• Title/Summary/Keyword: Microvascular

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Alterations in the Activities of Antioxidant Enzymes of Human Dermal Microvascular Endothelial Cells Infected with Orientia tsutsugamushi

  • Koh, Young-Sang
    • Journal of Microbiology
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    • v.39 no.2
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    • pp.142-145
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    • 2001
  • Changes in the Activities of several antioxidant enzymes in transformed human dermal microvascular endothelial Cells (HMEC-1) by infection with the obligate intracellular bacterium Orientia tsutsugamushi, the causative agent of scrub typhus, were investigated. The activities of glucose-6-phosphate dehydrogenase, catalase, and glutathione peroxidase were significantly decreased in HMEC-1 cells infected with Ο. tsutsugamushi. However, the level of superoxide dismutase increased slightly. Furthermore, Increased levels of intracellular peroxide was observed in HMEC-1 during infection. These results support the hypothesis that cells infected by this intracellular bacterium experience oxidant-mediated injury that may eventually contribute to cell death.

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Microvascular Decompression for Primary Trigeminal Neuralgia : Short-Term Follow-Up Results and Prognostic Factors

  • Tucer, Bulent;Ekici, Mehmet Ali;Demirel, Serkan;Basarslan, Seyit Kagan;Koc, Rahmi Kemal;Guclu, Bulent
    • Journal of Korean Neurosurgical Society
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    • v.52 no.1
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    • pp.42-47
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    • 2012
  • Objective : The aim of this prospective study was to demonstrate the influence of some factors on the prognosis of microvascular decompression in 37 patients with trigeminal neuralgia. Methods : The results of microvascular decompression (MVD) in 37 patients with trigeminal neuralgia were evaluated at 6 months after surgery and were compared with clinical and operative findings. Results : The sex of the patient, the patient's age at surgery, the side of the pain, and the duration of symptoms before surgery did not play any significant roles in prognosis. Also, the visual analogue scale (VAS) of the patient, the duration of each pain attack, and the frequency of pain over 24 hours did not play any significant roles in prognosis. In addition, intraoperative detection of the type of conflicting vessel, the degree of severity of conflict, and the location of the conflict around the circumference of the root did not play any roles in prognosis. The only factors affecting the prognosis in MVD surgery were intraoperative detection of the site of the conflict along the root and neuroradiological compression signs on preoperative magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA). Conclusion : These findings demonstrated that if neurovascular compression is seen on preoperative MRI/MRA and/or compression is found intraoperative at the root entry zone, then the patient will most likely benefit from MVD surgery.

Morbidity of the Foot as a Free-Flap Donor Site (유리 피판 공여부로서 족부의 이병률)

  • Lee, Kwang-Suk;Wie, Dae-Gon;Han, Sang-Won
    • Archives of Reconstructive Microsurgery
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    • v.6 no.1
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    • pp.39-46
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    • 1997
  • The methods of clinical applications of the foot as a free-flap donor site includes microvascular toe-to-finger transfer, free neurovascular flap transfer, first web space flap transfer, and osteocutaneous free flap transfer. We have evaluated the results of treatment for 35 patients to be undergone a microvascular reconstructive procedure with the foot as a donor site from January 1982 to June 1996. The performed operations were 16 cases of thumb reconstruction with wrap around procedure, 3 cases of tenocutaneous flap transfer, 10 cases of dorsalis pedis flap transfer, 2 cases of first web space free flap and 4 cases of toe-to-finger transfer. The follow up study was 69 months in average. Regarding to the various donor sites, morbidity was divided into five different categories: Cosmesis, Functional loss, Sensory loss, Wound complication, and Pain. According to the results of examination(35 patients), the results was excellent(25), good(9), fair(1), and poor(0). Among the categories, morbidity was higher at cosmesis. The patients under 50 years were better outcome. Among the operative methods from the foot as a donor site, thumb reconstruction with wrap around procedure showed poorest outcomes. So, We conclude that the foot as a free flap donor site is a good source for the microvascular reconstructive surgery. But, Preoperative donor site evaluation, adequate operative technique and post operative management are essential to decrease the morbidity of donor site.

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Microvascular Anastomosis with Non-penetrating Vascular Clips in Head and Neck Free Flap Surgery (두경부 유리피판 수술에 있어서의 비천공성 혈관 클립을 이용한 미세혈관 문합술)

  • Chang, Hak;Minn, Kyung-Won;Kim, Woo-Ram;Shin, Hyun-Woo;Koh, Kyung-Suck
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.57-62
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    • 2005
  • Microvascular anastomosis with suture technique is a basic skill but there are several problems such as stenosis, thrombosis and long operating time. Recently plastic surgeons have developed non-suturing mechanical coupling devices for microvascular anastomosis. The authors applied non-penetrating vascular clips (VCS clips) in the field of free flap surgery of head and neck area. Between August of 2004 and January of 2005, we performed 9 free flaps (16 vessels) using small-sized VCS clips. Four stay sutures were applied first and then VCS clips were placed between sutures about 1 mm apart. Vascular pedicle of free flap included the descending branch of lateral circumflex femoral vessel, thoracodorsal vessel, deep inferior epigastric vessel and cephalic vein. The recipient vessels were the superior thyroid artery, superficial temporal artery, internal jugular vein, external jugular vein, and superficial temporal vein. We performed 13 end-to-end (4 arteries and 9 veins) and 3 venous end-to-side anastomoses. No flap related complication occurred but we applied additional clips or sutures in two cases due to blood leakage after completion of anastomosis. Primary patency rates seemed to be good and more rapid anastomosis could be done than conventional suture technique. Advantages of VCS technique are high patency rate, low thrombogenecity and rapidity. Although the high cost of VCS instrument may be a problem, this clip could be applied safely in microvascular free tissue transfer.

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The Efficacy and Safety of Microvascular Decompression for Hemifacial Spasm in Elderly Patients

  • Jeon, Chul-Jin;Kong, Doo-Sik;Lee, Jeong-A;Park, Kwan
    • Journal of Korean Neurosurgical Society
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    • v.47 no.6
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    • pp.442-445
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    • 2010
  • Objective : The purpose of this study was to examine the efficacy and safety of microvascular decompression (MVD) for hemifacial spasm (HFS) in elderly patients. Methods : Between 1997 and June 2008, 1,174 patients had undergone MVD for HFS at our institute. Among these, 53 patients were older than 65 years. We retrospectively reviewed and compared the complication and the cure rates of these patients with those of younger patients. Results : There were 38 females and 15 males. The mean duration of symptoms of HFS of these patients was 94.6 months (range, 12-360 months), compared with 67.2 months (range, 3-360 months) in the younger group. The overall cure rate in elderly patients who underwent MVD for HFS during this period was 96.2%. Permanent cranial nerve dysfunctions, such as hearing loss and facial palsy, were seen in 2 patients (3.8%, 2/53) in the elderly group and 19 patients (1.7%, 19/1121) in the younger group. The difference in permanent cranial nerve dysfunction between the two groups was not statistically significant. There was no operative mortality in either group. Conclusion : Microvascular decompression is the most effective surgical modality available for the treatment of HFS. Results of this study indicate that such technique can be performed in the elderly without higher rates of morbidity or mortality. Any patient with HFS, whose general health is acceptable for undergoing general anesthesia, should be considered as a candidate for MVD.

Treatment of Intraoperative Thrombosis and Spasm in Free Tissue Transfers Using the Fogarty Catheter (포가티 카테터를 이용한 유리조직 전이술 시 수술 중 혈전 및 연축의 치료)

  • Lee, Seung Ryul;Yun, Young Mook;Oh, Sang-Ha
    • Archives of Plastic Surgery
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    • v.35 no.2
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    • pp.159-164
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    • 2008
  • Purpose: Microvascular free tissue transfer has become a reliable technique for the reconstruction of complex wounds. Occasionally, unexpected intraoperative thrombosis and/or spasm of recipient artery might be annoying problems even for the technically competent microvascular surgeons. If such problems are not treated properly, they will inevitably cause to flap failure. Methods: From January 2006 to February 2007, soft tissue reconstructions by free tissue transfers were performed on 21 patients having complex defects in the lower extremity. Although segmental revision and various pharmacologic agents were repeatedly applied, arterial occlusions were not managed in 6 cases. For removal of thrombi and release of spasm, Fogarty No. 2 or No. 3 catheters were inserted into the lumen to the proximal recipient artery. Its balloon was then inflated after passing through a resistant area. Next, the catheter was gently withdrawn backward. Results: After the Fogarty catheter was inserted two or three times, the pulsatile arterial flow was restored. When the catheter was inserted into the lumen, a feeling of resistance existed in a 5-10cm more proximal portion that could not be easily accessed from the vascular end. After the reestablishment of blood flow, successful anastomoses were achieved and immediate rethrombosis or spasm did not occur. No long-term sequelae associated with balloon trauma to the arterial wall were observed. Conclusion: The use of the Fogarty catheter can be an effective method in treating pedicle thrombosis and spasm. This is a very simple and rapid technique that offers microvascular surgeons another option to increase the success rate of microvascular anastomosis in free tissue transfers.