• Title/Summary/Keyword: Recipient

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Arterialized Venous Free Flap at the Insufficient Vascular Recipient Bed in Finger Reconstruction (수지 재건시 불충분한 혈행상태의 수혜부에 시행한 동맥화 정맥 유리 피판술)

  • Lee, Young-Keun;Park, Ki-Tae;Lee, Jun-Mo;Park, Hyuk
    • Archives of Reconstructive Microsurgery
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    • v.21 no.2
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    • pp.131-136
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    • 2012
  • Purpose: Arterialized venous flap is useful for reconstruction of the traumatic soft tissue defect in fingers, but insufficient circulation of the traumatic fingers makes surgeons annoying to use the flap. We have grafted flaps in 7 fingers with insufficient vascular bed hoping to expanded the category of the flap. Materials and Methods: Arterialized venous flap have transplanted in 7 fingers from March 2008 through February 2010 and followed up for 4 to 16 months(average 7.2 months). They were all male with a mean age at the time of surgery was 33. The main injury was crushing in 4 degloving, contact burn and saw injury was I respectively. Time interval from injury to flap transplantation was average 3.1. weeks(3 days to 6 weeks). Designed flap size ranges from $8cm{\times}3.5cm$to $4cm{\times}3cm$. Vessel type of flap was one artery with two veins were 5 cases and one artey with one vein 2. Flap type was cutaneous in 3, tendocutaneous 2, neurotendocutaneous 1 and neurocutaneous 1. The circulation state of recipient site was avascular in 2 cases, insufficiency 3 and tip avascular 2. Results: Arterialized venous flap was complete survived in 2 cases, partial necrosis(less than 10%) 3 and failed in 2. Conclusion: An arterialized venous free flap could be a useful procedure for reconstruction in soft tissue or combined defect of the finger despite an avascular or insufficient vascular beds if the recipient beds were free from infection.

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Effects of stage and quality of embryo, synchrony between donor and recipient and difficulty of transfer on pregnancy rate following non-surgical transfer of frozen-thawed bovine embryos (젖소 동결수정란의 비외과적 이식에 있어서 수정란의 상태 및 이시조건이 수태율에 미치는 영향)

  • Lee, Eun-song;Jo, Choong-ho;Hwang, Woo-suk
    • Korean Journal of Veterinary Research
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    • v.29 no.3
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    • pp.361-371
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    • 1989
  • This study was performed to investigate the effects of stage and quality of embryo, synchrony between donor and recipient and difficulty of transfer on pregnancy rate following non-surgical transfer of frozen-thawed bovine embryos. The results were as follows; 1. The overall pregnancy rate of this experiment was 63.4% and that of heifers(73.1%) was higher than that of cows(46.7%). 2. The pregnancy rates of recipients transferred with morulae, early blastocysts and blastocysts were 50.0%, 64.7% and 71. 4%, respectively. 3. The pregnancy rate of recipients transferred with good embryos(67.9%) was higher than that of recipients transferred with fair embryos(53.8%). 4. The pregnancy rates of embryos transferred to left and right uterine horn were 63.2% and 63.6%, respectively. 5. The pregnancy rate of recipients in estrous synchrony 0(76.2%) was higher than those of recipients in synchrony -1(55.6%) and +1(44.4%). 6. The pregnancy rate of recipients transferred with 2 embryos (71. 4%) was higher than that of recipients transferred with 1 embryo(61.8%). 7. The pregnancy rate of embryos transferred to uterine tip (72.0%) was higher than that of embryos transferred to uterine base(50.0%). 8. Ease of transfer was ranked to a scale of one to three on the basis of increasing difficulty. Transfers ranked as ease score 1 accounted for 77.8% of pregnancies and had higher pregnancy rate than ease score 2(66.7%) or 3(45.5%). 9. The pregnancy rate of recipients with excellent corpus luteum(CL) (70.0%) was higher than those of recipients with good CL(61.1%) or fair CL(61.5) %. In reviewing above results, it was considered that the factors such as embryo stage, embryo quality, estrous synchrony, corpus luteum quality, transfer site within uterus, recipient's parity and ease score affected the pregnancy rate after non-surgical transfer of frozen-thawed bovine embryos.

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Effect of Pretransplant Donor-specific Blood Transfusion on Cardiac Allograft Survival in Rats (실험쥐모델에서 이식전 제공자 전혈 수혈이 이식심장의 생존에 미치는 영향)

  • 서충헌;박만실
    • Journal of Chest Surgery
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    • v.32 no.11
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    • pp.984-988
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    • 1999
  • Background: Donor-specific blood transfusion(DSBT) before organ transplantation has been demonstrated to prolong allograft survival; the mechanism of this effect has remained unclear. Only a few researches have been performed on this subject in our country. Material and Method: To investigate the effect of DSBT, we selected 5 donor recipient combinations using rats of pure strain such as PVG, ACI, and LEW. One ml of donor whole blood was transfused to each recipient through the femoral vein 7 days prior to transplantation. The donor heart was transplanted to the recipient's abdominal vessels heterotopically using modified Ono and Lindsey's microsurgical technique. Five transplantations were done for each combination. Postoperatively, donor heart beat was palpated everyday through the recipent's abdominal wall. Rejection was defined as complete cessation of donor heart beat. Result: The allogeneic heart grafts transplanted from PVG strain to ACI strain(PVG ACI) without DSBT were acutely rejected(mean survival 10.2 days). With pretransplant DSBT, the cardiac allografts in PVG ACI and LEW PVG combinations survived indefinitely(more than 100 days), those in ACI PVG combination survived 12 to 66 days(mean 31.8 days), those in PVG LEW survived 8 to 11 days(mean 10.0 days), and those in ACI LEW survived 7 to 9 days(mean 8.0 days). In brief, DSBT prior to heart transplantation was definitely effective in PVG ACI and LEW PVG combinations and moderately effective in ACI PVG combination, but not effective in PVG LEW and ACI LEW combinations. Conclusion: DSBT prior to heart transplantation showed variable effects, but might prolong cardiac allograft survival indefinitely in some donor recipient strain combinations. The mechanism of this effect should be further investigated.

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A Novel Method of Dermis Graft for Better Outcome (미용적 향상을 위한 진피이식술)

  • Han, Seung-Kyu;Lee, Min-Ah;Yoon, Tae-Hwan;Chun, Kyung-Wook;Lee, Byung-Il;Kim, Woo-Kyung
    • Archives of Plastic Surgery
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    • v.33 no.3
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    • pp.341-346
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    • 2006
  • The two major concerns in skin grafting are poor color match in the recipient site and the donor site morbidity. A new skin graft(dermis graft; deepithelialized split thickness skin graft), was used to minimize these problems. The important aspects of this method involve immediate return of epidermis to the donor site and restoration of the recipient site's epidermis by inducing epithelialization from adjacent skin. From April of 2001 to March of 2004, dermis graft and a conventional split thickness skin graft(STSG) were performed in 53 and 33 patients, respectively. The healing time, the scar condition, and the patients' satisfaction were compared. Regarding the recipient sites, the wounds of the dermis graft(n=53) and STSG(n=33) had reepithelialized after $15.5{\pm}1.9$ and $11.8{\pm}1.6$ days, respectively. The scarring were less severe on the dermis graft in terms of pigmentation, height, and vascularity(p<0.05). No significant difference in pliability was detected. The patients' satisfaction with the dermis graft was also better. Concerning the donor sites, the wounds healed within $7.5{\pm}0.8$ and $12.8{\pm}1.1$ days, respectively. In terms of scar quality and patients' satisfaction, the dermis graft(n=26) showed better results. The dermis graft is superior to conventional STSG both aesthetically and functionally in both the recipient and donor sites.

A Clinical Anatomic Study of Internal Mammary Perforators as Recipient Vessels for Breast Reconstruction

  • Baek, In-Soo;You, Jae-Pil;Rhee, Sung-Mi;Son, Gil-Su;Kim, Deok-Woo;Dhong, Eun-Sang;Park, Seung-Ha;Yoon, Eul-Sik
    • Archives of Plastic Surgery
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    • v.40 no.6
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    • pp.761-765
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    • 2013
  • Background Partially resecting ribs of the recipient site to facilitate easy anastomosis of the internal mammary vessels to free flaps during breast reconstruction can cause chest wall pain or deformities. To avoid this, the intercostal perforating branches of the internal mammary vessels can be used for anastomosis. The purpose of this study was to investigate the location and size of the internal mammary perforator vessels based on clinical intraoperative findings and to determine their reliability as recipient vessels for breast reconstruction with microsurgical free tissue transfer. Methods Twelve patients were preoperatively screened for the presence of internal mammary perforators using Doppler tracing. After modified radical mastectomy was performed by a general surgeon, the location and size of the internal mammary perforator vessels were microscopically investigated. The external diameter was examined using a vessel-measuring gauge from a mechanical coupling device, and the distance from the mid-sternal line to the perforator was also measured. Results The largest arterial perforator averaged 1.5 mm, and the largest venous perforator averaged 2.2 mm. Perforators emerging from the second intercostal space had the largest average external diameter; the second intercostal space also had the largest number of perforators arising from it. The average distance from the mid-sternal line to the perforator was 20.2 mm. Conclusions Internal mammary perforators presented consistent and reliable anatomy in this study. Based on these results, the internal mammary perforators appear to have a suitable diameter for microvascular anastomosis and should be considered as an alternative recipient vessel to the internal mammary vessel.

Social Support, Quality of Life, and the Impact of Social Support on Quality of Life Among Medicaid Recipient with Chronic Illness (만성질환을 가진 의료급여 수급권자의 사회적 지원과 삶의 질: 성별, 질환별, 거주지역별 비교)

  • Lee, Ick-Seop;Hong, Young-Su
    • Korean Journal of Social Welfare
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    • v.57 no.2
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    • pp.71-92
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    • 2005
  • This study investigated social support, quality of life, and the impact of social support on quality of life among medicaid recipient with chronic illness such as hypertension, arthritis, diabetes, and stroke in Dec, 2003(N=221). Subjects were collected using stratified sampling by sex, age, diagnosis, and domicile on national data from National Health Insurance Corporation. Descriptive analysis and regression were performed. Results showed social support and quality of life was very low and social support was different in diagnosis and domicile, and social support, especially emotional support from family members, positively impacted on quality of life. The relationship of the two variables showed the differences in sex, diagnosis and domicile. This study will be used as theoretical bases for enhancing social support and quality of life among medicaid recipient with chronic illness.

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Heterologous Transformation of Saccharomyces cerevisiae by Glucoamylase Gene of Saccharomyces diastaticus (Saccharomyces diastaticus Glucoamylase Gene에 의한 Saccharomyces cerevisiae의 Transformation)

  • Kim, Young-Ho;Jun, Do-Youn;Seu, Jung-Hwn
    • Microbiology and Biotechnology Letters
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    • v.16 no.6
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    • pp.489-493
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    • 1988
  • To obtain a new yeast strain that is able to efficiently produce ethanol from starch, the glucoamylase gene of Saccharomyces diastaticus was transformed into S. cerevisiae without a cloning vector. The competent cells of S. cerevisiae, induced by the treatment of Li$_2$SO$_4$, were transformed with the partial BamHI-digests of chromosomal DNA of S. diastaticus, and the transformants were selected by their abilities to utilize and ferment starch. The transformants, which appeared at a frequency of 8.5$\times$10$^{-7}$, were able to withstand up to 800 ppm of copper sulfate like the recipient and retained the phenotypic expression of the recipient with the exception of the acquisition of STA gene and MAL gene, as regards fermentation of carbohydrates. The enzymatic properties of glucoamylases produced by transformants were very similar to those produced by S. diastaticus as based on optimium pH and temperature.

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Comparison of the second and third intercostal spaces regarding the use of internal mammary vessels as recipient vessels in DIEP flap breast reconstruction: An anatomical and clinical study

  • Seong, Ik Hyun;Woo, Kyong-Je
    • Archives of Plastic Surgery
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    • v.47 no.4
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    • pp.333-339
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    • 2020
  • Background The purpose of this study was to compare the anatomical features of the internal mammary vessels (IMVs) at the second and third intercostal spaces (ICSs) with regard to their use as recipient vessels in deep inferior epigastric artery perforator (DIEP) flap breast reconstruction. Methods A total of 38 consecutive DIEP breast reconstructions in 36 patients were performed using IMVs as recipient vessels between March 2017 and August 2018. The intraoperative findings and postoperative complications were analyzed. Anatomical analyses were performed using intraoperative measurements and computed tomography (CT) angiographic images. Results CT angiographic analysis revealed the mean diameter of the deep inferior epigastric artery to be 2.42±0.27 mm, while that of the deep inferior epigastric vein was 2.91±0.30 mm. A larger mean vessel diameter was observed at the second than at the third ICS for both the internal mammary artery (2.26±0.32 mm vs. 1.99±0.33 mm, respectively; P=0.001) and the internal mammary vein (IMv) (2.52±0.46 mm vs. 2.05±0.42 mm, respectively; P<0.001). Similarly, the second ICS was wider than the third (18.08±3.72 mm vs. 12.32±2.96 mm, respectively; P<0.001) and the distance from the medial sternal border to the medial IMv was greater (9.49±2.28 mm vs. 7.18±2.13 mm, respectively; P<0.001). Bifurcations of the IMv were found in 18.4% of cases at the second ICS and in 63.2% of cases at the third ICS. Conclusions The IMVs at the second ICS had more favorable anatomic features for use as recipient vessels in DIEP flap breast reconstruction than those at the third ICS.

Recipient Vessel Selection in Immediate Breast Reconstruction with Free Abdominal Tissue Transfer after Nipple-Sparing Mastectomy

  • Yang, Sung-Jun;Eom, Jin-Sup;Lee, Taik-Jong;Ahn, Sei-Hyun;Son, Byung-Ho
    • Archives of Plastic Surgery
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    • v.39 no.3
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    • pp.216-221
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    • 2012
  • Background : Nipple-sparing mastectomy (NSM) is gaining popularity due to its superior aesthetic results. When reconstructing the breast with free abdominal tissue transfer, we must readdress the recipient vessel, because NSM can cause difficulty in access to the chest vessel. Methods : Between June 2006 and March 2011, a total of 92 women underwent NSM with free abdominal tissue transfer. A lateral oblique incision was used for the nipple-sparing mastectomy. For recipient vessels, the internal mammary vessels were chosen if the mastectomy flap did not block access to the vessels. If it did, the thoracodorsal vessels were used. Age, degree of breast ptosis, weight of the mastectomy specimen, and related complications of the internal mammary vessel group and the thoracodorsal vessel group were compared. Results : Thoracodorsal vessels were used as recipient vessels in 59 cases, and internal mammary vessels in 33 cases including 4 cases with perforators of the internal mammary vessels. Breast reconstruction was successful in all cases except one case involving a total flap failure, which was replaced by a silicone gel implant. The internal mammary group and the thoracodorsal group were similar in terms of age, height, breast weight, and degree of ptosis. The flap related complications such as flap loss and take-back operation rates were not significantly different between the two groups. The rate of nipple necrosis was higher in the internal mammary group. Conclusions : The thoracodorsal vessels could produce comparable outcomes in breast reconstruction after nipple-sparing mastectomies. If access to internal mammary vessels is difficult, the thoracodorsal vessel can be a better choice.

Reconstruction of the Lower Extremity Using Free Flaps

  • 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.