• Herbal Formula Science
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• v.14 no.1
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• pp.105-119
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• 2006

Objectives & Methods : This present study was performed to investigate the effect of Hwadamtongrak-Tang extract (HTT) on the regulation of cerebral hemodynamics in terms of regional cerebral blood flow (rCBF) and mean arterial blood pressure (MABP)] in normal and cerebral ischemic rats. Also the effects of HTT on changes in local blood flow, inhibition of LD H activity in neuronal cells, and levels of cytokine production in the serum were determined in the ischemic rat model. The major findings are summarized below. Results : 1. HTT significantly increased rCBF in a dose-dependent manner, but MABP was not changed by HTT treatment. These results suggest that HTT may increase rCBF by dilating cerebral arterial diameter. 2. HTT-induced increase in rCBF was blocked by pretreatment with cyclooxygenase inhibitor indomethacin (IDN, 1 mg/kg, i.p.) and MABP was significantly increased by ID N. 3. Pretreatment of methylene blue $(MTB,\;10\;{\mu}g/kg,\;i.p.)$, an inhibitor of guanylate cyclase, significantly decreased both rCBP and MABP in HTT-treated rats. 4. HTT treatment significantly increased rCBP to a stable level during the period of cerebral reperfusion. 5. HTT significantly inhibited LD H activity in neuronal cells, suggesting a neuroprotection by HTT. 6. Serum interleukin $(IL)-1{\beta}$ and tumor necrosis factor $(TNF)-{\alpha}$ levels were significantly decreased in the femoral artery 1 hr after middle cerebral arterial occlusion in HTT-treated rats. IL-10 levels in the serum were significantly increased by HTT treatment whereas transforming growth factor $(TGF)-{\beta}$ levels were similar between HTT-treated and control groups. 7. Serum interleukin $(IL)-1{\beta}$ and tumor necrosis factor $(TNF)-{\alpha}$ levels were significantly decreased in the femoral artery 1 hr after reperfusion in HTT-treated rats. Serum IL-10 levels were significantly decreased in HTT-treated rats compared with the control group, and no significant changes in $(TGF)-{\beta}$ in the serum were observed by HTT treatment. Conclusions: The present data suggest that HTT may have an anti-ischemic effect via the improvement of cerebral hemodynamics and thus protect the brain from ischemic damage.

• Tuberculosis and Respiratory Diseases
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• v.54 no.5
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• pp.522-531
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• 2003

Background : Hemorrhagic shock and trauma are two of the most common causes of acute lung injury. The activation of cyclooxygenase is one of the important causes of acute lung injury. This study investigated the effect of aspirin, a well-known cyclooxygenase inhibitor, on severe hemorrhage-induced acute lung injury in rats. Methods : The hemorrhagic shock was induced by withdrawing blood; 20ml/kg of B.W., through the femoral artery in 5 min. The mean arterial pressure was recorded through the femoral artery on a polygraph. Results : In the present investigation, the lung tissue myeloperoxidase activity, protein contents and leukocyte counts, in bronchoalveolar lavage fluid, increased significantly 2 and 24 h after the hemorrhage induction. Although the decreased mean arterial pressure spontaneously recovered, acute lung injury occurred after severe hemorrhage. These changes were effectively prevented by a single intravenous injection of aspirin (10 mg/kg of B.W.) 30 min before the hemorrhage. Conclusion : These results suggest that severe hemorrhage-induced acute lung injury is mediated, in part, by the activation of cyclooxygenase. Furthermore, pretreatment of aspirin in acute lung injury-prone patients, or prophylactic treatment of aspirin to the patients with precipitating conditions, could be helpful in the prevention of acute lung injury.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.4
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• pp.360-364
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• 2005

The anterolateral thigh flap was originally described in 1984 as a septocutaneous flap based on the descending branch of the lateral circumflex artery. This flap has some significant advantages for reconstruction of the head and neck. It can be raised as a subcutaneous flap, a fasciocutaneous flap, or a myocutaneous flap and can resurface large defects in the head and neck. In addition, it has a large and long vascular pedicle, and because of the distance of the donor site from the head and neck, it can easily be harvested with a 2-team approach. However, the number and locations of cutaneous perforators vary individually, and thus, it is not widely used because flap elevation is often complicated and time-consuming owing to unexpected anatomical variations. The purposes of this study are to classify the vascular anatomy and to assess the suitability of anterolateral thigh flap for head and neck reconstruction in Korean. We performed an anatomic study on cadavers and analyzed the anatomic pattern of the lateral circumflex femoral arterial system and the perforators nourishing the anterolateral thigh flap. This study suggest the characteristics of vascular anatomic patterns of anterolateral thigh flap of Korean and utility of this flap for head and neck reconstruction.

• Biomedical Science Letters
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• v.13 no.2
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• pp.111-117
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• 2007

Temporary occlusion of the parent artery or feeding artery is an useful method in microsurgery for cerebrovascular diseases. The advantages of the temporary clipping for intracranial aneurysm surgery have already been proven by many experimental and clinical reports. Currently, there are two methods of temporary clipping: 1) intermittent clipping, 2) continuous clipping. In many previous studies, the intermittent, repeated clipping technique was reported to reduce ischemic damage to the brain, but it is still debated. On the other hand, a comparison of the histological changes on the arterial wall between each clipping method has not been sufficiently reported yet. So the authors performed experimental temporary clipping on the common carotid and femoral arteries of about 25 rats using the Sugita temporary mini-clip. The specimens were divided into two major groups and seven subgroups: Group I (I-1, I-2, I-3, I-4, intermittent clippings for 5 minutes were done once, twice, three times, and few times), and Group C (C-10, C-15, C-20, continuous clippings for 10, 15, 20 minutes, respectively). The reperfusion time after the temporary clipping was the same as the clipping duration. Under light microscope, the histological findings by Hematoxylin-Eosin staining were examined in all specimens, which were obtained at each time interval after temporary clipping. Then the histological changes of the arterial walls by two different methods were compared with the normal specimen. The results suggest that intermittent temporary clipping is less damaging on the arterial wall than single continuous clipping.

• Archives of Reconstructive Microsurgery
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• v.14 no.1
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• pp.57-62
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• 2005

Microvascular anastomosis with suture technique is a basic skill but there are several problems such as stenosis, thrombosis and long operating time. Recently plastic surgeons have developed non-suturing mechanical coupling devices for microvascular anastomosis. The authors applied non-penetrating vascular clips (VCS clips) in the field of free flap surgery of head and neck area. Between August of 2004 and January of 2005, we performed 9 free flaps (16 vessels) using small-sized VCS clips. Four stay sutures were applied first and then VCS clips were placed between sutures about 1 mm apart. Vascular pedicle of free flap included the descending branch of lateral circumflex femoral vessel, thoracodorsal vessel, deep inferior epigastric vessel and cephalic vein. The recipient vessels were the superior thyroid artery, superficial temporal artery, internal jugular vein, external jugular vein, and superficial temporal vein. We performed 13 end-to-end (4 arteries and 9 veins) and 3 venous end-to-side anastomoses. No flap related complication occurred but we applied additional clips or sutures in two cases due to blood leakage after completion of anastomosis. Primary patency rates seemed to be good and more rapid anastomosis could be done than conventional suture technique. Advantages of VCS technique are high patency rate, low thrombogenecity and rapidity. Although the high cost of VCS instrument may be a problem, this clip could be applied safely in microvascular free tissue transfer.

• Archives of Plastic Surgery
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• v.40 no.3
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• pp.214-219
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• 2013

Background We established the Microvascular Research Center Training Program (MRCP) to help trainee surgeons acquire and develop microsurgical skills. Medical students were recruited to undergo the MRCP to assess the effectiveness of the MRCP for trainee surgeons. Methods Twenty-two medical students with no prior microsurgical experience, who completed the course from 2005 to 2012, were included. The MRCP comprises 5 stages of training, each with specific passing requirements. Stages 1 and 2 involve anastomosing silicone tubes and blood vessels of chicken carcasses, respectively, within 20 minutes. Stage 3 involves anastomosing the femoral artery and vein of live rats with a 1-day patency rate of >80%. Stage 4 requires replantation of free superficial inferior epigastric artery flaps in rats with a 7-day success rate of >80%. Stage 5 involves successful completion of one case of rat replantation/transplantation. We calculated the passing rate for each stage and recorded the number of anastomoses required to pass stages 3 and 4. Results The passing rates were 100% (22/22) for stages 1 and 2, 86.4% (19/22) for stage 3, 59.1% (13/22) for stage 4, and 55.0% (11/20) for stage 5. The number of anastomoses performed was $17.2{\pm}12.2$ in stage 3 and $11.3{\pm}8.1$ in stage 4. Conclusions Majority of the medical students who undertook the MRCP acquired basic microsurgical skills. Thus, we conclude that the MRCP is an effective microsurgery training program for trainee surgeons.

• Korean Journal of Veterinary Research
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• v.45 no.4
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• pp.575-579
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• 2005

A 6-month-old male Poodle was referred with chief complaint of dysponea and cough. Cyanosis was not detected. This dog was diagnosed as a case of canine patent ductus arteriosus (PDA) by X-ray and ultrasonography. Diuretics and bronchodialators were administered for 4 weeks. Clinical symptoms were not improved. Thoracotomy was done at right recumbent position. The length of ductus arteriosus was 8 mm and the diameter was 6 mm, respectively. Double ligation was performed in surgery. Continuous cardiac murmur, cough and strong femoral pulsation were disappeared after surgery. The diameters of the pulmonary artery and vein found to normal by X-ray on 10 days after operation. The diameter of the aorta measured to be larger than that of the main pulmonary artery by ultrasonography. The fractional shortening (FS) on 10 days after surgery was 17.32% by ultrasonography. The needle-acupuncture therapy was used in acupoints BL-15 as local point plus PC-6, HT-7 and HT-5 as distant points for 3 days (15 min/once/a day). The FSs were increased to 21.31% and 29.44% at 1 and on 3 days after acupuncture, respectively. The present patient was a case of typical canine PDA that showed favorable therapeutic responses by surgery combined with needle-acupuncture treatment.

• Journal of Chest Surgery
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• v.5 no.1
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• pp.13-18
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• 1972

In 1835,Schlesinger first described a case of subisthmlc lower thoracic aortic coarctation. Since Olim`s unsuccessful reconstructive surgery in 1949 and Beattie`s first successful resection with homograft replacement on such a lesion in 1951 were reported,about 20 cases of atypical aortic coarctation had been treated by definitive surgery until 1964. In Korea, only 2 cases of atypical aortic coarctation treated by bypass graft were reported until now. This is the third case-report treated by reconstructive surgery. The patient,11 year old girl who had 2 year history of headache, visual weakness, intermittent claudlcation, and general weakness, was first diagnosed of having the hypertension due to atypical coarctation by the findings of high blood pressure[170/110mmHg] at the upper extremity and weak pulsation on both femoral artery,murmur on the epigastrium, absence of aortic knob, and aorto graphy. Aortography demonstrated the isolated segmental narrowing[length 5cm, diameter 0.4cm] at the level of aortic hiatus 2cm above celiac arterial origin, the dilated right 9th, 10th, 11th intercostal arteries with multiple dimunitive collaterals and no associated abnormalities in the other arteries. Preoperatlve positive findings were strong positive mantoux test, high AST[720 units]. transient mild cardiomegaly with right lung infiltration on chest X-ray and suggestive left ventricular hypertrophy on ECG. On December 1970, through separate left thoracotomy and abdominal approach, bypass graft between descending thoracic aorta and abdominal aorta below renal artery was performed. The operation was first successful with satisfactory reduction of hypertension on the upper trunk[postoperatlve 130/80mmHg] and strong pulsation on the lower extremities[postop. O, postop. 140/100mmHg]. However,6 weeks after surgery, she expired of sudden hemoptysis and shock due to anastomotic leak within the thorax. Operative finding disclosed that the affected aorta was firm, with rich periaortic fibrosis and the outer diameter of stenotic site was not attenuated. Histopathology of the resected specimen was also compatible with primary arteritis.

• Herbal Formula Science
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• v.7 no.1
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• pp.167-181
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• 1999

Rhizoma Arisaematis, Lignum Akebiae, Rhizoma Zedoariae, Cortex Eucommiae, Folium Perillae, Radix Sophorae Subprostratae, Radixi, Radix Ledeboutriellae, Rhizoma Atractylodis, Herba Ephedrae, Radix Puerariae and Radi Aconitx Bupleuri have been used in Korea for many centuries as a treatment for various disease. The purpose of the present study is to determine the effect of several herbs on norepinephrine(NE) induced blood vessel contraction in rabbits and pigs. Rabbit(2 kg, male) were killed by $CO_2$ exposure and a segment (8-10mm) of each rabbit was cut into equal segments and mounted in a tissue bath. Contractile force was measured with force displacement transducers under 2-3 g loading tension. The dose of norepinephrine(NE) which evoked 50% of maximal response $(ED_{50})$ was obtained from cumulative dose response curves for NE $(10^{-6}{\sim}10^{-3}M)$. Contractions evoked by NE $(ED_{50})$ were inhibited significantly by Rhizoma Arisaematis, Lignum Akebiae, Rhizoma Zedoariae, Cortex Eucommiae, Folium Perillae, Radix Sophorae Subprostratae and Herba Ephedrae in abdominal aorta. Contractions evoked by NE $(ED_{50})$ were inhibited significantly be Lignum Akebiae, Rhizoma Zedoariae, Cortex Eucommiae, Herba Ephedrae, Radix Puerariae and Radix Bupleuri in femoral artery. Contractions evoked by NE $(ED_{50})$ were inhibited significantly by Radix Sophorae Subprostratae, Radix Aconiti and Herba Ephedrae in renal artery. These results indicate that each herb can relax NE induced contraction of rabbit and pig blood vessel selectively, and that this relaxation relates to Gui-Gyung(歸經).

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.769-774
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• 2010

Purpose: As the soft tissue defect around the knee is difficult to reconstruct, local flap or free flap is used. Distally based anterolateral thigh pedicled flap introduced by Zhang uses sufficient reverse flow supplied from the vascular network around the knee. We report successful reconstruction of defect around knee by this method. Methods: Four patients with skin & soft tissue defect around knee have been treated for reconstruction using the distally based anterolateral thigh pedicled flap. First, the doppler was used to check the perforator flap of the descending branch of the lateral circumflex femoral artery and to draw and dissect the perforator flap as much as needed. After the dissection, the proximal of the descending branch was clamped and checked for sufficient supply of blood flow from the reverse flow and then ligated. It was dissected along the descending branch and in order to prevent damage to the joined parts of the descending branch and the lateral superior geniculate artery, a more careful ligation was done starting from 10 cm superior to the knee. The defect was reconstructed after securing enough vascular pedicle to cover all the damaged parts. Results: Not all patients suffered from flap necrosis. In case of the patient with chronic osteomyelitis, slight venous congestion was observed right after the surgery but it disappeared the following day. All three patients had no occurences of additional complications. Conclusion: Distally based anterolateral thigh pedicled flap was enough to provide large flap for knee reconstruction. It had sufficient blood flow and vascular pedicle. It also had taken short operation time compared to the free flap operation. The distally based anterolateral thigh pedicled flap used by the authors is a very useful way of reconstructing the area around knee.