• Clinical and Experimental Reproductive Medicine
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• v.17 no.1
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• pp.57-63
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• 1990

The purpose of this study is to improve fertilization rate in IVF-ET program of patients with male infertility used micromanipulation technique, partial zona dissection (PZD) or micro-insemination by sperm transfer (MIST). The results were as follows 1. The fertilization rate of non-micromanipulated oocytes and micromanipulated (PZD) oocytes were 12.5% (n=2) and 42.2% (n=19), respectively, and showed significant differences between two groups (p<0.05). 2. The fertilization rate of micromanipulated (MIST) oocytes was 30% (n=27). 3. The damage rate of Group 1 (PZD) and Group 2 (MIST) were 15.7% (3/19) and 29.6% (8/27), respectively. 4. One pregnancy resulted following replacement of micromanipulated (MIST) embryos in 4 patients.

• Archives of Plastic Surgery
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• v.41 no.3
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• pp.225-230
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• 2014

The increased application of the da Vinci robotic platform (Intuitive Surgical Inc.) for microsurgery has led to the development of new adjunctive surgical instrumentation. In microsurgery, the robotic platform can provide high definition $12{\times}-15{\times}$ digital magnification, broader range of motion, fine instrument handling with decreased tremor, reduced surgeon fatigue, and improved surgical productivity. This paper presents novel adjunctive tools that provide enhanced optical magnification, micro-Doppler sensing of vessels down to a 1-mm size, vein mapping capabilities, hydro-dissection, micro-ablation technology (with minimal thermal spread-$CO_2$ laser technology), and confocal microscopy to provide imaging at a cellular level. Microsurgical outcomes from the use of these tools in the management of patients with infertility and chronic groin and testicular pain are reviewed. All these instruments have been adapted for the robotic console and enhance the robot-assisted microsurgery experience. As the popularity of robot-assisted microsurgery grows, so will its breadth of instrumentation.

• Molecules and Cells
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• v.41 no.3
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• pp.198-206
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• 2018

Aortic dissection (AD) is a catastrophic disease with high mortality and morbidity, characterized with fragmentation of elastin and loss of smooth muscle cells. Although AD has been largely attributable to polymorphisms defect in the elastin-coding gene, tropoelastin (TE), other undermined factors also appear to play roles in AD onset. Here, we investigated the effects of post-transcriptional control of TE by microRNAs (miRNAs) on elastin levels in aortic smooth muscle cells (ASMC). We found that miR-144-3p is a miRNA that targets TE mRNA in both human and mouse. Bioinformatics analyses and dual luciferase reporter assay showed that miR-144-3p inhibited protein translation of TE, through binding to the 3'-UTR of the TE mRNA. Interestingly, higher miR-144-3p levels and lower TE were detected in the ASMC obtained from AD patients, compared to those from non-AD controls. In a mouse model for human AD, infusion of adeno-associated viruses (serotype 6) carrying antisense for miR-144-3p (asmiR-144-3p) under CAG promoter significantly reduced the incidence and severity of AD, seemingly through enhancement of TE levels in ASMC. Thus, our data suggest an essential role of miR-144-3p on the pathogenesis of AD.

• Journal of Korean Neurosurgical Society
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• v.30 no.10
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• pp.1187-1192
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• 2001

Objective : The lateral extracavitary approach(LECA) to the thoracolumbar spine is known as one of procedure which allows not only direct vision of pathologic lesion, but also ventral decompression, and dorsal fixation of the spine through the same incision. However, some drawbacks of LECA, including the technically- demanding, time-consuming, unfamiliar surgical anatomy and excessive blood loss, make surgeons to hesitate to use this approach. This study is to provide the surgical anatomy of LECA using cadavers, for detailed informations when LECA is considered for the surgery. Methods : We performed the 10 cadaveric studies, 7 male and 3 female, and careful dissection was carried out on right side of thoracolumbar region, except one for thoracic region. The photographs with micro-lens were taken to depict the close-up findings and for demonstrating detailed anatomy. Results : The photographs and hand-drawings demonstrated the relationships among the musculature, segmental vessels and nerve roots seen during each dissection plane. The lateral branches of dorsal rami of spinal nerve and the transverse process were confirmed to be the most important landmark of this approach. Conclusion : We concluded that detailed anatomical findings for LECA through this step-by-step dissection would be useful during operative intervention to reduce the intraoperative complications in LECA.

• Archives of Plastic Surgery
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• v.44 no.4
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• pp.293-300
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• 2017

Background Simulation training is becoming an increasingly important component of skills acquisition in surgical specialties, including Plastic Surgery. Non-living simulation models have an established place in Plastic Surgical microsurgery training, and support the principles of replacement, reduction and refinement of animal use. A more sophisticated version of the basic chicken thigh microsurgery model has been developed to include dissection of a type 1-muscle flap and is described and validated here. Methods A step-by-step dissection guide on how to perform the chicken thigh adductor profundus free muscle flap is demonstrated. Forty trainees performed the novel simulation muscle flap on the last day of a 5-day microsurgery course. Pre- and post-course microvascular anastomosis assessment, along with micro dissection and end product (anastomosis lapse index) assessment, demonstrated skills acquisition. Results The average time to dissect the flap by novice trainees was $82{\pm}24$ minutes, by core trainees $90{\pm}24$ minutes, and by higher trainees $64{\pm}21$ minutes (P=0.013). There was a statistically significant difference in the time to complete the anastomosis between the three levels of training (P=0.001) and there was a significant decrease in the time taken to perform the anastomosis following course completion (P<0.001). Anastomosis lapse index scores improved for all cohorts with post-test average anastomosis lapse index score of $3{\pm}1.4$ (P<0.001). Conclusions The novel chicken thigh adductor profundus free muscle flap model demonstrates face and construct validity for the introduction of the principles of free tissue transfer. The low cost, constant, and reproducible anatomy makes this simulation model a recommended addition to any microsurgical training curriculum.

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.106-111
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• 1996

Purpose : Propose a surgical technique in donor harvesting method in free vascularized proximal fibular epiphysis. Methodology : Concerned about growth potentials of the transplanted epiphysis in our long term results of the epiphyseal transplanted 13 cases more than 4 years follow-up, anterior tibial artery which contains anterior tibial recurrent artery is most reliable vessel to proximal fibular epiphysis which is the best donor of the free vascularized epiphyseal transplantation. In vascular anatomical aspect proximal fibular epiphysis norished by latearl inferior genicular artery from popliteal, posterior tibial recurrent artery and anterior tibial recurrent artery from anterior tibial artery and peroneal artery through metaphysis. The lateral inferior genicular artery is very small and difficult to isolate, peroneal artery from metaphysis through epiphyseal plate can not give enough blood supply to epiphysis itself. The anterior tibial artery which include anterior tibial recurrent and posterior tibial recurrent artery is the best choice in this procedure. But anterior tibial recurrent artery merge from within one inch from bifucating point of the anterior and posterior tibial arteries from popliteal artery. So it is very difficult to get enough vascular pedicle length to anastomose in recipient vessel without vein graft even harvested from bifucating point from popliteal artery. Authors took recipient artery from distal direction of anterior tibial artery after ligation of the proximal popliteal side vessel, which can get unlimited pedicle length and safer dissection of the harvesting proximal fibular epiphysis. Results : This harvesting procedure can performed supine position, direct anterolateral approach to proximal tibiofibular joint. Dissect and isolate the biceps muscle insertion from fibular head, micro-dissection is needed to identify the anterior tibial recurrent arteries to proximal epiphysis, soft tissue release down to distal and deeper plane to find main anterior tibial artery which overlying on interosseous membrane. Special care is needed to protect peroneal nerve damage which across the surgical field. Conclusions : Proximal fibular epiphyseal transplantation with distally directed anterior tibial artery harvesting technique is effective and easier dissect and versatile application with much longer arterial pedicle.

• Reproductive and Developmental Biology
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• v.34 no.3
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• pp.135-141
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• 2010

Embryoid bodies (EBs) generated from human embryonic stem cells (hESCs) include spontaneously induced endodermal lineage cells (ELCs). Activin-A plays important roles in the endoderm differentiation of hESCs. Despite studies on the generation of ELCs from hESCs with treatment of Actvin-A, it was unclear for localization and pattern of ELCs by Activin-A during differentiation of hESCs. Accordingly in this study, we knew that Actvin-A increased the cystic EBs formation, including the highly enriched AFP (endoderm lineage specific marker)-expressing cells in the surface of cystic EBs. To induce the EBs formation from undifferentiated hESCs, cells were transferred onto petri-dish and cultured in suspension condition without bFGF removed hESC media (EB media) for 3 days. Next to investigate the effect of Activin-A, EBs were subsequently cultured in EB media supplement with 100 ng/ml Activin-A for 3 days. After 5~7 days of Activin-A treatment, cystic EBs began to appear which increased in numbers reaching ~60% of initially formed EBs over 5 days. Endoderm lineage marker, AFP were highly expressed and specifically localized at the surface region of cystic EBs comparison with normal EBs. We next attached the cystic EBs onto gelatin-coated plates and cultured for 5 days. In the results of real-time PCR and immunocytochemistry analysis, AFP-expressing cells migrated and localized at the outgrowth region of attached cystic EBs. To obtain the AFP-expressing cells of the outgrowth region, we manually isolated by using micro-dissection and cultured them. These cells strongly express AFP over 70% of isolated cells post re-plating. Here, we first showed an expression pattern of specifically localized ELCs by Activin-A during differentiation of hESCs. From this observation, we could highly purified ELCs from undifferentiated hESCs. Taken together, our system will provide a novel and efficient option to generate ELCs from hESCs.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1675-1679
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• 2014

Objectives: MicroRNAs (miRNAs) are important regulators of many physiological and pathological processes, including tumorigenesis and metastasis. In this study, we sought to determine the underlying molecular mechanisms of metastatic cervical carcinoma by performing miRNA profiling. Methods: Tissue samples were collected from ten cervical squamous cancer patients who underwent hysterectomy and pelvic lymph node (PLN) dissection in our hospital, including four PLN-positive (metastatic) cases and six PLN-negative (non-metastatic) cases. A miRNA microarray platform with 1223 probes was used to determine the miRNA expression profiles of these two tissue types and case groups. MiRNAs having at least 4-fold differential expression between PLN-positive and PLN-negative cervical cancer tissues were bioinformatically analyzed for target gene prediction. MiRNAs with tumor-associated target genes were validated by quantitative reverse transcription-polymerase chain reaction (RT-PCR). Results: Thirty-nine miRNAs were differentially expressed (>4-fold) between the PLN-positive and PLN-negative groups, of which, 22 were up-regulated and 17 were down-regulated. Sixty-nine percent of the miRNAs (27/39) had tumor-associated target genes, and the expression levels of six of those (miR-126, miR-96, miR-144, miR-657, miR-490-5p, and miR-323-3p) were confirmed by quantitative (q)RT-PCR. Conclusions: Six MiRNAs with predicted tumor-associated target genes encoding proteins that are known to be involved in cell adhesion, cytoskeletal remodeling, cell proliferation, cell migration, and apoptosis were identified. These findings suggest that a panel of miRNAs may regulate multiple and various steps of the metastasis cascade by targeting metastasis-associated genes. Since these six miRNAs are predicted to target tumor-associated genes, it is likely that they contribute to the metastatic potential of cervical cancer and may aid in prognosis or molecular therapy.

• Journal of Embryo Transfer
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• v.25 no.2
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• pp.93-96
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• 2010

The isolation of preantral follicles from the ovaries of bovine was performed under mechanical and enzymatic methods. A significant increase in the total number of follicles retrieved was detected when tissue chopper was used. Micro-dissection could supply good quality, larger sized follicles (400 to $700{\mu}m$) but with the lowest yield ($9.0{\pm}1.0$). The isolated preantral and early antral follicles were cultured for 14 days. Follicles isolated by the mechanical method had a greater growth during a culture period than follicles collected enzymatically. Morphologically normal bovine oocytes from early antral follicles after 14 days culture were 59.6% after culture and after 24 h of maturation culture, 12.9% of in vitro-grown oocytes reached the second metaphase. In conclusion, this study showed that mechanical method can be used effectively to isolate intact preantral follicles from bovine ovaries.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.2
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• pp.254-261
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• 2000

Since callus distraction technique was applied clinically for the correction of dentofacial deformity to the patients with hemifacial dysplasia by McCarthy in 1992, many surgeons have tried to apply this method to the maxillofacial region. But this technique has some drawbacks. One of the disadvantages of this technique is extensive scar formation in the facial area, which is a sequelae of extraoral approach for supraperiosteal dissection of the periosteum overlying the mandible. Recently, we have made an effort to perform this technique through intraoral approaches to prevent scar formation on the submandibular area and modified the design of the osteotomy, that is step osteotomy technique, to increase the raw bone surface on both osteotomized segments. The rationale for the application of this step osteotomy technique is to increase the amount of regenerated bone and the length of distraction, to avoid damage of inferior alveolar neurovascular bundle, and to increase initial stability of the splitted segments. Step osteotomy procedure can be done with fine micro-osteotomy saw through subperiosteal tunneling. Extraoral pins should be inserted before making the osteotomy. Since 1994 we have applied this technique at 8 sites In 5 patients with mandibular deficiencies: 2 cases of hemifacial microsomia, 1 case of developmental facial asymmetry and 2 cases of mandibular bony defect. Mandibular elongation have been achieved from 12 to 20mm in length. 1 out of 8 site, we experienced non-union in the case of mandibular body defect. Some skeletal relapse and growth retardation phenomenon have been observed in some cases with the longest follow-up of 48 months.