• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권5호
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• pp.270-277
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• 2023

Objectives: Concha cartilage is recommended for correction of cleft nasal deformities. Morbidities at the donor site have been reported in esthetic rhinoplasty cases. Reports on cleft patients are limited, so we investigated the complications of concha cartilage harvesting using the retroauricular approach in cleft rhinoplasty and their management. Materials and Methods: This was a retrospective review of the charts of 63 patients with cleft deformities who underwent septorhinoplasty with concha cartilage. All cases were harvested using a retroauricular approach. Data on patient demographics, surgery type, amount of cartilage harvested, and complications were gathered. Results: Sixty-three patients were enrolled (21 males and 42 females). The mean age of patients was 20.2±5.9 years. Complications were observed in 6 cases (9.5%) and included delayed wound healing (4.8%), prolonged postoperative pain (1.6%), postoperative paresthesia (1.6%), and prominauris (1.6%). Conclusion: The rate of complications associated with concha cartilage harvesting using a retroauricular approach is low. The use of meticulous surgical techniques, especially hemostasis control and adequate wound dressing, is key to minimizing postoperative complications.

• Archives of Reconstructive Microsurgery
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• 제12권2호
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• pp.112-118
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• 2003

Purpose : Soft tissue defect and exposed tendons and bones with concomitant infection in the foot and lower leg have to be covered with vascularized flap as the one stage treatment. Authors have performed 6 cases of pedicled dorsalis pedis island flaps under the loupes magnification and evaluated the benefits. Materials and methods : From 1994 through 2003, we have performed 6 pedicled dorsalis pedis island flaps for reconstruction of soft tissue defects in the foot and lower leg. The causes were trauma in 3 cases, skin necrosis and secondary infection after Achilles tendon repair in 2 cases and acute osteomyelitis in 1 case. Average age was 38 years and 5 cases were male and 1 female. The results of the procedure was evaluated by survival of the island flap, comfort in putting on shoes and walking, comfort in the donor site, comfort in the recipient site and range of motion of the ankle joint. Results : All pedicled dorsalis pedis island flaps survived except 1. Three cases felt discomfort in the dorsum of foot as the donor site and 1 case of the Achilles tendon ruptured and repaired showed limited dorsiflexion of ankle joint. Conclusion : Nonmicrosurgical pedicled dorsalis pedis island flaps under the loupes magnification are one of the useful treatment methods because procedure is rapid, survival is confident and overall reconstructive results are good.

• Archives of Plastic Surgery
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• 제44권6호
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• pp.502-508
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• 2017

Background Breast-conserving therapy is defined as a breast-conserving wide local excision (WLE) of a mammary tumour combined with postoperative radiotherapy. Immediate restoration of the mammary shape by use of breast reduction techniques (volume displacement) or tissue replacement techniques (volume replacement) is gaining popularity to prevent breast malformation. Methods To date, using the internal mammary artery perforator (IMAP) flap has been suggested for immediate volume replacement after WLE, but has never been evaluated in a published study. Results We applied this flap in 12 women (mean age, 56.1 years) after WLE (mean specimen weight, 46.5 g) of the medial aspect of the breast. Over a median follow-up of 35.3 months (standard deviation, 1.2 months), 4 women needed repeated surgery for dog-ear correction of the donor site. Conclusions In our experience, the use of an IMAP flap was a reliable technique with good cosmetic outcomes after oncoplastic reconstruction. In this series, donor site revision often proved necessary initially, but we showed that this may easily be prevented.

• Archives of Reconstructive Microsurgery
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• 제17권2호
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• pp.94-100
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• 2008

In the past decade, there has been increasing breast reconstructions after mastectomy, and the abdomen has been the gold standard for donor site. TRAM (transverse rectus abdominis myocutaneous), MSTRAM (muscle sparing transverse rectus abdominis myocutaneous), DIEP (deep inferior epigastric artery perforator), SIEA (superficial inferior epigastric artery) flap has been widely used nowadays. Among them, DIEP free flap spares the whole rectus abdominis muscle and anterior rectus sheath resulting in decreased donor site morbidity. Between March of 2006 and February of 2008, six patients had undergone immediate breast reconstructions using DIEP free flap. The mean age of patients was 48.5 years. All patients had unilateral breast reconstructions. We dissected two perforators which were included in the unilateral pedicle. Thoracodorsal artery and its venae comitantes were chosen as recipient vessels. For venous anastomosis, we used the GEM Microvascular Anastomotic Coupler System (Synovis Micro Companies Alliance, Inc., Birmingham, Ala.) in four cases. All flaps were survived completely except one who showed fatty abdomen in old age. She showed repetitive vascular spasm intraoperatively. None of the patients had abdominal hernia, bulge or weakness. We believe that DIEP free flap provides a reliable method for autologous breast reconstruction if the patients are selected appropriately and performed by a skillful surgeon.

• Journal of Chest Surgery
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• 제36권2호
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• pp.101-104
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• 2003

말기 폐기종 환자에 대한 치료로 폐이식이 가장 효과적인 방법으로 받아들여지고 있으나 장기 공여자를 구하기가 쉽지 않고 다른 장기에 비해 비교적 건강한 폐를 얻기가 매우 어려운데다가 키와 몸무게, 흉곽크기 등을 고려한 장기 크기의 적합성을 맞추기는 더욱 힘들다. 공여자의 폐가 절대적으로 부족한 상황에서 일측 폐이식술이 양측 폐이식술에 비해 많이 시행되고 있는 추세이며 수술 결과에 따른 장기 생존율에 있어서도 큰 차이가 없는 것으로 보고되고 있다. 최근에는 폐이식 수술 시 흉곽크기 등을 고려한 장기 크기 측정보다는 기능적 기준으로서 나이, 성별, 키를 변수로 한 예측 총폐활량이 보다 적절한 평가방법으로 받아들여지고 있다.

• 한국사회복지학
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• 제35권
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• pp.1-30
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• 1998

본 연구는 민간 복지 자원의 중요한 한 축으로 기능하는 일반 시민들의 후원 활동과 관련하여 이러한 활동을 수행하는 사람들의 일반적인 특징과 후원 행동 및 그들의 후원 노력(philanthropic effort)의 수준을 파악하고 기술하는 것 그리고 후원 활동에 참여하는 사람들이 나타내는 각기 다른 수준의 후원 노력(philanthropic effort)을 예측하고 설명하는 변수들이 무엇인지를 파악하는 것에 연구의 기본 관심을 둔다. 본 연구는 후원 활동을 하는 사람들 중에서 안정된 직업을 갖는 사람들, 고등 교육을 받은 사람들, 기독교를 종교로 갖는 사람들, 기혼자들의 비중이 큼을 보여준다. 후원활동의 동기에서는 "joy of giving"과 같은 내적 동기를 갖는 사람들의 비중이 큼을 보여준다. 그리고 후원금 활용 신뢰도 및 후원 기관에 대한 만족도 그리고 후윈 활동에의 참여의 적극성 모두에서 대다수가 상당히 긍정적인 이해를 하고 있음을 보여준다. 후원 지속 기간에서는 3년과 4년을 중심으로 정적으로 분포되어 있음이, 그리고 후원금 규모에서도 월 2만원을 중심으로 정적으로 분포되어 있음이 관찰된다. 후원 활동에 참여하는 사람들이 나타내는 개인 후원 노력 비율은 1.2%를 중심으로 정적으로 분포되어 있고 이러한 후원 노력은 소득에 의해 가장 많은 설명을 할 수 있는 데 그 형태가 미국에서의 조사 결과와 마찬가지로 U의 모습을 갖고 있는 것으로 나타났다. 본 연구는 후원 노력이라는 주제에 대한 연구와 논의의 발전을 위해 중요한 기초적 자료가 될 수 있을 것으로 생각된다.

• 한국수정란이식학회지
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• 제10권2호
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• pp.105-113
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• 1995

This study was conducted to examine the efficiency of enucleation and blastomere isolation from recipient oocytes and donor embryos, respectively and to determine the effect of oocyte age and electric voltage on the fusion rate and in vitro development of the fused oocytes in rabbit nuclear transplantation. Immature oocytes collected from ovarian follicles were matured in vivo for 12 h in TCM-199 containing FCS and hormones and in vivo matured oocytes were collected 17 to 18 h post-HCG. The fresh and frozen donor embryos of 8- to 16-cell stage were collected from the oviduct of superovulated does. The proportion of successfully enucleated oocytes was greatly lower in in vitro matured oocytes (42.3%) than that (62.7%) in in vivo matured oocytes The level of cytochalasin B for in vivo matured oocytes did not affect the efficiency of enuleation, but 7.5 $\mu$g /mL cytochalasin B for in vitro matured oocytes showed a high enucleation rate significantly. The isolation efficiency of a single blastomere nucleus did not differ between 8- and 16-cell stage embryos. The percentage of single blastomeres isolated from 16-cell stage fresh embryos after 0.5% pronase treatment was greatly higher at 16-min treatment (94.4%) than at 8-min(78. 1%) and the blastomeres(61.5%) isolated from frozen-thawed embryos after 16-min pronase were significantly fewer than those of fresh embryos. The age of recipient oocytes affected nuclear fusion rate. The reconstituted oocytes fused at 24-h age showed slightly higher fusion rate (77.8%) than those (65.0%)fused at 18-h age. The fusion rate of in vitro and in vivo matured oocytes inserted with fresh blastomere did not differ among electric voltages, but the cleavage rate and development to morula-blastocysts of in vitro matured oocytes was more higher under 0.6 kV/cm than under 0.8 to 1.2 kV/cm, while the cleavage rate and development of in vivo matured oocytes was higher under 0.8 to 1.0 kV/cm than under 1.2 kV/cm. The fusion and cleavage rate fol1owing insertion with frozen-thawed blastomere was not different between the in vitro and in vivo matured oocytes and was similar to those from fresh blastomere insertion.

• Molecules and Cells
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• 제24권2호
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• pp.255-260
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• 2007

Bone marrow (BM) derived mesenchymal stem cells (MSC) are pluripotent cells which can differentiate into osteogenic, adipogenic and other lineages. In spite of the broad interest, the information about the changes in BM cell composition, in particularly about the variation of MSC number and their properties in relation to the age of the donor is still controversial. The aim of this study was to investigate the age associated changes in variations of BM cell composition, phenotype and differentiation capacities of MSC using a rat model. Cell populations were characterized by flow cytometry using light scattering parameters, DNA content and a set of monoclonal antibodies. Single cell analysis was performed by conventional fluorescent microscopy. In vitro culture of MSC was established and their phenotype and capability for in vitro differentiation into osteogenic and adipogenic cells was shown. Age related changes in tibiae and femurs, amount of BM tissue, BM cell composition, proportions of separated MSC and yield of MSC in 2 weeks of in vitro culture were found. At the same time, neither change in phenotype no in differentiation capacities of MSC was registered. Age-related changes of the number of MSC should be taken into account whenever MSC are intended to be used for investigations.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.27-34
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• 2011

Purpose: Anterolateral thigh (ALT) perforator free flap is commonly used because of its various benefits. The author reports important factors of preoperative and perioperative ALT perforator free flap and causes of failure. Methods: 84 patients who were treated with ALT perforator free flap from December 2004 to 2008, and February 2010 to April 2010 were studied. 61 patients were male and 23 were female. The mean age of patients was 51.1. The main cause was neoplasm and the main reconstructive areas were head and neck area. The size of flap was various from $3{\times}4$ to $12{\times}18$ cm. 6 patients received split thickness skin graft at donor site. Preoperative angiography was checked to all patients. Results: Among the 84 patients, partial necrosis of flaps occurred in 4 patients because of atherosclerosis, varicose vein, or inattention of patient, etc. And total flap necrosis in 5 patients because of abnormal vessels of recipient area or delay of operation, etc. One case of serous cyst was found as the complication of donor area. Two cases of skin graft on donor site were done because of suspected muscle compartment syndrome, 4 cases of that because of large flap. Septocutaneous perforators were found in 7 cases. The author couldn't find reliable perforator in 3 cases, ipsilateral anteromedial thigh perforator and contralateral ALT perforator and latissimus dorsi musculocutaneous free flap were done instead of ALT. There was no case which needed reoperation because of the impairment of blood supply, and 3 cases were revised by leech because of the burn injury by a lamp or venous congestion. Conclusion: Although ALT perforator free flap is widely used with its various merits, many factors such as preoperative condition of donor or recipient area, morphology of defect and operating time need to consider to prevent flap necrosis. And operators should need careful technique because septocutaneous perforator is uncommon, and musculocutaneous perforator is common but difficult to dissect.

• Radiation Oncology Journal
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• 제17권2호
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• pp.158-165
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• 1999

목적 : 유방암 환자의 피부 섬유모세포를 이용한 in vitro 배양 실험을 통하여 16 세포집락 비율 분포의 변화를 관찰하여 16 세포집락 비율과 in vitro 세포 노화 및 섬유모세포 공여자의 in vivo 연령과의 연관성을 조사하고자 하였다. 대상 및 방법 :유방암 수술을 받은 3명의 환자로부터 얻은 유방부위 피부를 본 실험대상으로 사용하였다. 각 환자의 유방부위 피부로부터 얻은 피부 섬유모세포 표본의 명칭을 C1, C2, C3a 및 C3b로 분류하였으며 각 표본 공여자의 연령은 C1이 44세, C2는 54세, 그리고 C3a 및 C3b는 동일한 공여자로서 연령은 55세였다. 피부 섬유모세포의 단일세포 부유액은 일차조직 배양법으로 얻었으며 100 개의 세포들을 100m1 의 조직배양 flask에 분주 후 37$^{\circ}C$에서 2주 동안 배양하였다. 5개의 flask에서 배양한 피부 섬유모세포의 16 세포집락 비율을 알기 위하여 crystal violet으로 염색한 후 10 배율의 입체현미경을 이용하여 16개 세포 이상으로 구성된 세포집락수를 1개 이상으로 구성된 세포 집락수로 나눈 수치를 16 세포집락 비율로 나타내었으며 각각 5개의 flask에서 얻어진 16 세포집락 비율 평균치를 각 계대배양에 대한 16 세포집락 비율로 나타내었다. C1, C2의 계대배양 횟수는 각각 12회, 17회 였으며 C3a와 C3b는 14회 계대배양 하였다. 결과 : C1, C2, C3a 및 C3b 피부섬유모세포 모두에서 16 세포집락 비율이 계대배양 횟수의 증가에 따라 감소하는 경향을 보였으며, 집단이배화증가에 따라 감소하였다. 그리고 계대배양 횟수가 증가함에 따라 집단이배화가 증가되는 것이 관찰되었으며 특히 C3a 섬유모세포의 상관계수가 0.954(P=0.0001)로서 가장 강한 상관관계가 있음을 보였다 동일한 지점의 집단이배화에서 16 세포집락 비율이 고연령자인 C3a 공여자보다 저 연령자인 C1 공여자에서 더 높게 나타났다. 결론 : 사람 피부 섬유모세포의 in vitro 배양에서 계대배양 횟수의 증가에 따라 집단이배화는 증가되고, 세포 노화로 인해 16 세포집락 비율은 감소되는 것을 알 수 있었다. 또한 저연령의 피부 섬유모세포일수록 집단이배화 증가에 따른 16 세포집락 비율 감소가 고연령의 경우보다 완만하였다. 따라서 피부 섬유모세포 in vitro 배양에서 관찰되는 16 세포집락 비율은 in vitro 세포노화의 지표로서 유용하며 또한 피부 섬유모세포 공여자의 연령 평가에 이용될 수 있을 것으로 사료된다.