• Title/Summary/Keyword: Vascular anatomy

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Rare Vascular Anomalies in the Femoral Triangle During Varicose Vein Surgery

  • Kim, Duk Sil;Kim, Sung Wan;Lee, Hyun Seok;Byun, Kyung Hwan;Choe, Michael SungPil
    • Journal of Chest Surgery
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    • v.50 no.2
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    • pp.99-104
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    • 2017
  • Background: We observed several cases of rare vascular anomalies within the femoral triangle during varicose vein operations. Methods: From among 2,093 patients who underwent stripping operations of the great saphenous vein between January 2002 and June 2016, 14 cases of rare vascular anomalies were enrolled in this study. Results: Twelve cases of femoral artery and vein transposition (0.57%), 1 case of separate entrance of the great saphenous vein trunk and its tributaries (0.05%), and 1 case of separate entrance with femoral artery and vein transposition (0.05%) were observed. The preoperative diagnosis rate was 71% (10 of 14) using duplex ultrasound. In all cases of femoral artery and vein transposition, the saphenofemoral junction was located at the lateral or posterolateral side of the superficial femoral artery, corresponding to complete or incomplete transposition, respectively. Among the 12 cases of femoral artery and vein transposition, 5 cases were complete transposition and 7 cases were incomplete transposition. In 2 cases of separate entrance of the great saphenous vein trunk and its tributaries, the separated tributaries formed a common trunk before connecting to the femoral vein. Conclusion: The anatomy of the saphenofemoral junction may infrequently be altered in some individuals. Detailed preoperative sonographic examinations and meticulous groin dissection during the operation are necessary to prepare for unexpected anatomical variations.

The Value of Preoperative Multidetector Computed Tomography for Deep Inferior Epigastric Artery Perforator Free Flap (심하복벽동맥 천공지 유리피판에서 술전 MDCT의 유용성)

  • Heo, Chan Yeong;Hong, Ki Yong;Yoon, Chang Jin;Eun, Seok Chan;Baek, Rong Min;Minn, Kyung Won
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.140-146
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    • 2009
  • Purpose: Autologous breast reconstruction with abdominal tissue is one of the best options after mastectomy. In a free transverse rectus abdominis myocutaneous(TRAM) or deep inferior epigastric artery perforator(DIEP) flap, a preoperative evaluation of the precise location of perforating vessels and vascular run - off systems is required. The objective of this report is to demonstrate the usefulness of multidetector computed tomography(MDCT) in the preoperative planning of patients undergoing breast reconstruction with abdominal flap. Methods: From June 2006 to January 2008, 28 patients underwent MDCT evaluation before breast reconstruction. All subjects were females with an age range of 30 to 55 years. The CT scan was performed using a 64 - slice MDCT scanner(Brilliance 64; Philips Medical Systems, Best, Netherlands). Results: One perforator or two major perforators were marked on image in good relation with a hand - held Doppler examination and intraoperative findings. All vascular run - off systems were cleared before operation. Conclusion: Preoperative evaluation of perforator arteries with MDCT angiography is beneficial in patients undergoing breast reconstruction. This technique provides a noninvasive approach of the vascular anatomy of the entire anterior abdominal wall.

Ginsenosides Inhibit HMGB1-induced Inflammatory Responses in HUVECs and in Murine Polymicrobial Sepsis

  • Lee, Wonhwa;Ku, Sae-Kwang;Jeong, Tae Cheon;Lee, Sangkyu;Bae, Jong-Sup
    • Bulletin of the Korean Chemical Society
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    • v.35 no.10
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    • pp.2955-2962
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    • 2014
  • Asian ginseng is used as a treatment for cardiovascular diseases, ischemia, and cancers. High mobility group box 1 (HMGB1) protein acts as a late mediator of severe vascular inflammatory conditions. However, the effect of ginsenosides from Asian ginseng on HMGB1-induced inflammatory responses has not been studied. We addressed this question by monitoring the effects of ginsenoside treatment on lipopolysaccharide (LPS) and cecal ligation and puncture (CLP)-mediated release of HMGB1, and HMGB1-mediated regulation of proinflammatory responses. Ginsenoside treatment suppressed LPS-mediated release of HMGB1 and HMGB1-mediated cytoskeletal rearrangements. Ginsenosides also inhibited HMGB1-mediated inflammatory responses. In addition, ginsenosides inhibited the production of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) and activation of protein kinase B (Akt), nuclear factor-${\kappa}B$ (NF-${\kappa}B$), and extracellular-regulated kinases (ERK) 1/2 by HMGB1. Ginsenosides also decreased CLP-induced release of HMGB1, production of interleukin (IL) $1{\beta}/6$, and mortality. These results suggested that ginsenosides may be potential therapeutic agents for treatment of vascular inflammatory diseases through inhibition of the HMGB1 signaling pathway.

Differentiation of Reaction Tissues in the First Internode of Acer saccharinum L. Seedling Positioned Horizontally (수평으로 위치한 은단풍(Acer saccharinum L.) 유식물의 제1절간에 있어서 반응조직의 분화)

  • 강경덕
    • Journal of Plant Biology
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    • v.35 no.3
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    • pp.211-217
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    • 1992
  • In order to elucidate the formation of reaction tissues during the transition from primary to secondary growth, the developmental anatomy was conducted in the first internode of Acer sacchan'num seedling in horizontal position. During the transition from primary to secondary growth, tension wood(gelatinous fiber) was gradually developed on the upper side only, And the tension wood formation in the upper side of the horizontal first internode proceeds acropetally from base to apical portion. Some of the anatomical features of tension wood start to be in the primary vascular tissue and a typical tension wood show during the secondary growth, Therefore, the procambium seems to respond to the gravity as well as vascular cambium. For this reason, both procambium and vascular cambium has to regard as the same meristem, On the other hand, the upper side vessels were longer than those of the lower side in the horizontal first internode. The lateral-wall pitting of vessel elements, however, showed no differences between upper and lower sides which have alternate type. The width and height of rayon the upper side of horizontal first internode was larger as compared with the lower side.r side.

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대추나무 미친병에 관한 연구(II) -엽 유관속구조에 미치는 해부학적 영향에 대해서-

  • 홍순우
    • Journal of Plant Biology
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    • v.3 no.2
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    • pp.29-34
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    • 1960
  • From the view point of phytopathological anatomy, the author has tried to study the effect of the shoot cluster disease virus on the internal structure of vascular tissues of chinese date tree (Ziziphus jujuba var. inermis Rehd.) comparing healthy checks and diseased plants. The materials were collected at the several sites, Kumgock-Ri, Masuc-Ri, Kyungi-Do, and near the campus of Korea University and around the area of Chongam-Dong, Seoul City, from August 15th to September 5th 1959. The leaf materials of healthy and diseased plants are fixed and aspirated in two kinds of killing solutions, formalin-acetic acid alcohol solution and Craf III solution. Sections were cut at 5-10$\mu$ thickness and stained with the double staining reagents of safranin and fast green. In this experiment the author has observed that there are marked structural changes in the infected plants in contrast of healthy checks. As figures 3-7 show that the following characteric changes have taken place on infected plants: 1) the arrangement of irregularly developed sieve elements in phloem, 2) the degeneration of phloem elements, 3) the irregular arrangement of epidermis in mid-vein, 4) more necrosis is observed among the parenchymatous cells, 5) abundant accumulatin of starch grains in parenchymatous cells, . In contrast to the above irregularities caused by the virus disease, the healthy checks appear normal structures as shown in figures 1 and 2. In adding to the all features noted above, the author could also observe an interesting feature that the xylem elements in mid-vein vascular bundle tissues are considerably disorganized to show the unspecialized vessel elements, the irregularly arranged xylem elements. However, this kind of irregularities which occur in xylem under the virus infection has not been reported previously. The features noted on the internal structure of vascular bundle under the condition of infection by the shoot cluster disease on chinese date trees appear to be more or less closely similar to the symptoms of the bunchy-top of banana and the yellow dwarf disease of barley in respect to the fact that whether phloem necrosis takes place as a primary symptom or a secondary symptom. In all these disease, primary histological changes of hypoplasia and hypertrophy are preceeded by the necrosis of phloem.

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Free Vascularized Fibular Transfer with Double Barrel Fashion (혈관부착 생비골 중첩 이식술)

  • Chung, Duke-Whan
    • Archives of Reconstructive Microsurgery
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    • v.7 no.1
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    • pp.54-61
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    • 1998
  • Free vascularized fibular is the most usuful bony donor of the long bone reconstruction in reconstructive microsurgical field. It has many benifits such as very strong strut tubular bone, very reliable vascular anatomy with large vascular diameter with long pedicle, minimal donor site morbity too. In that situations of the huge long bone defects in distal femur or proximal tibia, the defective bony shape and strength of the transplanted fibular bone is not enough if only one strut of the fibula is transfered. The bony circulation of the fibula has two ways, one from nutrient artery via peroneal artery through nutrient foramen which makes endosteal arterial network inside of the fibula, another way is periosteal network through outside encircling vascular network of the bone which distributed in muscle sleeves of the fibular diaphysis. Authors modified free vascularized fibular bone graft with transverse osteotomy is made from the anterolateral aspect of the fibular shaft just distal to entry of the nutrient artery. This produces two vascularized bone struts that may be folded pararell to each other but that remain connected by the periosteum and muscle cuff surrounding the peroneal artery and veins. The proximal strut is vascularized by both a periosteal and endosteal blood supply, whereas the distal strut is vascularized by a periosteal blood supply alone. This procedure can call "doule barrel" free vascularized fibular graft. We performed 7 cases of doule barrel fashined fibular transplantation on distal femur and proximal tibial large defects. Average bone union time takes 7 months from that procedure. There were no significant bone union time differences between both proximal and distal struts. After solid union of the transfered double barrel fibular graft, there were no stress fracture in our series. We can propose double barrel free vascualized fibular graft is usuful method in that cases with very large bone defect on large long bones especially metaphyseal defects.

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Sensory Bearing Scapular Free Flap (감각 유리견갑피판술)

  • Chung, Duke-Whan
    • Archives of Reconstructive Microsurgery
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    • v.7 no.1
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    • pp.20-27
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    • 1998
  • Among many kinds of introduced free flaps, scapular freeflap is one of the most popularly using modalities in fasciocutaneous defect coverage with minimal donor defect and easier procedure and constant vascular patterns of the donor. Many surgeons who had experience of this flap pointed out deficit of the reliable sensation of the transplanted flap is the main shortcoming of the scapular free flap. If we can subjugate that point, scapular free flap is the most excellent procedure in such a cases as heel pad reconstruction and hand reconstruction which are relatively important to have skin with protective sensation. Author performed anatomical literature review, 10 cadaveric dissections and 12 clinical dissections. In surgical anatomical aspect, the upper six dorsal rami of the thoracic nerves have medial branches which pierce Longissimus thoracis and Multifidus muscle with small cutaneous twigs which pierce Latissimus dorsi and Trapezius muscle. Among that cutaneous twigs, several twigs distribute to the skin of the back from midline to lateral aspect which territory is identical to scapular free flap. We analysed clinical experiences of that sensory bearing scapular free flap surgical anatomy and one year follow-up studies with several results. 1) Two to three cutaneous twigs which pierced from the Trapezius muscle over the scapular free flap region. 2) Each twigs has two to four nerve fascicles with small artery. 3) The nerve distributed to the ordinary scapular free flap and large enough size and pedicle length to neurorrhapy with various recipient site nerves. 4) The inconvenience of this procedure is the vascular pedicle and nerve pedicle have opposite directions, vascular pedicle of that comes from lateral direction from subscapular vessels, but nerve pedicle comes from medial direction from trapezius muscle. Author can found constant cutaneous nerve branches which come from piercing the Trapezius. This nerves are helpful for protective sensation in transplanted scapular free flap. We can't had enough follow-up and evaluation of the nerve function of this procedure, we need continuous research works to application of this procedure. The in conveniences come from directional differences of pedicle can solve with longer harvest neural pedicle and change direction of the neural pedicle.

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Successful Treatment of Duodenal Variceal Bleeding with Coil-Assisted Retrograde Transvenous Obliteration: A Case Report (코일을 이용한 역행성 경정맥 폐색술에 의한 십이지장 정맥류 출혈의 성공적 치료: 증례 보고)

  • Se Jin Park;Young Hwan Kim;Ung Rae Kang;Seung Woo Ji
    • Journal of the Korean Society of Radiology
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    • v.81 no.1
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    • pp.231-236
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    • 2020
  • Duodenal varices can develop in patients with portal hypertension secondary to liver cirrhosis. Although upper gastrointestinal bleeding is often severe and fatal, the definite treatment or guideline has not been established. Although endoscopy is the primary therapeutic modality, the use of radiologic interventions, such as transjugular intrahepatic portosystemic shunt, balloon or vascular plug-assisted retrograde transvenous obliteration, and percutaneous transhepatic variceal obliteration, can be considered alternative treatment methods for duodenal varices. Herein, we report a case of duodenal varix in a patient with poor hepatic functional reserve and vascular anatomy, which are contraindications for an occlusion balloon or a vascular plug, successfully treated with coil-assisted retrograde transvenous obliteration.

Experimental Studies on the Hair Growth Activity of Drynariae Rhizoma Extracts in C57BL/6N Mice (C57BL/6N 생쥐에서 골쇄보(骨碎補) 추출물을 이용한 발모(發毛)효과에 대한 실험적 연구)

  • Jung, Suk-Young;Jung, Il-Kook;Kim, Dae-Keun;Jo, Han-Young;Jung, Han-Sol;Lee, Chang-Hyun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.2
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    • pp.453-461
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    • 2007
  • Drynariae Rhizoma has been used for promotes mending of the sinews and bone, tonifies the kidney for such symptoms as weak low back and knees, and stimulates the growth of hair as a tinctute for alopecia in oriental medicine. This experiment examined the effect of an acetone extracts of Drynariae Rhizomas(GSB-1), its EtoAc fraction(GB-2) and n-buOH fraction(GSB-3), on hair growth activity of the C57BL/6L mice after topical application to skin. First, We examined on hair growth activity of extracts of Drynariae Rhizomas compare to control and 1 % minoxidil groups. Second, We investigated on the number of hair follicle and mast cells after topical application of extracts of the Drynariae Rhizomas to skin for 16 day. Third, We investigated immunoreactive density of vascular endothelial growth factor(VEGF), protein kinase C-${\alpha}$(PKC-${\alpha}$) and stem(mast) cell factor(SCF) in skin of C57BL/6N mice by immunohistochemical methods. The results were as follows : Hair growth effect of acetone extracts of Drynariae Rhizomas, its EtoAc fraction and n-BuOH fraction was observed in 98 %, 96 % and 60 % in hair removed skin area in 16 day respectively, Immunoreactive density of VEGF in skin of GSB-1 group was weakly stained compare to control group in 10 day, But GSB-2 and GSB-3 groups were mildy stained in bulge and root sheath of skin. Immunolocalization of SCF antigens was observed weakly stained density in epidermis, bulge, stem cells and dermal papilla of control gruop. but in experimental group, immunoreactivity of SCF antigens was observed mildly stained density in bulge, epidermis and root sheath of GSB-1 gruop, heavily stained density in epidermis, bulge and root sheath of GSB-2 and GSB-3 groups to the hair removal skin of C57BL/6N mice on day 10. These experiment suggest that acetone extracts of Drynariae Rhizomas and its EtoAc fraction may be used for topical treatment of alopecia areata.

Morphological and Anatomical Evaluation of Grafted Pinus merkusii

  • Susilowati, Arida;Iswanto, Apri Heri;Wahyudi, Imam;Supriyanto, Supriyanto;Siregar, Iskandar Z
    • Journal of the Korean Wood Science and Technology
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    • v.44 no.6
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    • pp.903-912
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    • 2016
  • Morphological and anatomical evaluation of grafted P. merkusii have been undertaken to obtain the information about compatible and incompatible symptoms of 18 years old grafts based on morphological observation and microscopic analysis. Samples of compatible and incompatible grafts were obtained from previous research conducted by the Silviculture Departement Team in 1994. Result showed that compatible grafts have normal stem form and secondary growth (diameter growth), but some abnormality symptoms like undulated pattern of annual growth rings, phloem thickening and abnormality resin ducts in inner and middle parts of the union area occurred. Incompatible ones showed abnormality of the stem form, cortex-bark necrosis and swelling in the union area. Microscopic observation showed abnormality of all parts of the union, undulated pattern of annual growth rings, phloem thickening, abnormal resin ducts, low numbers and discontinuity of vascular elements in the union area.