• Archives of Plastic Surgery
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• v.36 no.4
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• pp.462-468
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• 2009

Purpose: The liposuction has been generalized & undergone in the field of plastic surgery and it has had a great influence on fat graft. But despite of liposuction and fat injection being performed widely, we did not focus on complication associated with donor site. So we reported satisfactory result with the intraoperative sustained limited expansion & direct closure to donor site tissue necrosis after liposuction and analyzed the cause & measures of donor site necrosis with the literature investigation Methods: From November 2007 to June 2008, we treated four cases of tissue necrosis and infection surrounding the thigh and forearm. Necrosis after liposuction was 1 case, donor site necrosis after fat injection were 3 cases and MRSA was detected in 2 cases. first, we debrided the necrotic tissue and treated with potadine gauze soaking dressing & susceptible antibiotics. After confirmation of healthy granulation tissue, we used intraoperative sustained limited expansion and closed directly of defect & observed the results. Results: The patient was displeased and worried with the unexpected damage concerning the donor site and the procedure concerning time and financial exhaustion, but after confirming no contracture of the scar tissues and only a thin or slightly widened line of scar, showed satisfaction. Conclusion: Because it is fastidious to avoid donor site complication after liposuction & fat injection, enough explanation and understanding on possible complication to donor site are necessary and careful surgery procedure & materials are required. But if donor site necrosis were occurred although close consideration of possible causes of necrosis, we should think about not only wound healing process but also the sequela like scar contracture & cosmetic effect and treat the most adequate method to satisfying both concerns.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.6
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• pp.586-589
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• 2006

Deep circumflex iliac artery (DCIA) flap can be harvested as a composite free flap and is often used to adequately reconstruct wide mandibular defects. However, the harvesting of this DCIA flap can result in severe osseous defect of the donor site causing a morphologic defect in the iliac crest. To reconstruct this defect of the iliac donor site, several innovative techniques using bioactive ceramic spacers, autogenous rib bone, polylactic acid mesh, or titanium plates have been introduced. Nonetheless, these methods have not been widely used due to high cost, secondary donor site morbidity, difficulty of use, and postoperative dissatisfaction. We used two titanium plates to reconstruct the donor iliac site defect at the harvesting time of primary DCIA flap surgery in the 30-year old female with an ameloblastoma in the left mandible. Postoperatively, both iliac sites were relatively balanced and there were few complications. At the 2 years follow-up, there were no specific abnormal radiographic findings and the patient was very satisfied with her esthetic iliac contouring. In our report, we evaluate the effect of two titanium plates on the reconstruction of the iliac donor site in the aspects of esthetics and usefulness. This technique has many advantages, such as reduced cost, simplicity, decreased postoperative pain or discomfort, and improved bilateral balance of both anterior iliac crest contours, especially in young female patients.

• Archives of Reconstructive Microsurgery
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• v.10 no.2
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• pp.75-80
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• 2001

Purpose : We have evaluated the morbidity of donor site after transfer of free fibular osseous and osteocutaneous flap to defect site of bone and soft tissue due to chronic osteomyelitis of long tubular bone, open fracture with bony defect, bone or soft tissue tumor and congenital anomaly. Materials and methods : The 54 cases of 79 cases to be carried out from May, 1982 to May, 2001 which could be followed up were reviewed. There were forty nine in male and five in female. The mean age was 35(4 to 66)years old and mean follow up period is 21.3 month(12 to 72). We have retrospectively analyzed the various postoperative complications such as compartment syndrome, donor site infection, skin defect, hypesthesia, hammer toes, ankle instability and activity of daily living by help of questionnaire, telephone, physical examination, follow up x-ray study and chart. Results : In the total 54 cases the medication period for pain control after operation were classified into three groups under 2 weeks(49 cases), from 2 weeks to 6 weeks(3 cases) and over 6 weeks(2 cases). The postoperative morbidity were occurred in total 12 cases(compartment syndrome: 0, infection : 2, skin defect: 1, hypesthesia: 5, hammer toe: 2 ankle pain: 2 discomfort in activity of daily living: 0), and also the morbidity rates of donor site were 23.5% in osseous flap and 21.6% in osteocutaneous flap were occurred. There was no statistical significonce in morbidity between osseous and osteocutaneous free fibular flap transfer(P>0.05). Discussion : In general the morbidity of free fibular flap transfer was relatively high but it did not have any effect on daily activity of living. We think that the meticulous operation technique, detailed wound care and early range of motion exercise will reduce the morbidity of donor site of flap.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.267-272
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• 2008

Purpose: Donor site seroma is the most common complication of extended latissimus dorsi flap for breast reconstruction. One of preventive treatments is to use the fibrin sealant in donor site before closure. Experimentally, it has been used successfully in the prevention of latissimus donor site seroma, but its clinical efficacy and results were very controversial. Thus, the purpose of this study is to evaluate the clinical efficacy and to determine the optimal dose of fibrin sealant. Methods: A retrospective study was done of patients operated under same surgical conditions by one operator with variable doses of fibrin sealant. The study group consisted of 60 consecutive patients who underwent breast reconstruction with extended latissimus flap reconstructions from January 2005 to December 2006. Patients were divided into 4 group by applied fibrin sealant amount(group 1=0 mL, group 2=1 mL, group 3=2 mL, group 4=4 mL). Retrospective data were obtained from total postoperative drainage amount, time from surgery to drain removal, and incidence and quantity of seroma formation in matched patients group. Results: Total drainage amount decreased relative to the amount of fibrin sealant. The seroma formation rate of 30% in the study group 4 was significantly less than group 1 rate of 71%(p<0.05). It was an improvement over the rates of as much as 79% described previously in the literature. Also, time from surgery to drain removal was shortened significantly in group 4 patients(p<0.05). Conclusion: The use of fibrin sealant in the extended latissimus dorsi flap donor site appears effective in preventing seroma. However, important factors to obtain lower seroma formation rates are proper techniques and proper amounts such as the authors suggested amount: $0.01mL/cm^2$ with spray type fibrin sealant.

• Journal of Periodontal and Implant Science
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• v.36 no.2
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• pp.305-318
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• 2006

This study was performed to evaluate the effect on the formation of keratinized attached gingiva when free gingival graft with strip technique was used. After the partial thickness flap was prepared, it was positioned apically more than 7mm using mucoperiosteal suture. At the donor site, strip was achieved with 2mm width, less than 1mm thickness, (mesiodistal teeth length + 6)$^{\ast}$2 mm length. Then, it was divided into 2 same pieces and located at the recipient bed apico-coronally with more or less 3mm interval. Follow-up check was made at 1,2,4,8,12 weeks after the operation. The results of this study were as follows : 1. The inter-strip space was mostly filled with keratinized attached gingiva. 2. The contraction of the graft was nigligible, and 92% of planned area was filled with keratinized attached gingiva. 3. The inconvenience of the patients at donor site was minimal. 4. The width of the strip was widened. In conclusion, free gingival graft using strip technique is useful to achieve the keratinized attached gingiva maximally with free gingival graft minimally and to minimize the inconvenience of donor palatal site of the patients.

• Journal of Plant Biology
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• v.31 no.3
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• pp.217-226
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• 1988

Effects of simazine [2-chloro-4,6-bis(methylamino)-s-triazine] on the photochemical reactions of isolaed spinach chloroplasts and crude thylakoids of Anabaena inequalis UTEX B-381 were compared. Simazine inhibited photosynthetic O2 evolution and increased the chlorophyll fluorescence in whole cells of Anabaena. The electron transfer from diphenylcarbazide to 2,6-dichlorophenolindophenol was inhibited by simazine treatment in spinach chloroplasts, but not in crude thylakoids of Anabaena. In spinach chloroplasts, the chlorophyll fluorescence was increased by simazine treatment in the presence of diphenylcarbazide and ferricyanide, but not in the presence of diphenylcarbazide and silicomolybdate. In crude thylakoids of Anabaena, simazine treatment did not increase the chlorophyll fluorescence in the presence of either diphenylcarbazide and silicomolybdate, or diphenylcarbazide and ferricyanide. There results suggest that the inhibitory site of simazine on photosynthetic electron transport chain of anabaena is different from that of spinach chloroplasts. And there may be a possiblity that the inhibition site of simazine in Anabaena lies on the donor side of photosystem II, before the site of electron donation by diphenylcarbazide.

• Analytical Science and Technology
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• v.7 no.2
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• pp.225-232
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• 1994

The podands I-VII, acyclic polyethers, expected high extractability for $Ag^+$ against $Pb^{2+}$ were designed and synthesized with high yields. Using podands I-VII as extractants, the %extraction(%Ex) of $Ag^+$ and $Pb^{2+}$ as picrates were determined in water/chloroform systems. The stability constants(log K) for the complexation of $Ag^+$ with podands I-VII were also determined by potentiometry. %Ex($Ag^+$) were proportional to the numbers of substituted sulfur donor atoms. Podand VI(log K : 7.65) having 3 substituted sulfur and podand VII(log K : 9.15) having 4 substituted sulfur, however, exhibited almost 100% of extractability, respectively. In %Ex($Ag^+/Pb^{2+}$, oxygen-sulfur mixed donor podands(IV-VII) showed the higher values. Otherwise, the values of log K and %Ex($Ag^+$) largely depended on the variation of donor-site of sulfur. From the results of NMR experiments, it seems that it is due to the ${\pi}-{\pi}$ stacking interaction between the aromatic end-groups.

• The Korean Journal of Ceramics
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• v.4 no.2
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• pp.68-71
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• 1998

The effect of Mn and Nb additions on the electrical properties of BaTiO$_3$ has been studied by means of equilibrium electrical conductivity as a function of temperature, oxygen partial pressure(Po$_2$) and composition. If the manganese ion is added to the normal Ti site, i.e. BaTi$_{1-x}Mn_xO_{\delta-6}$, the equilibrium conductivity shows strong evidence of acceptor-doped behavior. The conductivity minimum, corresponding to the transition from oxygen excess, p-type behavior to oxygen deficient, n-type behavior with decreasing Po$_2$, is displaced to lower Po$_2$ and is broadened and flattened. The partial replacement of Mn ion with Nb decreases the acceptor-doped effect and the total replacement exhibits a typical donor-doped behavior. It was confirmed that unlike undoped or other acceptor-doped behavior. It was confirmed that unlike undoped or other acceptor-doped samples, for the p-type region, the electrical conductivity follows the 1/6th power dependence of oxygen partial pressure.

• Archives of Plastic Surgery
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• v.33 no.2
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• pp.213-218
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• 2006

As the large defect of peripheral nerve occurs, the autologous nerve graft is the most ideal method but it has many limitations due to donor site morbidities. Various materials have been developed for the nerve defect as the conduits, but none of these materials is satisfactory. Among them, $Gore-Tex^{(R)}$ tube seems to be one of the most ideal nerve conduit materials at peripheral nerve defect. Many researches have focused on finding the neurotrophic factors. It is recently demonstrated that Valproic acid(VPA) has an effect of axonal regeneration as a neurotrophic factor without enzymatic degradation and toxicity problems. The purpose of this study is to evaluate the effect of VPA on the nerve regeneration at the peripheral nerve defect. A 10 mm gap of rat sciatic nerve was made and $Gore-Tex^{(R)}$ tube filled with biceps femoris muscle was placed at the nerve defect site. We let the rat take VPA as drinking water in experimental group and did not give VPA to the control group. We estimated the results as electrophysiologic and histological aspects for 16 weeks after the surgery. The nerve conduction velocity, total myelinated axon count, myelin sheath thickness and mean nerve fiber diameter significantly increased in VPA-treated experimental group when compared to the control (p < 0.05). From the above results, we conclude that VPA promotes the nerve regeneration at the peripheral nerve defect site. It is suggested that $Gore-Tex^{(R)}$ tube filled with skeletal muscle and VPA administration may be a good substitute for autologous nerve graft.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.844-853
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• 1990

We have performed 27 cases of orthotopic homologous cardiac transplantation using Korean mongrel dogs and one case of sham operation for the evaluation of harmful effect of cardiopulmonary bypass itself on the dog from April, 1989 to June, 1990. Our previous reports have already demonstrated basal hemodynamic and hematologic data on the canine homologous heart transplantation and the fundamental principles of transplantation of the heart. The mean body weight of recipients was 13.2$\pm$1.2kg with a rage of 11 ~ 15kg, and the hemodynamic and hematologic pictures were almost same as the result of previous reports from our hospital, except marked decrease in postoperative platelet count[from 3.18 $\pm$0.80x106/mm3 to 1.41$\pm$0 37x 106/mm3]. Mean survival time was 24.82$\pm$49.40 hours with the longest survival of 264 hours. Donor cardiectomy included coronary vasodilatation with diltiazem, potassium arrest, and the rapid cooling of the heart suspending in the specially designed ice-bath. Median sternotomy provided excellent exposure of the surgical field. 6 \ulcorner0 prolene suture was used for the anastomosis of both atrial cuffs and the great arteries, and we found the fact that stenosis, bleeding, thrombus formation around the anastomotic site could be decreased with the use of everted horizontal mattress suture techniques. Immunosuppression was done with a combination of lower dose Cyclosporin-A, Azathioprine, methyl-prednisolone, but our cases still showed too short survival to worry about graft rejection. Still poor was our quality control of experimental animal, we had much difficulties in postmortem evaluation of the dogs. Low cardiac output due to biventricular failure, intractable supraventricular or ventricular tachyarrhythmia, postoperative massive bleeding, sepsis were most frequent findings that could be thought as a cause of death. A few cases showed subendocardial patch hemorrhage in both ventricular cavity or atrial septum at autopsy, suggesting acute subendocardial infarction. Although our team overcome most of the technical problems of orthotopic heart transplantation, we should pile up further knowledges about donor heart preservation, quality control of animal, infection, rejection, the effect of the cardiopulmonary bypass to improve the results.