• 대한두경부종양학회지
• /
• 제28권1호
• /
• pp.50-53
• /
• 2012

Advanced cancer of the oral cavity has been treated with wide excision in conjunction with mandibulectomy and neck dissection. This has resulted in significant mandibulofacial defects with functional and cosmetic significance. Therefore, proper mandibular reconstruction is very important for physiologic and esthetic restoration. The risk factors of free flap reconstruction have been reported including obesity, age, smoking, previous irradiation, and systemic vascular disease. We recently experienced a case of donor site necrosis after fibular osteocutaneous free flap in oral cavity cancer.

• Archives of Reconstructive Microsurgery
• /
• 제21권2호
• /
• pp.153-158
• /
• 2012

Purpose: The first web space of the foot has a similar thickness and skin texture of the pulp of the fingers. Moreover, it has a reliable blood vessel and sensory nerve. The purpose of this study was to evaluate the clinical results of the first web space free flap to reconstruct the pulp of fingers. Materials and Methods: Authors have performed 23 cases of first web space free flap to reconstruct the pulp defect of the fingers between June 2004 and May 2009. The age of the patients ranged from 20 years old to 55 years old. The size of the flap ranged from $1{\times}1.5cm$ to $8.5{\times}2.5cm$. The mean flap area was 5.4 cm2. In 4 cases, we elevated the flap including lateral aspect of the big toe and medial aspect of the second toe. And then we made an artificial syndactyly to reconstruct the pulps on two fingers at the same time. In all cases, we performed 1 digital artery and 1 dorsal vein anastomosis. Every donor site that had a small defect healed spontaneously without any additional operations to cover it. Results: Of this type of surgery 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. There was no severe complication in the donor sites. There was no walking disturbance due to the skin defect of the donor site. The static 2 point discrimination in 11 cases that we could check ranged from 3 mm to 15 mm. Conclusion: The authors believe that the first web space free flap of the foot is a good option for the reconstruction of the pulp of the fingers and it has a minimal donor site morbidity.

• Archives of Plastic Surgery
• /
• 제37권5호
• /
• pp.595-599
• /
• 2010

Purpose: Trochanteric pressure sores management has been improved through the development of musculocutaneous flaps. But it has many drawbacks such as donor site morbidity and functional muscle sacrifice. With the introduction of perforator flap, it is possible to use in every location where musculocutaneous perforators are present. We have reconstructed trochanteric pressure sores using perforator-based flaps from the ascending branch of lateral circumflex femoral artery. Methods: Between May of 2006 and April of 2008, we performed six cases of perforator-based flap from the ascending branch of lateral circumflex femoral artery for the coverage of trochanteric pressure sores. For identifying perforators, a line was drawn from the anterior superior iliac spine to the superolateral border of the patella as the vertical axis, from the pubis to the trochanteric prominence as the horizontal axis. In the lateral aspect of the intersection of these two axes, various flap were designed according to its defects. The flap was raised in the subcutaneous plane above the fascia and the pedicle was traced by doppler and identified. The pedicle was meticulously dissected not to injure the periadventitial tissues and transposed to the defect. The donor site was closed primarily. Results: The mean age of patients was 56.2 years. Four male and two female patients were studied. Five patients were paraplegic. The mean defect size was $6{\times}4\;cm$. The largest flap dimension was $14{\times}7\;cm$. Donor sites were closed primarily without any complications. All flaps survived completely without necrosis, hematoma or infection. There were no recurrence during the follow-up period. Conclusion: Trochanteric pressure sores using perforator-based flap from the ascending branch of lateral circumflex femoral artery can be performed safely and it would be a reliable option for coverage of trochanteric pressure sores with minimal donor site morbidity.

• Archives of Plastic Surgery
• /
• 제41권3호
• /
• pp.277-284
• /
• 2014

Background The most crucial factor in hair transplantation for male pattern baldness (MPB) patients is the efficient utilization of the donor-recipient ratio. However, there is no known factor that scientifically predicts the rate of progression of alopecia or indicates a permanently safe donor area. Methods The study considered 1,008 Korean adult males with MPB; of these, it excluded 56 males with an absence of parietal whorls (PWs). The authors investigated the distance from the vertical bimeatal line (VM) to the PW, from the PW to the upper border of the helical rim (HR), and the distance from the PW to the occipital fringe (OF) in 952 subjects with a PW. Furthermore, we examined the distance from the PW to the OF considering the duration of alopecia and age in 322 subjects with vertex alopecia. Results The distance between the VM and PW varied from 1.5 to 11 cm, with an average distance of 6.25 cm. The PW-HR distance ranged from 3.4 to 17.5 cm, and the average distance was 7.79 cm. The PW-OF distance ranged from 0.5 to 5.5 cm, and the average distance was 2.37 cm. Conclusions For the PW, very large variations existed in the vertical direction. The position of the PW could predict the progression range of the total alopecia of the vertex. Alopecia mostly progresses within 6 cm of the PW toward the occipital side.

• Archives of Plastic Surgery
• /
• 제35권2호
• /
• pp.214-218
• /
• 2008

Purpose: Reconstruction of microtia using costal cartilage graft is commonly used technique nowadays. The chest wall depression at the donor site after the graft, however, has been noticed in many articles. Prevention or correction technique for the depression at the donor site also has been reported and we also have been concerned about the problem. This article is a case report about a new technique preventing chest wall depression after costal cartilage graft. Methods: We selected total 15 microtia patients who visited our clinic, from December 2005 to July 2007. They were 10 male and 5 female patients and the mean age was 11.9 years. The average follow up period was 9.2 months(2 to 15 months). We used 6, 7, and $8^{th}$ costal cartilage for microtia reconstruction. And then we turned over pivot of cartilage resection margin, after bihalving costal cartilage involving about 5-6 cm of $6^{th}$ and $7^{th}$ rib bone. After microtia reconstruction, chest donor sites were evaluated by physical examination and radiography. Results: Postoperative depression at the donor site was much less when the costal cartilage turnover technique was performed. Postoperative physical examination and three dimensional reconstruction CT showed that the rest part of rib bone was turned over and it supported the soft tissue defect during respiration. Conclusion: We expect that the turnover rib bone will not be absorbed after graft, as well as offering mechanical support, compared to the other reports.

• 한국수정란이식학회지
• /
• 제2권1호
• /
• pp.27-32
• /
• 1987

This study was carried out in order to find out better ways for superovuiation and egg collection by checking some factors affecting on donor cows such as iactating and dried, age, season of treatment and sequence of treatment. The results were summarized as follows:1. Number of corpus luteum and collected eggs of eactating and dried doner were 9.8 vs 8.0 and 9.6 vs 7.9,respectively. However, the rate of transferable embryos of lactating doner were higher than that of dried, 82.5% vs 48.1%. 2. The average number of corpus luteum and collected eggs of lactating donors under 7 years of age (6.7 vs lactating 5.3) were slightly lower than those of over 8 years of age (11.1 vs 9.2). But the rate of transferable embryoswas better in under 7 years old donors than over 8 years (81.1% vs 49.3%). were 6.0, 4.8, 1.5, 1.8 and 75%, and those in the summer were 2.9, 3.8, 2.2 and 46.7%, respectively. 3. The average number of corpus luteum was the highest in winter (10.5) and the rate of egg collection was the best in autumn (94.7%). The rate of the transferable embryo was the highest in winter (64.3%). 4. The average number of corpus luteum was the lowest (5.5) in the animals treated six or more superovulating treatments. The rate of egg collection was the best in the third treatment group (90.2%), but it was getting worse after fifth treatment, The rate of transferable embryos was the highest in the second treatment group (94.1%), and it was decreased thereafter.

• Nutrition Research and Practice
• /
• 제17권4호
• /
• pp.597-615
• /
• 2023

Healthy aging can be defined as an extended lifespan and health span. Nutrition has been regarded as an important factor in healthy aging, because nutrients, bioactive food components, and diets have demonstrated beneficial effects on aging hallmarks such as oxidative stress, mitochondrial function, apoptosis and autophagy, genomic stability, and immune function. Nutrition also plays a role in epigenetic regulation of gene expression, and DNA methylation is the most extensively investigated epigenetic phenomenon in aging. Interestingly, age-associated DNA methylation can be modulated by one-carbon metabolism or inhibition of DNA methyltransferases. One-carbon metabolism ultimately controls the balance between the universal methyl donor S-adenosylmethionine and the methyltransferase inhibitor S-adenosylhomocysteine. Water-soluble B-vitamins such as folate, vitamin B6, and vitamin B12 serve as coenzymes for multiple steps in one-carbon metabolism, whereas methionine, choline, betaine, and serine act as methyl donors. Thus, these one-carbon nutrients can modify age-associated DNA methylation and subsequently alter the age-associated physiologic and pathologic processes. We cannot elude aging per se but we may at least change age-associated DNA methylation, which could mitigate age-associated diseases and disorders.

• Clinical and Experimental Reproductive Medicine
• /
• 제44권2호
• /
• pp.111-117
• /
• 2017

Objective: The aim of this study was to evaluate pregnancy outcomes and the live birth rate at 1-year age increments in women aged ${\geq}40years$ undergoing fresh non-donor in vitro fertilization (IVF) and embryo transfer (ET), and to identify predictors of success in these patients. Methods: This retrospective study was performed among women ${\geq}40years$ of age between 2004 and 2011. Of the 2,362 cycles that were conducted, ET was performed in 1,532 (73.1%). Results: The clinical pregnancy rate and live birth rate in women ${\geq}40years$ significantly decreased with each year of increased age (p<0.001). Maternal age (odds ratio [OR], 0.644; 95% confidence interval [CI], 0.540-0.769; p<0.001), basal follicle-stimulating hormone (FSH) levels (OR, 0.950; 95% CI, 0.903-0.999; p=0.047), the number of high-quality embryos (OR, 1.258; 95% CI, 1.005-1.575; p=0.045), and the number of transferred embryos (OR, 1.291; 95% CI, 1.064-1.566; p=0.009) were significant predictors of live birth. A statistically significant increase in live birth rates was seen when ${\geq}3$ embryos were transferred in patients 40 to 41 years of age, whereas poor pregnancy outcomes were seen in patients ${\geq}43years$ of age, regardless of the number of transferred embryos. Moreover, the cumulative live birth rate increased in patients 40 to 42 years of age with repeated IVF cycles, but the follicle-stimulating hormone in those ${\geq}43years$ of age rarely showed an increase. Conclusion: IVF-ET has acceptable outcomes in those < 43 years of age when a patient's own oocytes are used. Maternal age, basal FSH levels, and the number of high-quality embryos and transferred embryos are useful predictors of live birth.

• Kidney Research and Clinical Practice
• /
• 제37권4호
• /
• pp.356-365
• /
• 2018

Background: Woman kidney donors face obstetric complication risks after kidney donation, such as gestational hypertension and preeclampsia. Studies on childbirth-related complications among Asian women donors are scarce. Methods: This retrospective cohort study included woman donors aged 45 years or younger at the time of kidney donation in a single tertiary hospital between 1985 and 2014. Pregnancy associated complications were investigated using medical records and telephone questionnaires for 426 pregnancies among 225 donors. Matched non-donor controls were selected by propensity score and the maternal and fetal outcomes were compared with those of donors. Primary outcomes were differences in maternal complications, and secondary outcomes were fetal outcomes in pregnancies of the donor and control groups. Results: A total of 56 cases had post-donation pregnancies. The post-donation pregnancies group was younger at the time of donation and older at the time of delivery than the pre-donation pregnancies group, and there were no differences in primary outcomes between the groups except the proportion receiving cesarean section. Comparison of the complication risk between post-donation pregnancies and non-donor matched controls showed no significant differences in gestational hypertension, preeclampsia, or composite outcomes after propensity score matching including age at delivery, era at pregnancy, systolic blood pressure, body weight, and estimated glomerular filtration ratio (odds ratio, 0.63; 95% confidence interval, 0.19-2.14; P = 0.724). Conclusion: This study revealed that maternal and fetal outcomes between woman kidney donors and non-donor matched controls were comparable. Studies with general population pregnancy controls are warranted to compare pregnancy outcomes for donors.

• Archives of Plastic Surgery
• /
• 제32권4호
• /
• pp.447-453
• /
• 2005

The coverage of soft tissue defects around the knee joint or upper one third of lower leg presents a difficult challenge to the reconstructive surgeon. Various reconstructive choices are available depending on the location, size and depth of the defect. The authors present their clinical application of a medial sural artery perforator island flap as a useful alternative method for upper one third of lower leg and knee reconstruction. From 2002 to 2004, we operated total 4 patients (total 4 flaps) using the medial sural artey perforator island flap for coverage of the defect on upper one third of lower leg and knee, of 4 patients, 3 patients was men and one was woman. Average patient age was 54.6 years. The largest flap obtained was 10x8cm2. Postoperative follow up of the patients ranged from two to 33 months. In two cases, defects was located on upper one third of lower leg and in other two cases, defects were on the knee. All four cases had bone exposure open wound. In angiography, 2 cases had injured in the anterior tibial artery, 1 case had injured in the posterior tibial artery. There were no diabetes or other vascular disease. All 4 flaps were survived completely, without minor complications such as venous congestion and hematoma. Donor morbidity was restricted substantially to the donor linear scar. There were no functional impairment. As the main advantages of the medial sural perforator island flap, it ensures constant location and reliable blood supply without sacrificing any main source artery or damaging underlying muscle. This procedure is valuable extension of local flap for defect coverage with minimal functional deficit donor site and good aesthetic result on the defect. We consider it as one of the useful methods of the upper one third of lower leg and knee reconstruction.