal of Physiology and Pharmacology
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v.17
no.3
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pp.229-235
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2013
Among several animal models of retinitis pigmentosa (RP), the more recently developed rd10 mouse with later onset and slower rate of retinal degeneration than rd1 mouse is a more suitable model for testing therapeutic modalities. We therefore investigated the time course of retinal degeneration in rd10 mice before adopting this model in our interventional studies. Electroretinogram (ERG) recordings were carried out in postnatal weeks (PW) 3~5 rd10 (n=23) and wild-type (wt) mice (n=26). We compared the amplitude and implicit time of the b-wave of ERG records from wt and rd10 mice. Our results showed that b-wave amplitudes in rd10 mice were significantly lower and the implicit time of b-waves in rd10 mice were also significantly slower than that in wt mice ($20{\sim}160{\mu}V$ vs. $350{\sim}480{\mu}V$; 55~75 ms vs. 100~150 ms: p<0.001) through PW3 to PW5. The most drastic changes in ERG amplitudes and latencies were observed during PW3 to PW4. In multichannel recording of rd10 retina in PW2 to PW4.5, we found no significant difference in mean spike frequency, but the frequency of power spectral peak of local field potential at PW3 and PW3.5 is significantly different among other age groups (p<0.05). Histologic examination of rd10 retinae showed significant decrease in thickness of the outer nuclear layer at PW3. TUNEL positive cells were most frequently observed at PW3. From these data, we confirm that in the rd10 mouse, the most precipitous retinal degeneration occurs between PW3~PW4 and that photoreceptor degeneration is complete by PW5.
Kim, Suh-Kyung;Kim, Young-Tae;Kim, Sun-Haeng;Rha, Jung-Ryul;Ku, Byung-Sahm
Clinical and Experimental Reproductive Medicine
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v.17
no.2
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pp.115-121
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1990
Ultrasonically guided oocyte collection gradually replaces laparoscope in many IVF center. In present study, we compare the efficacy of both methods in our IVF program. Totally 377 cycles which were undertaken in vitro fertilization treatment were divided into 2 groups. Ultrasonically guided transvaginal follicular aspiration was performed in 188 cycles and laparoscopic follicular aspiration was performed in 189 cycles under local anesthesisa. The mean age for both groups was similar. Follicular recruitment was achieved with human menopausal gonadotropin (hMG) or a com bination of clomiphene citrate and hMG or a combination of FSH and hMG. In the ultrasonically guided aspiration group, 1821 follicles were aspirated with 61.8% of recovery rate (1125 oocytes), 81.5% of embryo transfer rate (145 cycles) and (17%), 26 cases intrauterine pregnancies were estabilished. In the laparoscopic group, 604 follicles were aspirated with 68.7% recovery rate (445 oocytes) and a 79.9% ET rate (127 cycles), 11 cases (8.7%) intrauterine pregnancies were estabilished. A valid comparison of these data is not possible because the 2 groups are dissimilar for factors known to influence oocyte development and recovery. No statistically significant differences could be demonstrated between 2 groups in all but the recovery rate and clinical pregnancy rate, In ultrasound group, the clinical pregnancy rate was significantly higher than that of laparoscope group. The potentially detrimental effect of CO2 pnemoperitonium present during laparoscope but not in ultrasound guided recovery on ova quality may underlie the observed difference in the clinical pregnancy rate between the 2 groups. Ultrasound guided aspiration seems to be as effective as laparoscopy in terms of oocyte retrieval and conception rate. Furthermore, the procedure is simple and inexpensive, it may replace laparoscopy as a method for oocyte collection in most patients who undergo IVF.
Even though maxillary cancer is usually discovered in advanced stage, its regional lymph node or distant metastases are not common comparing to other head and neck cancer. So the result of treatment depends upon local control of the tumor. Because maxillary sinus is anatomically located adjacent to orbit and skull base, it is difficult to remove the tumor completely with sufficient safety margin like in other malignant tumor. Traditionally, surgery including aggressive resection, radiotherapy or both combined therapy have been widely accepted in many institutes, but their results are not still satisfactory. Sixteen cases of maxillary cancer( all squamous cancer, T2 1 case, T3 6 cases, T4 9 cases, mean age 57.2 years) were treated by intraarterial chemotherapy, raditherapy and surgery and followed up retrospectively. 5 year survival rate by Kaplan-Meier method was 51.95%, and orbit, palate or cheek skin could be preserved in many cases and their functional result was good.
Journal of The Korean Society of Clinical Toxicology
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v.7
no.1
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pp.10-18
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2009
Purpose: Carbon Monoxide Poisoning is an important medical emergency in Korea, but the factors leading to its serious manifestation are not well studied. Methods: We conducted a 5-year retrospective study of 98 carbon monoxide poisoned patients who visited the emergency departments of the Medical Center between December 2004 and March 2009. We categorized the patients into those exhibiting only local symptoms (group 1) and those showing systemic symptoms and complications (group 2). We compared the general characteristics as well as the clinical and laboratory findings between both groups. Results: The male to female ratio was 1.18. The most common systemic symptom was a mental change (43.9%), while the most common complication was rhabdomyolysis (31.6%). Poisoned area closed private room in group 2 were 23 (41.8%) cases and burning region in group 2 were 16(29.1%) cases (p=0.956). Individuals who were accidentally poisoned comprised of 43 (78.2%) cases while those that attempted suicidal poisoning comprised 12 (21.8%) cases (p=0.016). The most common symptom at arrival was mental change 33 (60.0%) cases in group 2. The mean time exposed to carbon monoxide was 43$\pm$3.97 hours in group 1 and 55$\pm$10.11 in group 2 (p=0.012). The patient's age, context of poisoning, symptom at arrival, and time exposed to the poison were found to be significant risk factors for complications by logistic regression analysis. Conclusion: Carbon monoxide poisoning is an emergency medical condition and the risk factors involved in the development of serious complications must be evaluated.
Purpose: A number of techniques and materials have been used for periodontal regeneration and bone graft procedures with guided tissue regeneration(GTR) have been suggested as alternatives to osseous surgery in the management of local infra-bony defects. However, the long-term stability and treatment outcome following bone graft procedure of infra-bony defects is poorly documented. The purpose of this study was to assess radiographic change in infra-bony defects over 2 years after bone graft procedures with various graft materials. Material and Methods: Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients showed clinical and radiographic evidence of infra-bony defect(s). 44 sites of 34 patients aged 31 to 69 (mean age 48.3) were treated by bone graft procedure with a bone graft material. Baseline and 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, defect depth, defect angle, bone graft materials) using the paired t-test were examined. Result: We observed $1.15{\pm}1.95\;mm$ of bone fill, $0.40{\pm}1.19\;mm$ of crestal resorption, $1.55{\pm}1.77\;mm$ of defect resolution, and $40{\pm}44%$ of percentage of defect resolution. Deeper initial defect depth, narrower initial defect angle showed significantly greater bone fill, defect resolution, and % of defect resolution. But no significant difference was observed in graft sites and graft materials. Conclusion: If good oral hygiene maintenance and periodic recall check of patients is assured, bone graft procedure using various graft materials is one of the appropriate treatment modality for regenerative therapy of infra-bony defects.
Objective : The purpose of this study is to examine safety of herbal medicine on liver function and compare with western medicine. Method : 303 subjects of skin disease(vitiligo and psoriasis) were chosen at a local oriental medical clinic, and tested with a spot liver function test from Sept 1, 2006 to Dec 31, 2006. Subjects were grouped into untreated, herbal medicine, western medicine, and combination group by treatment record. Total bilirubin, AST, ALT and LDH was compared in each group, odds ratio and regression coefficient was calculated. Results : Subjects comprised of 116 individuals receiving western medication(38.28%), 54 receiving herbal medication(17.82%), 107 receiving combined forms of medication(35.31%), and 26 individuals without any types of medication(8.58%). With the mean age of 37.0 yr. 204 were male(67.3%), 99 were female(32.7%). Comparing variables of liver functions, there was no significant difference between the control and experiment groups. After adjusting potential confounders, monthly $\beta$(SE) of multiple regression -0.009~0.000 for the herbal group, -0.005~0.000 for the western group, and -0.001~0.001 for the combination group. No significant difference between the groups. OR of T-bilirubin were 1.02, 1.05, and 1.04. AST were 0.92, 0.94, and 0.98. ALT were 0.85, 0.99, and 0.97. LDH were 0.96, 1.06, 1.00 for the herbal, western, and combination group, respectively. Conclusion : Comparing with western medication, herbal medication did not cause special ill-effect on the liver function based on liver function tests.
This study was aimed to determine the biometry of genital organs, incidence of gynecological disorders and pregnancy loss in Black Bengal goat (Capra hircus). Genitalia of 118 does were collected from local abattoirs. Biometric parameters of genital organs were measured and gross and histopathological examinations were carried out for detection of abnormalities. For gravid uterus, age of the fetus was determined by measuring crown-rump length. There was no significant difference in the length, width and weight of right and left ovaries (P>0.05). However, the number of follicles between left ($5.3{\pm}2.3$) and right ovaries ($7.4{\pm}2.7$) varied significantly (P<0.05). The mean length of right fallopian tube and uterine horn were not varied with those of left fallopian tube and uterine horn. The length of uterine body, cervix and vagina were $1.3{\pm}0.1cm$, $3.3{\pm}0.5cm$ and $6.8{\pm}1.3cm$, respectively. Overall, 29 (24.6%) genitalia had abnormalities. Fifteen genitalia (12.7%) had ovarian abnormalities including ovaro-bursal adhesions (6.8%), parovarian cyst (5.1%) and follicular cyst (0.9%). Uterine abnormalities were found in 12 genitalia (10.2%) and predominant uterine lesion was endometritis (6.8%) followed by adenomyosis (1.7%), hemorrhagic lesion on endometrial surface (0.9%) and cyst in broad ligament (0.9%). In addition, cyst in fallopian tube (0.9%) and vagina (0.9%) were recorded. The proportion of slaughtered pregnant goats was 15.3% (18/118). The pregnancy wastage was highest in the first month (50.0%) followed by second (33.3%) and third (16.7%) month. It can be concluded that ovaro-bursal adhesions, parovarian cyst and endometritis are the gynecological disorders of major concern in Black Bengal goat.
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