• Title/Summary/Keyword: Revascularization

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The Usefulness of Transcutaneous Tissue Oxygen Pressure ($TcpO_2$) for Determination of the Point of Time at Venous Revascularization (적절한 정맥 재혈류 시점의 판단을 위한 조직산소분압의 유효성)

  • Lee, Eun-Sang;Choung, Jong-Pil;Park, Seung-Ha;Lee, Byung-Il
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.547-554
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    • 2010
  • Purpose: The purpose of this study is to delineate the optimal time of venous revascularization for preventing the flap necrosis due to venous occlusion, and to clarify the usefulness of tissue oxygen pressure ($TcpO_2$) in the determination of the point of time for venous revascularization. Methods: Thirty-six, $3{\times}3\;cm$ sized epigastric island flap was elevated in left abdomen of male Sprague-Dawley rat weighing 250 gram. Flaps were randomly assigned to six groups of six flaps according to the duration of venous occlusion with microvascular clamp; 10 minutes in the group I as the control, 60 minutes in the group II, 2 hours in the group III, 3 hours in the group IV, 4 hours in the group V, and 6 hours in the group VI, respectively. Just before removal of clamp after flap was reposed in situ, the ratio of $TcpO_2$ (tissue oxygen pressure) of the island flap to that of right abdomen was calculated in each group, and tissue specimen was harvested from the distal area of the flap for histological evaluation of vascular change. Five days later, survival area of the flap was estimated, and evaluated the correlation between the tissue oxygen pressure and the rate of flap survival. Results: The $TcpO_2$ and the survival rate of flap were decreased proportionally with the duration of venous occlusion. The ratio of the $TcpO_2$ of the flap is decreased abruptly to below sixty percentile compared to the $TcpO_2$ of normal tissue, and the survived area of the flap is decreased to nine-tenth of the designed size after three hours of total venous occlusion. Histologically, the number of congested vessels was increased according to venous occluded time, and proportionally increased after 3-hours of occlusion significantly. Conclusion: There is a close correlation between the $TcpO_2$ and the survival rate of flaps according to the duration of venous occlusion. Therefore, the $TcpO_2$ represents the hemodynamic changes within the flap, and thought to be an alternative effective tool in the flap monitoring for venous revascularization.

A Retrospective Study on the Treatment of Dens Evaginatus for the Last 5 Years (최근 5년간 시행된 치외치 치료에 대한 후향적 연구)

  • Jonghwa, Lim;Gimin, Kim;Jaesik, Lee;Soonhyeun, Nam;Hyunjung, Kim
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.2
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    • pp.158-169
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    • 2022
  • The purpose of this study was to analyze treatment methods, results, timings and clinical signs and symptoms in failed cases of each treatment method of dens evaginatus on the premolar areas. In this study, 151 patients and 417 teeth were included. Resin restoration and direct pulp capping as preventive treatment and pulp revascularization, apexification and conventional endodontic treatment as endodontic treatment were included for treatment methods. In the preventive resin restoration, successful results were shown in the intact tubercles and also effective when the tubercles were fractured. In the direct pulp capping, resolved clinical symptoms and growth of the roots were shown when there was only pain during chewing without apical lesion. Apical lesion was the most common pretreatment signs and symptoms of the pulp revascularization, apexification and conventional endodontic treatment. In the pulp revascularization, successful results was obtained in most cases. But in some cases, root length or root wall thickness was not increased. Effective results were shown both of the apexification and conventional endodontic treatment. In order to increase success rate of preventive treatment of dens evaginatus, resin restoration was required to be done when tubercle did not occluded or in the presence of intact tubercles. When tubercle was fractured, root development stage and pulp condition should be considered for successful treatment.

Cognitive Outcome of Pediatric Moyamoya Disease

  • Shim, Kyu-Won;Park, Eun-Kyung;Kim, Ju-Seong;Kim, Dong-Seok
    • Journal of Korean Neurosurgical Society
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    • v.57 no.6
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    • pp.440-444
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    • 2015
  • Quality of life is the current trend and issue for the most of human diseases. In moyamoya disease (MMD), surgical revascularization has been recognized as the possible assistance to reduce the neurological insult. However, the progressive nature of the disease has been invincible so far. To improve the quality of life of MMD patients not only the protection from the neurological insult but also the maintenance or improvement of cognitive function is inevitable. For pediatric MMD patients, younger age or longer duration of disease is the key factor among the prognostic factors for bad neurological outcomes. Hence, 'the earlier, the better' is the most precious rule for treatment. Protection from neurological insult is very critical and foremost important to improve cognitive outcome. Clinicians need to know the neuropsychological profile of MMD patients for the care of whole person and make an effort to protect the patients from neurological insults to maintain or improve it.

Effects of Polyphosphate on Skin Wound Healing in Rabbits (토끼 피부창상 치유에 있어서 Polyphosphate의 효과)

  • 이광인;한정희;채수경;김홍렬;이창훈;정성목;서강문
    • Journal of Veterinary Clinics
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    • v.20 no.2
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    • pp.198-206
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    • 2003
  • The purpose of the present study was to investigate the effect of polyphosphate on healing of skin wound in rabbits. Four skin wounds of 8mm in diameter were induced bilaterally(4 wounds/rabbit) on the dorsolateral aspect of the trunk of 15 male New Zealand white rabbits. Ten percent polyphosphate(poly P) type 25, 10% poly P type 35, 10% poly P type 25+10% poly P type 35 and 0.85% sterile saline solution were applied on the wound area and examined grossly and histopathologically. The rate of wound contraction and histopathological changes after poly P application on the skin wound were investigated. In gross findings, the wound contraction rates of 10% poly P 25 group were significantly decreased from day 2 to day 7 after operation than those of 0.85% sterile saline solution treated group (p < 0.01). Although the hemorrhage and inflammation were observed on days 3, 6 and 9 after operation in all groups, but in 10% poly P 25 was gradually decreased. Revascularization and reepithelialization were seen 3, 6 and 9 days after operation in all groups, especially in 10% poly P 25 was formed completely on 9 days. Fibroplasia were seen 3. 6 and 9 days after operation in all groups, especially in 10% poly P 25 was compact than other groups on 9 days. The results suggested that polyphosphate, especially 10% poly P 25 would be effective on healing of skin wound in rabbits through decrease of would contraction rate, increase of revascularization, reepithelialization and fibroplasia.

Transmetacarpal Replantation and Revascularization (중수골 부위 절단상(transmetacarpal amputation)에 시행한 재접합술)

  • Kim, Joo-Sung;Song, Keum-Young;Jun, Deuk-Soo;Kim, Hye-Oh;Baek, Goo-Hyun;Chung, Moon-Sang
    • Archives of Reconstructive Microsurgery
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    • v.7 no.2
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    • pp.95-101
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    • 1998
  • From march 1993 to march 1998, twenty consecutive transmetacarpal replantations and revascularizations were reviewed retrospectively. Nine patients sustained severe and diffuse crush injuries, four patients had local crush injuries, and seven suffered guillotine type amputation. Six replantations and fourteen revascularizations were performed. 76 of 81 replantable digits(93%) were salvaged. 15 patients required secondary surgery, 10 patients for tendon and joint scarring and 5 for nonunions or malunions. Intrinsic muscle function and pinch and grip strengths were weak or absent. According to Chen's grading system of functional return, 2(10%) were grade I, 6(30%) were grade II, 10(50%) were grade III, and 2(10%) grade IV. The follow-up period ranged from 6months to 46 months. Only 3 patients resumed his prior occupation(one as a supervisor); 2 were permanently disabled, 4 pursued new occupations as a manual worker, 1 were still in therapy. Only two of the manual laborers were able to return to their preinjury occupation. Despite these unacceptable functional results, all patients were satisfied with the surgery.

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Long Segmental Reconstruction of Diffusely Diseased Left Anterior Descending Coronary Artery Using Left Internal Thoracic Artery with Extensive Endarterectomy

  • Heo, Woon;Min, Ho-Ki;Kang, Do Kyun;Lee, Sung Kwang;Jun, Hee Jae;Hwang, Youn-Ho
    • Journal of Chest Surgery
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    • v.48 no.4
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    • pp.285-288
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    • 2015
  • In coronary artery bypass grafting, a diffusely diseased left anterior descending coronary artery (LAD) is an obstacle to achieving complete revascularization, consequently leading to the possibility of a poor prognosis. Long segmental reconstruction with or without endarterectomy is a revascularization method for treating diffusely diseased coronary arteries. Herein, we report a successful case of long segmental reconstruction of a diffusely diseased LAD using a left internal thoracic artery onlay patch after endarterectomy.

Coronary three vessel disease: hydrodynamic simulations including the time-dependence of the microvascular resistances

  • Harmouche, Majid;Anselmi, Amedeo;Maasrani, Mahmoud;Mariano, Chiara;Corbineau, Herve;Verhoye, Jean-Philippe;Drochon, Agnes
    • Advances in biomechanics and applications
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    • v.1 no.4
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    • pp.279-292
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    • 2014
  • This paper presents some simulations of fluxes and pressures in the coronary network, in the case of very severe coronary disease (several stenoses on the left branches and total occlusion of the right coronary artery). In that case, coronary artery bypass graft surgery is the commonly performed procedure. However, the success of the intervention depends on many factors. Modeling of the coronary circulation is thus important since it can help to understand the influence of all these factors on the coronary haemodynamics. We previously developed an analog electrical model that includes the eventual presence of collateral flows, and can describe the different revascularization strategies (two grafts, three grafts, ...). The aim of the present work is to introduce in our simulations the time-dependence of the coronary microvascular resistances, in order to better represent the effect of the systolic ventricular contraction (which induces an elevation of the resistances because the vessels are squeezed).

Superior Gluteal Artery-pedicled Iliac Crest for the Treatment of Avascular Necrosis of Femoral Head (상둔 동맥 혈관경 후방 장골릉 골 이식을 이용한 대퇴골 두 무혈성 괴사의 치료)

  • Lee, Sang-Uk;Song, Seok-Whan;Suh, Yoo-Jun;Park, Seung-Bum
    • Archives of Reconstructive Microsurgery
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    • v.17 no.1
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    • pp.42-47
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    • 2008
  • Introduction: To evaluate the efficacy of superior gluteal artery-pedicled iliac crest for the treatment of avascular necrosis of femoral head. Material & Method: From January 2001 to October 2001, we used the superior deep branches of superior gluteal artery for the pedicled posterior iliac crest bone graft to revascularize the avascular femoral head in 4 patients. They were 1 man and 3 women, and the mean age of the patients was 34 years (range, 27 to 60). The average follow-up after surgery was over 57 months (range, 15 to 82). We analyzed the clinical results by the Harris hip score, and evaluated the vascularity of the femoral head by radiographic methods. Results: All cases showed no evidence of collapse on femoral heads and good revascularizations on the radiographic images. The average Harris hip score was 88.5 points. There was no complication. Conclusion: The revascularization procedure using the superior gluteal artery-pedicled posterior iliac crest was thought to be one of the effective and promising techniques for the treatment of the avascular necrosis of femoral head.

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Coronary Revascularization without Extracorporeal Circulation -Two Case Reports (체외순환을 사용하지 않은 관상동맥 우회술 -2례 보고-)

  • 홍종면;전용선
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1132-1135
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    • 1997
  • We have experienced two cases of coronary revascularization without extracorporeal circulation in a 63 year old female patient and a 75 year old male patient. The first patient had the lesion which was the nearly total occulusion of mid-LAD, about 90% luminal narrowing of second diagonal branch and less than 50% stenosis of proximal RCA. The other male patient had a single vessel disease involving about 95% stenosis of proximal LAD and 1st diagonal branch. PTCA failed in the irst patient because of relatively long sinus pause during procedure In both of the patients, the coronary revascularizations were done at distal LAD and diagonal branch using left internal mammary artery and saphenous vein graft under the beating state, respectively. The postoperative courses were uneventful and the patients were discharged without any complications.

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Descending Thoracic Aorta to Bilateral Femoral Artery Bypass in a Hostile Abdomen

  • Lee, Hong-Kyu;Kim, Kun-Il;Lee, Won-Yong;Kim, Hyoung-Soo;Lee, Hee-Sung;Cho, Sung-Woo
    • Journal of Chest Surgery
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    • v.45 no.4
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    • pp.257-259
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    • 2012
  • Descending thoracic aorta to femoral artery bypass has been used as a remedial operation after aortic or axillofemoral graft failure or graft infection and other intra-abdominal pathologies not amenable to standard aortofemoral revascularization. It can avoid abdomen approach and has been known as a durable procedure with excellent long-term patency. We reported descending thoracic aorta to femoral artery bypass grafting for primary revascularization in a 55-year-old male with hostile abdominal conditions.