• Title/Summary/Keyword: Microvascular

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Clinical Benefits of Narrow Band Imaging Bronchoscopy in Central Lung Cancer (중심성 폐암 발견에 있어 협대역 내시경의 임상적 유용성)

  • Park, Jin-Kyeong;Jo, Young-Sun;Jang, Sae-Jin;Park, Young-Soo;Choi, Chang-Min
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.1
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    • pp.16-21
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    • 2010
  • Background: Lung cancer is usually diagnosed at an advanced stage, resulting in a poor prognosis. The detection of these lesions at an earlier stage would be a clear benefit to patients. However, it is extremely difficult to detect carcinomatous lesions in the bronchial mucosal sites during a routine bronchoscopy. Methods: This study employed a novel optical technique, known as narrowband imaging (NBI), which allows noninvasive visualization of the microvascular structure of an organ's surface using reflected light. Results: Narrow band imaging was performed on 10 patients who were radiologically suspicious or had a high risk of lung cancer. The median age of the patients was 57.5 years (range, 44~81 years), and 80% of the patients were male. All lesions showed a microvascular proliferation pattern (dotted, tortuous and abruptly ending vessel) on the magnified NBI. Two lesions were confirmed histologically to be adenocarcinoma and the remaining lesions were squamous cell carcinomas. Two lesions were confirmed histologically to be a carcinoma in situ. Conclusion: NBI is a promising and potentially powerful tool for identifying carcinomas at an earlier stage or a central lesion during a routine bronchoscopy examination.

Suggestions for the Effective Intraoperative Neurophysiological Monitoring in Microvascular Decompression Surgery of Hemifacial Spasm (편측성 안면경련 환자의 미세혈관 감압수술에서 효과적인 수술 중 신경계 감시검사를 위한 제안)

  • Lim, Sung-Hyuk
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.3
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    • pp.262-268
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    • 2016
  • Hemifacial spasm is a disease caused by involuntary facial muscles with repeated unilateral convulsive spasms. It involves contraction of multiple muscles at the same time (synkinesia). The pathogenesis appears to be the pressure on the vessel by the facial nerve. This study included hemifacial spasm patients, who received microvascular decompression surgery. Brainstem auditory evoked potential and the examination time were carefully noted when using brain surgical retractor. The facial nerve electromyography tests for the identification of artifacts and EMG waveform when the facial nerve damage, about the importance of the maintenance of anesthesia in the lateral spread response and in a somatosensory evoked potential propose a new method. Based on the above test, it will be more effective.

Factors Related to Fundus Examination in Diabetes Mellitus Patients (당뇨병환자 안저검사 수검 요인)

  • Choi, Joo-Hyuck;Na, Baeg-Ju;Chun, Sung-A
    • Health Policy and Management
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    • v.20 no.1
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    • pp.125-136
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    • 2010
  • Objectives: The purpose of this study is to analyze the proportion of fundus examination of DM patients for preventing microvascular complication and to examine the factors related to fundus examination in DM patients. Methods: This study used 2005 Korean national health and nutrition survey data. We selected all 1,129 diabetes mellitus patients from the data. And we choose 8 factors related to diabetes mellitus patients. These are sex, age group, type of residential area(rural or urban), education level, income level, comorbidity with hypertension, current insulin use, and duration of suffering from DM. We have analysed these factors by whether he had been examined fundus or no through Chi-square and logistic regression analysis. Results: Female DM patients have tendency to get more fundus examination than Male DM patients. And Young patients, patients who live in urban area, well educated patients, high income patients, comorbidity with hypertension, patients have got the insulin injection, patients have long duration of suffering from DM are to get more fundus examination. According to multivariate logistic regression analysis, sex and education level, income level, and duration of suffering from DM, comorbidity with hypertension, patients have got the insulin injection are significant factors on fundus examination for prevent microvascular diabetes mellitus complications. Conclusions and Discussion: We have concluded that physicians and policy makers should consider to fundus examination especially of man and DM patients who have more shorter disease period and low educated patients and low incomed patients and patients who have taken insulin therapy.

Microvascular Anastomosis Using Horizontal Mattress Suture Technique (Horizontal Mattress Suture Technique을 이용한 미세혈관 문합)

  • Woo, Sang-Hyun;Kim, Jeong-Cheol;Jung, Yung-Sik;Choi, See-Ho;Choi, Won-Hee
    • Journal of Yeungnam Medical Science
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    • v.6 no.2
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    • pp.71-78
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    • 1989
  • Horizontal mattress suture technique on microvascular anastomosis of rat(body weight : 200-250gm) femoral artery was evaluated. The present study was conducted to compare the horizontal mattress suture with simple interrupted suture on the suture time, patency rate of the sutured vessels, and the histological changes of surgical site of the vessel wall during wound healing period. The mean suture time of the vessel wall with horizontal mattress suture technique was 15min. 49sec. ${\pm}$ 2.14, which is significantly shorter than that of simple interrupted suture technique. The patency rate of the sutured vessel in both groups was statistically not different each other till post-operative 3rd day but patency rate of horizontal mattress suture was higher than that of simple interrupted suture at post-operative 3rd week. The histological findings such as intimal noss, medial degenention and intimal regeneration were similar in both groups.

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Expression of Vascular Endothelial Growth Factor and Peritumoral Brain Edema in Intracranial Meningiomas (수막종에서 혈관내피성장인자의 발현과 종양주변부 부종)

  • Kim, Tae Young;Park, Jong Tae;Han, Weon Cheol;Moon, Seong Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1222-1227
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    • 2000
  • Objective : Vascular endothelial growth factor(VEGF), an endothelial cell specific cytokine, is a potent angiogenic growth factor implicated in the tumor angiogenesis and increases vascular permeability dramatically. Peritumoral brain edema(PTBE) occurs in 40-60% of meningiomas. Many causative factors have been investigated, but the mechanism of PTBE associate with meningioma is unclear. VEGF has been implicated as one of the causative factors of PTBE. This study was designed to determine whether the extent of VEGF expression is correlated with degree of PTBE in meningiomas. Methods : Meningioma tissue samples from 40 patients(7 men and 33 women, mean age $53{\pm}13years$) who underwent surgery were examined retrospectively for the expression of VEGF immunohistochemically. The extent of PTBE was estimated by using preoperative CT or MRI as an edema index(EI). In addition to VEGF, several causative factors including tumor size, location, histologic type, microvasculature(CD31) were compared with EI. Results : Twenty-six meningiomas demonstrated PTBE, and the other 14 did not. Of the 40 patients of meningiomas, 28 were positive(17 were 1+ and 11 were 2+) for VEGF. The EI increased significantly just as VEGF was strongly expressed(p=0.006). Microvascular proliferation was also closely correlated with the extent of peritumoral brain edema(p<0.05). Conclusion : These data suggest that VEGF expression and microvascular proliferation are closely correlated with PTBE in meningioma.

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Anatomical Review of Latissimus Dorsi Free Flap for Oral Cavity and Facial Reconstruction (구강 및 안면재건을 위한 광배근 유리피판의 해부학적 고찰)

  • Kim, Soung-Min;Jung, Young-Eun;Eo, Mi-Young;Kang, Ji-Young;Seo, Mi-Hyun;Kim, Hyun-Soo;Myoung, Hoon;Lee, Jong-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.6
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    • pp.549-558
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    • 2011
  • The latissimus dorsi myocutaneous flap (LDMF) was initially described at the turn of the century by Tansini et al, and latissimus dorsi myocutaneous free flap (LDMFF) was also first described for the coverage of a chronically infected scalp by Maxwell et al. As a pedicled flap, LDMF has been often used for breast reconstruction and for soft tissue replacement near the shoulder and the lower reaches of the head and neck. LDMFF is a flat and broad soft tissue flap with large-caliber thoracodorsal vessels for microvascular anastomosis. A skin paddle of the LDMFF can be more than $20{\times}40$ cm, so very large defects in the oral cavity and outer facial region can be covered by this LDMFF. Other advantages include consistent vascular anatomy, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with tumor resection. For a better understanding of LDMFF as a routine reconstructive procedure in large defects of the oral cavity and facial legion, anatomical findings must be learned and memorized by young doctors during the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article discusses the anatomical basis of LDMFF with Korean language.

Mandibularl Reconstruction with Various Methods Including Iliac and Fibular Osteocutaneous free Flaps (유리 피판술을 포함한 다양한 방법의 하악골의 재건술)

  • Kim, In Chul;Minn, Kyoung Won;Kim, Chin Whan;Park, Chul Gyoo;Lee, Yoonho;Kim, Suk Wha;Kwon, Sung Tack;Kim, Ji Hyuk;Lee, Min Goo
    • Archives of Reconstructive Microsurgery
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    • v.9 no.1
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    • pp.6-14
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    • 2000
  • Reconstruction of the composite mandibular defect resulting from ablative resection of tumor involved jaw has been challenging task to the plastic surgeon. A wide variety of different techniques were used with limited success until the advent of microsurgery. The high success rate of microsurgical procedures has allowed for significant improvement in both functional and aesthetic results. A variety of free flap donor sites have been used successfully for mandibular reconstruction. Between April of 1991 and August of 1998, 20 mandibular reconstructions were performed for oncologic defects. 4 patients underwent mandibular reconstruction with pectoralis major flap, 3 patients with free nonvascularized bone graft, 1 patient with metal plate. 12 patients underwent microvascular mandibular reconstruction(8: fibula, 4: ilium). The type of free flap was determined by the requirements of the defect. Satisfactory aesthetic and functional results were achieved in all cases without significant complications. So microvascular mandibular reconstruction should be considered as primary choice in all mandibular defect without hesitation.

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Immunohistochemical Evaluation of Angiogenesis Related Markers in Pyogenic Granuloma of Gingiva

  • Seyedmajidi, Maryam;Shafaee, Shahryar;Hashemipour, Golnarsadat;Bijani, Ali;Ehsani, Hodis
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7513-7516
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    • 2015
  • Background: Pyogenic granuloma is a common non-neoplastic connective tissue proliferation. ICAM-1 and VCAM-1 are vascular adhesion molecules and CD34 is a marker for evaluation of angiogenesis. The purpose of this study was to compare the immunohistochemical expression of ICAM-1, VCAM-1 & CD34 in oral pyogenic granuloma and normal gingiva. Materials and Methods: This study was performed on thirty five formalin-fixed, paraffin embedded samples of gingival pyogenic granuloma. Also we used thirty five paraffined blocks of normal gingiva as control group which were taken from crown lengthening surgery. We employed immunohistochemistry staining for our prepared microscopic slides using monoclonal mouse anti-human antibodies against ICAM-1 (CD54), VCAM-1 (CD106) and CD34. Slides were examined under light microscope and then the mean amount of stained vessels also known as microvascular density (MVD) in highly vascularized areas (hot spots) was measured. Paired t-test and repeated measures ANOVA were used to compare the difference between quantitative variables and Chi-square test for qualitative variables in different groups. Pearson correlation coefficient was used to compare relations between quantitative variables. P<0.05 was considered significant. Results: The mean of MVD for ICAM-1, VCAM-1 and CD34 was significantly higher in pyogenic granuloma than normal gingiva (p<0.001 & p<0.001 & p<0.001, respectively). Expression of CD34 in pyogenic granuloma was significantly higher than ICAM-1 and VCAM-1 (P<0.001). Besides, expression of ICAM-1 in normal gingiva, was significantly lower than two other markers (p<0.001). Conclusions: Regarding the results, it seems that ICAM-1, VCAM-1 and CD34 are useful biomarkers in evaluation of vascular and inflammatory lesions such as gingival pyogenic granuloma and the results indicate the role of these biomarkers in pathogenesis of oral pyogenic granuloma.

Evaluation of Thermal Properties for the Far Infrared Therapy After Microvascular Anastomosis for the Treatment of Circulatory Diseases (미세혈관 문합 후 순환계 질환 개선을 위한 원적외선 치료기의 열적 특성 평가)

  • Yang, Young-Kyu;Oh, Seung-Hyun;Kim, Cheol-Woong
    • Transactions of the KSME C: Technology and Education
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    • v.1 no.2
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    • pp.179-186
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    • 2013
  • Far-infrared radiation therapies are becoming more popular for blood circulation disorders, cardiovascular disease, skin diseases, inhibit cancer cell, etc replacing conventional operations. In this research, thermal characteristics of heating part in panel radiators, which is effective on the blood circulation disorders were experimentally analyzed. The heating line supplies heat energy to insulation coatings with heat flux of $150mW/m^2$ in normal status and as a result the coatings reached 20% of the heating line temperature. In other words, the insulation itself could increase surface temperature of heating plates by 20% and raise thermal time constant promote blood circulation effect. We also found that space arrangement of the heating lines was an important factor in designing heating parts and both coefficient of heat conduction and density of the heating plate should be also considered for superimpose of thermal diffusion.

Anterograde Intra-Arterial Urokinase Injection for Salvaging Fibular Free Flap

  • Lee, Dae-Sung;Jung, Sun-Il;Kim, Deok-Woo;Dhong, Eun-Sang
    • Archives of Plastic Surgery
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    • v.40 no.3
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    • pp.251-255
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    • 2013
  • We present a case of a 57-year-old male patient who presented with squamous cell carcinoma on his mouth floor with cervical and mandibular metastases. Wide glossectomy with intergonial mandibular ostectomy, and sequential reconstruction using fibular osteomyocutaneous free flap were planned. When the anastomosis between the peroneal artery of the fibular free flap and the right lingual artery was performed, no venous flow was observed at the vena comitans. Then re-anastomosis followed by topical application of papaverine and lidocaine was attempted. However, the blood supply was not recovered. Warm saline irrigation over 30 minutes was also useless. Microvascular thromboses of donor vessels were clinically suspected, so a solution of 100,000 units of urokinase was infused once through a 26-gauge angiocatheter inserted into the recipient artery just at the arterial anastomotic site, until the solution gushed out through the flap vena comitans. Immediately after the application of urokinase, arterial flow and venous return were restored. There were no complications during the follow-up period of 11 months. We believe that vibrating injuries from the reciprocating saw during osteotomies and flap insetting might be the cause of microvascular thromboses. The use of urokinase may provide a viable option for the treatment of suspicious intraoperative arterial thrombosis.