• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권6호
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• pp.526-530
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• 2009

Recently, the anterolateral thigh(ALT) flap, based on the septocutaneous vessels or musculocutaneous perforators from the descending branch of the lateral circumflex femoral artery has gained popularity in head and neck soft-tissue reconstruction. It has some advantages in free-flap surgery with respect to the radial forearm free flap, such as low donor site morbidity, availability of different tissues with large amounts of skin, adaptability as a sensate or flow-through flap (with the possibility of harvesting a long pedicle with a suitable vessel diameter). Moreover, the thickness of the flap is adjustable until the subdermal fat level, allowing it to be used as a thin or ultrathin flap. This clinical cases are ALT free flap reconstructions without functional impairment of the donor limbs (transitory and permanent) based on anastomosis with superficial temporal arteries and veins in patient of huge resection defect on face, lip and tongue.

• Journal of Chest Surgery
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• 제26권12호
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• pp.920-925
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• 1993

Extra-anatomic bypass was proposed by Freeman in 1952 and has been used for patient with lower extremity arterial occlusion who had very high operative risk, especially elderly or severly illed patient.We had performed 14 cases of extra-anatomic bypasses from Jan. 1991 till July 1993 and having been following up them. Their results were summarized as follow. Among total 14 patients, 13 was male. Their mean age was 64.8 years old, ranged from 48 to 80. The most common complaint was pain on lower limb and they visited hospital 6.1 months in average after onset of symptom. Frequently, they were associated with systemic diseases such as generalized atherosclersis, hypertension, diabetes mellius, etc. Axillary artery was used as donor artery in 8 cases and crossover femoro-femoral or femoro-popliteal bypass was performed in 6 cases. Postoperative complications were notedd in 8 cases so their morbidity rate was 42.8%. Except for two contraindicated cases, one or more anticoagulants were used routinely . Among them, combined use of aspirin and persantine was most commonly applied.After bypass graft, nine cases were occluded beteween 10 and 53 months. So their average duration of freedom from reocclusion was 35.7 months and 3-year patency rate was 63%.

• 대한수의학회지
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• 제50권1호
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• pp.49-53
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• 2010

A 5-year-old female Cocker spaniel dog (body weight 7.0 kg) was presented with primary complaints of exercise intolerance and loud precordial thrill which was noticed since she was a puppy. Physical examination revealed a grade V/VI continuous murmur over the maximal point of the left basal area, bounding femoral pulse, but no differential cyanosis. Tall R waves were detected in electrocardiogram, suggesting left ventricular enlargement. Diagnostic imaging studies showed enlarged left ventricle, bulged descending aorta (dAo), markedly dilated right pulmonary artery, and continuous shunt flow between the dAo and main pulmonary artery. Based on these findings, the dog was diagnosed as left to right shunted patent ductus arteriosus (PDA). The patent ductus arteriosus was treated by lodging a PDA duct occluder via the transvenous approach. Clinical signs were markedly improved after the ductal occlusion, the shunt flow was mildly persistent. The case presented is the first case of PDA occluded by the PDA duct occluder via the transvenous approach in a small breed of dog. Although the residual shunt flow was mildly persisted, the dog was clinically normal without detectable murmurs.

• Journal of Chest Surgery
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• 제33권8호
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• pp.676-680
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• 2000

To minimize the period of brain ischemia and the potential for neurologic damage during aortic arch replacement, we used the arch-first technique. First case was a 28-year-old female with extensive aneurysm involving ascending, arch and descending thoracic aorta. Exposure was obtained via a bilateral via a bilateral thoracotomy (clamshell incision) in the anterior 4th right and 3rd left intercostal space with oblique sternotomy. To prepare for arch perfusion, the side-arm graft(10mm) was anastomosed to the aortic graft, opposite the site of the planned anastomosis to the arch vessels. After completing the arch anastomosis under total circulatory arrest(37min) and retrograde cerebral perfusion(12min), aortic graft was clamped on either side and the arch was perfused via side-arm graft for 36min. When distal aortic anastomosis was finished, distal clamp of aortic graft was released and arch vessels were perfused via common femoral artery, and the proximal aortic anastomosis was accomplished. The patient was discharged with no event. Second case was a 48-year-old male with extensive aneurysm involving ascending, arch, and aortic regurgitaiton(grade III/IV). This case was also done using the clamshell incision. Aortic valve replacement was done by valved-conduit(Vascutek 30mm), both coronary artery anastomosis using Cabrol's procedure. Last operation procedure was the same as the 1st case.

• Archives of Plastic Surgery
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• 제48권5호
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• pp.543-546
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• 2021

Despite the extensive use of lithotomy position in several plastic surgery procedures, most reports regarding the related incidence of complications are presented in the urologic, gynecologic, and anesthesiologic fields. We present the case of a 54-year-old male patient. polytrauma patient who underwent internal iliac artery embolization leading to extensive gluteal necrosis requiring: debridement, abdominoperineal resection and composite anterolateral thigh flap reconstruction with prolonged lithotomy position. The patient presented lower limb ischemia briefly after surgical theater. A computed tomography scan revealed the obstruction of the left superficial femoral artery requiring emergency revascularization. Arterial thrombosis is a potentially devastating complication and plastic surgeons should be aware of the possible dangers when performing surgeries in prolonged lithotomy position. Preoperative detection of patients at high risks for developing complications should be performed in order to implement preventive measures and avoid potentially life-threatening sequelae.

• The Korean Journal of Physiology
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• 제19권1호
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• pp.25-33
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• 1985

Renal arterial infusion of renotropic agents has been a very useful technique in the renal function studies. This type of experiments have usually been conducted in the large animals such as dogs and sheep. In these animals a catheter can be placed in the site without much disturbances of renal blood flow. Rabbits as an experimental model, however, caused a disturbances of renal blood flow by a catheterization of renal artery by its properties. Therefore we have developed a new technique that allows a simple and selective access to one side of renal arteries and the other as a control, without any disturbances of renal function. The distance between the both bifurcations of renal arteries on abdominal aorta is about 7 mm. To locate the tip of catheter on one side renal artery, ascending cannulation performed via femoral artery was done. We did an experiment with the technique to clarify the effect of calmodulin inhibitor on the renal function. One of the phenothiazine derivatives, trifluoperazine known as a powerful calmodulin inhibitor. Trifluoperazine, actual dose ranges of $2.76-5.20\;ug\;{\cdot}\;kg^{-1}\;{\cdot}\;min^{-1}$, increased urine volume and glomerular filtration rate significantly. Significant increases in urinary excretion of sodium, chloride and potassium were found. Fractional excretion of sodium and free water clearance increased significantly. These data suggest that this new technique is very useful in field of renal physiology and that striking effect of trifluoperazine on the renal function may be caused by increasing the renal hemodynamics, and by the inhibition of sodium, chloride and potassium reabsorption in the renal tubules.

• Journal of Korean Neurosurgical Society
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• 제47권3호
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• pp.203-209
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• 2010

Objective : The purpose of study was to evaluate the feasibility of brain magnetic resonance (MR) images of the rat obtained using a 1.5T MR machine in several blood-brain barrier (BBB) experiments. Methods : Male Sprague-Dawley rats were used. MR images were obtained using a clinical 1.5T MR machine. A microcatheter was introduced via the femoral artery to the carotid artery. Normal saline (group 1, n = 4), clotted autologous blood (group 2, n = 4), triolein emulsion (group 3, n = 4), and oleic acid emulsion (group 4, n = 4) were infused into the carotid artery through a microcatheter. Conventional and diffusion-weighted images, the apparent coefficient map, perfusion-weighted images, and contrast-enhanced MR images were obtained. Brain tissue was obtained and triphenyltetrazolium chloride (TTC) staining was performed in group 2. Fluorescein isothiocyanate (FITC)-labeled dextran images and endothelial barrier antigen (EBA) studies were performed in group 4. Results : The MR images in group 1 were of good quality. The MR images in group 2 revealed typical findings of acute cerebral infarction. Perfusion defects were noted on the perfusion-weighted images. The MR images in group 3 showed vasogenic edema and contrast enhancement, representing vascular damage. The rats in group 4 had vasogenic edema on the MR images and leakage of dextran on the FITC-labeled dextran image, representing increased vascular permeability. The immune reaction was decreased on the EBA study. Conclusion : Clinical 1.5T MR images using a rat depicted many informative results in the present study. These results can be used in further researches of the BBB using combined clinical MR machines and immunohistochemical examinations.

• Journal of Chest Surgery
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• 제41권4호
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• pp.536-539
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• 2008

52세 여자는 승용차 조수석에 앉아가다가 타차와 충돌후 다발성 늑골골절과 혈기흉과 함께 다량의 출혈을 야기한 우측 전완의 절단에 가까운 손상을 입었다. 응급실에 도착시 명료하지 못한 의식과 저혈압의 소견을 보였다. 혈액량 감소 쇼크로 판단되어 다량의 혈액과 수액을 급속수액주입기(레벨 1)를 이용하여 좌측 쇄골하정맥관을 통해 주입하였다. 폐좌상의 소견이 호전되었을 때 일반 흉부 X선 사진의 좌폐야에 이물질이 확인되었다. 폐동맥조영술에서 15 cm 정도의 이물질이 좌측 폐기저동맥에 있었다. 경피적 중재시술을 통해 혈관 겸자로 잡아 제거할 수 있었다.

• Archives of Plastic Surgery
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• 제39권1호
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• pp.55-58
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• 2012

We experienced satisfactory outcomes by synchronously transplanting an artery and vein using an anterolateral thigh flap pedicle between the vascular pedicle and recipient vessel of a flap for scalp reconstruction. A 45-year-old man developed a subdural hemorrhage due to a fall injury. In this patient, the right temporal cranium was missing and the patient had $4{\times}3cm$ and $6{\times}5cm$ scalp defects. We planned a scalp reconstruction using a latissimus dorsi free flap. Intraoperatively, there was a severe injury to the right superficial temporal vessel because of previous neurosurgical operations. A 15 cm long pedicle defect was needed to reach the recipient facial vessels. For the vascular graft, the descending branch of the lateral circumflex femoral artery and two venae comitantes were harvested. The flap survived well and the skin graft was successful with no notable complications. When an interposition graft is needed in the reconstruction of the head and neck region for which mobility is mandatory to a greater extent, a sufficient length of graft from an anterolateral flap pedicle could easily be harvested. Thus, this could contribute to not only resolving the disadvantages of a venous graft but also to successfully performing a vascular anastomosis.

• Journal of Ginseng Research
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• 제34권3호
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• pp.212-218
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• 2010

Korean red ginseng (KRG) has been shown to enhance endothelium-dependent vasorelaxation in experimental animals; however, little is known about its pharmacological effects on vascular stiffness in patients with coronary artery disease (CAD). This randomized, double-blind, placebo-controlled crossover trial was carried out to determine whether KRG has beneficial effects on arterial stiffness, cardiovascular risk factors such as plasma lipid profiles and blood pressure (BP), and Rho-associated kinase (ROCK) activity. Twenty patients (mean age, 62.5 years) with stable angina pectoris were given KRG (2.7 g/day) and a placebo alternatively for 10 weeks. Blood biochemical analysis and pulse wave velocity (PWV) recording were performed on day 0 and after the completion of each treatment. ROCK activity was assessed based on the level of phospho-$Thr^{853}$ in the myosin-binding subunit of myosin light chain phosphatase, determined by Western blot analysis of peripheral blood mononuclear cells. KRG significantly decreased the systolic BP, brachial ankle PWV, and heart femoral PWV in the patients (all p<0.05), but did not significantly alter the serum lipid profiles, including triglycerides and total, high-density lipoprotein, and low-density lipoprotein cholesterol levels. The ROCK activity tended to decrease (p=0.068) following KRG treatment. The placebo did not significantly alter any of the variables. In conclusion, KRG decreased systolic BP and arterial stiffness, probably via the inhibition of ROCK activity, in patients with CAD, but had a neutral effect on serum lipid profiles. Our data suggest that KRG has a therapeutic effect on CAD.